Cullingford G L, Coffey J F, Carr-Locke D L
Department of Gastroenterology, Leicester Royal Infirmary, UK.
Digestion. 1992;52(3-4):209-13. doi: 10.1159/000200955.
The irritable bowel syndrome (IBS) is a common disorder estimated to affect up to 20% of adult Caucasians, with only a small percentage requiring investigation. This prospective study was performed to substantiate the impression that patients with IBS experience more pain during endoscopic examination of the colon than do patients with other conditions. Patients with IBS were observed to experience significantly more pain during colonoscopy than did patients without IBS (median observed pain scores 46 and 9, respectively), p < 0.001. The intensity of the pain perceived during examination was significantly higher for patients with IBS than for those without IBS (median 52.5 and 23.5, respectively), p < 0.001. Within the groups, there was no significant difference between flexible sigmoidoscopy and colonoscopy in observed or perceived pain. 64% of the patients with IBS said that the pain experienced at colonoscopy was identical to their presenting pain. This study supports the hypothesis of a lower colonic pain threshold with colonic hyperalgesia in patients with IBS. We have found that hypersensitivity to the endoscopic examination of the colon is a useful clinical adjunct in the diagnosis of the IBS in those selected to undergo colonoscopy.
肠易激综合征（IBS）是一种常见疾病，据估计在成年白种人中发病率高达20%，只有一小部分患者需要进行检查。本前瞻性研究旨在证实IBS患者在结肠镜检查过程中比其他疾病患者经历更多疼痛这一印象。观察发现，IBS患者在结肠镜检查期间经历的疼痛明显多于无IBS患者（观察到的疼痛评分中位数分别为46和9），p < 0.001。IBS患者在检查期间感觉到的疼痛强度明显高于无IBS患者（中位数分别为52.5和23.5），p < 0.001。在各组中，乙状结肠镜检查和结肠镜检查在观察到的或感觉到的疼痛方面没有显著差异。64%的IBS患者表示结肠镜检查时经历的疼痛与他们就诊时的疼痛相同。本研究支持IBS患者存在结肠痛阈降低和结肠痛觉过敏的假说。我们发现，对结肠镜检查的超敏反应是在选择进行结肠镜检查的患者中诊断IBS的一种有用的临床辅助手段。
