Bonamico M, Culasso F, Colombo C, Giunta A M
I Clinica Pediatrica, Università La Sapienza, Roma, Italy.
Ital J Gastroenterol. 1995 Jan-Feb;27(1):13-20.
A multicentre study was carried out on 285 children suffering from irritable bowel syndrome (IBS). Patients were divided according to clinical symptoms and age: Toddler's diarrhoea (TD) under 3 years of age and recurrent abdominal pain (RAP) over 3 years of age characteristics in children with TD and RAP were compared with those found in 114 subjects suffering from various gastrointestinal diseases (GIC) and in 192 normal children. This analysis allowed a complete profile of children with IBS in Italy to be obtained. The TD group, and to a lesser extent the RAP group, differ from the GIC and healthy controls (HC) on the basis of telephone calls to the doctor, physician visits, inappropriate dietary restrictions, multiple medications and multiple non-GI complaints. For children under 3, a history of food intolerance and the presence of mucus and undigested food in the feces are the variables that discriminate patients with IBS from those with GIC; for children over 3, colics in the first 3 months of life, a history of food intolerance, loose feces with abdominal pain, pain relieved by evacuation and undigested vegetables in the feces most discriminate the two groups. Finally, we tried to compute a diagnostic score to discriminate IBS children from GIC: this proved to be sensitive to IBS but not specific enough to be of clinical utility.
对285名患有肠易激综合征(IBS)的儿童进行了一项多中心研究。根据临床症状和年龄对患者进行分组:3岁以下的幼儿腹泻(TD)组和3岁以上的复发性腹痛(RAP)组。将TD组和RAP组儿童的特征与114名患有各种胃肠道疾病(GIC)的受试者以及192名正常儿童的特征进行了比较。该分析使得能够获取意大利IBS儿童的完整概况。基于给医生打电话、看医生、不适当的饮食限制、多种药物治疗以及多种非胃肠道主诉,TD组,以及在较小程度上RAP组,与GIC组和健康对照组(HC)存在差异。对于3岁以下儿童,食物不耐受史以及粪便中存在黏液和未消化食物是区分IBS患儿与GIC患儿的变量;对于3岁以上儿童,出生后头3个月的腹绞痛、食物不耐受史、伴有腹痛的稀便、排便后疼痛缓解以及粪便中未消化的蔬菜最能区分这两组。最后,我们试图计算一个诊断评分来区分IBS患儿与GIC患儿:结果证明该评分对IBS敏感,但特异性不足,不具有临床实用性。