Ludidi S, Mujagic Z, Jonkers D, Keszthelyi D, Hesselink M, Kruimel J, Conchillo J, Masclee A
Division Gastroenterology-Hepatology, Department of Internal Medicine, NUTRIM School for Nutrition, Toxicology and Metabolism - Maastricht University Medical Center+, Maastricht, The Netherlands.
Neurogastroenterol Motil. 2014 Aug;26(8):1104-11. doi: 10.1111/nmo.12365. Epub 2014 Jun 11.
Irritable bowel syndrome (IBS) is a heterogenous disorder with visceral hypersensitivity as important hallmark. It is not known whether IBS patients with visceral hypersensitivity have different epidemiological and clinical characteristics compared with IBS patients without visceral hypersensitivity. Aim of our study was to compare in detail a large group of hyper- vs normosensitive IBS patients with respect to epidemiological and clinical characteristics.
IBS patients (Rome III criteria) have been recruited for a large-scale cohort study. All patients from this cohort who underwent a rectal barostat procedure were included and allocated based on those with and without visceral hypersensitivity. Patient demographics, and symptoms were collected using questionnaires (GSRS, HADS, SF-36) and a 14-day symptom diary for IBS-related symptoms. A multivariate logistic regression model was used to identify risk markers for having visceral hypersensitivity.
Ninety-five normosensitive and 93 hypersensitive IBS patients participated in this study. Hypersensitive patients had significantly higher scores for GSRS abdominal pain (p < 0.05), indigestion, reflux and constipation syndrome (all p < 0.01), and IBS symptom intensity, discomfort (both p < 0.05) and mean symptom composite score (p < 0.01). Age, female sex, and the use of SSRI medication were significantly different between the normo- and the hypersensitive IBS patients. However, after adjustment for other risk markers, only increasing age was found to be significantly associated with lower odds for having hypersensitivity (OR 0.97 [95% CI: 0.94; 0.99]).
CONCLUSIONS & INFERENCES: Apart from more severe symptomatology, hypersensitive IBS patients are characterized by significantly younger age compared with normosensitive IBS patients. The study has been registered in the US National Library of Medicine (http://www.clinicaltrials.gov, NCT00702026).
肠易激综合征（IBS）是一种异质性疾病，内脏高敏感性是其重要特征。目前尚不清楚内脏高敏感性的IBS患者与无内脏高敏感性的IBS患者在流行病学和临床特征上是否存在差异。我们研究的目的是详细比较一大组内脏高敏感与内脏正常敏感的IBS患者的流行病学和临床特征。
招募符合罗马III标准的IBS患者进行大规模队列研究。该队列中所有接受直肠压力测定的患者均被纳入，并根据有无内脏高敏感性进行分组。通过问卷（GSRS、HADS、SF-36）和14天IBS相关症状症状日记收集患者的人口统计学和症状信息。使用多变量逻辑回归模型确定内脏高敏感性的风险标志物。
95名内脏正常敏感和93名内脏高敏感的IBS患者参与了本研究。高敏感患者的GSRS腹痛评分（p < 0.05）、消化不良、反流和便秘综合征评分（均p < 0.01）以及IBS症状强度、不适感评分（均p < 0.05）和平均症状综合评分（p < 0.01）均显著更高。内脏正常敏感和内脏高敏感的IBS患者在年龄、女性性别和使用SSRI药物方面存在显著差异。然而，在对其他风险标志物进行调整后，仅发现年龄增加与高敏感性的较低几率显著相关（OR 0.97 [95% CI：0.94；0.99]）。
除了症状更严重外，内脏高敏感的IBS患者与内脏正常敏感的IBS患者相比，年龄显著更小。该研究已在美国国立医学图书馆注册（http://www.clinicaltrials.gov，NCT00702026）。
