健康相关性事件: 主观回忆与病历记录的比较 1月内 71 2-3月 69% 4-8月 39 9-12月26% 对3月内发生的事件回忆的准确性是可接受的 Means, et al. 1989
健康相关性事件： 主观回忆与病历记录的比较 ⚫ 1月内 71% ⚫ 2-3月 69% ⚫ 4-8月 39% ⚫ 9-12月 26% 对3月内发生的事件回忆的准确性是可接受的 Means, et al. 1989
罗马Ⅲ标准* 反复发作的腹痛或腹部不适*,最近3个月内每月发 作至少3日,伴有以下2项或2项以上: 1.排便后症状改善 2.发作时伴有排便频率的改变 3发作时伴有粪便性状(外观)改变 诊断前症状出现至少6个月,近3个月符合以上诊断标准; *腹部不适是指难以用疼痛来形容的感觉
罗马 III 标准* 反复发作的腹痛或腹部不适**，最近3个月内每月发 作至少3日，伴有以下2项或2项以上： 1.排便后症状改善 2.发作时伴有排便频率的改变 3.发作时伴有粪便性状（外观）改变 *诊断前症状出现至少6个月，近3个月符合以上诊断标准； ** 腹部不适是指难以用疼痛来形容的感觉
Clinical Features of Ibs Dominant symptoms abdominal pain or discomfort altered bowel habit Other gI symptoms ■Non- GI symptoms Triggers ■ Psychosocial issues
Clinical Features of IBS ◼ Dominant symptoms: - abdominal pain or discomfort - altered bowel habit ◼ Other GI symptoms ◼ Non-GI symptoms ◼ Triggers ◼ Psychosocial issues
Pain(OPORST Onset of disease 口 Position O Qual 0 Relationship to anything or other bodily function/position Radiation where moved to Relieving or aggravating factors -any activities or position O Severity- how it affects daily work/physical activities. Wakes him up at night, cannot sleep/do any work Imir ng reatment received or/and outcome re there any associated symptoms
Pain (OPQRST) Position Severity – how it affects daily work/physical activities. Wakes him up at night, cannot sleep/do any work. Relationship to anything or other bodily function/position. Radiation: where moved to Relieving or aggravating factors – any activities or position Quality Timing Treatment received or/and outcome. Onset of disease Are there any associated symptoms?
Abdominal pain in ibs Position Anywhere, usually lower abdomen ■ Anal rectal pain Quality Colicky, gripes,twinges Timing a Anytime, usually during day a may be exacerbated by meals
Abdominal Pain in IBS Position ◼ Anywhere, usually lower abdomen ◼ Anal rectal pain Quality ◼ Colicky, ‘gripes’ , ‘twinges’ Timing ◼ Anytime, usually during day ◼ May be exacerbated by meals