炎症性肠病缓解深度与肠易激综合征的关系：与缓解深度和炎症无关。
Irritable Bowel Syndrome on Inflammatory Bowel Disease in Deep Remission: No Relation with Remission Deepening and Inflammation.
机构信息
Department of Gastroenterology, Faculty of Medicine, Mersin University, Mersin, Turkey.
Department of İnternal Medicine, Haydarpaşa Numune Education and Research Hospital, İstanbul, Turkey.
出版信息
Turk J Gastroenterol. 2021 Oct;32(10):870-878. doi: 10.5152/tjg.2021.20806.
BACKGROUND
The aim of the study was to establish the frequency of irritable bowel syndrome (IBS) in patients with inflammatory bowel disease (IBD) in clinical, endoscopic, and histologic remission and in relation to both the depth of remission and inflammation markers.
METHODS
Patients with ulcerative colitis (UC) and with Crohn's disease (CD) in clinical remission for at least 6 months were enrolled in the study. All of the patients underwent colonoscopy, and biopsy specimens were taken to evaluate endoscopic and histopathologic remission. Patients were evaluated according to Rome III criteria for IBS. Fecal calprotectin level and blood samples for C-reactive protein (CRP), sedimentation rate, and fibrinogen levels were studied.
RESULTS
IBS frequency was 20.9% in UC cases and 28.9% in CD cases in clinical remission. Rates with and without endoscopic remission in UC (20.5% vs. 22.2%, P = .727) and CD (25% vs. 33.3%, P = .837, respectively) were not different. Similarly, rates with and without histopathologic remission in UC (15.7% vs. 26.6%, P = .723), and CD (21.4% vs. 33.3%, P = .999) were not statistically different. Also, it was not related to inflammation markers.
CONCLUSION
IBS frequency among IBD patients with remission was in a substantial rate; these rates kept up with the process of deep remission and even complete mucosal healing and were irrelevant to inflammation.
背景
本研究旨在确定处于临床、内镜和组织学缓解状态且缓解深度和炎症标志物相关的炎症性肠病（IBD）患者中肠易激综合征（IBS）的频率。
方法
本研究纳入了至少缓解 6 个月的溃疡性结肠炎（UC）和克罗恩病（CD）患者。所有患者均接受结肠镜检查，并取活检标本评估内镜和组织病理学缓解情况。根据罗马 III 标准评估患者是否患有 IBS。研究了粪便钙卫蛋白水平以及 C 反应蛋白（CRP）、血沉和纤维蛋白原水平等血液标志物。
结果
在临床缓解的 UC 病例中 IBS 频率为 20.9%，在 CD 病例中为 28.9%。UC（20.5%比 22.2%，P =.727）和 CD（25%比 33.3%，P =.837）内镜缓解病例的发生率无差异。同样，UC（15.7%比 26.6%，P =.723）和 CD（21.4%比 33.3%，P =.999）组织病理学缓解病例的发生率也无差异。此外，IBS 频率与炎症标志物无关。
结论
处于缓解状态的 IBD 患者中 IBS 频率较高；这些频率与深度缓解过程保持一致，甚至与完全黏膜愈合相关，与炎症无关。
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