Fass R, Fullerton S, Naliboff B, Hirsh T, Mayer E A
CURE Digestive Diseases Research Center, Department of Medicine UCLA, Los Angeles, Calif. 90073, USA.
Digestion. 1998;59(1):79-85. doi: 10.1159/000007471.
The prevalence and type of sexual dysfunction in patients with functional gastrointestinal (GI) disorders involving the upper (functional dyspepsia) or lower GI tract (irritable bowel syndrome) were studied in 683 patients seen at a tertiary referral center and a comparison group of 247 community volunteers. Associations between sexual dysfunction and type and severity of GI symptoms, and psychological symptoms were examined. All subjects were evaluated with a validated bowel syndrome questionnaire, which included questions about sexual function. Psychological symptom severity was assessed by SCL-90R. The prevalence of self-reported sexual dysfunction in patients with functional GI disorders was 43.3% and did not differ by gender, age stratification or disease subtype: irritable bowel syndrome (IBS); non-ulcer dyspepsia (NUD), and IBS + NUD. In the comparison subjects without IBS symptoms and those with IBS symptoms but not seeking health care (IBS non-patients), the reported sexual dysfunction prevalence was significantly lower (16.1 and 24.4%, respectively, p < 0.005). Decreased sexual drive was the symptom most commonly reported by both male (36.2%) and female (28.4%) patients. Dyspareunia was reported by 16.4% of females and 4% of males with IBS, but was rarely observed in patients with NUD. Report of sexual dysfunction was positively associated with perceived GI symptom severity, but not with psychological symptom severity. Sexual dysfunction should be incorporated into the quality-of-life assessment of patients with functional GI disorders and addressed in future outcome studies.
在一家三级转诊中心就诊的683例患者以及247名社区志愿者组成的对照组中,研究了涉及上消化道(功能性消化不良)或下消化道(肠易激综合征)的功能性胃肠(GI)疾病患者性功能障碍的患病率和类型。研究了性功能障碍与胃肠道症状的类型和严重程度以及心理症状之间的关联。所有受试者均通过一份经过验证的肠易激综合征问卷进行评估,该问卷包括有关性功能的问题。心理症状严重程度通过SCL-90R进行评估。功能性胃肠疾病患者自我报告的性功能障碍患病率为43.3%,在性别、年龄分层或疾病亚型(肠易激综合征(IBS)、非溃疡性消化不良(NUD)以及IBS + NUD)方面无差异。在没有IBS症状的对照受试者以及有IBS症状但未寻求医疗保健的受试者(IBS非患者)中,报告的性功能障碍患病率显著较低(分别为16.1%和24.4%,p < 0.005)。性欲减退是男性(36.2%)和女性(28.4%)患者最常报告的症状。16.4%的IBS女性患者和4%的IBS男性患者报告有性交困难,但在NUD患者中很少观察到。性功能障碍的报告与感知到的胃肠道症状严重程度呈正相关,但与心理症状严重程度无关。性功能障碍应纳入功能性胃肠疾病患者的生活质量评估中,并在未来的结局研究中加以解决。