Functional dyspepsia： Are psychosocial factors of relevance？

The pathogenesis of Functional Dyspepsia (FD) remains unclear, appears diverse and is thus inadequately understood. Akin to other functional gastrointestinal disorders, research has demonstrated an association between this common diagnosis and psychosocial factors and psychiatric morbidity. Conceptualising the relevance of these factors within the syndrome of FD requires application of the biopsychosocial model of disease. Using this paradigm, dysregulation of the reciprocal communication between the brain and the gut is central to symptom generation, interpretation and exacerbation. Appreciation and understanding of the neurobiological correlates of various psychological states is also relevant. The view that psychosocial factors exert their influence in FD predominantly through motivation of health care seeking also persists. This appears too one-dimensional an assertion in light of the evidence available supporting a more intrinsic aetiological link. Evolving understanding of pathogenic mechanisms and the heterogeneous nature of the syndrome will facilitate effective management. Co-morbid psychiatric illness warrants treatment with conventional therapies. Acknowledging the relevance of psychosocial variables in FD, the degree of which is subject to variation, has implications for assessment and management. Available evidence suggests psychological therapies may benefit FD patients particularly those with chronic symptoms. The rationale for use of psychotropic medications in FD is apparent but the evidence base to support the use of antidepressant pharmacotherapy is to date limited.     

Giardia lamblia infection in patients with irritable bowel syndrome and dyspepsia： A prospective study

AIM:To evaluate the prevalence of Giardia lamblia(G.lamblia)infection in patients with irritable bowel syndrome(IBS)and dyspepsia and to establish which is the mostaccurate test to diagnose the infection in this setting.METHODS:One hundred and thirty-seven patients whoconsecutively attended the Outpatient GastroenterologyClinic for the first time between January 2002 and De-cember 2003 due to symptoms of IBS and/or dyspepsiawere recruited.All patients underwent clinical evaluation,first-step haematology and chemistry tests,serologic as-says for celiac disease,lactose-H2 breath test,abdominalultrasonography,and esophagogastroduodenoscopy.Helicobacter pylori status was evaluated.In patients withsymptoms of IBS older than 45 years,colonoscopy wasalso performed.In all patients,duodenal biopsies andstool samples were examined for trophozoites and cystsof G.lamblia by several methods.RESULTS:G.lamblia was identified in 9 patients.Thefollowing diagnoses were also made:IBS(100/137,73%),functional dyspepsia(62/137,45%),organicdyspepsia(33/137,24%),and lactose intolerance(75/137,55%).A significant association was foundbetween giardiasis and H pylori infection(X~2=6.632,OR=12.4,CI=1.5-68.1).There were no symptomsthat reliably allowed the recognition of giardiasis.Direct search of the parasite in duodenal biopsy andstool sample examinations gave concordant results inall cases while histological examination of duodenal biopsies displayed a low sensitivity(e.g.,22.2%).CONCLUSION:In this consecutive series,diagnosisof G.lamblia infection accounted for 6.5% of patientswith IBS and dyspepsia.Duodenal biopsies for diag-nosis of giardiasis may be unnecessary if stool sampleexamination is performed.     

Irritable bowel syndrome and chronic pelvic pain： A singular or two different clinical syndrome？

Irritable bowel syndrome （IBS） and chronic pelvic pain （CPP） are both somatoform disorders with a high prevalence within the population in general. The objective was to compare both entities, to find the differences and the similarities related to epidemiology and psychosocial aspects like stressful life events, physical and sexual abuse, illness behaviour and comorbidity. The technical literature was reviewed systematically from 1971 to 2006 and compared. According to literature, IBS and CPP seem to be one rather than two different entities with the same Iocalisation of pain. Both syndromes also are similar concerning prevalence, the coexistence of mental and somatoform disorders, the common history of sexual and physical abuse in the past and their health care utilization. It could be shown that there were many similarities between IBS and CPP. Nevertheless both are traded as different clinical pictures as far. Therefore it seems to be reasonable and necessary to generate a common diagnosis algorithm and to bring gynaecologists and gastroenterologists into dialogue.     

