IMPACT OF FUNCTIONAL BOWEL DISEASE IN THE ELDERLY

功能性肠病对老年人的影响

• 批准号: 3121297
• 负责人: NICHOLAS J TALLEY
• 金额: $ 24.46万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 1991
• 资助国家: 美国
• 起止时间: 1991-09-30 至 1995-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3121297
• 关键词: behavioral medicine; chronic disease /disorder; constipation; coping; diarrhea; dietary fiber; drug adverse effect; fecal incontinence; gastrointestinal disorder; gastrointestinal disorder diagnosis; gastrointestinal function; gastrointestinal imaging /visualization; gastrointestinal sign /symptom; human morbidity; human old age (65+); human subject; human very old age (85+); interview; medical records; noninvasive diagnosis; nutrition; nutrition related tag; pathologic process; quality of life; questionnaires; social psychology; social support network

Most of the data on diseases of the bowel concern younger individuals, and there is a paucity of information on the effects of aging on gastrointestinal symptoms and pathophysiology. Moreover, the effect of colonic disorders on functional status and well being is largely unexplored. Chronic idiopathic constipation and chronic abdominal pain associated with an abnormal bowel habit in the absence of organic disease (irritable bowel syndrome [IBS]) are common and important functional bowel diseases in the community. The pathogenesis of these disorders is unknown, although they may be accompanied by demonstrable pathophysiological abnormalities. The overall goals of this proposal are to determine the prevalence of chronic gastrointestinal symptoms (including constipation, diarrhea, and fecal incontinence) and functional bowel disease in the elderly, and to explore the pathogenesis and impact on quality of life of functional bowel disease. Specifically, we aim to assess the prevalence of individual gastrointestinal symptoms, as well as particular functional syndromes in a community, using a validated questionnaire. This phase will also address whether psychosocial factors influence which elderly persons with symptoms present to physicians (and which do not), and whether certain health habits (smoking, alcohol, analgesics) or medications (including laxatives or enemas) play a role. Based on this information, we will then identify subpopulations with well-characterized symptom clusters (chronic painless constipation, constipation-predominant IBS, diarrhea-predominant IBS). In these subgroups, we will test the hypotheses that the following, alone or in combination, are of relevance to pathogenesis: a) dietary factors (including fiber) and overall nutrition and b) colonic dysfunction as reflected by altered transit of orally nutrition and b) colonic dysfunction as reflected by altered transit of orally ingested markers and, in a random sample of those with chronic constipation and prolonged colonic transit, a new scintigraphic assessment. We will also test the hypothesis that psychological distress (including depression), lack of social support and poor coping strategies impact negatively on symptom severity and functional status. These approaches will be facilitated by interaction between Mayo's Rochester Epidemiology Project and the physiological expertise of the Gastroenterology Research Unit. This proposal should help elucidate the genesis and impact of these important, highly morbid conditions in the elderly.

大多数关于肠病的数据涉及年轻人，以及 关于衰老的影响的信息很少 胃肠道症状和病理生理学。 而且， 关于功能状态和福祉的结肠疾病在很大程度上是 未探索。 慢性特发性便秘和慢性腹痛 在没有有机疾病的情况下，与异常的肠习惯有关 （肠易激综合征[IBS]）是常见且重要的功能性肠 社区中的疾病。 这些疾病的发病机理尚不清楚， 尽管它们可能伴有可证明的病理生理学 异常。 该提案的总体目标是确定 慢性胃肠道症状的患病率（包括便秘， 腹泻，粪便尿失禁）和功能性肠病 老年人，并探索对生命质量的发病机理和影响 功能性肠病。 具体来说，我们旨在评估 单个胃肠道症状，以及特定功能 使用经过验证的调查表中的社区综合征。 这个阶段将 还解决了社会心理因素是否影响老年人 与医生出现的症状（并且没有），以及是否确定 健康习惯（吸烟，酒精，镇痛药）或药物（包括 泻药或灌肠）发挥作用。 基于此信息，我们将 识别具有良好特征症状簇的亚群（慢性 无痛的便秘，便秘的IBS，腹泻促进 肠易激综合症）。 在这些亚组中，我们将测试以下的假设， 单独或组合，与发病机理相关：a）饮食 因素（包括纤维）和整体营养和b）结肠功能障碍 正如口服营养和b）结肠反映的 功能障碍反映由口服摄入标记的转运变化以及， 在慢性便秘和长时间结肠的随机样本中 过境，一种新的闪烁图评估。 我们还将检验假设 心理困扰（包括抑郁症），缺乏社会支持 不良的应对策略对症状严重程度和 功能状态。 这些方法将通过互动来促进 在梅奥的罗切斯特流行病学项目与生理学之间 胃肠病研究部门的专业知识。 该建议应该有帮助 阐明这些重要，高病的起源和影响 老年人的条件。