Alander Ture, Svärdsudd Kurt, Johansson Sven-Erik, Agréus Lars
Family Medicine, Karolinska Institute, Stockholm, Sweden.
BMC Med. 2005 May 13;3:8. doi: 10.1186/1741-7015-3-8.
Some individuals with functional gastrointestinal disorders (FGID) suffer long-lasting symptoms without ever consulting their doctors. Our aim was to study co-morbidity and lifestyle differences among consulters and non-consulters with persistent FGID and controls in a defined adult population.
A random sample of the general adult Swedish population was obtained by a postal questionnaire. The Abdominal Symptom Questionnaire (ASQ) was used to measure GI symptomatology and grade of GI symptom severity and the Complaint Score Questionnaire (CSQ) was used to measure general symptoms. Subjects were then grouped for study by their symptomatic profiles. Subjects with long-standing FGID (n = 141) and subjects strictly free from gastrointestinal (GI) symptoms (n = 97) were invited to attend their local health centers for further assessment.
Subjects with FGID have a higher risk of psychological illness [OR 8.4, CI95(4.0-17.5)] than somatic illness [OR 2.8, CI95(1.3-5.7)] or ache and fatigue symptoms [OR 4.3, CI95(2.1-8.7)]. Subjects with psychological illness have a higher risk of severe GI symptoms than controls; moreover they have a greater chance of being consulters. Patients with FGID have more severe GI symptoms than non-patients.
There is a strong relation between extra-intestinal, mental and somatic complaints and FGID in both patients and non-patients. Psychological illness increases the chance of concomitantly having more severe GI symptoms, which also enhance consultation behaviour.
一些功能性胃肠疾病(FGID)患者长期遭受症状困扰却从未咨询过医生。我们的目的是研究在特定成年人群中,持续性FGID的咨询者与未咨询者以及对照组之间的共病情况和生活方式差异。
通过邮政问卷从瑞典成年普通人群中获取随机样本。使用腹部症状问卷(ASQ)来测量胃肠道症状及胃肠道症状严重程度分级,使用主诉评分问卷(CSQ)来测量一般症状。然后根据症状特征对受试者进行分组研究。邀请患有长期FGID的受试者(n = 141)和完全没有胃肠道(GI)症状的受试者(n = 97)到当地医疗中心进行进一步评估。
FGID患者患心理疾病的风险[比值比(OR)8.4,95%置信区间(CI95)(4.0 - 17.5)]高于患躯体疾病的风险[OR 2.8,CI95(1.3 - 5.7)]或疼痛和疲劳症状的风险[OR 4.3,CI95(2.1 - 8.7)]。患有心理疾病的受试者比对照组有更高的严重胃肠道症状风险;此外,他们更有可能是咨询者。FGID患者比非患者有更严重的胃肠道症状。
在患者和非患者中,肠外、精神和躯体主诉与FGID之间存在密切关系。心理疾病增加了同时出现更严重胃肠道症状的可能性,这也增强了咨询行为。