Locke G R
Mayo Medical School, Rochester, Minnesota, USA.
Gastroenterol Clin North Am. 1996 Mar;25(1):1-19. doi: 10.1016/s0889-8553(05)70362-9.
This article has summarized the epidemiology of several disorders commonly seen in a gastroenterologist's practice. The emphasis has been on population-based data because many people with these disorders never seek health care, and psychological features have been shown to be strongly associated with health care-seeking behavior. Each of these disorders is common in the community; in fact, the majority of the population experiences intermittent gastrointestinal symptoms. In general, the national surveys sponsored by the U.S. Public Health Service have been shown to underestimate the prevalence of these conditions. In part, this is due to the fact that subjects are asked to report diagnoses rather than symptoms, and current coding schemes do not provide specific codes for each of the functional gastrointestinal disorders. Still, these studies have demonstrated the large number of physician visits and overall costs attributable to these disorders. A number of surveys of more limited populations have been done to assess the prevalence of these disorders. Rates have varied because of the definitions used and the degree to which organic diagnoses are excluded. These studies have been helpful in demonstrating the burden of illness in the community. Age and gender differences in the community have been much less marked than those identified in clinic-based studies, thus highlighting the importance of population-based research. Future studies need to focus on the incidence and natural history of these disorders. Studies of incidence cases can best evaluate the role of etiologic factors, whereas studies of prevalent cases are best for assessing the burden of disease in the community. Understanding the natural history of these disorders is important in determining the efficacy of future therapeutic interventions. The fact that these disorders represent 50% of visits to a gastroenterologist practice highlights the importance of these disorders and the potential contribution of gastrointestinal dysmotility in clinical practice.
本文总结了胃肠病医生临床实践中常见的几种疾病的流行病学情况。重点是基于人群的数据，因为许多患有这些疾病的人从未寻求过医疗护理，而且心理特征已被证明与寻求医疗护理的行为密切相关。这些疾病在社区中都很常见；事实上，大多数人都经历过间歇性的胃肠道症状。一般来说，美国公共卫生服务机构发起的全国性调查显示低估了这些疾病的患病率。部分原因在于，调查要求受试者报告诊断结果而非症状，而且当前的编码方案并未为每种功能性胃肠疾病提供特定编码。尽管如此，这些研究仍表明了因这些疾病导致的大量就诊次数和总体费用。已经开展了一些针对更有限人群的调查，以评估这些疾病的患病率。由于所采用的定义以及排除器质性诊断的程度不同，患病率有所差异。这些研究有助于证明社区中的疾病负担。社区中的年龄和性别差异远不如基于诊所的研究中所确定的那么明显，从而凸显了基于人群研究的重要性。未来的研究需要关注这些疾病的发病率和自然史。发病率病例的研究最能评估病因因素的作用，而现患病例的研究最适合评估社区中的疾病负担。了解这些疾病的自然史对于确定未来治疗干预措施的疗效很重要。这些疾病占胃肠病医生临床诊疗量的50%，这一事实凸显了这些疾病的重要性以及胃肠动力障碍在临床实践中的潜在作用。
