Pigot François, Siproudhis Laurent, Bigard Marc-André, Staumont Ghislain
Service de Proctologie, Hôpital Bagatelle, Talence.
Gastroenterol Clin Biol. 2006 Dec;30(12):1371-4. doi: 10.1016/s0399-8320(06)73557-6.
The perception patients consulting for primary care have of anorectal disorders has never been evaluated. Our aim was to analyze proctological complaints among outpatients consulting general practitioners.
Among 1484 physicians who responded to a nationwide mailing in France, 161 enrolled 437 females and 358 males consulting between October 2004 and December 2005.
Females were younger than males (46 +/- 15 vs 51 +/- 13 years) (p<0.0001). Intermediate and upper social-occupational categories were overrepresented as compared with the general population. Symptoms were pain (48%), bleeding (37%), swelling (26%) and pruritus (24%). For 76%, these symptoms persisted for less than one month and 58% mentioned earlier visits or prior treatment. The first manifestation was correlated with a pregnancy in 31% of women. Present symptoms were secondary to acute constipation (52%), stress (33%), ingestion of spices (29%) or alcohol (20%), and diarrhea (8%). Symptoms were considered important in 61% or a cause of anxiety in 33% of patients. Treatment was prescribed for all patients: ointments (90%), phlebotonics (66%) or suppositories (51%), in combination for 75% of prescriptions. Patients preferred oral medicines (41%), ointments (30%) and suppositories (7%).
Proctological complaints are a reason for repeated visits to the general practitioner and lead to repeated prescriptions. Patients appreciate anti-hemorrhoidal treatments variably.
从未对因初级保健前来咨询的患者对肛肠疾病的认知情况进行过评估。我们的目的是分析在咨询全科医生的门诊患者中的直肠疾病主诉。
在法国全国范围内回复邮件的1484名医生中，有161名医生纳入了在2004年10月至2005年12月期间前来咨询的437名女性和358名男性患者。
女性比男性年轻（46±15岁对51±13岁）（p<0.0001）。与普通人群相比，社会职业类别处于中等及以上的人群占比过高。症状包括疼痛（48%）、出血（37%）、肿胀（26%）和瘙痒（24%）。76%的患者这些症状持续时间不到一个月，58%的患者提到曾有过更早的就诊或先前的治疗。31%的女性患者首发症状与妊娠相关。当前症状继发于急性便秘（52%）、压力（33%）、食用香料（29%）或酒精（20%）以及腹泻（8%）。61%的患者认为症状严重，33%的患者因症状感到焦虑。所有患者均接受了治疗：使用药膏（90%）、静脉活性药物（66%）或栓剂（51%），75%的处方为联合用药。患者更倾向于口服药物（41%）、药膏（30%）和栓剂（7%）。
直肠疾病主诉是患者反复就诊全科医生并导致反复开药的原因。患者对治疗痔疮的各种疗法的接受程度不一。
