复旦大学：《内科学 Internal Medicine MBBS》课程教学资源（课件讲稿）消化系统_Irritable boewl symdrone

Irritable Bowel syndrome

Irritable Bowel Syndrome

Functional gastrointestinal disorders Definition A variable combination of chronic or recurrent gastrointestinal symptoms attributed to the pharynx, esophagus, stomach, biliary tree, small or large intestine or anorectum) s not explained by structural or biochemical abnormalities Rome criteria, 1990

Functional gastrointestinal disorders Definition  A variable combination of chronic or recurrent gastrointestinal symptoms  (attributed to the pharynx, esophagus, stomach, biliary tree, small or large intestine, or anorectum)  not explained by structural or biochemical abnormalities. Rome criteria, 1990

FGIDs including Digestie System The Functional Gl Disorders Include: Irritable Bowel Esophageal Syndrome (Ibs Disorders and GERD Esophagus Gastroduodenal Constipation Disorders Stomach Liver Pancreas Gabhddet transverse Diarrhea Colen Duodenum Descend Abdominal coon Pelvic Bloating Ascending or pain malrtestne Floor pain Cecum sigmoid Coin Rectum Biliary penair Incontinence Disorders

FGIDs including

The rome lll criteria divided functional Gastrointestinal Disorders(FGIDs) into 8 dignostic classification adult (6 classification) children and adolescents(2 classification)

 The Rome III criteria divided Functional Gastrointestinal Disorders (FGIDs) into 8 dignostic classification adult (6 classification) children and adolescents(2 classification)

Rome Functional gastrointestinal Disorders (adult A Functional esophageal disorders C4. Functional diarrhea A1. Functional heartburn C5. Unspecified functional bowel disorder A2, Functional chest pain of presumed esophageal D Functional abdominal pain syndrome A3. Functional dysphagia E Functional gallbladder and Sphincter of A4. Globo Oddi (so) disorders E1. Functional gallbladder disorder B Functional gastroduodenal disorders E2. Functional biliary So disorder B1. Functional dyspepsia E3. Functional pancreatic So disorder Bla Postprandial distress syndrome B1b Epigastric pain syndrome F Functional anorectal disorders B2 Belching disorders F1. Functional fecal incontinence B2a. Aerophagia F2. Functional anorectal pain B2b Unspecified excessive belchin F3. Functional defecation disorders B3. Nausea and vomiting disorders B3a. Chronic idiopathic nausea B3b Functional vomiting B3c Cyclic vomiting syndrome 34, Rumination syndrome in adults C. Functional bowel disorders C1 Irritable bowel syndrome C2. Functional bloating unctional constipation

Rome III Functional Gastrointestinal Disorders （adult ） A. Functional esophageal disorders A1. Functional heartburn A2. Functional chest pain of presumed esophageal origin A3. Functional dysphagia A4. Globus B. Functional gastroduodenal disorders B1. Functional dyspepsia B1a. Postprandial distress syndrome B1b. Epigastric pain syndrome B2. Belching disorders B2a. Aerophagia B2b. Unspecified excessive belching B3. Nausea and vomiting disorders B3a. Chronic idiopathic nausea B3b. Functional vomiting B3c. Cyclic vomiting syndrome B4. Rumination syndrome in adults C. Functional bowel disorders C1. Irritable bowel syndrome C2. Functional bloating C3. Functional constipation C4. Functional diarrhea C5. Unspecified functional bowel disorder D. Functional abdominal pain syndrome E. Functional gallbladder and Sphincter of Oddi (SO) disorders E1. Functional gallbladder disorder E2. Functional biliary SO disorder E3. Functional pancreatic SO disorder F. Functional anorectal disorders F1. Functional fecal incontinence F2. Functional anorectal pain F3. Functional defecation disorders

Rome Functional gastrointestinal Disorders children and adolescents G Functional disorders: neonates and H. Functional disorders: toddlers G1. Infant regurgitation children and adolescents Hl. G2, Infant rumination syndrome G3, Cyclic vomiting syndrome Vomiting and aerophagia G4 Infant colic H1a Adolescent rumination G5. Functional diarrhea syndrome G6, Infant dyschezia H1b. Cyclic vomiting syndrome G7. Functional constipation H1C. Aerophagia H2. Abdominal pain-related functional gastrointestinal dIsorders H2a. Functional dyspepsia H2b Irritable bowel syndrome H2c. Abdominal migraine(偏头痛) H2d. Childhood functional abdominal pain H2d1 childhood functional abdominal pain syndrome H3, Constipation and incontinence

Rome III Functional Gastrointestinal Disorders （children and adolescents） G. Functional disorders: neonates and toddlers  G1. Infant regurgitation  G2. Infant rumination syndrome  G3. Cyclic vomiting syndrome  G4. Infant colic  G5. Functional diarrhea  G6. Infant dyschezia  G7. Functional constipation H. Functional disorders: children and adolescents H1. Vomiting and aerophagia  H1a. Adolescent rumination syndrome  H1b. Cyclic vomiting syndrome  H1c. Aerophagia H2. Abdominal pain-related functional gastrointestinal disorders  H2a. Functional dyspepsia  H2b. Irritable bowel syndrome  H2c. Abdominal migraine(偏头痛)  H2d. Childhood functional abdominal pain  H2d1. Childhood functional abdominal pain syndrome H3. Constipation and incontinence

Irritable Bowel Syndrome Definition A functional gi disorder characterized abdominal pain and/or discomfort associated with altered bowel habits or @ OriginalArtist disturbed defecation Reproduction rights obtainable from www.cartoonStock.com relieve after defecation Not explained by structural or known biochemical abnormalities No doubt about it. Mr Mcridew-you've got Imitable Bowel Syndrome

Irritable Bowel Syndrome  Definition  A functional GI disorder characterized - abdominal pain and/or discomfort - associated with altered bowel habits or disturbed defecation - relieve after defecation  Not explained by structural or known biochemical abnormalities …

IBS- Epidemiology 12-22% 15% 19% 8-12% Drossman DPS 1993: Sandler. GE 1984; Jones. MJ 1992, Thompson. DDS 2002

Drossman. DPS 1993；Sandler. GE 1984；Jones. MJ 1992；Thompson. DDS 2002 14% 19% 15% 16% 8-12% 9% 12-22% IBS - Epidemiology

IBS- Epidemiology U. S Prevalence 18 16 14 12 10 % 口 female 86420 15-30 31-44 45-60 >60 age In years

U.S. Prevalence 0 2 4 6 8 1 0 1 2 1 4 1 6 1 8 15-30 31-44 45-60 >60 age in years % male female IBS - Epidemiology

IBS- Epidemiology Doctor Visits by Gender USA AFRICA INDIA

IBS - Epidemiology Doctor Visits by Gender