Radboud University Medical Centre, Radboud University, Nijmegen, The Netherlands.
Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, United Kingdom; Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, United Kingdom.
Clin Gastroenterol Hepatol. 2016 May;14(5):659-68.e1; quiz e54-5. doi: 10.1016/j.cgh.2015.09.031. Epub 2015 Nov 19.
BACKGROUND & AIMS: Patients with microscopic colitis and patients with irritable bowel syndrome (IBS) present with similar symptoms. We examined the association between IBS and microscopic colitis in a systematic review and meta-analysis.
We searched the medical literature to identify cross-sectional surveys or case-control studies reporting the association between microscopic colitis and IBS in 50 or more unselected adult patients. We recorded the prevalence of IBS symptoms in patients with histologically confirmed microscopic colitis, or the prevalence of histologically confirmed microscopic colitis in patients with IBS. Data were pooled using a random-effects model; the association between microscopic colitis and IBS was summarized using an odds ratio (OR) with a 95% confidence interval (CI).
The search strategy identified 3926 citations, of which 10 were eligible for our analysis. The pooled prevalence of IBS in patients with microscopic colitis was 33.4% (95% CI, 31.5%-40.6%), but was not significantly higher in patients with microscopic colitis than in patients with diarrhea (OR, 1.39; 95% CI, 0.43-4.47). In 3 cross-sectional surveys, the pooled OR for microscopic colitis in participants with IBS, compared with other patients with diarrhea, was 0.68 (95% CI, 0.44-1.04). In 4 case-control studies the prevalence of IBS in patients with microscopic colitis was significantly higher than in asymptomatic controls (OR, 5.16; 95% CI, 1.32-20.2).
Based on a meta-analysis, one third of patients with microscopic colitis reported symptoms compatible with IBS, but the prevalence of IBS was no higher than in other patients with diarrhea. The odds of microscopic colitis were no higher in patients with IBS compared with other patients with diarrhea. The value of routine colonoscopy and biopsy to exclude microscopic colitis in patients with typical IBS symptoms, unless other risk factors or alarm symptoms are present, remains uncertain.
患有显微镜结肠炎和肠易激综合征（IBS）的患者表现出相似的症状。我们通过系统评价和荟萃分析来检查 IBS 与显微镜结肠炎之间的关联。
我们检索医学文献，以确定报告 50 例或以上未经选择的成年患者中显微镜结肠炎和 IBS 之间关联的横断面调查或病例对照研究。我们记录了组织学证实的显微镜结肠炎患者中 IBS 症状的患病率，或 IBS 患者中组织学证实的显微镜结肠炎的患病率。使用随机效应模型汇总数据；使用比值比（OR）及其 95%置信区间（CI）总结显微镜结肠炎与 IBS 之间的关联。
搜索策略确定了 3926 条引文，其中有 10 条符合我们的分析标准。显微镜结肠炎患者中 IBS 的总患病率为 33.4%（95%CI，31.5%-40.6%），但显微镜结肠炎患者中的患病率并不明显高于腹泻患者（OR，1.39；95%CI，0.43-4.47）。在 3 项横断面研究中，与其他腹泻患者相比，IBS 患者中显微镜结肠炎的汇总 OR 为 0.68（95%CI，0.44-1.04）。在 4 项病例对照研究中，显微镜结肠炎患者中 IBS 的患病率明显高于无症状对照者（OR，5.16；95%CI，1.32-20.2）。
基于荟萃分析，三分之一的显微镜结肠炎患者报告有符合 IBS 的症状，但 IBS 的患病率并不高于其他腹泻患者。与其他腹泻患者相比，IBS 患者中显微镜结肠炎的几率没有更高。除非存在其他风险因素或警报症状，否则在具有典型 IBS 症状的患者中常规进行结肠镜检查和活检以排除显微镜结肠炎的价值仍不确定。
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