Geeraerts B, Van Oudenhove L, Fischler B, Vandenberghe J, Caenepeel P, Janssens J, Tack J
Department of Internal Medicine, Division of Gastroenterology, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium.
Neurogastroenterol Motil. 2009 Jan;21(1):33-41. doi: 10.1111/j.1365-2982.2008.01178.x. Epub 2008 Aug 6.
Patients with functional gastrointestinal disorders have elevated rates of sexual or physical abuse, which may be associated with altered rectal sensorimotor function in irritable bowel syndrome. The aim was to study the association between abuse history and gastric sensorimotor function in functional dyspepsia (FD). We studied gastric sensorimotor function with barostat (sensitivity, compliance and accommodation) and gastric emptying test in 233 consecutive FD patients from a tertiary care centre (162 women, mean age 41.6 +/- 0.9). Patients filled out self-report questionnaires on history of sexual and physical abuse during childhood or adulthood. Eighty-four patients (out of 198, 42.4%) reported an overall history of abuse [sexual and physical in respectively 30.0% (60/200) and 20.3% (42/207)]. FD patients reporting general as well as severe childhood sexual abuse have significantly lower discomfort thresholds during gastric distension [respectively 10.5 +/- 0.4 vs 7.5 +/- 1.0 mmHg above minimal distending pressure (MDP), P = 0.014 and 10.5 +/- 0.4 vs 6.6 +/- 1.2 mmHg above MDP, P = 0.007]. The corresponding intra-balloon volume was also significantly lower (respectively 579 +/- 21 vs 422 +/- 59 mL, P = 0.013 and 579 +/- 19 vs 423 +/- 79 mL, P = 0.033). Gastric accommodation was significantly more pronounced in patients reporting rape during adulthood (91 +/- 12 vs 130 +/- 40 mL, P = 0.016). Abuse history was not associated with differences in gastric emptying. A history of abuse is associated with alterations in gastric sensorimotor function in FD. Particularly sexual abuse, rather than physical abuse, may influence gastric sensitivity and motor function.
功能性胃肠病患者遭受性虐待或身体虐待的比例较高，这可能与肠易激综合征患者直肠感觉运动功能改变有关。本研究旨在探讨功能性消化不良（FD）患者的虐待史与胃感觉运动功能之间的关联。我们采用恒压器（检测敏感性、顺应性和容受性）及胃排空试验，对一家三级医疗中心的233例连续性FD患者（162例女性，平均年龄41.6±0.9岁）的胃感觉运动功能进行了研究。患者填写了关于童年或成年期性虐待和身体虐待史的自我报告问卷。198例患者中有84例（42.4%）报告有虐待史[性虐待和身体虐待分别占30.0%（60/200）和20.3%（42/207）]。报告有一般及严重童年期性虐待的FD患者在胃扩张期间的不适阈值显著降低[分别为高于最小扩张压力（MDP）10.5±0.4 mmHg与7.5±1.0 mmHg，P = 0.014；以及10.5±0.4 mmHg与6.6±1.2 mmHg，P = 0.007]。相应的球囊内体积也显著降低（分别为579±21 mL与422±59 mL，P = 0.013；以及579±19 mL与423±79 mL，P = 0.033）。报告成年期遭受强奸的患者胃容受性显著更明显（91±12 mL与130±40 mL，P = 0.016）。虐待史与胃排空差异无关。虐待史与FD患者胃感觉运动功能改变有关。特别是性虐待，而非身体虐待，可能会影响胃的敏感性和运动功能。
