Talley N J, Fett S L, Zinsmeister A R
Department of Medicine, University of Sydney, Nepean Hospital, Australia.
Am J Gastroenterol. 1995 Mar;90(3):366-71.
A link between functional bowel disease and sexual, physical, emotional, or verbal abuse remains controversial. We aimed to determine whether abuse is associated with functional bowel disease in outpatients.
A consecutive sample of outpatients completed a validated questionnaire; 997 responded. Using standard criteria, we obtained data on symptoms, psychosocial factors, and abuse (sexual, physical, and emotional or verbal). Logistic regression analysis was used to determine whether abuse was associated with functional bowel disease (versus organic disease) and with irritable bowel syndrome (IBS)-type symptoms defined by the Manning criteria. Adjustments were made for age, gender, marital status, education level, psychological distress, and social support.
Of those with a physician-based diagnosis of functional bowel disease (n = 440), 22% reported some form of abuse (13% sexual and/or physical abuse), compared with those with organic disease (n = 557), 16% of whom reported some form of abuse; this difference was not significant. However, abused patients were significantly more likely to report IBS-type symptoms than those who did not report a history of abuse (odds ratio = 1.7, 95% confidence interval = 1.2, 2.5).
Outpatients who report abuse are more likely to have IBS-type symptoms.
功能性肠病与性虐待、身体虐待、情感虐待或言语虐待之间的联系仍存在争议。我们旨在确定在门诊患者中,虐待是否与功能性肠病有关。
连续选取门诊患者样本完成一份经验证有效的问卷;997人做出回应。我们使用标准标准获取了有关症状、心理社会因素和虐待(性虐待、身体虐待以及情感或言语虐待)的数据。采用逻辑回归分析来确定虐待是否与功能性肠病(相对于器质性疾病)以及与由曼宁标准定义的肠易激综合征(IBS)型症状相关。对年龄、性别、婚姻状况、教育水平、心理困扰和社会支持进行了调整。
在经医生诊断为功能性肠病的患者中(n = 440),22%报告有某种形式的虐待(13%为性虐待和/或身体虐待),而患有器质性疾病的患者(n = 557)中,16%报告有某种形式的虐待;这一差异不显著。然而,与未报告有虐待史的患者相比,报告有虐待的患者更有可能报告IBS型症状(比值比 = 1.7,95%置信区间 = 1.2,2.5)。
报告有虐待的门诊患者更有可能出现IBS型症状。