Department of Internal Medicine, National Cancer Center, Goyang, Gyeonggi-do, Korea. ; Center for Cancer Prevention & Detection, National Cancer Center, Goyang, Gyeonggi-do, Korea.
J Neurogastroenterol Motil. 2013 Oct;19(4):521-31. doi: 10.5056/jnm.2013.19.4.521. Epub 2013 Oct 7.
BACKGROUND/AIMS: Although several studies have suggested overlaps between gastroesophageal reflux symptom and irritable bowel syndrome (IBS), the studies for the association between erosive esophagitis and IBS are rare. The aim of this study was to evaluate the association among IBS, non-erosive reflux disease (NERD), and erosive esophagitis.
A total of 2,769 participants completed questionnaires and underwent esophagogastroduodenoscopy and colonoscopy. IBS was diagnosed by Rome III; NERD was defined as heartburn or acid regurgitation occurring at least once per week without erosive esophagitis. Erosive esophagitis was defined by Los Angeles classification. Psychological distress was evaluated with modified 4 dimensions from revised Hopkins symptom checklist 90.
Psychological distress was associated with both IBS and NERD, but not with erosive esophagitis. IBS was associated with somatization (adjusted OR, 2.88; 95% CI, 1.55-5.36; P < 0.001), anxiety (adjusted OR, 2.82; 95% CI, 1.36-5.88; P = 0.005), and hostility (adjusted OR, 2.06; 95% CI, 1.10-3.87; P = 0.024) and NERD was associated with somatization (adjusted OR, 5.65; 95% CI, 2.92-10.98; P < 0.001) and anxiety (adjusted OR, 3.29; 95% CI, 1.47-7.34; P = 0.004). Erosive esophagitis was associated with somatization (adjusted OR, 2.69; 95% CI, 1.26-7.91; P < 0.001). Hiatal hernia and male sex were related with erosive esophagitis but not with IBS or NERD. H. pylori had an inverse relationship with erosive esophagitis, but had no association with IBS. Whereas IBS was positively associated with NERD (adjusted OR, 2.72; 95% CI, 1.84-4.03; P < 0.001), it had no association with erosive esophagitis.
IBS shared many risk factors with NERD but not with erosive esophagitis. It partially explains why IBS was associated with NERD, but not with erosive esophagitis.
背景/目的：尽管有几项研究表明胃食管反流症状和肠易激综合征（IBS）之间存在重叠，但关于糜烂性食管炎和 IBS 之间关联的研究很少。本研究旨在评估 IBS、非糜烂性反流病（NERD）和糜烂性食管炎之间的关联。
共有 2769 名参与者完成了问卷调查，并接受了食管胃十二指肠镜检查和结肠镜检查。IBS 通过罗马 III 标准诊断；NERD 定义为每周至少出现一次烧心或反酸但无糜烂性食管炎。糜烂性食管炎采用洛杉矶分类定义。心理困扰采用改良的修订后的霍普金斯症状清单 90 中的 4 个维度进行评估。
心理困扰与 IBS 和 NERD 相关，但与糜烂性食管炎无关。IBS 与躯体化（调整后的 OR，2.88；95%CI，1.55-5.36；P<0.001）、焦虑（调整后的 OR，2.82；95%CI，1.36-5.88；P=0.005）和敌意（调整后的 OR，2.06；95%CI，1.10-3.87；P=0.024）相关，而 NERD 与躯体化（调整后的 OR，5.65；95%CI，2.92-10.98；P<0.001）和焦虑（调整后的 OR，3.29；95%CI，1.47-7.34；P=0.004）相关。糜烂性食管炎与躯体化（调整后的 OR，2.69；95%CI，1.26-7.91；P<0.001）相关。膈疝和男性与糜烂性食管炎相关，但与 IBS 或 NERD 无关。H. pylori 与糜烂性食管炎呈负相关，但与 IBS 无关。而 IBS 与 NERD 呈正相关（调整后的 OR，2.72；95%CI，1.84-4.03；P<0.001），但与糜烂性食管炎无关。
IBS 与 NERD 有许多共同的危险因素，但与糜烂性食管炎无关。这部分解释了为什么 IBS 与 NERD 相关，而与糜烂性食管炎无关。
