临床实践。肠易激综合征。
Clinical practice. Irritable bowel syndrome.
作者信息
Mayer Emeran A
机构信息
Center for Neurobiology of Stress, Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-6949, USA.
出版信息
N Engl J Med. 2008 Apr 17;358(16):1692-9. doi: 10.1056/NEJMcp0801447.
Abstract
A 28-year-old woman presents with a 7-month history of recurrent, crampy pain in the left lower abdominal quadrant, bloating with abdominal distention, and frequent, loose stools. She reports having had similar but milder symptoms since childhood. She spends long times in the bathroom because she is worried about uncontrollable discomfort and fecal soiling if she does not completely empty her bowels before leaving the house. She feels anxious and fatigued and is frustrated that her previous physician did not seem to take her distress seriously. Physical examination is unremarkable except for tenderness over the left lower quadrant. How should her case be evaluated and treated?
摘要
一名28岁女性，有7个月的左下腹反复痉挛性疼痛病史，伴有腹胀和频繁的稀便。她自述自幼就有类似但较轻的症状。由于担心出门前如果不能完全排空肠道会出现无法控制的不适和粪便污染，她在卫生间花费很长时间。她感到焦虑和疲劳，并且对之前的医生似乎没有认真对待她的痛苦感到沮丧。体格检查除左下腹压痛外无异常。该如何评估和治疗她的病例？
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