Rao Satish S C, Tuteja Ashok K, Vellema Tony, Kempf Joan, Stessman Mary
*Department of Medicine, Division of Gastroenterology, University of Iowa College of Medicine, Iowa City, Iowa 52242, USA.
J Clin Gastroenterol. 2004 Sep;38(8):680-5. doi: 10.1097/01.mcg.0000135929.78074.8c.
To understand the nature of bowel disturbance in patients with dyssynergia, we prospectively examined demographics, stool patterns, and quality of life by administering a 31-item questionnaire to 120 patients who fulfilled symptomatic and manometric criteria for dyssynergia (Rome II). Data from 118 subjects (M/F = 27/91) was analyzed. Eighty four percent of patients reported excessive straining, and 76% reported feeling of incomplete evacuation; 9.7% had no urge to defecate. Abdominal bloating was reported by 74%. More women than men reported infrequent bowel movements and need to strain excessively (P < 0.05). Forty eight percent of patients, more women (P < 0.05) than men used digital maneuvers to evacuate. Hard stools was reported by 60% of women and 41% of men. Sexual abuse was reported by 22%; 21% were women (P = 0.02). Physical abuse was reported by 32%. Bowel problem adversely affected family life in 33%, sexual life in 56%, work life in 69% and social life in 76% of patients. Most patients with dyssynergia reported an excessive need to strain, feeling of incomplete evacuation and abdominal bloating and one half used digital maneuvers. It significantly affected quality of life, particularly in women.
为了解排便协同失调患者肠道紊乱的本质,我们通过对120名符合排便协同失调(罗马II)症状和测压标准的患者进行一项包含31个条目的问卷调查,前瞻性地研究了人口统计学特征、排便模式和生活质量。对118名受试者(男/女 = 27/91)的数据进行了分析。84%的患者报告有过度用力排便的情况,76%的患者报告有排便不尽感;9.7%的患者没有便意。74%的患者报告有腹胀。报告排便次数少和需要过度用力排便的女性多于男性(P < 0.05)。48%的患者,使用手法辅助排便的女性(P < 0.05)多于男性。60%的女性和41%的男性报告有硬便。22%的患者报告曾遭受性虐待;其中21%为女性(P = 0.02)。32%的患者报告曾遭受身体虐待。肠道问题对33%的患者家庭生活、56%的患者性生活、69%的患者工作生活以及76%的患者社交生活产生了不利影响。大多数排便协同失调患者报告有过度用力排便的需求、排便不尽感和腹胀,且一半的患者使用手法辅助排便。这对生活质量有显著影响,尤其是对女性。