Helvaci Mehmet Rami, Algin Mustafa Cem, Kaya Hasan
Mustafa Kemal University, Faculty of Medicine, Department of Internal Medicine, Antakya, Turkey.
Dumlupınar University, Faculty of Medicine, Department of General Surgery, Kütahya, Turkey.
Eurasian J Med. 2009 Dec;41(3):158-61.
Approximately 10-20% of the general population has irritable bowel syndrome (IBS), and IBS patients usually suffer from chronic gastritis (CG), hemorrhoids (H), and urolithiasis (U).
We randomly chose consecutive patients with upper abdominal discomfort. All possible causes of IBS including celiac sprue, giardiasis, lactose intolerance, and cholelithiasis were investigated. U was diagnosed either by medical history or as a result of laboratory findings.
IBS patients (51) and patients without IBS (70) were studied. CG was diagnosed in 78.4% (40) of IBS cases, whereas this ratio was 50.0% (35) in cases without IBS (p<0.001). Similarly, H was detected in 33.3% (17) of IBS cases, but it was only detected in 15.7% (11) of cases without IBS (p<0.05). Additionally, U was detected in 17.6% (9) of IBS cases and in 5.7% (4) of cases without IBS (p<0.05).
Relationships between IBS and CG, H, and U are significant. IBS is a cascade of many physiologic events that is initiated by infection, inflammation, and psychological disturbances like many stresses, and this eventually terminates with gut dysfunction. Gastric acid is probably not involved in the etiology of IBS, but psychological factors also seem to be important in CG. The significant association between CG and IBS also support this hypothesis. Therefore, we believe CG is one of terminating points of the physiologic cascade of events in IBS. Bearing these associations in mind will be helpful during prevention, treatment, and follow up of these disorders, especially in internal medicine, urology, and general surgery polyclinics and primary health centers.
普通人群中约10 - 20%患有肠易激综合征(IBS),IBS患者通常还患有慢性胃炎(CG)、痔疮(H)和尿路结石(U)。
我们随机选取连续的上腹部不适患者。对IBS的所有可能病因进行了调查,包括乳糜泻、贾第虫病、乳糖不耐受和胆结石。U通过病史或实验室检查结果进行诊断。
对51例IBS患者和70例非IBS患者进行了研究。IBS病例中78.4%(40例)被诊断为CG,而非IBS病例中这一比例为50.0%(35例)(p<0.001)。同样,IBS病例中33.3%(17例)检测出H,但非IBS病例中仅15.7%(11例)检测出H(p<0.05)。此外,IBS病例中17.6%(9例)检测出U,非IBS病例中5.7%(4例)检测出U(p<0.05)。
IBS与CG、H和U之间存在显著关联。IBS是由感染、炎症以及许多压力等心理干扰引发的一系列生理事件,最终以肠道功能障碍告终。胃酸可能与IBS的病因无关,但心理因素在CG中似乎也很重要。CG与IBS之间的显著关联也支持这一假设。因此,我们认为CG是IBS生理事件级联反应的终点之一。牢记这些关联将有助于这些疾病的预防、治疗和随访,尤其是在内科、泌尿外科、普通外科门诊和初级卫生保健中心。