Institute of Inflammation and Repair, Stopford Building, University of Manchester, Oxford Road, Manchester M13 9PL, UK.
BMC Fam Pract. 2013 Dec 2;14:183. doi: 10.1186/1471-2296-14-183.
Estimates of the prevalence of irritable bowel syndrome (IBS) vary widely, and a large proportion of patients report having consulted their general practitioner (GP). In patients with new onset gastrointestinal symptoms in primary care it might be possible to predict those at risk of persistent symptoms. However, one of the difficulties is identifying patients within primary care. GPs use a variety of Read Codes to describe patients presenting with IBS. Furthermore, in a qualitative study, exploring GPs' attitudes and approaches to defining patients with IBS, GPs appeared reluctant to add the IBS Read Code to the patient record until more serious conditions were ruled out. Consequently, symptom codes such as 'abdominal pain', 'diarrhoea' or 'constipation' are used. The aim of the current study was to investigate the prevalence of recorded consultations for IBS and to explore the symptom profile of patients with IBS using data from the Salford Integrated Record (SIR).
This was a database study using the SIR, a local patient sharing record system integrating primary, community and secondary care information. Records were obtained for a cohort of patients with gastrointestinal disorders from January 2002 to December 2011. Prevalence rates, symptom recording, medication prescribing and referral patterns were compared for three patient groups (IBS, abdominal pain (AP) and Inflammatory Bowel Disease (IBD)).
The prevalence of IBS (age standardised rate: 616 per year per 100,000 population) was much lower than expected compared with that reported in the literature. The majority of patients (69%) had no gastrointestinal symptoms recorded in the year prior to their IBS. However a proportion of these (22%) were likely to have been prescribed NICE guideline recommended medications for IBS in that year. The findings for AP and IBD were similar.
Using Read Codes to identify patients with IBS may lead to a large underestimate of the community prevalence. The IBS diagnostic Read Code was rarely applied in practice. There are similarities with many other medically unexplained symptoms which are typically difficult to diagnose in clinical practice.
肠易激综合征（IBS）的患病率估计差异很大，很大一部分患者报告曾就诊于他们的全科医生（GP）。在初级保健中出现新发胃肠道症状的患者中，可能有可能预测那些持续存在症状的风险。然而，其中一个困难是在初级保健中识别患者。全科医生使用各种 Read 代码来描述出现 IBS 的患者。此外，在一项探索全科医生对定义 IBS 患者的态度和方法的定性研究中，全科医生似乎不愿意在排除更严重的疾病之前将 IBS Read 代码添加到患者记录中。因此，使用了症状代码，如“腹痛”、“腹泻”或“便秘”。本研究的目的是调查使用 Salford 综合记录（SIR）记录的 IBS 就诊的患病率，并探讨 IBS 患者的症状特征。
这是一项使用 SIR 的数据库研究，SIR 是一个整合初级、社区和二级保健信息的本地患者共享记录系统。从 2002 年 1 月至 2011 年 12 月，对胃肠道疾病患者的队列获得了记录。比较了三组患者（IBS、腹痛（AP）和炎症性肠病（IBD））的患病率、症状记录、药物处方和转诊模式。
与文献报道相比，IBS 的患病率（年龄标准化率：每 10 万人每年 616 人）低得多。大多数患者（69%）在出现 IBS 之前的一年中没有胃肠道症状记录。然而，其中一部分（22%）可能在该年被开具了 NICE 指南推荐的 IBS 药物。AP 和 IBD 的发现相似。
使用 Read 代码识别 IBS 患者可能会导致社区患病率的大量低估。IBS 诊断 Read 代码在实践中很少应用。与许多其他医学上无法解释的症状有相似之处，这些症状在临床实践中通常难以诊断。