Functional brain imaging in irritable bowel syndrome with rectal balloon－distention by using fMRI

AIM: Irritable bowel syndrome (IBS) is characterized by abdominal pain and changes in stool habits. Visceral hypersensitivity is a key factor in the pathophysiology of IBS. The aim of this study was to examine the effect of rectal balloon-distention stimulus by blood oxygenation level-dependent functional magnetic resonance imaging (BOLD-fMRI) in visceral pain center and to compare the distribution, extent, and intensity of activated areas between IBS patients and normal controls. METHODS: Twenty-six patients with IBS and eleven normal controls were tested for rectal sensation, and the subjective pain intensity at 90 ml and 120 ml rectal balloon-distention was reported by using Visual Analogue Scale. Then, BOLD-fMRI was performed at 30 ml, 60 ml, 90 ml, and 120 ml rectal balloon-distention in all subjects. RESULTS: Rectal distention stimulation increased the activity of anterior cingulate cortex (35/37), insular cortex (37/37), prefrontal cortex (37/37), and thalamus (35/37) in most cases. At 120 ml of rectal balloon-distention, the activation area and percentage change in MR signal intensity of the regions of interest (ROI) at IC, PFC, and THAL were significantly greater in patients with IBS than that in controls. Score of pain sensation at 90 ml and 120 ml rectal balloon-distention was significantly higher in patients with IBS than that in controls. CONCLUSION: Using fMRI, some patients with IBS can be detected having visceral hypersensitivity in response to painful rectal balloon-distention. fMRI is an objective brain imaging technique to measure the change in regional cerebral activation more precisely. In this study, IC and PFC of the IBS patients were the major loci of the CNS processing of visceral perception.     

Antibiotics,gut microbiota,and irritable bowel syndrome: What are the relations?

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder in which recurrent abdominal pain is associated with defecation or a change in bowel habits (constipation, diarrhea, or both), and it is often accompanied by symptoms of abdominal bloating and distension. IBS is an important health care issue because it negatively affects the quality of life of patients and places a considerable financial burden on health care systems. Despite extensive research, the etiology and underlying pathophysiology of IBS remain incompletely understood. Proposed mechanisms involved in its pathogenesis include increased intestinal permeability, changes in the immune system, visceral hypersensitivity, impaired gut motility, and emotional disorders. Recently, accumulating evidence has highlighted the important role of the gut microbiota in the development of IBS. Microbial dysbiosis within the gut is thought to contribute to all aspects of its multifactorial pathogenesis. The last few decades have also seen an increasing interest in the impact of antibiotics on the gut microbiota. Moreover, antibiotics have been suggested to play a role in the development of IBS. Extensive research has established that antibacterial therapy induces remarkable shifts in the bacterial community composition that are quite similar to those observed in IBS. This suggestion is further supported by data from cohort and case-control studies, indicating that antibiotic treatment is associated with an increased risk of IBS. This paper summarizes the main findings on this issue and contributes to a deeper understanding of the link between antibiotic use and the development of IBS.     

Systematic review of modulators of benzodiazepine receptors in irritable bowel syndrome： Is there hope？

Several drugs are used in the treatment of irritable bowel syndrome(IBS) but all have side effects and variable efficacy.Considering the role of the gut-brain axis,immune,neural,and endocrine pathways in the pathogenesis of IBS and possible beneficial effects of benzodiazepines(BZD) in this axis,the present systematic review focuses on the efficacy of BZD receptor modulators in human IBS.For the years 1966 to February 2011,all literature was searched for any articles on the use of BZD receptor modulators an...     

Ambulatory electrogastrography in patients with sclerodermia, delayed gastric emptying, dyspepsia, and irritable bowel syndrome. Is there any clinical relevance?

Background: Changes in electrogastrographic parameters are described in patients with irritable bowel syndrome, sclerodermia, dyspepsia, and delayed gastric emptying in static measurements. However, no information is available about changes in ambulatory measurements. The objective of this study was to find parameters that discriminate between these diseases using cutaneous 24-h-electrogastrography. Methods: Cutaneous 24-h electrogastrography (EGG) measurements were taken from 20 patients with dyspepsia, 10 patients with systemic sclerosis (sclerodermia, SSc), 7 patients with irritable bowel syndrome (IBS), 7 patients with delayed gastric emptying, and 10 healthy volunteers. Measurements were made using a DIGITRAPPER EGG (Synectics Medical Inc., Stockholm, Sweden) and the accompanying computerized data analysis package (ElectroGastroGram Version 6.30, Gastrosoft Inc., Synectics Medical Inc., Stockholm, Sweden). Frequency and power were compared pre- and postprandially, as well as during the entire day of measurement. Results: The 24-h measurements in healthy volunteers revealed 45.00%+/-12.12% normal values (2.4-3.7 cpm), 30.10%+/-7.15% bradygastric values (<2.4 cpm), and 24.20%+/-7.76% tachygastric values (>3.7 cpm). There was no significant change in frequency between rest and motion, but there was a significant increase in power (P<0.05). There was significantly more bradygastria in patients with dyspepsia periprandially as well as after 24 h (P<0.01) than in healthy volunteers. The mean power of patients with dyspepsia was significantly higher than that of patients with IBS (P<0.05). Conclusion: Cutaneous 24-h-EGG may be used as an additional means of differentiating between dyspepsia and IBS.     

