Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
J Gastroenterol Hepatol. 2011 Apr;26 Suppl 3:12-4. doi: 10.1111/j.1440-1746.2011.06644.x.
Functional gastrointestinal disorders (FGIDs) are common in clinical practice and in communities around the world, including Korea. In a recent point prevalence study on functional dyspepsia (FD) in Korea using the Rome III criteria, 13.4% of community respondents reported dyspepsia. Forty-seven percent of these FD cases were classified as postprandial distress syndrome, 26% as epigastric pain syndrome, and 27% as overlap syndrome. Upper and lower GI symptoms commonly overlap and FGIDs are related to psychological disorders. In our recent study of subjects recruited from a health-screening program, the point prevalence of FD, irritable bowel syndrome (IBS), and reflux esophagitis (RE) was 13.2%, 3.9%, and 8.2%, respectively. The odds ratio of having FD and IBS together was estimated to be 4.4 (95% CI: 1.21-15.71). We found a positive relationship between FD and IBS. Recently, several genetic studies have suggested that serotonin transporter (SERT) gene polymorphisms and the G-protein β3 (GNβ3) C825T gene polymorphism are associated with FD and IBS. However, we did not find an association between SERT and GNβ3 C825T genetic polymorphisms and overlap syndrome, including FD and IBS, in our previous study in a Korean population. We therefore undertook a validation study of the Rome III criteria for FGIDs by factor analysis of symptoms. The sensitivity and specificity of Rome III criteria in discriminating FGIDs from organic diseases of the upper GI tract was 60% and 53%, respectively, while the sensitivity and specificity of these criteria for the lower GI tract was 80% and 50%, respectively, partially supporting the use of the Rome III criteria in Korea.
功能性胃肠病（FGIDs）在世界范围内的临床实践和社区中都很常见，包括韩国。在最近一项使用罗马 III 标准的韩国功能性消化不良（FD）的现患率研究中，13.4%的社区受访者报告有消化不良。这些 FD 病例中有 47%被归类为餐后不适综合征，26%为上腹痛综合征，27%为重叠综合征。上消化道和下消化道症状通常重叠，FGIDs 与心理障碍有关。在我们最近对一项健康筛查计划中招募的受试者进行的研究中，FD、肠易激综合征（IBS）和反流性食管炎（RE）的现患率分别为 13.2%、3.9%和 8.2%。同时患有 FD 和 IBS 的优势比估计为 4.4（95%CI：1.21-15.71）。我们发现 FD 和 IBS 之间存在正相关关系。最近，几项遗传研究表明，5-羟色胺转运体（SERT）基因多态性和 G 蛋白β3（GNβ3）C825T 基因多态性与 FD 和 IBS 相关。然而，在我们之前对韩国人群的研究中，我们没有发现 SERT 和 GNβ3 C825T 遗传多态性与 FD 和 IBS 重叠综合征之间的关联。因此，我们进行了一项验证研究，通过症状的因子分析来评估罗马 III 标准对 FGIDs 的诊断价值。罗马 III 标准在鉴别上消化道器质性疾病与 FGIDs 的敏感性和特异性分别为 60%和 53%，而在鉴别下消化道疾病的敏感性和特异性分别为 80%和 50%，部分支持罗马 III 标准在韩国的应用。
