International Foundation for Functional Gastrointestinal Disorders
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Reviewed by Author, 2009
Gut Reactions – Topics in Functional Gastrointestinal Dia
Irritable Bowel Syndrome:
Does It Cau Other Dia?
By: W. Grant Thompson, M.D., F.R.C.P.C.,
Emeritus Professor of Medicine, University of Ottawa,
Ontario, Canada
IFFGD
700 W. Virginia St., #201
Milwaukee, WI 53204
Toll-free (in the U.S.): 888-964-2001
Fax: 414-964-7176
www.iffgd
例如英文Gut Reactions – Topics in Functional Gastrointestinal Dia
Irritable Bowel Syndrome: Does It Cau Other Dia? By: W. Grant Thompson, M.D., F.R.C.P.C., Emeritus Professor of Medicine, Ottawa University, Ontario, Canada
There are many discussions of the plausible caus of irritable bowel syndrome (IBS), but the question of whether IBS caus other dias receives less attention. It is a further paradox that we know little about the cau of IBS, yet can be confident that it caus no rious intestinal dia. The syndrome can be very troublesome and disruptive, but it is incorrect to blame it for structural gut dias. (Table 1).
Common Caus of Concern
Several obrvations might cau you to be concerned that IBS could expo you to the risk of other dias.
1. If you have IBS and develop another more rious disorder, it is natural for you to think that one may have caud the other. Such coincidences occur from time to time, but anecdotes count for little in medical science. IBS occurs in the lifetimes of at least a quarter of humanity, and tho experiencing the syndrome are not immune to other afflictions.
2. IBS symptoms draw attention to the intestines and it is natural to be concerned that other dias might ensue. While abdominal pain, diarrhea, or constipation do occur in many rious dis
eas, their pattern of interaction with each other and the abnce of more alarming symptoms are characteristic of IBS.
3. The medical literature and popular press sometimes report associations of IBS with other conditions. However, association does not imply causation. Several dias may occur in people with IBS, becau like IBS they are common in a particular society or population. Were the associations to be constant in all IBS populations, a common cau might be suspected, but that is not the ca. Moreover, many of the reported associations are subject to bias; that is, they ari in academic centers, ethnic groups, or geographic areas where certain dias may be especially common. Thus, IBS neither puts a person at risk for a rious gut dia, nor imparts immunity.
Other GI Dias Wrongly Blamed on IBS
Colon Cancer
While IBS is itlf distressful, many people consult doctors becau of fear that their symptoms might mean they have cancer. Sometimes doctors fail to recognize this fear so, if you have such concerns, it is wi to ask your doctor outright. Usually the doctor can promptly reassure you that your symptoms are not tho of malignant dia. Depending upon your age, family history, and sy
mptoms, your doctor can confirm that you are free of cancer with one or two tests. Moreover, your physician can assure you that there is no evidence that having IBS predispos you to future cancer. While both IBS and colon cancer are common in Western countries, the latter is rare in many Asian countries where IBS ems equally prevalent. Thus, the two dias are unrelated, and probably share no common cau.
Nevertheless, colon cancer is one of the most common cancers in Europe and America and a leading cau of death. The risk of acquiring it cannot be taken lightly whether you have IBS or not. If you have a first-degree relative with colon cancer you should discuss having a colonoscopy with your doctor. Many cancer and gastroenterology societies are now suggesting that entire Western populations should have a single colonoscopy (or other screening procedure) at about age 50 to discover and remove any colon polyps. Since a few polyps become cancer, and almost all colon cancers begin with polyps, such screening would greatly reduce the incidence of colon cancer and save many lives. In future, techniques
such as genetic testing or virtual colonoscopy (an advanced imaging technique) may make such screening less invasive and more practical.
The risk of cancer is slight in the twenties and thirties when IBS usually begins, but doctors are alert to warning signs such as rectal bleeding or an abdominal mass, which are not symptoms of IBS. Nevertheless, most rectal bleeding is not due to cancer, and in a young person an abdominal mass is more likely to be due to a non-malignant process such as inflammatory bowel dia. Prompt investigation will reveal the truth.
Diverticular Dia
迅雷下载限速Over half the elderly populations of Western countries have small pockets in their colons known as diverticula. (See Diverticula, diverticulosis, diverticulitis: what’s the difference. IFFGD Fact Sheet No. 169.) However, the cau no symptoms and most people who have diverticula are unaware of them. In a very few cas, the pockets may bleed, or become infected (diverticulitis) resulting in a rious illness. However, for most people they are inconquential. While IBS is a worldwide phenomenon, diverticular dia is uncommon in Asian and African people, perhaps becau their relatively high-fiber diet protects them.
Many years ago, my colleagues and I interviewed 97 patients about to have a barium enema (x-ray examination of the colon). About one-third had diverticular dia on the x-ray, yet the symptoms of
IBS were equally prent in tho with and without the diverticula. The and other data suggest no relationship between IBS and diverticular dia.
Thus, IBS symptoms are not caud by diverticula, and do not predispo one to diverticula or diverticulitis. When the two common dias occur in the same person, it is a coincidence.
吉林省特产
Inflammatory Bowel Dia (IBD)
There are reports of IBD (ulcerative colitis or Crohn’s dia) being “finally diagnod” after years of suffering from symptoms that were blamed on IBS. While IBD with abdominal pain and diarrhea may not always be immediately recognized, in such reports it is more likely that IBS was indeed prent and that IBD intervened later. IBS is much more common than IBD, and it is not uncommon for IBD patients to also have symptoms caud by IBS before, during, and after episodes of their colitis or Crohn’s dia.