Efficacy and safety of ecabet sodium on functional dyspepsia： A prospective, double-blinded, randomized, multi-center controlled trial

AIM: To compare ecabet sodium and cimetidine in relieving symptoms of functional dyspepsia. METHODS: We performed a multi-center, prospective, randomized, double-blinded controlled trial to compare the clinical efficacy of ecabet sodium and cimetidine in patients with functional dyspepsia. Two-hundred and seventy-two patients with dyspeptic symptoms fulfilling the Rome-II criteria were enrolled from 7 centers. In the study group (115 patients), 1.5 g ecabet sodium was given twice a day. In the control group (121 patients), 400 mg cimetidine was given twice a day. Symptoms and parameters of quality of life were analyzed at baseline, 3, 14, and 28 d after initiating the treatment. RESULTS: Two-hundred and thirty-six patients completed the clinical trial. After 4 wk of treatment, the rates of improvement in patients with dyspeptic symptoms were not different between two groups (77.4% in the ecabet group and 79.3% in the cimetidine group, respectively, P > 0.05). Likewise, the rates of symptomatic improvement were not different at 3 d and 14 d. The parameters of quality of life did not change significantly during the study period in both groups. There was no clinically significant adverse event in both groups. CONCLUSION: In patients with functional dyspepsia, ecabet sodium has similar clinical efficacy with cimetidine.     

Irritable bowel syndrome consulters in Zhejiang province： The symptoms pattern, predominant bowel habit subgroups and quality of life

AIM: To investigate the pattern of symptoms, predominant bowel habits and quality of life (QOL) by the Chinese version of the SF-36 in irritable bowel syndrome (IBS) consulters in Zhejiang province. METHODS: From January 2001 to January 2002, 662 Roma Ⅱ criteria-positive IBS patients were enrolled by gastroenterologists in 10 hospitals from Digestive Disease Center of Zhejiang (DDCZ). Patients were classified into constipation predominant IBS (IBS-C), diarrhea predominant IBS (IBS-D) and alternating constipation and diarrhea IBS (IBS-A) according to the predominant bowel habits. All patients were evaluated for the demographic checklists, IBS bowel symptoms, extra-colonic symptoms, and QOL by Chinese version of the SF-36 questionnaire. RESULTS: (1) Besides abdominal pain, the predominant colonic symptoms were in order of altered stool form, abnormalities of stool passage, abdominal distension and passage of mucus in IBS patients. Also, IBS subjects reported generalized body discomfort and psychosocial problems including dyspeptic symptoms, poor appetite, heartburn, headache, back pain, difficulty with urination, fatigue, anxiety and depression. (2) IBS-C and IBS-A are more common among female patients, whereas male patients experienced more cases of IBS-D. In regards to the IBS symptoms, there were significant differences among IBS subgroups. Abdominal pain (frequency ≥2 days per week and duration ≥1 hour per day) was frequent in IBS-A patients (P=0.010 and 0.027, respectively), IBS-D patients more frequently experienced the passage of mucus, dyspeptic symptoms and anxiety (P=0.000, 0.014 and 0.015, respectively). (3) IBS patients experienced significant impairment in QOL, decrements in QOL were most pronounced in vitality, general health, mental health, and bodily pain. Compared with the general population (adjusted for gender and age), IBS patients scored significantly lower on all SF-scales (P&lt;0.001), except for physical function scale (P=0.149). (4) QOL was impaired in all subgroups, particularly in scales of vitality, general health and mental health. Compared with IBS-D, QOL in IBS-C scored significantly lower on physical function, role physical, general health, role emotional, and mental health scales (P=-0.037, 0.040, 0.039, 0.005 and 0.026, respectively). CONCLUSION: Besides colonic symptoms, IBS could cause generalized body discomfort and psychosocial problems. The IBS subgroups based on predominant bowel habits are helpful to identify clinical distinction of the IBS. QOL is significantly impaired in IBS patients. The Chinese version of the SF-36 health survey scales may be a useful measurement of IBS patients.     

