Malagelada J-R
Hospital Universitari Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain.
Int J Clin Pract. 2006 Jan;60(1):57-63. doi: 10.1111/j.1368-5031.2005.00744.x.
Irritable bowel syndrome (IBS) is a common gastrointestinal disorder. Characterised by abdominal pain or discomfort, bloating and altered bowel habit, IBS is a chronic recurring condition, typically affecting up to 15% of the Western population, IBS can be subclassified into IBS with constipation (IBS-C), IBS with diarrhoea (IBS-D), or IBS with alternating constipation or diarrhoea symptoms (IBS-A). Conventional clinical diagnosis focuses on excluding all potential organic causes of patient symptoms. However, a positive diagnosis of IBS may be established using published criteria such as the Manning and/or Rome criteria. While these methods are useful to identify patients with IBS who are suitable for enrollment into clinical trials, the criteria are relatively complex and not readily applicable to general practice. In this review we present an 'identify, eliminate, probe' algorithm that may be appropriate to establish a positive diagnosis of patients with IBS-C, as symptoms characteristic of patients in this IBS subgroup are least likely to be confused with symptoms reflecting serious organic disease.
肠易激综合征（IBS）是一种常见的胃肠道疾病。其特征为腹痛或不适、腹胀以及排便习惯改变，是一种慢性复发性疾病，在西方人群中发病率通常高达15%。IBS可细分为便秘型肠易激综合征（IBS-C）、腹泻型肠易激综合征（IBS-D）或便秘与腹泻症状交替型肠易激综合征（IBS-A）。传统的临床诊断侧重于排除患者症状的所有潜在器质性病因。然而，可使用如曼宁和/或罗马标准等已发表的标准来确诊IBS。虽然这些方法有助于识别适合纳入临床试验的IBS患者，但这些标准相对复杂，不太适用于一般临床实践。在本综述中，我们提出一种“识别、排除、探究”算法，该算法可能适用于确诊IBS-C患者，因为该IBS亚组患者的症状最不容易与反映严重器质性疾病的症状相混淆。
