McNally M A, Locke G R, Zinsmeister A R, Schleck C D, Peterson J, Talley N J
Division of Gastroenterology, Mayo Clinic, Jacksonville, FL 32082, USA.
Aliment Pharmacol Ther. 2008 Aug 1;28(3):334-43. doi: 10.1111/j.1365-2036.2008.03715.x.
Prospective data are lacking to determine if irritable bowel syndrome (IBS) is a risk factor for cholecystectomy, or if biliary disease and cholecystectomy predisposes to the development of IBS.
To test the hypothesis that IBS and biliary tract disease are associated.
Validated symptom surveys sent to cohorts of Olmsted County, MN, (1988-1994) with follow-up in 2003. Medical histories were reviewed to determine any 'biliary events' (defined by gallstones or cholecystectomy). Analyses examined were: (i) time to a biliary event post-initial survey and separately and (ii) risk of IBS (Rome II) in those with vs. without a prior biliary event.
A total of 1908 eligible subjects were mailed a follow-up survey. For analysis (i) of the 726 without IBS at initial survey, 44 (6.1%) had biliary events during follow up, in contrast to 5 of 93 (5.4%) with IBS at initial survey (HR 0.8, 95% CI 0.3-2.1). For analysis (ii) of the 59 subjects with a biliary event at initial survey, 10 (17%) reported new IBS on the follow-up survey, while in 682 without a biliary event up to 1.5 years prior to the second survey, 58 (8.5%) reported IBS on follow-up (OR = 2.2, 95% CI 1.1-4.6, P = 0.03).
There is an increased risk of new IBS in community subjects who have been diagnosed as having a biliary event.
缺乏前瞻性数据来确定肠易激综合征（IBS）是否为胆囊切除术的危险因素，或者胆道疾病及胆囊切除术是否易引发IBS。
检验IBS与胆道疾病相关的假说。
向明尼苏达州奥姆斯特德县队列（1988 - 1994年）发送经过验证的症状调查问卷，并于2003年进行随访。回顾病史以确定任何“胆道事件”（由胆结石或胆囊切除术定义）。所进行的分析包括：（i）初次调查后发生胆道事件的时间，并分别进行分析；（ii）有或无既往胆道事件者发生IBS（罗马II标准）的风险。
共向1908名符合条件的受试者邮寄了随访调查问卷。对于分析（i），初次调查时无IBS的726名受试者中，44名（6.1%）在随访期间发生了胆道事件，相比之下，初次调查时有IBS的93名受试者中有5名（5.4%）发生了胆道事件（风险比0.8，95%置信区间0.3 - 2.1）。对于分析（ii），初次调查时有胆道事件的59名受试者中，10名（17%）在随访调查问卷中报告新发IBS，而在第二次调查前长达1.5年无胆道事件的682名受试者中，58名（8.5%）在随访时报告有IBS（比值比 = 2.2，95%置信区间1.1 - 4.6，P = 0.03）。
在已被诊断患有胆道事件的社区受试者中，新发IBS的风险增加。