Safety of endoscopic retrograde cholangiopancreatography in pregnancy: Fluoroscopy time and fetal exposure,does it matter?

AIM: To estimate the fetal radiation exposure using thermoluminescent dosimeters (TLD’s) in pregnant patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) and assess its relevance. METHODS: Data on thirty-five therapeutic ERCPs conducted in pregnant patients from 2001 to 2009 were retrieved from a prospective database. Techniques to minimize fluoroscopy time were implemented and the fluoroscopy times captured. TLD’s were placed on the mother to estimate the fetal radiation exposure and the results were compared to the maximum allowed dose of radiation to the fetus [0.005 gray (Gy)]. Obstetrics consultations were obtained and the fetus was monitored before and after the ERCP. Fluoroscopy wasperformed at 75 kVp. ERCP was performed with the patients supine by dedicated biliary endoscopists performing more than 500 cases a year. RESULTS: A total of 35 pregnant patients underwent ERCP and biliary sphincterotomy (14 in first trimester, 11 in second trimester, and 10 in third trimester). Mean maternal age was 25 years (range 16-37 years) and mean gestational age was 18.9 wk (range 4-35 wk). Mean fluoroscopy time was 0.15 min (range 0-1 min). For 23 women, the estimated fetal radiation exposure was almost negligible (< 0.0001 Gy) while for 8 women, it was within the 0.0001-0.0002 Gy range. Three women had an estimated fetal radiation exposure between 0.0002 and 0.0005 Gy and 1 woman had an estimated fetal radiation exposure greater than 0.0005 Gy. Complications included 2 post-sphincterotomy bleeds, 2 post-ERCP pancreatitis, and 1 fatal acute respiratory distress syndrome. One patient developed cholecystitis 2 d after ERCP. CONCLUSION: ERCP with modified techniques is safe during pregnancy, and estimating the fetal radiation exposure from the fluoroscopy time or measuring it via TLD’s is unnecessary.     

肠易激综合征流行病学研究现状与进展

肠易激综合征(irritable bowel syndrome,IBS)是一种以慢性或者反复发作的腹痛伴排便习惯改变为特征的功能性肠病,并缺乏形态学和生化标志的异常。IBS是一种全球性疾病,人群患病率较高,其症状可反复发作,严重影响患者的生活质量,并占用了大量的医疗资源。IBS的病因和发病机制尚未明了,随着对IBS认识的不断深入和发展,国内外在不同时期,采用不同的标准和方法,对IBS的流行病学进行了较深入的研究,但不同国家和地区、不同人群的IBS患病率及其分布特征研究结果不尽相同,影响IBS的危险因素主要包括社会心理因素及遗传、感染、食物、药物因素等,现就近年来国内外IBS流行病学的研究情况作一综述。     

精神心理因素在肠易激综合征和功能性消化不良重叠症中的作用

目的探讨精神心理因素在肠易激综合征和功能性消化不良重叠症中的作用。方法对38例肠易激综合征（iBS）与功能性消化不良（FD）重叠症患者采用汉密尔顿焦虑量表（HAMA）14项和汉密尔顿抑郁量表（HAMD）17项版本进行心理测评,并将调查对象分为体力劳动组和非体力劳动组,比较分析各组评分的特点。结果女性FD与IBS重叠症患者焦虑抑郁障碍发病率较男性无显著性差异（68．2％vs75．0％,X2=0．21,P〉0．05）,非体力劳动者FD与IBS重叠症患者焦虑抑郁障碍发病率较体力劳动者显著升高（85．2％vs36．4％,X2=9．09,P〈0．005）。结论非体力劳动者FD与IBS重叠症患者合并精神心理压力可能通过增加内脏敏感性使FD与IBS重叠症发病率更高,提示心理治疗可能有助于治疗FD与IBS重瞢症。     

