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童年期虐待史与消化不良的发生有关:一项日本基于人群的调查。

Childhood abuse history is associated with the development of dyspepsia: a population-based survey in Japan.

机构信息

Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan,

出版信息

J Gastroenterol. 2015 Jul;50(7):744-50. doi: 10.1007/s00535-014-1014-3. Epub 2014 Nov 22.

Abstract

BACKGROUND

Functional dyspepsia (FD) is a heterogeneous disorder, and it is not clear whether childhood abuse influences the severity of dyspeptic symptoms and the type of dyspepsia. Accordingly, we administered a questionnaire survey to evaluate the association of abuse history in the development of dyspepsia.

METHODS

Study subjects were selected from among a panel of volunteers, to make equal distribution of age, sex, and residential area. A Web-based questionnaire was administered to uninvestigated dyspepsia subjects who had obtained a consultation at a medical institute, dyspepsia subjects who had not, and healthy control subjects. Dyspepsia was categorized into epigastric pain syndrome (EPS) and postprandial distress syndrome (PDS) using the Rome III adult FGID questionnaire. Physical, sexual, and psychological abuse history and severity of dyspeptic symptoms were assessed by a questionnaire.

RESULTS

Each type of abuse was significantly prevalent in uninvestigated dyspepsia subjects. Childhood abuse history was significantly prevalent in dyspepsia. However, these abuse histories were not associated with consultation behavior. Childhood abuse was more prevalent in subjects with dyspepsia and in females. Severity of dyspeptic symptoms was significantly greater in dyspepsia subjects with a history of abuse. Childhood abuse was more prevalent in dyspepsia subjects with the overlap of EPS and PDS and in those who also had irritable bowel syndrome (IBS).

CONCLUSIONS

Childhood abuse history was associated with the development of dyspepsia especially in the overlapping diagnoses of EPS and PDS, and overlapping with IBS but not with consultation behavior. Abuse history should be assessed in the care of patients with dyspepsia.

摘要

背景

功能性消化不良(FD)是一种异质性疾病,目前尚不清楚儿童期虐待是否会影响消化不良症状的严重程度和消化不良的类型。因此,我们进行了问卷调查,以评估虐待史与消化不良发展之间的关系。

方法

从志愿者小组中选择研究对象,以年龄、性别和居住区域均衡分布。我们对在医疗机构就诊的未调查消化不良患者、未就诊的消化不良患者和健康对照者进行了基于网络的问卷调查。消化不良根据罗马 III 成人 FGID 问卷分为餐后不适综合征(PDS)和上腹疼痛综合征(EPS)。通过问卷评估躯体、性和心理虐待史以及消化不良症状的严重程度。

结果

每种类型的虐待在未调查的消化不良患者中均明显更为常见。儿童期虐待史在消化不良患者中更为常见。然而,这些虐待史与就诊行为无关。在有消化不良的患者中,女性中儿童期虐待更为常见。有虐待史的消化不良患者的消化不良症状严重程度显著更高。在同时患有 EPS 和 PDS 的消化不良患者中,以及同时患有肠易激综合征(IBS)的患者中,儿童期虐待更为常见。

结论

儿童期虐待史与消化不良的发生有关,特别是在 EPS 和 PDS 的重叠诊断中,并且与 IBS 重叠,但与就诊行为无关。在消化不良患者的治疗中应评估虐待史。

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