Pace Fabio, Zuin Giovanna, Di Giacomo Stefania, Molteni Paola, Casini Valentina, Fontana Massimo, Porro Gabriele Bianchi
Gastroenterology Department, University Hospital L. Sacco-Milan, Italy.
World J Gastroenterol. 2006 Jun 28;12(24):3874-7. doi: 10.3748/wjg.v12.i24.3874.
To assess the late outcome of teen-agers with a previous history of recurrent abdominal pain (RAP) or irritable bowel syndrome (IBS).
A group of 67 children with RAP referred to the department from January 1986 to December 1995 was followed up between 5 and 13 years after the initial diagnosis by means of a structured telephone interview. We hypothesized that those patients with persistent adult IBS-like symptoms would be significantly more likely to report a family history of IBS in comparison with adults with no persistent abdominal complaint.
Out of the 52 trackable subjects, 15 were found to present IBS-like symptoms at follow-up (29%) whereas the majority (37 subjects) did not. Subjects with IBS-like symptoms were almost three times more likely to present at least one sibling with similar symptoms compared to subjects not complaining (40.0% vs 16.0%), respectively (P < 0.05 at Student t test). Subjects with IBS-like symptoms also reported a higher prevalence of extra-intestinal symptoms, such as back pain, fibromyalgia, headache, fatigue and sleep disturbances.
The study confirms previous observations indicating that pediatric RAP can predict later development of IBS. The latter appears to be greatly influenced by intrafamilial aggregation of symptoms, possibly through the learning of a specific illness behavior.
评估既往有复发性腹痛(RAP)或肠易激综合征(IBS)病史的青少年的远期结局。
1986年1月至1995年12月间转诊至该科室的67例RAP患儿,在初次诊断后5至13年通过结构化电话访谈进行随访。我们假设,与无持续性腹部不适的成年人相比,那些有持续性成人IBS样症状的患者报告IBS家族史的可能性显著更高。
在52例可追踪的受试者中,15例在随访时出现IBS样症状(29%),而大多数(37例受试者)未出现。与无相关症状的受试者相比,有IBS样症状的受试者出现至少一名有类似症状的兄弟姐妹的可能性几乎高出三倍(分别为40.0%对16.0%)(Student t检验P<0.05)。有IBS样症状的受试者还报告了更高的肠外症状患病率,如背痛、纤维肌痛、头痛、疲劳和睡眠障碍。
该研究证实了先前的观察结果,表明儿科RAP可预测IBS的后期发展。后者似乎受到症状在家族内聚集的极大影响,可能是通过学习特定的疾病行为。