中国大城市肠易激综合征和功能性消化不良患者抑郁、焦虑现况研究

目的了解中国大城市消化内科肠易激综合征和功能性消化不良患者抑郁、焦虑症状患病率及既往诊治情况。方法采用现况研究方法，于2004年6月1日到9月1日在北京、广州和成都6家综合性医院的消化内科连续收集肠易激综合征303例和功能性消化不良患者305例。由经培训的调查员用统一的调查表进行面对面调查，同时使用综合医院焦虑抑郁量表（HAD）、Hamilton焦虑量袭和Hamilton抑郁量表进行心理测评。结果肠易激综合征和功能性消化不良的抑郁、焦虑症状患病率分别为24．8％和23．6％。在具有抑郁、焦虑症状的患者中，两类患者抑郁和（或）焦虑障碍的患病率分别为69．6％和68．7％；在具有抑郁、焦虑症状的非首诊患者中，两类患者既往抑郁障碍诊断史和抗抑郁治疗的比例均低于12％，而既往焦虑障碍诊断史和抗焦虑治疗的比例则更低于8％。肠易激综合征女性患者的抑郁症状患病率显著高于男性（17．0％比8．7％；χ^2=4．432，P=0．035），其抑郁障碍、焦虑障碍、抑郁合并焦虑障碍以及抑郁、焦虑障碍的患病率均高于男性（52．6％比25，0％，χ^2=4．612，P=0．032；79．5％比53．8％，χ^2=4．815，P=0．028；51．4％比21．7％，F=5．112，P=0．024；78．6％比55．6％，χ^2=4．112，P=0．043）。结论中日大城市综合医院肠易激综合征和功能性消化不良门诊患者具有较高的抑郁、焦虑症状和抑郁、焦虑障碍患病率，且既往诊治率较低，这一现状值得卫生管理部门和临床医务人员关注。     

Post-infectious irritable bowel syndrome

Post-infectious irritable bowel syndrome （PI-IBS） is a common disorder wherein symptoms of IBS begin after an episode of acute gastroenteritis. Published studies have reported incidence of PI-IBS to range between 5% and 32%. The mechanisms underlying the development of PI-IBS are not fully understood, but are believed to include persistent sub-clinical inflammation, changes in intestinal permeability and alteration of gut flora. Individual studies have suggested that risk factors for PI-IBS include patients＇ demographics, psychological disorders and the severity of enteric illness. However, PI-IBS remains a diagnosis of exclusion with no specific disease markers and, to date, no definitive therapy exists. The prognosis of PI- IBS appears favorable with spontaneous and gradual resolution of symptoms in most patients.     

青少年儿童肠易激综合征的流行病学调查

目的分析青少年儿童肠易激综合征(IBS)的患病率、分布特征(包括区域、学龄段、性别分布等)及其致病的相关危险因素。方法采用多级整群随机抽样方法,对黑龙江省与上海市共9所学校中5403名中小学生进行流行病学问卷调查,估算符合罗马Ⅱ诊断标准IBS的期间患病率,对其致病的相关危险因素进行单因素与多因素分析。结果推测被调查的两地中小学生符合罗马Ⅱ诊断标准的IBS患病率为13.25%,男女患病率差异无统计学意义(P>0.05)。区域性分层研究表明,患病率在黑龙江省(14.02%)和上海市(11.72%)之间差异有统计学意义(P<0.05)。学龄段分层研究表明,高中生患病率(17.80%)明显高于其他学龄段(P<0.01)。多因素回归分析表明,饮酒、吸烟、辛辣食物、痢疾史、腹部手术史、服用大量抗生素史、受凉、疲劳、心情焦虑、心情压抑及内向性格11个因素为最具可能性的危险因素,其OR值分别为1.25、1.44、1.13、1.37、1.63、1.93、2.83、1.10、1.07、1.13及1.05。结论IBS是青少年儿童人群的常见病和多发病。青少年儿童IBS患病率存在区域性与学龄段差异。心理因素、食物、不良外界环境因素及家庭环境因素等可能是诱发青少年儿童IBS致病的相关危险因素。     

Changing face of irritable bowel syndrome

Recent years have witnessed tremendous progress in ourunderstanding of irritable bowel syndrome (IBS).It isevident that this is a truly global disease associated withsignificant symptoms and impairments in personal andsocial functioning for afflicted individuals.Advances inour understanding of gut flora-mucosal interactions,theenteric nervous system and the brain-gut axis have ledto substantial progress in the pathogenesis of symptomsin IBS and have provided some hints towards the basicetiology of this disorder,in some subpopulations,at thevery least.We look forward to a time when therapy willbe addressed to pathophysiology and perhaps,evento primary etiology.In the meantime,a model basedon a primary role for intestinal inflammation serves tointegrate the various strands,which contribute to thepresentation of IBS     

