Neumann Helmut, Monkemuller Klaus, Kandulski Arne, Malfertheiner Peter
Department of Gastroenterology, Hepatology and Infectious Diseases, Otto von Guericke University of Magdeburg, Magdeburg, Germany.
Dig Dis. 2008;26(3):243-7. doi: 10.1159/000121354. Epub 2008 May 7.
INTRODUCTION: Irritable bowel syndrome (IBS) and functional dyspepsia (FD) are highly prevalent in the general population as does gastroesophageal reflux disease (GERD). Therefore, it is expected that these conditions may frequently overlap. OBJECTIVE: We aimed at evaluating the presence ofFD and IBS symptoms in patients with erosive (ERD), non-erosive reflux disease (NERD) and Barrett's esophagus (BE). PATIENTS AND METHODS: 71 patients presenting at the reflux disease outpatient clinic were prospectively included in this study. 33 patients had NERD, 25 ERD and 13 BE according to the Montreal classification. All patients with ERD and NERD had typical reflux symptoms, as assessed by a validated GERD questionnaire (RDQ). The diagnosis of functional dyspepsia and IBS symptoms was assessed according to the Rome III criteria. RESULTS: IBS symptoms (bloating, abdominal pain, constipation and diarrhea) were slightly more prevalent in NERD (54.6, 63.6, 21.20, 24.2%, respectively) than in ERD (48.0, 44.0, 12.0, 20.0%, respectively) and in BE (53.9, 23.10, 15,4, 23.1%, respectively), but none of these differences reached statistical significance. NERD patients had more FD symptoms than patients with ERD or BE, but again this difference did not reach statistical significance. CONCLUSION: Our data show that IBS and FD are common in the entire spectrum of GERD. The presence of these disorders might explain why many patients with GERD are deemed as treatment failures if they have no complete symptom relief with proton pump inhibitors.
引言:肠易激综合征(IBS)和功能性消化不良(FD)在普通人群中高度流行,胃食管反流病(GERD)亦是如此。因此,预计这些病症可能经常重叠。 目的:我们旨在评估糜烂性反流病(ERD)、非糜烂性反流病(NERD)和巴雷特食管(BE)患者中FD和IBS症状的存在情况。 患者与方法:前瞻性纳入反流病门诊的71例患者。根据蒙特利尔分类,33例患者患有NERD,25例患有ERD,13例患有BE。所有ERD和NERD患者均有典型反流症状,通过经过验证的GERD问卷(RDQ)进行评估。根据罗马III标准评估功能性消化不良和IBS症状的诊断。 结果:IBS症状(腹胀、腹痛、便秘和腹泻)在NERD患者中(分别为54.6%、63.6%、21.2%、24.2%)比在ERD患者中(分别为48.0%、44.0%、12.0%、20.0%)和BE患者中(分别为53.9%、23.1%、15.4%、23.1%)略为普遍,但这些差异均未达到统计学意义。NERD患者比ERD或BE患者有更多的FD症状,但同样这种差异未达到统计学意义。 结论:我们的数据表明,IBS和FD在GERD的整个范围内都很常见。这些病症的存在可能解释了为什么许多GERD患者如果使用质子泵抑制剂后症状没有完全缓解就被视为治疗失败。
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