Hillilä Markku T, Siivola Matti T, Färkkilä Martti A
Helsinki University Central Hospital, Department of Medicine, Division of Gastroenterology, Hus, Finland.
Scand J Gastroenterol. 2007 Jul;42(7):799-806. doi: 10.1080/00365520601113927.
Patients suffering from irritable bowel syndrome (IBS) have more somatic and psychiatric comorbidity and use more health-care services for comorbid conditions than do other patients. Little is known about the frequency of comorbid symptoms among IBS sufferers in the general population and their influence on use of health-care facilities. The objective of this study was to compare the frequency of somatic and psychiatric symptoms between IBS sufferers and controls in the general population, and to study how comorbidity rates are distributed among consulters and non-consulters and how they predict the use of health care-services.
By means of a questionnaire sent to 5000 randomly selected adults IBS was identified according to the Rome II criteria. The questionnaire also covered upper GI symptoms, non-GI somatic symptoms, depression and anxiety. A logistic regression analysis with 26 variables was carried out to determine the independent predictors of health-care seeking for GI and non-GI complaints.
The response rate was 73% and prevalence of IBS 5.1% (95% CI 4.4-5.8%). Dyspeptic symptoms, somatic extra-GI symptoms and psychiatric symptoms were reported by 45%, 69% and 51% of IBS sufferers, respectively, and 6%, 35% and 27%, of controls, respectively. Visiting a physician because of GI complaints was associated with disturbing abdominal symptoms, but not with depression or anxiety. Of the present GI conditions, only dyspeptic symptoms were associated with an increased consultation rate also for non-GI complaints.
In the general population, both IBS consulters and non-consulters demonstrate high rates of comorbidity. Seeking health care for abdominal complaints is associated with abdominal symptoms rather than psychiatric comorbidity.
肠易激综合征（IBS）患者比其他患者有更多的躯体和精神共病，并且因共病状况使用更多的医疗服务。对于普通人群中IBS患者共病症状的频率及其对医疗设施使用的影响知之甚少。本研究的目的是比较普通人群中IBS患者与对照组之间躯体和精神症状的频率，并研究共病率在就诊者和未就诊者中的分布情况以及它们如何预测医疗服务的使用。
通过向5000名随机选择的成年人发送问卷，根据罗马II标准确定IBS。问卷还涵盖上消化道症状、非胃肠道躯体症状、抑郁和焦虑。进行了一项包含26个变量的逻辑回归分析，以确定因胃肠道和非胃肠道疾病寻求医疗服务的独立预测因素。
应答率为73%，IBS患病率为5.1%（95%可信区间4.4 - 5.8%）。分别有45%、69%和51% 的IBS患者报告有消化不良症状、非胃肠道躯体症状和精神症状，而对照组分别为6%、35%和27%。因胃肠道不适就诊与令人困扰的腹部症状相关，但与抑郁或焦虑无关。在目前的胃肠道疾病中，只有消化不良症状也与非胃肠道疾病的就诊率增加相关。
在普通人群中，IBS就诊者和未就诊者均表现出较高的共病率。因腹部不适寻求医疗服务与腹部症状相关，而非精神共病。
