nogrЭкспериментальная и клиническая гастроэнтерологияExperimental and Clinical Gastroenterology1682-8658«Global Media Technologies»10.31146/1682-8658-ecg-182-10-71-77nogr-1453Research ArticleКЛИНИЧЕСКАЯ ГАСТРОЭНТЕРОЛОГИЯCLINICAL GASTROENTEROLOGYКлинико-психиатрическое сопоставление дивертикулярной болезни толстой кишки и синдрома раздраженного кишечникаClinical and psychiatric comparison of diverticular disease of the colon and irritable bowel syndromehttps://orcid.org/0000-0002-0197-8145МаховВ. М.MakhovV. M.

кафедра факультетской терапии № 1 института клинической медицины им. Н. В. Склифосовского, профессор, д. м. н.

119991, Москва, ул. Трубецкая, д. 8, стр. 2

doctor of medical sciences, professor, Department of Faculty Therapy No. 1

119991, Russia, Moscow, Trubetskaya Street, 8, bldg. 2

https://orcid.org/0000-0002-3586-6336РомасенкоЛ. В.RomasenkoL. V.

руководитель отделения психосоматических, профессор, д. м. н.

AutorID: 422449

119991, ГСП-2, г. Москва, Кропоткинский пер., д. 23

doctor of medical sciences, professor, head of the psychosomatic department

AutorID: 422449

119034, Russia, Moscow, Kropotkinskiy lane, 23

https://orcid.org/0000-0002-4324-7615ПанферовА. С.PanferovA. S.

кафедра факультетской терапии № 1, доцент кафедры, кандидат медицинских наук

 119991, Москва, ул. Трубецкая, д. 8, стр. 2

candidate of medical sciences, associate professor, Department of Faculty Therapy No. 1

119991, Russia, Moscow, Trubetskaya Street, 8, bldg. 2

ДоронинаЮ. А.DoroninаYu. A.

кафедра факультетской терапии № 1, аспирант кафедры

 119991, Москва, ул. Трубецкая, д. 8, стр. 2

graduate student of the department, Department of Faculty Therapy No. 1

119991, Russia, Moscow, Trubetskaya Street, 8, bldg. 2

https://orcid.org/0000-0001-6440-8636ИсайкинаМ. А.IsaykinaM. A.

кафедра факультетской терапии № 1, ассистент кафедры

 119991, Москва, ул. Трубецкая, д. 8, стр. 2

assistant chair, Department of Faculty Therapy No. 1

119991, Russia, Moscow, Trubetskaya Street, 8, bldg. 2

Manon_17@mail.ruЮражМ. В.YurazhM. V.

УКБ № 1, отделение гастроэнтерологии, врач гастроэнтеролог

 119991, Москва, ул. Трубецкая, д. 8, стр. 2

Gastroenterologist, Department of Gastroenterology, University clinical hospital 1

119991, Russia, Moscow, Trubetskaya Street, 8, bldg. 2

ФГАОУ ВО Первый МГМУ им. И. М. Сеченова Минздрава РоссииРоссияFederal State Autonomous Educational Institution of Higher Education “First Moscow State Medical University named after I. M. Sechenov” of the Ministry of Health of the Russian Federation (Sechenov University)Russian FederationФГБУ «Национальный медицинский исследовательский Центр психиатрии и наркологии имени В. П. Сербского» Минздрава РоссииРоссияFederal State Budgetary Institution “National Medical Research Center for Psychiatry and Narcology named after V. P. Serbsky” of the Ministry of Health of the Russian FederationRussian Federation2020271020200107177Copyright © Махов В.М., Ромасенко Л.В., Панферов А.С., Доронина Ю.А., Исайкина М.А., Юраж М.В., 20202020Махов В.М., Ромасенко Л.В., Панферов А.С., Доронина Ю.А., Исайкина М.А., Юраж М.В.Makhov V.M., Romasenko L.V., Panferov A.S., Doroninа Y.A., Isaykina M.A., Yurazh M.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.nogr.org/jour/article/view/1453Цель исследования

Цель исследования: сравнить социально-демографические показатели, клиническую симптоматику, результаты консультации психиатра и психометрического тестирования, исследования качества жизни пациентов с дивертикулярной болезнью толстой кишки  (ДБТК) и синдромом раздраженного кишечника (СРК).

