Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
J Gastroenterol Hepatol. 2011 Apr;26 Suppl 3:2-11. doi: 10.1111/j.1440-1746.2011.06635.x.
Functional gastrointestinal disorders (FGIDs), namely functional dyspepsia (FD) and irritable bowel syndrome (IBS) are common disorders important to public health in the Asia-Pacific region. Our objectives were to determine the current practices in diagnosis and management of these disorders in the Asia-Pacific region.
Forty-three physicians and researchers in FGID who attended the first Asian Pacific Topic Conference at Tokyo in November 2010 were invited to answer a questionnaire. Twenty-three Japanese doctors and twenty doctors from other Asia-Pacific Societies answered the questionnaire, which consisted of 60 multiple-choice questions concerning physician's preferences in diagnosis and management of FGIDs.
Overall, there were similarities in diagnostic approach, such as differential diagnosis, exclusion of organic diseases, psychophysiological assessment, medical advice or medication with psychological drugs, not only among different Asia-Pacific region but also between FD and IBS. Several notable differences were seen. For example, general practitioners did not commonly use the term FD or diagnose FD by themselves, while the term IBS was widely used and frequently diagnosed. Sub-categorization was more common in IBS than FD. There was also a difference between Japan and other Asia-Pacific region; upper GI endoscopy and blood examination were more common in Japan, while eradication of Helicobacter pylori was more frequently done in other countries. Anti-secretory drugs for FD and mild laxatives or anti-diarrheal drug for IBS were frequently used, and prokinetics were used for all patients with FD or IBS. Interestingly, drugs developed in Japan and Chinese herbal medicines were more frequently prescribed in Japan.
Information obtained in this survey is useful for understanding the most common clinical approaches for FGIDs in the Asia-Pacific region.
功能性胃肠病（FGIDs），即功能性消化不良（FD）和肠易激综合征（IBS），是亚太地区对公共健康很重要的常见疾病。我们的目的是确定亚太地区这些疾病的当前诊断和管理实践。
2010 年 11 月在东京举行的第一届亚太专题会议上，邀请了 43 名 FGIDs 医生和研究人员回答问卷。23 名日本医生和来自其他亚太学会的 20 名医生回答了问卷，问卷包含 60 个关于 FGIDs 诊断和管理的医生偏好的多项选择题。
总体而言，在诊断方法上存在相似之处，例如鉴别诊断、排除器质性疾病、心理生理评估、医学建议或心理药物治疗，不仅在不同亚太地区之间，而且在 FD 和 IBS 之间也存在相似之处。也存在一些明显的差异。例如，全科医生通常不使用 FD 一词，也不自行诊断 FD，而 IBS 一词则广泛使用并经常诊断。IBS 比 FD 更常见进行亚分类。日本和其他亚太地区之间也存在差异；日本更常进行上消化道内镜检查和血液检查，而其他国家更常进行幽门螺杆菌根除。FD 常用抗分泌药物，IBS 常用轻度泻药或抗腹泻药物，所有 FD 或 IBS 患者均使用促动力药物。有趣的是，日本开发的药物和中草药在日本更常被开处。
本调查获得的信息有助于了解亚太地区 FGIDs 最常见的临床方法。
