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肠易激综合征中腹胀和腹部膨隆的发生情况：胃肠道通过时间的意义

Bloating and Distension in Irritable Bowel Syndrome: The Role of Gastrointestinal Transit

Agrawal A, Houghton LA, Reilly B 2010/4/21 16:31:23

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Am J Gastroenterol, 2009,

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Objectives:
Patients with irritable bowel syndrome and constipation (IBS-C) show more abdominal distension than do those with diarrhea. Because constipation is often associated with delayed gastrointestinal transit, this study aimed at establishing whether patients with delayed transit show more distension and bloating than do those with normal transit.

Methods:
Abdominal girth was recorded for 24h using abdominal inductance plethysmography (AIP) in 30 IBS-C (Rome II criteria) patients (aged 18–68 years; 27 women) and in 30 healthy volunteers (21–58 years of age; 26 women). Within 2 weeks of this recording, orocecal and colonic transits were assessed. Orocecal transit was determined from the increase in breath hydrogen after a standard meal, and colonic transit from the number of radio-opaque markers identified on a plain abdominal X-ray. Bloating severity was assessed hourly during AIP recording using a 0–5 scale.

Results:
IBS-C patients showed more bloating and distension than did healthy volunteers (P<0.001). They also had prolonged colonic (P<0.001) and orocecal (P=0.05) transits than did healthy volunteers, such that 47 and 17%, respectively, had colonic and orocecal transit times greater than the normal reference range. Those with delayed colonic (P=0.025) and orocecal (P=0.13) transits had greater distension but not bloating (P=0.63 and P=0.48, respectively) compared with those with normal transit. Moreover, distension directly correlated with orocecal (r=0.40; P=0.03) and colonic (r=0.51; P=0.004) transit times and inversely with stool consistency (r=−0.43; P=0.07).

Conclusions:
IBS-C patients with delayed transit show greater abdominal distension than do those with normal transit. Therefore, drugs that accelerate transit may be expected to alleviate this troublesome problem.

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疾病资源中心

高血压	慢性阻塞性肺病
脂肪性肝病	糖尿病
卒中	肺癌
冠心病	子宫内膜异位症
结直肠癌	乳腺癌
心力衰竭	心律失常

病例分析 [栏目介绍]

甲状腺功能亢进合并黄疸

王燕燕王曙

上海交通大学附属瑞金医院内分泌科

患者，女，69岁。2009年1月无明显诱因下出现乏力，当时程度较轻，未予以重视。2009年3月患者乏力症状加重，尿色逐渐加深，大便习惯改变，颜色变淡。4月18日入我院感染科治疗，诉轻度头晕、心慌，体重减轻10kg。无肝区疼痛，无发热，无腹痛、腹泻、腹胀、里急后重，无恶性、呕吐等。入院半月前于外院就诊，查肝功能：ALT 601IU/L，AST 785IU/L，TBIL 97.7umol/L，白蛋白 41g/L，甲状腺功能：游离T3 30.6pmol/L，游离T4 51.9pmol/L，心电图示快速房颤。

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