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Yıl 2014, Cilt: 4 Sayı: 2, 64 - 68, 02.08.2014

Doğan Atılgan Bekir Parlaktaş Engin Kölükçü Abdülkerim Yılmaz Nihat Uluocak Fikret Erdemir

Öz

Objectives: Irritable bowel syndrome (IBS) affects as many as 5-20% of individuals worldwide and causes a reduced quality of life. Approximately 50% of IBS patients have at least one co-morbid somatic complaint and many IBS patients meet diagnostic criteria for other functional disorders. In this study we aimed to evaluate lower urinary tract symptoms (LUTS) and erectile function in men with IBS. Material and Methods: Between January 2012 and March 2013 fifty men diagnosed with IBS in gastorenterology clinic and 50 healhty male voulanters without any gastrointestinal disorders were included in this study. After routine urological examination, the IPSS, IIEF, OAB-V8 and BECK depression scale scores of the patients were evaluated. All patients underwent uroflowmetric evaluation. Qmax values and postvoidal residual urine volumes, measured with suprapubic USG, were recorded. The results were compared statistically. Results: Mean age of the patients was 44.1±14.3 in group 1 and 46.76±8.58 in group 2. Mean Qmax values and mean postvoid residual urine volumes in group 1 and group 2 were 20.52±8.69, 25.4±38.5 cc and 19.10±9.23, 15.6±19.29 cc, respectively. Mean IPSS scores were 10.61±6.15 in group 1 and 10.50±6.08 in group 2. While mean OAB-V8 scores of the groups were 9.1±5.78 and 5.24±3.28, mean IIEF scores were 19.92±7.08 ve 18.92±7.13, respectively. Overactive bladder was determined in 48% (n=24) in group 1 and 12% (n=12) in control group. There were no statistically significant difference between groups in terms of mean age, IIEF scores, IPSS scores, mean Qmax and mean postvoidal residual urine volumes (p>0.05). However, mean OAB-V8 scores and mean BECK depression scores were significantly higher in Group 1 in comparision with control group (p<0.001). Conclusion: IBS, is a major health problem with serious psychosocial side effects and significantly reduces patients quality of life. LUTS and ED may be seen frequently in patients with IBS. Therefore, during menagement of these patients multydiciplinary assesment should be kept in mind.