Материалы и методы

Материалы и методы: Обследовано 112 пациентов с дивертикулезом ободочной кишки  (ДОК), клинически выраженным дивертикулезом (КВД) и дивертикулярной болезнью  (ДБ), из которых мужчин 26, женщин 86, средний возраст — 64 ± 10,7 лет и 112 больных с синдромом раздраженного кишечника (СРК) (мужчин 31, женщин 81), средний возраст  — 37,2 ± 12,6 лет. Применены: ирригоскопия, колоноскопия, анализ кала на фекальный  кальпротектин, очная консультация психиатра, опросник SCL-90-K и опросник SF-36.

Результаты

Результаты: Психические расстройства, главным образом, нозогенного характера выявлены у 80 (71,4%) больных с ДОК, КВД, ДБ. Установлена корреляция выраженности психической патологии с этапом дивертикулеза. При СРК у 107 (95,5%) определены изменения психики преимущественно с депрессивными синдромами различной  структуры. Соматические проявления заметных различий не продемонстрировали.  Показатели ФК были одинаковы при СРК и ДОК и превышены при КВД и особенно при ДБ.

Заключение

Заключение: Различия при ДБТК и СРК выявлены в сфере психических расстройств различной выраженности, что требует дифференцированной терапии. Клинические проявления не продемонстрировали значимых различий.

Objective

Objective: to compare socio-demographic indicators, clinical symptoms, results of a psychiatrist consultation and psychometric testing, quality of life studies of patients with diverticular colon disease (DBTK) and irritable bowel syndrome (IBS).

Materials and methods

Materials and methods: 112 patients with colon diverticulosis (DOC), clinically severe diverticulosis (CVD) and diverticular disease (DB) were examined, of which 26 were men, 86 were women, the average age was 64 ±10.7 years and 112 were patients with irritable syndrome intestines (IBS) (31 men, 81 women), average age — 37.2 ±12.6 years. Applied: irrigoscopy, colonoscopy, fecal fecal calprotectin analysis, in-person psychiatrist  consultation, SCL-90-K questionnaire and SF-36 questionnaire.

Results

Results: Mental disorders, mainly of a nosogenic nature, were detected in 80 (71.4%) patients with DOC, CVD, and DB. A correlation was established between the severity of mental pathology and the stage of diverticulosis. With IBS, in 107 (95.5%) mental changes were determined mainly with depressive syndromes of various structures. Somatic manifestations did not show noticeable diff erences. The indices of FC were the same for IBS and PKD and exceeded for CVD and especially for DB.

Conclusion

Conclusion: Diff erences in DBTK and IBS were revealed in the fi eld of mental disorders of varying severity, which requires diff erentiated therapy. Clinical manifestations did not show signifi cant diff erences.

