浙江大学医学院：肠易激综合征（PPT讲稿）Irritable Bowel Syndrome（IBS）

肠易激综合征 Irritable Bowel Syndrome(IBs) 王良静 浙江大学医学院附属第二医院消化科 2014-11-28

肠易激综合征 Irritable Bowel Syndrome (IBS) 王良静 浙江大学医学院附属第二医院消化科 2014-11-28

An Ibs sufferer Everywhere i went I had to know where the bathroom was-how far i was from the bathroom a Sarah 19 girl remembered her first date. She was nervous and ended up moving her bowels, which help her relieve her cramping abdominal pain. Even more embarrassingly, she would stain her underpants with a small amount of brown liquids stool. When she drank alcohol. this sometimes made her whole problem worse

An IBS sufferer ◼ Everywhere I went I had to know where the bathroom was-how far I was from the bathroom ◼ Sarah 19 girl remembered her first date. She was nervous and ended up moving her bowels, which help her relieve her cramping abdominal pain. Even more embarrassingly, she would stain her underpants with a small amount of brown liquids stool. When she drank alcohol, this sometimes made her whole problem worse

Do you have? 3 months history of abdominal pain or discomfort 3 days per month)? and it was Improved with defecation; and/or There was a change in frequency of stool There was a change in form of stool

Do you have? ◼ 3 months history of abdominal pain or discomfort (3 days per month)? and it was ◼ Improved with defecation; and/or ◼ There was a change in frequency of stool; and/or ◼ There was a change in form of stool

What is IBs IBS is a condition characterized abdominal pain, bloating or other discomfort occurring in association with disturbed bowel pattern in the absence of organic causes that can be detected by routing tests

What is IBS ◼ IBS is a condition characterized by abdominal pain, bloating or other discomfort occurring in association with disturbed bowel pattern in the absence of organic causes that can be detected by routing tests

Introduction First described in 1771 50%o of patients present <35 years old a 70% of sufferers are symptom free after 5 vears a Very common problem during gastroenterology p ractice

Introduction ◼ First described in 1771. ◼ 50% of patients present <35 years old. ◼ 70% of sufferers are symptom free after 5 years. ◼ Very common problem during gastroenterology practice

epidemiology Prevalence of ibs in some countries Country Diagnostic criteria Age(yr) Sampling Number prevalence (% Male Fe male Total China 18~70 Random 2486 0.8 48.8(Average age) 231 25.0 ≥16 Random 271 3.2 Random 20.6 India M anning 37. 2( Average age) 2549 7.9 6.9 Adult 3.4 Thailand M Adult Random 4.4 Denmark Europe M anning 30~60 4851 7.5 Sweden 18~79 7.4 13.3 12.5 9~11 449 19.6 Dutch 48. 0(Average age) 9.0 M anning 20~69 22.9 16.8 1200 20~79 Random 13.6 Africa gera Medical students Australia Oceania New Zealand M Random Born from April 1972 1037 12,7 me lI America USa 643 20.4 9.0

Prevalence of IBS in some countries Epidemiology Country Diagnostic criteria Age (yr) Sampling Number prevalence Male Female Total Random Random Random Random Random Random Random Random Non-Random Random Random Random Asia Europe Africa Oceania America China Japan Singapore Bengal India Iran Thailand Denmark Sweden Russia Dutch England France Spain Italy Nigeria Australia New Zealand USA Brazil (Average age) Average age) Adult Adult (Average age) Adult Adult Medical students Adult Born from April 1972 to May 1973 Adult

临床表现特点 腹痛、腹部不适是最核心的症状 与排便相关是最突出的特点 排便后减轻 正重程度? 部位? Hahn BAet al. Aliment pharmacol Ther. 1997 11: 553 潘国宗,等中华内科杂志,199938:81

临床表现特点 ⚫ 腹痛、腹部不适是最核心的症状 ⚫ 与排便相关是最突出的特点 －排便后减轻 －严重程度？ －部位？ Hahn BA,et al. Aliment Pharmacol Ther, 1997 11:553. 潘国宗,等.中华内科杂志, 1999 38: 81

排便习惯改变 排便次数增加 排便次数减少 ●粪便性状改变 变干 变稀 *与无腹痛、腹部不适时比较

⚫ 排便习惯改变 －排便次数增加 －排便次数减少 ⚫ 粪便性状改变 －变干 －变稀 *与无腹痛、腹部不适时比较

BS诊断标准的进展 19781984199219992006 anning UIS 标准 标准 标准 标准 标准

IBS诊断标准的进展 Manning 标准 Kruis 标准 罗马I 标准 罗马Ⅱ 标准 罗马Ⅲ 标准 1978 1984 1992 1999 2006

Initial assessment a Consider assessment for Ibs if any of these symptoms have been present for at least 3 month A bdominal pain or discomfort Bloating hange in bowel habit

◼ Consider assessment for IBS if any of these symptoms have been present for at least 3 months Initial assessment • Abdominal pain or discomfort • Bloating • Change in bowel habit