Anahtar Kelimeler

irritable bowel syndrome lower urinary tract symptoms erectile function

Kaynakça

  • El-Salhy M. Irritable bowel syndrome: diagnosis and pathogenesis. World J Gastroenterol. 2012; 18: 5151-63.
  • Agréus L, Svärdsudd K, Nyrén O, Tibblin G. Irritable bowel syndrome and dyspepsia in the general population: overlap and lack of stability over time. Gastroenterology 1995; 109:671-80.
  • Systematic review on the management of irritable bowel syndrome in the European Union. Eur J Gastroenterol Hepatol 2007; 19 Suppl 1: 11-37.
  • Surdea-Blaga T, Băban A, Dumitrascu DL. Psychosocial determinants of irritable bowel syndrome. World J Gastroenterol. 2012;18: 616-26.
  • Zimmerman J. Extraintestinal symptoms in irritable bowel syndrome and inflammatory bowel diseases: nature, severity, and relationship to gastrointestinal symptoms. Dig Dis Sci 2003; 48: 743-9.
  • Whitehead WE, Burnett CK, Cook EW, Taub E. Impact of irritable bowel syndrome on quality of life. Dig Dis Sci 1996; 41: 2248-53.
  • Gralnek IM, Hays RD, Kilbourne A, Naliboff B, Mayer EA. The impact of irritable bowel syndrome on health-related quality of life. Gastroenterology 2000; 119: 654-60.
  • Schuster MM. Defining and diagnosing irritable bowel syndrome. Am J Manag Care 2001; 7: 246-51.
  • Locke GR, Zinsmeister AR, Talley NJ, Fett SL, Melton LJ. Familial association in adults with functional gastrointestinal disorders. Mayo Clin Proc 2000; 75: 907-12.
  • Sicherer SH, Sampson HA. Food allergy: recent advances in pathophysiology and treatment. Annu Rev Med 2009; 60: 261-77.
  • Spiller R, Garsed K. Infection, inflammation, and the irritable bowel syndrome. Dig Liver Dis 2009; 41: 844-9.
  • Spiller R. Serotonin, inflammation, and IBS: fitting the jigsaw together? J Pediatr Gastroenterol Nutr 2007; 45 Suppl 2: 115-9.
  • Spiller RC, Jenkins D, Thornley JP, Hebden JM, Wright T, Skinner M, Neal KR. Increased rectal mucosal enteroendocrine cells, T lymphocytes, and increased gut permeability following acute Campylobacter enteritis and in post-dysenteric irritable bowel syndrome. Gut 2000; 47: 804-11.
  • Minderhoud IM, Oldenburg B, Wismeijer JA, van Berge Henegouwen GP, Smout AJ. IBS-like symptoms in patients with inflammatory bowel disease in remission; relationships with quality of life and coping behavior. Dig Dis Sci 2004; 49: 469-74.
  • Quigley EM, Craig OF. Irritable bowel syndrome; update on pathophysiology and management. Turk J Gastroenterol. 2012; 23: 313-22.
  • Chang L, Berman S, Mayer EA, Suyenobu B, Derbyshire S, Naliboff B, Vogt B,FitzGerald L, Mandelkern MA. Brain responses to visceral and somatic stimuli in patients with irritable bowel syndrome with and without fibromyalgia. Am J Gastroenterol. 2003; 98: 1354-61.
  • Birder L, Drake M. Neural control. In: Abrams P,Cardozo L, Khoury S, Wein A, eds. Incontinence,4th edn. Paris: Health Publications Ltd, 2009: 167–253.
  • De Wachter S, de Jong A, Van Dyck J, Wyndaele JJ. Interaction of filling related sensation between anorectum and lower urinary tract and its impact on the sequence of their evacuation. A study in healthy volunteers. Neurourol Urodyn 2007; 26: 481–5.
  • Noronha R, Akbarali H, Malykhina A et al. Changes in urinary bladder smooth muscle function in response to colonic inflammation. Am J Physiol Renal Physiol 2007; 293: F1461–7.
  • De Wachter S, Wyndaele JJ. Impact of rectal distention on the results of evaluations of lower urinary tract sensation. J Urol 2003; 169: 1392–4.
  • Franco I. Overactive bladder in children. Part 1: pathophysiology. J Urol 2007; 178: 761–8.
  • Francis CY, Duffy JN, Whorwell PJ, Morris J. High prevalence of irritable bowel syndrome in patients attending urological outpatient departments. Dig Dis Sci 1997; 42: 404–7.
  • Sperber AD, Dekel R. Irritable Bowel Syndrome and Co-morbid Gastrointestinal and Extra-gastrointestinal Functional Syndromes. J Neurogastroenterol Motil. 2010;16: 113-9.
  • Walker EA, Katon WJ, Jemelka R, Alfrey H, Bowers M, Stenchever MA. The prevalence of chronic pelvic pain and irritable bowel syndrome in two university clinics. J Psychosom Obstet Gynaecol 1991;12: 65-75.
  • Guo YJ, Ho CH, Chen SC, Yang SS, Chiu HM, Huang KH. Lower urinary tract symptoms in women with irritable bowel syndrome. Int J Urol 2010; 17: 175-81.
  • Coyne K, Sexton C, Kopp Z, et al. The prevalence, bother, and overlap of LUTS in the US, UK, and Sweden: EpiLUTS. Eur Urol 2008; 7: 238.
  • Irwin DE, Milsom I, Hunskaar S, Reilly K, Kopp Z, Herschorn S, et al. Population- based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol. 2006; 50: 1306-14.
  • Whorwell PJ, Lupton EW, Erduran D, Wilson K. Bladder smooth muscle dysfunction in patients with irritable bowel syndrome. Gut. 1986; 27: 1014-7.
  • Whorwell PJ, McCallum M, Creed FH, Roberts CT. Non-colonic features of irritable bowel syndrome. Gut 1986; 27: 37-40.
  • Fass R, Fullerton S, Naliboff B, Hirsh T, Mayer EA. Sexual dysfunction in patients with irritable bowel syndrome and non-ulcer dyspepsia. Digestion 1998; 59: 79-85.

