Manning A P, Thompson W G, Heaton K W, Morris A F
Br Med J. 1978 Sep 2;2(6138):653-4. doi: 10.1136/bmj.2.6138.653.
A questionnaire to establish the presence of 15 symptoms thought to be typical of the irritable bowel syndrome (IBS) was given to 109 unselected patients referred to gastroenterology or surgery clinics with abdominal pain or a change in bowel habit or both. Review of case records 17--26 months later established a definite diagnosis of IBS in 32 patients and of organic disease in 33. Four symptoms were significantly more common among patients with IBS--namely, distension, relief of pain with bowel movement, and looser and more frequent bowel movements with the onset of pain. Mucus and a sensation of incomplete evacuation were also common in these patients. The more of these symptoms that were present the more likely was it that the patient's pain or altered bowel habit, or both, was due to IBS. We conclude that a careful history can increase diagnostic confidence and reduce the amount of investigation in many patients with chronic abdominal pain.
一份用于确定15种被认为是肠易激综合征（IBS）典型症状的问卷，被发放给了109名因腹痛或排便习惯改变或两者皆有而转诊至胃肠病科或外科诊所的未经挑选的患者。17至26个月后对病例记录进行复查，确诊32例患者患有IBS，33例患有器质性疾病。有四种症状在IBS患者中明显更为常见，即腹胀、排便后疼痛缓解、疼痛发作时大便变稀且更频繁。黏液和排便不尽感在这些患者中也很常见。出现的这些症状越多，患者的疼痛或排便习惯改变或两者兼有的原因越有可能是IBS。我们得出结论，详细的病史可以提高诊断的可信度，并减少许多慢性腹痛患者的检查量。
