基于全国健康和营养调查的数据，探讨有腹泻症状和无腹泻症状个体粪便急迫感的危险因素。
Risk Factors for Fecal Urgency Among Individuals With and Without Diarrhea, Based on Data From the National Health and Nutrition Examination Survey.
机构信息
Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
出版信息
Clin Gastroenterol Hepatol. 2018 Sep;16(9):1450-1458.e2. doi: 10.1016/j.cgh.2018.02.020. Epub 2018 Feb 21.
BACKGROUND & AIMS: Fecal urgency is a common symptom among patients with gastrointestinal disorders, but can also occur in healthy individuals with normal bowel habits. There have been few studies of fecal urgency in the general population. We performed a cross-sectional analysis of data from the National Health and Nutrition Examination Survey (NHANES) to analyze the prevalence of and risk factors for this symptom.
METHODS
We analyzed data from 4676 persons who completed the Bowel Health Questionnaire from the NHANES, from 2009 through 2010. The NHANES sampled a nationally representative group of adults in the United States and provides information on demographics, medical comorbidities, and dietary habits of survey participants. The Bowel Health Questionnaire provided additional information about bowel symptoms such as urgency, incontinence, constipation, and diarrhea. We identified individuals with fecal urgency and calculated differences in fecal urgency among subgroups using chi-squared analysis. We used logistic regression to identify factors associated with urgency.
RESULTS
In our study population, the prevalence of fecal urgency was 3.3%; 29.5% of individuals with fecal urgency had diarrhea. The prevalence of fecal urgency was significantly higher in individuals who had diarrhea (14.8%) than in individuals without diarrhea (3.1%). Older age, female sex, poverty, urinary urge incontinence, diarrhea, and increased stool frequency were all associated with fecal urgency on multivariable analysis. Decreased fiber intake and increased carbohydrate intake were associated with urgency among individuals with diarrhea.
CONCLUSIONS
In an analysis of data from 4676 individuals who completed a Bowel Health Questionnaire from the NHANES, we found a significantly higher proportion of individuals with diarrhea to have fecal urgency. However, most individuals with fecal urgency do not have diarrhea. Factors associated with fecal urgency vary among individuals with and without diarrhea.
背景与目的
粪便急迫感是胃肠道疾病患者的常见症状，但在排便习惯正常的健康人群中也可能出现。目前，针对普通人群中粪便急迫感的研究较少。我们对 2009 年至 2010 年国家健康和营养检查调查（NHANES）的数据进行了横断面分析，以分析该症状的流行情况和危险因素。
方法
我们分析了来自 NHANES 的 4676 名完成肠道健康问卷的个体的数据。NHANES 对美国成年人进行了全国代表性抽样，提供了调查参与者的人口统计学、合并症和饮食习惯信息。肠道健康问卷提供了关于肠道症状（如急迫感、失禁、便秘和腹泻）的更多信息。我们确定了有粪便急迫感的个体，并使用卡方分析计算了亚组之间粪便急迫感的差异。我们使用逻辑回归确定与急迫感相关的因素。
结果
在我们的研究人群中，粪便急迫感的患病率为 3.3%；有粪便急迫感的个体中，29.5%有腹泻。有腹泻的个体急迫感的患病率（14.8%）明显高于无腹泻的个体（3.1%）。多变量分析显示，年龄较大、女性、贫困、尿失禁、腹泻和粪便频率增加均与粪便急迫感相关。在腹泻患者中，膳食纤维摄入量减少和碳水化合物摄入量增加与急迫感相关。
结论
在对来自 NHANES 的 4676 名完成肠道健康问卷的个体的数据进行分析后，我们发现有腹泻的个体中粪便急迫感的比例明显更高。然而，大多数有粪便急迫感的个体并没有腹泻。有腹泻和无腹泻的个体与粪便急迫感相关的因素不同。
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