İrritable Bağırsak Sendromu (İBS) Tanısı Almış Erkek Hastalarda Alt Üriner Sistem Semptomları ve Erektil Fonksiyonların Değerlendirilmesi

Yıl 2014, Cilt: 4 Sayı: 2, 64 - 68, 02.08.2014

Doğan Atılgan Bekir Parlaktaş Engin Kölükçü Abdülkerim Yılmaz Nihat Uluocak Fikret Erdemir

Öz

Amaç: İrritable bağırsak sendromu (İBS) dünya genelinde yaklaşık %5-20 insanı etkilemekte ve yaşam kalitesinde düşmeye sebep olmaktadır. İBS hastalarının yaklaşık %50’sinde en az bir ek somatik bozukluk bulunmakta ve İBS’lu hastaların çoğu başka bir fonksiyonel bozukluğa bağlı tanı kriterlerini karşılamaktadır. Biz bu çalışmada, İBS’lu erkek hastalarda alt üriner sistem semptomlarının (AÜSS) ve erektil fonksiyonların değerlendirilmesini amaçladık.

Gereç ve Yöntem: Ocak 2012- Mart 2013 tarihleri arasında gastroenteroloji kliniğinde İBS tanısı almış 50 erkek hasta ve gastrointestinal problemi olmayan ve İBS tanı kriterlerini karşılamayan 50 kontrol çalışmaya dâhil edildi. Rutin ürolojik değerlendirmeyi takiben tüm hastaların IPSS, IIEF, OAB-V8 ve BECK depresyon skorları tespit edildi. Ek olarak tüm hastalara üroflowmetri yapılarak Qmax değerleri ve işeme sonrası rezidüel idrar miktarları kaydedildi. Sonuçlar istatistiksel olarak değerlendirildi.

Bulgular: Grupların yaş ortalaması grup 1 ve 2 için sırasıyla 44,1±14,3 ve 46,76±8,58 idi. Grup 1 ve Grup 2 deki hastaların ortalama Qmax değerleri ve işeme sonrası ortalama rezidüel idrar miktarları sırasıyla 20,52±8,69, 25,4±38,5 ve 19,10±9,23, 15,6±19,29 olarak saptanırken, ortalama IPSS değerleri sırasıyla 10,61±6,15 ve 10,50±6,08 idi. Grup 1 de ortalama OAB-V8 skoru 9,1±5,78 ve Grup 2 de ortalama OAB-V8 skoru 5,24±3,28 saptandı. Grup 1 deki hastaların %48’inde (n=24) aşırı aktif mesane semptomları tespit edilirken bu sayı kontrol grubunda 6 (%12) olarak bulundu. IIEF skorları Grup 1 ve Grup 2 için sırasıyla 19,92±7,08 ve 18,92±7,13 olarak tespit edildi. Ortalama yaş, IPSS skoru, IIEF skoru, Qmax ve işeme sonrası rezidüel idrar açısından gruplar arsında anlamlı fark tespit edilmedi (p>0,05). IBS grubunda ortalama OAB-V8 ve BECK depresyon skorları kontrol grubu ile karşılaştırıldığında anlamlı olarak yüksek bulundu (p<0,001).

Sonuç: İBS ciddi psikososyal yan etkileri olan önemli bir sağlık problemidir ve hastaların yaşam kalitesini düşürür. AÜSS ve erektil disfonksiyon İBS’lu hastalarda sık olarak görülebilir bu nedenle bu hastaların değerlendirilmesinde multidisipliner yaklaşım akılda tutulmalıdır.