Indeed, in managing IBD it is sometimes difficult to distinguish symptoms of inflammation that require drugs with important side effects, from IBS symptoms that do not require them. Nevertheless, like cancer and diverticular dia, there is no evidence that IBS predispos you to IBD. While IBS is common in all populations, IBD is most common in persons of Jewish and Norther
n European descent, and relatively uncommon in persons of African and Asian descent. [See Jaffin, BW. Clinical Features and Treatments of Inflammatory Bowel Dia (IBD) - An Update. IFFGD. Fact Sheet No. 126.]静态ip设置
独开头的成语Celiac Dia
Doctors in the north of England and Ireland report that many patients with a diagnosis of IBS have celiac dia, a chronic small intestinal malabsorption state due to nsitivity to wheat protein. The reports are from areas where the prevalence of celiac dia is relatively high. While the data have less relevance elwhere, they do underline your doctor’s need to consider a person’s ethnicity, and other personal characteristics when making a diagnosis. As in the above dias, the association with IBS is likely coincidental, even in England and Ireland. Nevertheless, it would be foolish not to consider riously a dia that is common in a community or ethnic group. As with IBD, IBS symptoms may accompany celiac dia, but no evidence supports the notion that IBS makes one prone to acquire it.
Other Functional Gastrointestinal Disorders
There are epidemiological and clinical reports of people who have IBS and another functional gut dis
order such as dyspepsia or functional heartburn. The are very common conditions so they may occur in the same person. However, functional disorders are different from the structural (pathological) dias discusd above in that they can only be described by their symptoms. Symptoms lack the precision of pathology (examination of tissue, x-ray, or blood test),
吕布之死and it may be that symptom-defined functional gut disorders are indistinct from one another. The symptoms are changeable, and IBS patients can expect to experience different gut symptoms from time to time. We do not know if having IBS makes one more prone to develop other functional gut disorders. Other Intestinal Dias
In developing countries, IBS can be difficult to identify among the many tropical gut infections that are endemic there. Where celiac dia is found in some regions in the developed world, tropical sprue (a chronic infectious dia resulting in malabsorption) occurs in some emerging communities. There is no reason to believe that IBS makes a person more (or less) likely to acquire the infections.
Dias Outside the Gut
Reports frequently link IBS with non-gastrointestinal disorders such as headache, fibromyalgia, or ch
ronic fatigue. Most of the data come from hospital clinics, so it is uncertain if the associations are true for all people with IBS. There may be a tendency of patients with veral of the conditions to ek the care of veral specialists. Some experts even take the view that the conditions and IBS are part of a generalized disorder that transcends organ boundaries. We certainly need to understand their relationships better. Nevertheless, most IBS patients do not have the conditions, and are probably at no greater risk of them than tho without IBS. Psychological Disorders
Depression, anxiety, panic attacks, and other psychological difficulties may accompany IBS and em to emerge when the disorder is more vere and impairing of quality of life. However, the are a part of having any type of chronic medical disorder. While the are major sources of distress for many patients, there is no proof that they are necessarily a conquence of having IBS, or indeed that they are more likely if you have IBS. Nonetheless, particularly when more vere, adequate treatment of the symptoms and related distress is likely to improve on e’s well being and quality of life.Conclusion
When diagnosing IBS, your doctor must consider other gut dias. Other disorders may coexist with IBS. However, if you have IBS, you should feel cure that you are no more prone to other gut disorders than if you did not have the syndrome. The fact that IBS is a condition that does not shorte
苹果汁减肥n life or require surgery is an important perspective. It is also understandable that any chronic disorder when vere can be associated with some psychological distress and impaired quality of life. Proper medical care, personal attention to one’s overall health, and the eking of proper treatments when needed are important to achieve a successful clinical outcome.
Further Reading
1. Thompson WG, Patel DG, Tao H, Nair RC. Does uncomplicated diverticular dia produce symptoms? Dig Dis Sci 1982; 27:605-608.
2. Thompson WG, Heaton KW. Irritable Bowel Syndrome. Second ed. Abbington, Oxford: Health Press, 200
3.
3. Sanders D, Carter MJ, Hurlstone DP, Pearce A, Ward AM, McAlindon ME, et al. Association of adult coeliac dia with irritable bowel syndrome: a ca-controlled study in patients fulfilling Rome II criteria referred to condary care. Lancet 2001; 358:1504-1508.
降央卓玛歌曲大全4. Thompson WG. Irritable bowel syndrome and celiac dia. Lancet 2002; 359 (Letter):1346-134
7.
Opinions expresd are an author’s own and not necessarily tho of the International Foundation for Functional Gastrointestinal Disorders (IFFGD). IFFGD does not guarantee or endor any product in this publication nor any claim made by an author and disclaims all liability relating thereto.
This article is in no way intended to replace the knowledge or diagnosis of your doctor. We advi eing a physician whenever a health problem aris requiring an expert's care.
IFFGD is a nonprofit education and rearch organization. Our mission is to inform, assist, and support people affected by gastrointestinal disorders. For more information, or permission to reprint this article, write to IFFGD, 700 W. Virginia St., #201, Milwaukee, WI 53204. Call toll-free (In the U.S.): 888-964-2001 or 414-964-1799. Visit our websites at: www.iffgd or
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