Berens Sabrina, Engel Felicitas, Gauss Annika, Tesarz Jonas, Herzog Wolfgang, Niesler Beate, Stroe-Kunold Esther, Schaefert Rainer
Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Im Neuenheimer Feld 410, D-69120 Heidelberg, Germany.
Department of Gastroenterology, Infectious Diseases and Intoxications, University of Heidelberg, Im Neuenheimer Feld 410, D-69120 Heidelberg, Germany.
Gastroenterol Res Pract. 2020 Jan 28;2020:9086340. doi: 10.1155/2020/9086340. eCollection 2020.
Overlaps between different functional gastrointestinal disorders (FGIDs) are common. However, little is known about the impact of this overlap on patients' health status. This study is aimed at analyzing the differences between patients with multiple as compared to one single FGID.
A retrospective, cross-sectional study was conducted with patients presenting to a tertiary care FGID specialty clinic between 06/2012 and 01/2015 ( = 294). They were characterized primarily according to their GI symptom severity (IBS-SSS) and secondarily to their physical as well as psychosocial symptom burden, quality of life, health care utilization, and work-related impairment. Differences between patients with >1 vs. 1 FGID were analyzed.
Of the 294 patients, 92.2% fulfilled the Rome III criteria for any FGID, and 48.0% had >1 FGIDs. FGID patients had a median age of 38 [23.0] years; 72.0% were female. Median GI symptom severity (IBS-SSS) scores were 339 [126] and 232 [163] in patients with >1 and 1 FGID, respectively ( < .001). Furthermore, patients with >1 FGIDs had higher general somatic symptom severity, higher illness anxiety, lower quality of life, and more work-related impairment. Almost no differences were found regarding their somatic as well as mental comorbidities.
Multiple FGIDs are associated with an increased risk for complicated courses of illness as reflected in higher GI and somatic symptom severity, as well as stronger psychosocial and diet- and work-related impairment. Stepped and interdisciplinary models of care including psychosocial expertise and dietary advice are needed, especially for patients with multiple FGIDs.
不同功能性胃肠疾病（FGID）之间的重叠很常见。然而，这种重叠对患者健康状况的影响却知之甚少。本研究旨在分析患有多种FGID的患者与仅患有单一FGID的患者之间的差异。
对2012年6月至2015年1月期间在一家三级医疗FGID专科诊所就诊的患者进行了一项回顾性横断面研究（n = 294）。主要根据他们的胃肠道症状严重程度（IBS-SSS）进行特征描述，其次根据他们的身体以及心理社会症状负担、生活质量、医疗保健利用情况和与工作相关的损害进行描述。分析了患有>1种与1种FGID的患者之间的差异。
在294例患者中，92.2%符合任何FGID的罗马III标准，48.0%患有>1种FGID。FGID患者的中位年龄为38[23.0]岁；72.0%为女性。患有>1种和1种FGID的患者的胃肠道症状严重程度（IBS-SSS）中位数评分分别为339[126]和232[163]（P <.001）。此外，患有>1种FGID的患者具有更高的一般躯体症状严重程度、更高的疾病焦虑、更低的生活质量以及更多与工作相关的损害。在他们的躯体和精神合并症方面几乎没有发现差异。
多种FGID与疾病复杂病程的风险增加相关，这表现为更高的胃肠道和躯体症状严重程度，以及更强的心理社会和饮食及工作相关损害。需要包括心理社会专业知识和饮食建议的逐步和跨学科护理模式，特别是对于患有多种FGID的患者。
