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著者: Singh P, Lee HN, Rangan V, Ballou S, Lembo J, Katon J, McMahon C, Friedlander D, Iturrino J, Nee J, Lembo A.
雑誌名: Clin Gastroenterol Hepatol. 2020 Feb;18(2):399-405.e1. doi: 10.1016/j.cgh.2019.08.020. Epub 2019 Aug 20.
Abstract/Text
BACKGROUND & AIMS: There have been few published studies of clinical and psychological characteristics of patients with functional diarrhea (FDr). We studied the clinical and psychological characteristics of patients with FDr presenting to a tertiary care clinic, and compared symptom profiles of FDr with those of IBS-diarrhea (IBS-D).
METHODS: Consecutive patients with a diagnosis of FDr (n = 48) or IBS-D (n = 49), per Rome IV criteria, completed a detailed symptom survey from October 2017 through July 2018. Abdominal pain and diarrhea severity were assessed using patient-reported outcomes measurement information system (PROMIS) questionnaires. Patients with anxiety, depression, or sleep disturbances were identified based on PROMIS T-score of 60 or more. Mean and proportions were compared using the Student t test and chi-square analyses, respectively.
RESULTS: A significantly lower proportion of patients with FDr reported abdominal pain (77.1%) than patients with IBS-D (100%, P < .001). The proportion of patients reporting abdominal bloating and level of severity did not differ significantly between groups. Proportions of bowel movements with diarrhea did not differ significantly between groups (P = .54), but the mean diarrhea PROMIS T-score was significantly higher among patients with IBS-D (P = .03). This difference resulted from the significantly higher levels of fecal urgency-related distress reported by patients with IBS-D (P = .007). Proportions of patients with anxiety, depression, or sleep disturbance, and their severities, did not differ significantly between groups.
CONCLUSIONS: In an analysis of about 100 patients with FDr or IBS-D, we found overlap in gastrointestinal and psychosomatic symptoms. These 2 entities appear to be a continuum.
Copyright © 2020 AGA Institute. Published by Elsevier Inc. All rights reserved.
PMID 31442602 Clin Gastroenterol Hepatol. 2020 Feb;18(2):399-405.e1. doi: 10.1016/j.cgh.2019.08.020. Epub 2019 Aug 20.
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