дивертикулярная болезньСРКполиморбидные психические расстройствафекальный кальпротектинкачество жизниdiverticular diseaseIBSpolymorbid mental disordersfecal calprotectinquality of lifeReferencesЛевченко С. В., Лазебник Л. Б., Потапова В. Б., Рогозина В. А. Клинико-морфологические варианты дивертикулярной болезни толстой кишки // ЭиКГ. 2013. № 3.Levchenko SV, Lazebnik LB, Potapova VB, Rogozina VA. Clinical and Morphological Variants of Diverticular Disease in Colon. Eksp Klin Gastroenterol. 2013;(3):23–30.Everhart JE, Ruhl CE. Burden of digestive diseases in the United States part II: lower gastrointestinal diseases. Gastroenterology. 2009;136:741–754. doi:10.1053/j.gastro.2009.01.015Everhart JE, Ruhl CE. Burden of digestive diseases in the United States part II: lower gastrointestinal diseases. Gastroenterology. 2009;136:741–754. doi:10.1053/j.gastro.2009.01.015Morini S, Ridola L, Hassan C, et al. Association between diverticulosis and colonic neoplastic lesions in individuals with a positive faecal immunochemical test. United European Gastroenterol J. 2017;5:134–138.Morini S, Ridola L, Hassan C, et al. Association between diverticulosis and colonic neoplastic lesions in individuals with a positive faecal immunochemical test. United European Gastroenterol J. 2017;5:134–138.Peery AF, Martin CF, Levinson SE, Sandler RS. Colonic diverticula are not associated with an increased risk of colorectal adenomas. Am J Gastroenterol. 2015;110:1694–1697.Peery AF, Martin CF, Levinson SE, Sandler RS. Colonic diverticula are not associated with an increased risk of colorectal adenomas. Am J Gastroenterol. 2015;110:1694–1697.Štimac D, Nardone G, Mazzari A, et al. What’s New in Diagnosing Diverticular Disease. J Gastrointestin Liver Dis. 2019;28(suppl. 4):17–22. Published 2019 Dec 19. doi:10.15403/jgld-553Štimac D, Nardone G, Mazzari A, et al. What’s New in Diagnosing Diverticular Disease. J Gastrointestin Liver Dis. 2019;28(suppl. 4):17–22. Published 2019 Dec 19. doi:10.15403/jgld-553Rustom LBO, Sharara AI. The natural history of colonic diverticulosis: much ado about nothing? Infl amm Intest Dis. 2018;3:69–74.Rustom LBO, Sharara AI. The natural history of colonic diverticulosis: much ado about nothing? Infl amm Intest Dis. 2018;3:69–74.Stollman N, Raskin J. B. Diverticular disease of the colon. Lancet. 2004;363:631–639.Stollman N, Raskin J. B. Diverticular disease of the colon. Lancet. 2004;363:631–639.Pautrat K, Bretagnol F, Huten N, de Calan L. Acute diverticulitis in very young patients: a frequent surgical management. Dis Colon Rectum. 2007;50:472–477.Pautrat K, Bretagnol F, Huten N, de Calan L. Acute diverticulitis in very young patients: a frequent surgical management. Dis Colon Rectum. 2007;50:472–477.Ambrosetti P. Value of CT for acute left-colonic diverticulitis: the surgeon’s view. Dig Dis. 2012;30:51–55.Ambrosetti P. Value of CT for acute left-colonic diverticulitis: the surgeon’s view. Dig Dis. 2012;30:51–55.Tursi A, Elisei W. Role of Inf lammation in the Pathogenesis of Diverticular Disease. Mediators Infl amm. 2019;2019:8328490. Published 2019 Mar 14. doi:10.1155/2019/8328490Tursi A, Elisei W. Role of Inf lammation in the Pathogenesis of Diverticular Disease. Mediators Infl amm. 2019;2019:8328490. Published 2019 Mar 14. doi:10.1155/2019/8328490Järbrink-Sehgal M. E., Andreasson A., Talley N. J., Agréus L., Song J. Y., Schmidt P. T. Symptomatic diverticulosis is characterized by loose stools. Clinical Gastroenterology and Hepatology. 2016;14(12):1763–1770. e1. doi: 10.1016/j.cgh.2016.06.014.Järbrink-Sehgal M. E., Andreasson A., Talley N. J., Agréus L., Song J. Y., Schmidt P. T. Symptomatic diverticulosis is characterized by loose stools. Clinical Gastroenterology and Hepatology. 2016;14(12):1763–1770. e1. doi: 10.1016/j.cgh.2016.06.014.Kaiser AM, Jiang JK, Lake JP, et al. The management of complicated diverticulitis and the role of computed tomography. Am J Gastroenterol. 2005;100:910–917.Kaiser AM, Jiang JK, Lake JP, et al. The management of complicated diverticulitis and the role of computed tomography. Am J Gastroenterol. 