Anahtar Kelimeler

irritable bağırsak sendromu; alt üriner sistem semptomları; erektil fonksiyon

Kaynakça

  • El-Salhy M. Irritable bowel syndrome: diagnosis and pathogenesis. World J Gastroenterol. 2012; 18: 5151-63.
  • Agréus L, Svärdsudd K, Nyrén O, Tibblin G. Irritable bowel syndrome and dyspepsia in the general population: overlap and lack of stability over time. Gastroenterology 1995; 109:671-80.
  • Systematic review on the management of irritable bowel syndrome in the European Union. Eur J Gastroenterol Hepatol 2007; 19 Suppl 1: 11-37.
  • Surdea-Blaga T, Băban A, Dumitrascu DL. Psychosocial determinants of irritable bowel syndrome. World J Gastroenterol. 2012;18: 616-26.
  • Zimmerman J. Extraintestinal symptoms in irritable bowel syndrome and inflammatory bowel diseases: nature, severity, and relationship to gastrointestinal symptoms. Dig Dis Sci 2003; 48: 743-9.
  • Whitehead WE, Burnett CK, Cook EW, Taub E. Impact of irritable bowel syndrome on quality of life. Dig Dis Sci 1996; 41: 2248-53.
  • Gralnek IM, Hays RD, Kilbourne A, Naliboff B, Mayer EA. The impact of irritable bowel syndrome on health-related quality of life. Gastroenterology 2000; 119: 654-60.
  • Schuster MM. Defining and diagnosing irritable bowel syndrome. Am J Manag Care 2001; 7: 246-51.
  • Locke GR, Zinsmeister AR, Talley NJ, Fett SL, Melton LJ. Familial association in adults with functional gastrointestinal disorders. Mayo Clin Proc 2000; 75: 907-12.
  • Sicherer SH, Sampson HA. Food allergy: recent advances in pathophysiology and treatment. Annu Rev Med 2009; 60: 261-77.
  • Spiller R, Garsed K. Infection, inflammation, and the irritable bowel syndrome. Dig Liver Dis 2009; 41: 844-9.
  • Spiller R. Serotonin, inflammation, and IBS: fitting the jigsaw together? J Pediatr Gastroenterol Nutr 2007; 45 Suppl 2: 115-9.
  • Spiller RC, Jenkins D, Thornley JP, Hebden JM, Wright T, Skinner M, Neal KR. Increased rectal mucosal enteroendocrine cells, T lymphocytes, and increased gut permeability following acute Campylobacter enteritis and in post-dysenteric irritable bowel syndrome. Gut 2000; 47: 804-11.
  • Minderhoud IM, Oldenburg B, Wismeijer JA, van Berge Henegouwen GP, Smout AJ. IBS-like symptoms in patients with inflammatory bowel disease in remission; relationships with quality of life and coping behavior. Dig Dis Sci 2004; 49: 469-74.
  • Quigley EM, Craig OF. Irritable bowel syndrome; update on pathophysiology and management. Turk J Gastroenterol. 2012; 23: 313-22.
  • Chang L, Berman S, Mayer EA, Suyenobu B, Derbyshire S, Naliboff B, Vogt B,FitzGerald L, Mandelkern MA. Brain responses to visceral and somatic stimuli in patients with irritable bowel syndrome with and without fibromyalgia. Am J Gastroenterol. 2003; 98: 1354-61.
  • Birder L, Drake M. Neural control. In: Abrams P,Cardozo L, Khoury S, Wein A, eds. Incontinence,4th edn. Paris: Health Publications Ltd, 2009: 167–253.
  • De Wachter S, de Jong A, Van Dyck J, Wyndaele JJ. Interaction of filling related sensation between anorectum and lower urinary tract and its impact on the sequence of their evacuation. A study in healthy volunteers. Neurourol Urodyn 2007; 26: 481–5.
  • Noronha R, Akbarali H, Malykhina A et al. Changes in urinary bladder smooth muscle function in response to colonic inflammation. Am J Physiol Renal Physiol 2007; 293: F1461–7.
  • De Wachter S, Wyndaele JJ. Impact of rectal distention on the results of evaluations of lower urinary tract sensation. J Urol 2003; 169: 1392–4.
  • Franco I. Overactive bladder in children. Part 1: pathophysiology. J Urol 2007; 178: 761–8.
  • Francis CY, Duffy JN, Whorwell PJ, Morris J. High prevalence of irritable bowel syndrome in patients attending urological outpatient departments. Dig Dis Sci 1997; 42: 404–7.
  • Sperber AD, Dekel R. Irritable Bowel Syndrome and Co-morbid Gastrointestinal and Extra-gastrointestinal Functional Syndromes. J Neurogastroenterol Motil. 2010;16: 113-9.
  • Walker EA, Katon WJ, Jemelka R, Alfrey H, Bowers M, Stenchever MA. The prevalence of chronic pelvic pain and irritable bowel syndrome in two university clinics. J Psychosom Obstet Gynaecol 1991;12: 65-75.
  • Guo YJ, Ho CH, Chen SC, Yang SS, Chiu HM, Huang KH. Lower urinary tract symptoms in women with irritable bowel syndrome. Int J Urol 2010; 17: 175-81.
  • Coyne K, Sexton C, Kopp Z, et al. The prevalence, bother, and overlap of LUTS in the US, UK, and Sweden: EpiLUTS. Eur Urol 2008; 7: 238.
  • Irwin DE, Milsom I, Hunskaar S, Reilly K, Kopp Z, Herschorn S, et al. Population- based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol. 2006; 50: 1306-14.
  • Whorwell PJ, Lupton EW, Erduran D, Wilson K. Bladder smooth muscle dysfunction in patients with irritable bowel syndrome. Gut. 1986; 27: 1014-7.
  • Whorwell PJ, McCallum M, Creed FH, Roberts CT. Non-colonic features of irritable bowel syndrome. Gut 1986; 27: 37-40.
  • Fass R, Fullerton S, Naliboff B, Hirsh T, Mayer EA. Sexual dysfunction in patients with irritable bowel syndrome and non-ulcer dyspepsia. Digestion 1998; 59: 79-85.
Toplam 30 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Orjinal Çalışma
Yazarlar

