Department of Gastroenterology, Nanjing Jiangbei People's Hospital, Medical School, Southeast University, 552 Geguan Road, Nanjing 210048, Jiangsu Province, China.
World J Gastroenterol. 2013 Mar 7;19(9):1466-71. doi: 10.3748/wjg.v19.i9.1466.
To determine the mortality associated with functional bowel disorders (FBDs) and their possible relationship with organic bowel disease.
Patients who satisfied the Rome III criteria for FBD (retrospective diagnosis) were followed up by telephone interview and/or outpatient review at 5 years after their first attendance. The patients were divided into the following groups: irritable bowel syndrome, functional abdominal bloating, functional constipation, functional diarrhea and unspecified FBD. The survival of the FBD patients overall and of those with each FBD were compared with data obtained from the Guangzhou population in 2005. The incidences of colonic cancer overall and for each FBD were compared with data from the Chinese population obtained from 56 cancer registries in 19 provinces of the country in 2008.
Two hundred and sixty-three patients were followed-up. Five patients died, which was not significantly different from the expected survival rate. No differences in mortality among the FBDs were found. There were nine cases of organic bowel disease: three colonic cancers and six colonic polyps. The incidence of colonic cancer in FBD patients was higher than that in the general Chinese population (0.23% vs 0.03%, P < 0.05). There were significant differences in the incidence of colonic cancer among the FBDs (0/134, 0/24, 2/29, 1/66, 0/10, respectively, P < 0.05); functional constipation was the most common. The incidence of colonic polyps was similar among the FBDs. The baseline age of patients who died was greater than that of those who survived (66.60 ± 6.84 years vs 45.14 ± 10.34 years, P < 0.05). The baseline age of patients who had colonic cancer or polyps during follow-up was greater than that of those without colonic cancer or polyps (60.33 ± 1.53 years vs 45.38 ± 10.62 years; 54.50 ± 6.47 years vs 45.34 ± 10.68 years, P < 0.05).
FBDs do not increase the risk of death. The incidence of colonic cancer in patients with FBDs may be increased, especially in those with functional constipation and in the elderly.
确定功能性肠病（FBD）相关的死亡率及其与器质性肠病的可能关系。
通过电话访谈和/或门诊复查对符合 Rome III FBD 标准的患者（回顾性诊断）进行 5 年随访。患者分为以下几组：肠易激综合征、功能性腹胀、功能性便秘、功能性腹泻和未特指的 FBD。将 FBD 患者的总体生存率与 2005 年广州人群的数据进行比较，并将功能性肠病患者的结肠癌总体发病率与 2008 年全国 19 个省 56 个癌症登记处的中国人群数据进行比较。
263 例患者得到随访。5 例患者死亡，与预期生存率无显著差异。FBD 之间的死亡率无差异。发现 9 例器质性肠病：3 例结肠癌和 6 例结肠息肉。FBD 患者的结肠癌发病率高于普通中国人群（0.23%比 0.03%，P < 0.05）。FBD 之间结肠癌的发病率有显著差异（分别为 0/134、0/24、2/29、1/66、0/10，P < 0.05）；功能性便秘最为常见。FBD 之间结肠息肉的发病率相似。死亡患者的基线年龄大于存活患者（66.60 ± 6.84 岁比 45.14 ± 10.34 岁，P < 0.05）。随访期间发生结肠癌或息肉的患者的基线年龄大于未发生结肠癌或息肉的患者（60.33 ± 1.53 岁比 45.38 ± 10.62 岁；54.50 ± 6.47 岁比 45.34 ± 10.68 岁，P < 0.05）。
FBD 不会增加死亡风险。FBD 患者结肠癌的发病率可能增加，尤其是功能性便秘和老年患者。