2005;100:910–917.Tursi A, Brandimarte G, Elisei W, et al. Assessment and grading of mucosal inflammation in colonic diverticular disease. J Clin Gastroenterol. 2008;42:699–703.Tursi A, Brandimarte G, Elisei W, et al. Assessment and grading of mucosal inflammation in colonic diverticular disease. J Clin Gastroenterol. 2008;42:699–703.Ивашкин В. Т., Шелыгин Ю. А., Ачкасов С. И., Васильев С. В. и др. Рекомендации Российской гастроэнтерологической ассоциации и Ассоциации колопроктологов России по диагностике и лечению взрослых больных дивертикулярной болезнью ободочной кишки. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2016; 26 (1): 65–80. https://doi.org/10.22416/1382–4376–2016–26–1–65–80. https://doi.org/10.22416/1382–4376–2016–26–1–65–80Ivashkin V. T., Shelygin Y. A., Achkasov S. I., et al. Diagno stics and treatment of diverticular disease of the colon: guidelines of the Russian gastroenterological Association and Russian Association of Coloproctology. Russian Journal of Gastroenterology, Hepatology,Simren M, Palsson OS, Whitehead WE. Update on Rome IV Criteria for Colorectal Disorders: Implications for Clinical Practice. Curr Gastroenterol Rep. 2017;19(4):15. doi:10.1007/s11894–017–0554–0Coloproctology. 2016;26(1):65–80. (In Russ.) https://doi.org/10.22416/1382–4376–2016–26–1–65–80Drossman D.A., Hasler W. L. Rome IV – Functional GI disorders: disorders of gut-brain interaction. Gastroenterology. 2016; 150(6): 1257–61.Simren M, Palsson OS, Whitehead WE. Update on Rome IV Criteria for Colorectal Disorders: Implications for Clinical Practice. Curr Gastroenterol Rep. 2017;19(4):15. doi:10.1007/s11894–017–0554–0Mumolo M. G., Bertani L., Ceccarelli L., et al. From bench to bedside: fecal calprotectin in inflammatory bowel diseases clinical setting. World Journal of Gastroenterology. 2018;24(33):3681–3694. doi: 10.3748/wjg.v24.i33.3681.Drossman D.A., Hasler W. L. Rome IV – Functional GI disorders: disorders of gut-brain interaction. Gastroenterology. 2016; 150(6): 1257–61.Tursi A, Brandimarte G, Elisei W, Giorgetti GM, Inchingolo CD, Aiello F. Faecal calprotectin in colonic diverticular disease: a case–control study. Int J Colorectal Dis. 2009;24:49–55. doi:10.1007/s00384–008–0595–9Mumolo M. G., Bertani L., Ceccarelli L., et al. From bench to bedside: fecal calprotectin in inflammatory bowel diseases clinical setting. World Journal of Gastroenterology. 2018;24(33):3681–3694. doi: 10.3748/wjg.v24.i33.3681.Tursi A, Elisei W, Picchio M, Brandimarte G. Increased faecal calprotectin predicts recurrence of colonic diverticulitis. Int J Colorectal Dis. 2014;29:931–935. doi:10.1007/s00384–014–1884–0Tursi A, Brandimarte G, Elisei W, Giorgetti GM, Inchingolo CD, Aiello F. Faecal calprotectin in colonic diverticular disease: a case–control study. Int J Colorectal Dis. 2009;24:49–55. doi:10.1007/s00384–008–0595–9Bolster LT., Papagrigoriadis S. Diverticular disease has an impact on quality of life – results of a preliminary study. Colorectal Dis. 2003; 5: 320–3.Tursi A, Elisei W, Picchio M, Brandimarte G. Increased faecal calprotectin predicts recurrence of colonic diverticulitis. Int J Colorectal Dis. 2014;29:931–935. doi:10.1007/s00384–014–1884–0Comparato G, Fanigliulo L, Aragona G. et al. Quality of life in uncomplicated symptomatic diverticular disease: is it another good reason for treatment? Dig Dis. 2007; 25: 252–9.Bolster LT., Papagrigoriadis S. Diverticular disease has an impact on quality of life – results of a preliminary study. Colorectal Dis. 2003; 5: 320–3.Humes DJ, Simpson J, Neal KR., et al. Psychological and colonic factors in painful diverticulosis. Br J Surg. 2008; 95: 195–8.Comparato G, Fanigliulo L, Aragona G. et al. Quality of life in uncomplicated symptomatic diverticular disease: is it another good reason for treatment? Dig Dis. 2007; 25: 252–9.Humes DJ, Simpson J, Neal KR., et al. Psychological and colonic factors in painful diverticulosis. Br J Surg. 2008; 95: 195–8.Humes DJ, Simpson J, Neal KR., et al. Psychological and colonic factors in painful diverticulosis. Br J Surg. 2008; 95: 195–8.

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