sechenovSechenov Medical JournalСеченовский вестник2218-73322658-3348Сеченовский Университетsechenov-661Research ArticleCLINICAL MEDICINEУСПЕХИ КЛИНИЧЕСКОЙ МЕДИЦИНЫIrritable bowel syndrome in women of reproductive and menopausal ageСиндром раздраженного кишечника у женщин репродуктивного и менопаузального возрастаМнацаканянМ. Г.MnatsakanyanM. G.

Мнацаканян Марина Генриковна, Кандидат медицинских наук, заведующая отделением гастроэнтерологии № 1 УКБ № 1 ФГБОУ ВО Первый МГМУ имени И.М. Сеченова Минздрава России, Клиника госпитальной терапии имени А.А. Остроумова 

105062, г. Москва, Подсосенский пер., д. 8

 

Marina Mnatsakanyan, Candidate of Medical Sciences, Head of Department of Gastroenterology № 1, University Hospital № 1

8, Podsosensky lane, Moscow, Russia, 105062

mnatsakanyan08@mail.ruПогромовА. П.PogromovA. P.

Доктор медицинских наук, профессор кафедры госпитальной терапии № 1 лечебного факультета 

Doctor of Medical Sciences, Professor at the Department of Hospital Therapy № 1, the Faculty of Medicine

ЗуевВ. М.ZuevV. M.

Доктор медицинских наук, профессор кафедры акушерства и гинекологии № 1 лечебного факультета

Doctor of Medical Sciences, Professor at Department of Hospital Therapy № 1, the Faculty of Medicine

ДюковаГ. М.DiukovaG. M.

Доктор медицинских наук, профессор кафедры нервных болезней Института профессионального образования 

Doctor of Medical Sciences, Professor at Department of Nerve Diseases, at the Institute of Post graduate Training

ТащянО. В.TashchaynO. V.

Врач-гастроэнтеролог отделения гастроэнтерологии № 1 УКБ 

Gastroenterologist, Department of Gastroenterology № 1, University Hospital № 1

ФГБОУ ВО Первый МГМУ имени И.М. Сеченова Минздрава России; Клиника госпитальной терапии имени А.А. ОстроумоваРоссияI.M. Sechenov First Moscow State Medical UniversityRussian FederationФГБОУ ВО Первый МГМУ имени И.М. Сеченова Минздрава РоссииРоссияI.M. Sechenov First Moscow State Medical UniversityRussian Federation201630092016037078Copyright © Mnatsakanyan M.G., Pogromov A.P., Zuev V.M., Diukova G.M., Tashchayn O.V., 20162016Мнацаканян М.Г., Погромов А.П., Зуев В.М., Дюкова Г.М., Тащян О.В.Mnatsakanyan M.G., Pogromov A.P., Zuev V.M., Diukova G.M., Tashchayn O.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.sechenovmedj.com/jour/article/view/661

In this article, we review the international literature and our findings irritable bowel syndrome (IBS) in women. The study objective was to compare extraintestinal associated symptoms (EAS) at IBS in the women and men groups; to investigate their frequency and characteristics depending on the age, type of IBS and changes in psychological and vegetative status. 245 patients with IBS were enrolled in the study: 183 women and 62 men, aged 19–81 (mean 45.3±6.9), 88 with IBS diarrhea-type (IBS-D), 48 with IBS constipation-type (IBS-C) and 109 with IBS mixed-type (IBS-M). The women with IBS were divided into two groups: under and over 45 (n=90 and n=93, respectively). We diagnosed IBS using Rome III criteria (2006). The EAS analysis of was done with SOMS-2 questionnaire (Screening for Somatoform Disorders 2; Rief W. and Hiller W., 2008). In IBS patients, we evaluated depression using the BDI scale (Beck Depression Inventory; Beck A.T., 1996) and anxiety using the STAI (State-Trate Anxiety Inventory; Spilberger Ch.D.). IBS is more frequent in women both in the reproductive and menopausal period than in men of the same age groups (women/men ratio is 3:1). In the women group, the EAS rate was significantly higher than in the men group, and increased with age (p <0,05). High prevalence of pain syndromes was in both women groups: back pain up to 60–70%, pain in the arms and legs and joint pain up to 40–60%; and increased increased with age (p <0,05). On the contrary, the prevalence of such symptoms as dispareunia, indifference to sex, irregular periods decreased with age. The prevalence of depression, the level of actual and personal anxiety increased in the group of women over 45 compared to the younger group (p <0,05). IBS-C type was diagnosed only in the women group, regardless of the age, and EAS increased with age (p <0,05). EAS are the integral part of IBS. We revealed their prevalence in the women group compared to the men group. The frequency of EAS increased significantly in the elder women group compared to the men. The similar tendency was observed in psychological and vegetative status changes, in particular in depression and anxiety.

Приведены современные сведения литературы и данные об особенностях течения синдрома раздраженного кишечника (СРК) у женщин, полученные в ходе исследования. Изучены внекишечные ассоциированные симптомы у женщин с СРК по сравнению с мужчинами; их проявления в зависимости от возраста, варианты течения СРК и изменения психовегетативного статуса. Обследованы 245 больных с СРК, из которых женщин – 183, мужчин – 62, в возрасте от 19 до 81 (ср. 45,31±6,9), клинические формы: СРК по варианту диареи – 88, СРК по варианту запоров – 48, СРК по смешанному варианту – 109. Анализ был проведен в двух группах женщин с СРК: моложе 45 лет (n=90) и старше 45 лет (n=93). Диагноз СРК устанавливался на основании Римских критериев III 2006 г. Анализ внекишечных ассоциированных симптомов проводился по анкете SOMS-2, психометрическое тестирование проводилось с использованием опросника тревоги Спилбергера – Ханина и шкалы депрессии Бэка. У женщин репродуктивного возраста и менопаузального периода СРК встречается значительно чаще, чем у мужчин соответствующего возраста, соотношение женщин/мужчин составляет 3:1. У женщин частота внекишечных ассоциированных симптомов существенно выше, чем у мужчин и с возрастом достоверно увеличивается их количество (р <0,05). В обеих группах женщин отмечена большая частота болевых синдромов: до 60–70% боли в спине, до 40– 60% боли в руках и ногах и в суставах, статистически значимо увеличивающиеся с возрастом (р <0,05). Наоборот, такие симптомы, как диспареуния, равнодушие к сексу, нерегулярный менcтруальный цикл с возрастом значимо уменьшаются (p <0,05). СРК по запорному варианту встречается исключительно у женщин независимо от возраста, характеризуется увеличением количества ассоциированных симптомов с возрастом (р <0,05). Также у женщин старше 45 лет статистически значимо возрастает депрессия, актуальная и личностная тревога по сравнению с женщинами репродуктивного возраста (р <0,05). Внекишечные ассоциированные симптомы являются неотъемлемой частью клинических проявлений СРК. Выявлено их преобладание у женщин по сравнению с мужчинами. В старшей возрастной группе их количество возрастает у женщин по сравнению с мужчинами. Подобная закономерность отмечена в изменении психовегетативного статуса, в частности депрессии и тревоги.

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The authors declare that there are no conflicts of interest present.