Doğan Atılgan Bu kişi benim

Bekir Parlaktaş Bu kişi benim

Engin Kölükçü Bu kişi benim

Abdülkerim Yılmaz Bu kişi benim

Nihat Uluocak Bu kişi benim

Fikret Erdemir Bu kişi benim

Yayımlanma Tarihi 2 Ağustos 2014
Yayımlandığı Sayı Yıl 2014 Cilt: 4 Sayı: 2

Kaynak Göster

APA Atılgan, D., Parlaktaş, B., Kölükçü, E., Yılmaz, A., vd. (2014). İrritable Bağırsak Sendromu (İBS) Tanısı Almış Erkek Hastalarda Alt Üriner Sistem Semptomları ve Erektil Fonksiyonların Değerlendirilmesi. Çağdaş Tıp Dergisi, 4(2), 64-68.
AMA Atılgan D, Parlaktaş B, Kölükçü E, Yılmaz A, Uluocak N, Erdemir F. İrritable Bağırsak Sendromu (İBS) Tanısı Almış Erkek Hastalarda Alt Üriner Sistem Semptomları ve Erektil Fonksiyonların Değerlendirilmesi. J Contemp Med. Ağustos 2014;4(2):64-68.
Chicago Atılgan, Doğan, Bekir Parlaktaş, Engin Kölükçü, Abdülkerim Yılmaz, Nihat Uluocak, ve Fikret Erdemir. “İrritable Bağırsak Sendromu (İBS) Tanısı Almış Erkek Hastalarda Alt Üriner Sistem Semptomları Ve Erektil Fonksiyonların Değerlendirilmesi”. Çağdaş Tıp Dergisi 4, sy. 2 (Ağustos 2014): 64-68.
EndNote Atılgan D, Parlaktaş B, Kölükçü E, Yılmaz A, Uluocak N, Erdemir F (01 Ağustos 2014) İrritable Bağırsak Sendromu (İBS) Tanısı Almış Erkek Hastalarda Alt Üriner Sistem Semptomları ve Erektil Fonksiyonların Değerlendirilmesi. Çağdaş Tıp Dergisi 4 2 64–68.
IEEE D. Atılgan, B. Parlaktaş, E. Kölükçü, A. Yılmaz, N. Uluocak, ve F. Erdemir, “İrritable Bağırsak Sendromu (İBS) Tanısı Almış Erkek Hastalarda Alt Üriner Sistem Semptomları ve Erektil Fonksiyonların Değerlendirilmesi”, J Contemp Med, c. 4, sy. 2, ss. 64–68, 2014.
ISNAD Atılgan, Doğan vd. “İrritable Bağırsak Sendromu (İBS) Tanısı Almış Erkek Hastalarda Alt Üriner Sistem Semptomları Ve Erektil Fonksiyonların Değerlendirilmesi”. Çağdaş Tıp Dergisi 4/2 (Ağustos 2014), 64-68.
JAMA Atılgan D, Parlaktaş B, Kölükçü E, Yılmaz A, Uluocak N, Erdemir F. İrritable Bağırsak Sendromu (İBS) Tanısı Almış Erkek Hastalarda Alt Üriner Sistem Semptomları ve Erektil Fonksiyonların Değerlendirilmesi. J Contemp Med. 2014;4:64–68.
MLA Atılgan, Doğan vd. “İrritable Bağırsak Sendromu (İBS) Tanısı Almış Erkek Hastalarda Alt Üriner Sistem Semptomları Ve Erektil Fonksiyonların Değerlendirilmesi”. Çağdaş Tıp Dergisi, c. 4, sy. 2, 2014, ss. 64-68.
Vancouver Atılgan D, Parlaktaş B, Kölükçü E, Yılmaz A, Uluocak N, Erdemir F. İrritable Bağırsak Sendromu (İBS) Tanısı Almış Erkek Hastalarda Alt Üriner Sistem Semptomları ve Erektil Fonksiyonların Değerlendirilmesi. J Contemp Med. 2014;4(2):64-8.