Lionis Christos, Olsen-Faresjo Ashild, Anastasiou Foteini, Wallander Mari-Ann, Johansson Saga, Faresjo Tomas
Clinic of Social and Family Medicine, Heraklion, Crete, Greece.
Rural Remote Health. 2005 Jul-Sep;5(3):409. Epub 2005 Aug 17.
Studies of the frequency and aetiology of functional gastrointestinal disorders in the general population have received increasing interest over the past few years; the field seems to be neglected in Southern Europe. The aim of this study was to report on the frequency of functional dyspepsia (FD), irritable bowel syndrome (IBS) and gastroenteritis within the primary care setting, to provide some information on the extent to which the recorded diagnoses in the physicians' notes fulfil existing diagnostic criteria.
A retrospective study was used, where all new cases of these diseases at five primary health care centres in three rural and two semi-rural areas of Crete were identified by scrutinizing medical records from 280,000 consecutive visits during a 4 year period. The occurrence rate per 1000 person-years were calculated for the three conditions. We also checked the extent to which the Talley's criteria for FD and Rome II diagnostic criteria for IBS were followed.
Gastroenteritis was revealed to be a quite frequent health problem among the rural population on Crete, while the occurrence rates for other problems, such as dyspepsia and IBS, were found to be lower than expected. IBS was over-represented among women compared with men, OR 2.04 (CI 1.39-3.00). In many cases a diagnosis of FD, IBS or gastroenteritis was evident to the research team on the basis of findings recorded in the notes, but the diagnosis was not recorded by the clinician at the time of consultation.
This study yielded two key messages: the first that gastroenteritis is still a frequent health problem, and the second that primary care physicians in rural Crete seem to fail in adequately diagnosing FD and IBS and need further training.
在过去几年中，普通人群功能性胃肠疾病的发病率及病因学研究受到了越来越多的关注；但在南欧该领域似乎被忽视了。本研究旨在报告基层医疗环境中功能性消化不良（FD）、肠易激综合征（IBS）和肠胃炎的发病率，并提供一些关于医生记录中的诊断在多大程度上符合现有诊断标准的信息。
采用回顾性研究，通过仔细审查克里特岛三个农村和两个半农村地区五个初级卫生保健中心在4年期间280,000次连续就诊的病历，确定这些疾病的所有新病例。计算了这三种疾病每1000人年的发病率。我们还检查了FD的塔利标准和IBS的罗马II诊断标准的遵循程度。
肠胃炎在克里特岛农村人口中是一个相当常见的健康问题，而消化不良和IBS等其他问题的发病率低于预期。与男性相比，IBS在女性中的比例过高，比值比为2.04（可信区间为1.39 - 3.00）。在许多情况下，根据病历记录中的发现，研究团队很明显可以诊断出FD、IBS或肠胃炎，但临床医生在会诊时并未记录该诊断。
本研究得出了两个关键信息：一是肠胃炎仍然是一个常见的健康问题，二是克里特岛农村的基层医疗医生似乎未能充分诊断FD和IBS，需要进一步培训。
