肠易激综合征匹兹堡大学ppt课件.pptVIP

Sept 2001 Bruce Davies * 生活家饮食保健孕期选择食用油的学问邢台市第四病院罕见护理应急预案猪气喘病综合防制技术动物营养系列理想蛋白与氨基酸模式的研究进展皮肤病的诊断包括病史体格检查和必要的实验室检查我国有关食物添加剂营养强化剂食物新资本的治理律例与标准 * Irritable Bowel Syndrome Dr Bruce Davies www.bradfordvts.co.uk Introduction First described in 1771. 50% of patients present 35 years old. 70% of sufferers are symptom free after 5 years. GPs will diagnose one new case per week. GPs will see 4-5 patients a week with IBS. Point prevalence of 40-50 patients per 2000 patients. Sept 2001 * Bruce Davies What Is IBS? A syndrome. One man’s constipation is another man’s normality. Cause unknown. 20% seem to start after an episode of gastroenteritis. Sept 2001 * Bruce Davies Diagnostic Criteria Rome 11 Diagnostic criteria. Manning’s Criteria. Sept 2001 * Bruce Davies Rome 11 Diagnostic Criteria. At least 12 weeks history, which need not be consecutive in the last 12 months of abdominal discomfort or pain that has 2 or more of the following: Relieved by defecation. Onset associated with change in stool frequency. Onset associated with change in form of the stool. Sept 2001 * Bruce Davies Rome 11 Diagnostic Criteria. Supportive symptoms. Constipation predominant: one or more of: BO less than 3 times a week. Hard or lumpy stools. Straining during a bowel movement. Diarrhoea predominant: one or more of: More than 3 bowel movements per day. Loose [mushy] or watery stools. Urgency. Sept 2001 * Bruce Davies Rome 11 Diagnostic Criteria. General: Feeling of incomplete evacuation. Passing mucus per rectum. Abdominal fullness, bloating or swelling. Sept 2001 * Bruce Davies Manning’s Criteria. Three or more features should have been present for at least 6 months: Pain relieved by defecation. Pain onset associated with more frequent stools. Looser stools with pain onset. Abdominal distension. Mucus in the stool. A feeling of incomplete evacuation after defecation. Sept 2001 * Bruce Davies Associated Symptoms In people with IBS in hospital OPD. 25% have depression. 25% have anxiety. Patient