褪黑激素与肠易激综合征

肠易激综合征是一种原因不明的慢性肠功能紊乱性疾病，其发病机制尚不清楚。其治疗方法也在不断改进中，褪黑激素对肠易激综合征的治疗有着积极的作用。     

Elevated pro-inflammatory and lipotoxic mucosal lipids characterise irritable bowel syndrome

AIM: To investigate the pathophysiology of irritable bowel syndrome (IBS) by comparing the global mucosal metabolic profiles of IBS patients with those of healthy controls. METHODS: Fifteen IBS patients fulfilling the Rome Ⅱ criteria, and nine healthy volunteers were included in the study. A combined lipidomics (UPLC/MS) and metabolomics (GC × GC-TOF) approach was used to achieve global metabolic profiles of mucosal biopsies from the ascending colon. RESULTS: Overall, lipid levels were elevated in patients with IBS. The most significant upregulation was seen for pro-inflammatory lysophosphatidylcholines. Other lipid groups that were significantly upregulated in IBS patients were lipotoxic ceramides, glycosphingolipids, and di- and triacylglycerols. Among the metabolites, the cyclic ester 2(3H)-furanone was almost 14-fold upregulated in IBS patients compared to healthy subjects (P = 0.03).CONCLUSION: IBS mucosa is characterised by a distinct pro-inflammatory and lipotoxic metabolic profile.Especially, there was an increase in several lipid species such as lysophospholipids and ceramides.     

伊托必利治疗功能性消化不良重叠便秘型肠易激综合征疗效观察

目的 观察伊托必利治疗功能性消化不良(FD)重叠便秘型肠易激综合征(C-IBS)患者的疗效.方法 将符合FD标准及重叠C-IBS患者分为FD治疗组(40例)、FD观察组(20例)、FD重叠C-IBS治疗组(40例)和FD重叠C-IBS观察组(20例),FD治疗组和FD重叠C-IBS治疗组均给予伊托必利100 rag/次,每日3次,疗程8周.观察并记录4组患者上腹饱胀、早饱、腹痛等症状及C-IBS患者便秘改善情况.FD治疗组和FD重叠C-IBS治疗组于治疗前及治疗后2周进行胃排空试验.结果 FD治疗组和FD重叠C-IBS治疗组患者腹痛、上腹饱胀、早饱等症状均有不同程度改善,其中FD重叠C-IBS治疗组改善程度更为明显,且排便情况亦有显著改善.B超监测胃排空显示,与观察组相比,FD治疗组和FD重叠C-IBS治疗组患者治疗后胃窦收缩幅度及胃排空时间均有显著改善(P<0.05).结论 伊托必利治疗FD有效,尤其是对FD重叠C-IBS治疗组的疗效优于FD治疗组.     

福建省青少年肠易激综合征的流行病学调查

目的分析城市中小学生肠易激综合征(IBS)的患病率、分布特征、致病的相关危险因素及焦虑性情绪障碍状况。方法采用多级整群随机抽样方法,对福建省两个地级市中4826名中小学生进行流行病学问卷调查。结果①校正后符合Manning及罗马Ⅱ诊断标准IBS的期间患病率分别是52．16％及17．10％,以高中生居多,男女患病率差异无统计学意义(P>0．05)。②Logistic回归分析揭示,年级、喜食辛辣或生冷食物、胃肠道感染、经常服用抗生素、遗传、经常因IBS症状而就诊、进食时吞咽困难、经常采用吞气来帮助终止打嗝、纳差、心情压抑11种因素为最具可能性的危险因素,其OR值均> 1。③4826名学生中有焦虑性情绪障碍倾向者占22．53％,男性17．84％,女性26．45％,两者差异有统计学意义(P<0．01)。④在儿童焦虑性情绪障碍筛查表(SCARED量表)5个领域的分值比较中,IBS学生高于非IBS学生,IBS就诊学生高于未就诊学生。结论①IBS是城市中小学生的常见病及多发病,患病率随年龄增长而上升;②不良饮食习惯、胃肠道感染、滥用抗生素、遗传及精神心理因素等可能是诱发城市中小学生IBS致病的相关危险因素;③焦虑性情绪障碍倾向发生率随年龄增长而上升。