Williams Rachel E, Hartmann Katherine E, Sandler Robert S, Miller William C, Steege John F
Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Obstet Gynecol. 2004 Sep;104(3):452-8. doi: 10.1097/01.AOG.0000135275.63494.3d.
We sought to evaluate whether there are unique characteristics associated with irritable bowel syndrome (IBS) within a population that has chronic pelvic pain.
This cross-sectional study of new referral patients attending a pelvic pain clinic between 1993 and 2000 (N = 987) evaluated characteristics associated with IBS at entry to the clinic. The characteristics that we evaluated included demographic characteristics, clinical diagnoses, history of abuse, depression, pain, and prior abdominal surgeries.
Thirty-five percent of chronic pelvic pain patients had IBS defined by Rome I criteria. Age 40 years or older (odds ratio [OR] = 1.98, 95% confidence interval [CI]: 1.27, 3.11), muscular back pain (OR = 5.37, 95% CI: 0.98, 29.29), Symptom Checklist-90 global index score in top quartile (OR = 1.77, 95% CI: 1.09, 2.86), depression (OR = 1.93, 95% CI: 1.24, 3.01), 6 or more pain sites (OR = 1.67, 95% CI: 1.01, 2.78), and history of adult physical abuse (OR = 1.51, 95% CI: 1.01, 2.26) were associated with IBS in the final reduced multivariable model.
Specific characteristics distinguish women with IBS suggesting that IBS and chronic pelvic pain are not simply manifestations of the same disorder. Our findings could help physicians attempt to effectively treat women with IBS and chronic pelvic pain. Physicians could diagnose and treat IBS in conjunction with treatment for chronic pelvic pain.
我们试图评估在患有慢性盆腔疼痛的人群中,肠易激综合征(IBS)是否具有独特特征。
这项横断面研究对1993年至2000年间在盆腔疼痛诊所就诊的新转诊患者(N = 987)进行了评估,以确定在进入诊所时与IBS相关的特征。我们评估的特征包括人口统计学特征、临床诊断、虐待史、抑郁、疼痛以及既往腹部手术史。
根据罗马I标准,35%的慢性盆腔疼痛患者患有IBS。在最终简化的多变量模型中,40岁及以上(优势比[OR]=1.98,95%置信区间[CI]:1.27,3.11)、肌肉背痛(OR = 5.37,95%CI:0.98,29.29)、症状自评量表90项全球指数得分处于最高四分位数(OR = 1.77,95%CI:1.09,2.86)、抑郁(OR = 1.93,95%CI:1.24,3.01)、6个或更多疼痛部位(OR = 1.67,95%CI:1.01,2.78)以及成年期身体虐待史(OR = 1.51,95%CI:1.01,2.26)与IBS相关。
特定特征可区分患有IBS的女性,这表明IBS和慢性盆腔疼痛并非同一疾病的简单表现。我们的研究结果有助于医生尝试有效治疗患有IBS和慢性盆腔疼痛的女性。医生可以在治疗慢性盆腔疼痛的同时诊断和治疗IBS。