Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Am J Gastroenterol. 2012 May;107(5):754-60. doi: 10.1038/ajg.2012.5. Epub 2012 Feb 14.
The relevance of colonic transit alterations for the overall symptom pattern in irritable bowel syndrome (IBS) is incompletely understood. The aim of this study was to assess the total and segmental colonic transit time (CTT) and their relationship to symptoms and subgroups in a large sample of IBS patients.
Total and segmental CTT was assessed using radiopaque markers in 359 patients with IBS (279 females). These results were compared with existing normal values for healthy men and women without gastrointestinal (GI) symptoms. Stool frequency and consistency (Bristol Stool Form (BSF) scale), and the perceived severity of three GI symptoms (bloating, flatulence, and abdominal pain) were noted in a daily diary during the measurement week. Patients could be classified by the BSF scale characteristics into Rome III subtypes (n=338), or by use of the Rome II modular questionnaire into Rome II subtypes (n=143).
CTT was normal in 287 patients (80%), whereas 53 (15%) had accelerated and 19 (5%) had delayed CTT. Transit abnormalities in relation to gender-specific reference values were more common in males (30.0%) than in females (17.2%; P < 0.05). IBS subgrouping according to Rome III (P < 0.0001) and Rome II criteria (P < 0.001) was associated with the presence of abnormal CTT. Stool form (r=-0.40; P < 0.0001) and stool frequency (r=-0.30; P<0.0001) were moderately and negatively correlated to total CTT. No correlations of clinical significance were found between transit data and the three GI symptoms.
Total and segmental colonic transit alterations are of importance for the abnormal bowel habit seen in men and women with IBS, but of no or minor importance for other IBS symptoms.
结肠传输改变与肠易激综合征（IBS）整体症状模式的相关性尚未完全明确。本研究旨在评估大量 IBS 患者的总结肠传输时间（CTT）和分段 CTT 及其与症状和亚组的关系。
使用不透射线标志物评估 359 例 IBS 患者（279 例女性）的总结肠和分段 CTT。将这些结果与无胃肠道（GI）症状的健康男性和女性的现有正常值进行比较。在测量周期间，通过日常日记记录粪便频率和稠度（布里斯托粪便形态（BSF）量表），以及三种 GI 症状（腹胀、排气和腹痛）的感知严重程度。患者可根据 BSF 量表特征分为罗马 III 亚型（n=338），或根据罗马 II 模块问卷分为罗马 II 亚型（n=143）。
287 例（80%）患者 CTT 正常，53 例（15%）患者 CTT 加速，19 例（5%）患者 CTT 延迟。根据性别特异性参考值，男性（30.0%）的 CTT 异常比女性（17.2%）更常见（P < 0.05）。根据罗马 III（P < 0.0001）和罗马 II 标准（P < 0.001）对 IBS 进行亚组分类与异常 CTT 有关。粪便形态（r=-0.40；P < 0.0001）和粪便频率（r=-0.30；P<0.0001）与总 CTT 呈中度负相关。在转运数据与三种 GI 症状之间未发现具有临床意义的相关性。
总结肠和分段 CTT 改变对男性和女性 IBS 患者异常的肠道习惯很重要，但对其他 IBS 症状的重要性不大或不重要。
