Halder Smita L S, Locke G Richard, Schleck Cathy D, Zinsmeister Alan R, Melton L Joseph, Talley Nicholas J
Dyspepsia Center, Enteric Neuroscience Program, Division of Gastroenterology and Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Gastroenterology. 2007 Sep;133(3):799-807. doi: 10.1053/j.gastro.2007.06.010. Epub 2007 Jun 20.
BACKGROUND & AIMS: Functional gastrointestinal disorders (FGID) are common in the community. The natural history of FGID is unknown because of a lack of prospective population-based studies and the indistinct nature of the phenotype. We sought to report the natural history of FGID in a US population.
This prospective cohort study used data from multiple validated surveys of random samples of Olmsted County, MN, residents over a mean of a 12-year period between 1988 and 2003 (n = 1365). The surveys measured gastrointestinal symptoms experienced during the past year. Each subject received a minimum of 2 surveys. Point prevalence, onset, and disappearance rates and transition probabilities were calculated for individual FGIDs.
Between the initial and final surveys, the point prevalences (per 100 residents) were stable for irritable bowel syndrome (8.3% and 11.4%, respectively) and functional dyspepsia (1.9% and 3.3%, respectively). The onset of each of the disorders studied was greater than the disappearance rate, but the transition probabilities varied across the different subgroups. Among people with symptoms at baseline, approximately 20% had the same symptoms, 40% had no symptoms, and 40% had different symptoms at follow-up.
Although the prevalence of the FGID was stable over time, the turnover in symptom status was high. Many episodes of symptom disappearance were due to subjects changing symptoms rather than total symptom resolution. This transition between different FGIDs suggests a common etiopathogenesis.
功能性胃肠病（FGID）在社区中很常见。由于缺乏基于人群的前瞻性研究以及该表型的性质不明确，FGID的自然病史尚不清楚。我们试图报告美国人群中FGID的自然病史。
这项前瞻性队列研究使用了1988年至2003年期间对明尼苏达州奥尔姆斯特德县居民随机样本进行的多次有效调查数据（n = 1365）。这些调查测量了过去一年中经历的胃肠道症状。每个受试者至少接受2次调查。计算了个体FGID的点患病率、发病率、消失率和转变概率。
在最初和最终调查之间，肠易激综合征（分别为8.3%和11.4%）和功能性消化不良（分别为1.9%和3.3%）的点患病率（每100名居民）稳定。所研究的每种疾病的发病率均高于消失率，但不同亚组的转变概率有所不同。在基线时有症状的人群中，约20%在随访时有相同症状，40%无症状，40%有不同症状。
尽管FGID的患病率随时间稳定，但症状状态的更替率很高。许多症状消失的情况是由于受试者症状改变而非症状完全缓解。不同FGID之间的这种转变提示了共同的病因。
