gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLC10.22416/1382-4376-2019-29-2-76-80gastro-j-357Research ArticleНАЦИОНАЛЬНАЯ ШКОЛА ГАСТРОЭНТЕРОЛОГОВ, ГЕПАТОЛОГОВNATIONAL COLLEGE OF GASTROENTEROLOGISTS, HEPATOLOGISTSДиагноз синдрома раздраженного кишечника: должна ли быть онконастороженность?Irritable Bowel Syndrome Diagnosis: Should There Be Alertness to Cancer?ШептулинА. А.SheptulinA. A.

доктор медицинских наук, профессор кафедры пропедевтики внутренних болезней

Dr. Sci. (Med.), Prof., Department of Internal Diseases Propedeutics, Medical faculty

arkalshep@gmail.comДжахаяН. Л.JahayaN. L.

кандидат медицинских наук, ассистент кафедры пропедевтики внутренних болезней

Cand. Sci. (Med.), Research Assistant, Department of Internal Diseases Propedeutics, Medical Faculty

СедоваА. В.SedovaA. V.

кандидат медицинских наук, ассистент кафедры пропедевтики внутренних болезней

Cand. Sci. (Med.), Research Assistant, Department of Internal Diseases Propedeutics, Medical Faculty

ФГАОУ ВО «Первый Московский государственный университет им. И.М. Сеченова» (Сеченовский университет) Министерства здравоохранения Российской ФедерацииРоссияI.M. Sechenov First Moscow State Medical University (Sechenov University), MoscowRussian Federation2019160520192927680Copyright © Шептулин А.А., Джахая Н.Л., Седова А.В., 20192019Шептулин А.А., Джахая Н.Л., Седова А.В.Sheptulin A.A., Jahaya N.L., Sedova A.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.gastro-j.ru/jour/article/view/357Цель обзора

Цель обзора. Обосновать необходимость включения колоректального рака (КРР) в круг дифференциально-диагностического поиска при подозрении на синдром раздраженного кишечника (СРК).

Основные положения

Основные положения. В соответствии с последними Римскими критериями СРК IV пересмотра диагноз данного заболевания ставится главным образом на оценке клинических симптомов и данных объективного обследования при очень ограниченном перечне дополнительных исследований. При этом колоноскопия при подозрении на СРК проводится лишь больным старше 50 лет при наличии наследственной предрасположенности к КРР и обнаружении «симптомов тревоги». В настоящее время показано, что КРР может протекать под «маской» СРК. При этом нередко опухоли толстой и прямой кишки могут встречаться у пациентов моложе

50 лет при отсутствии наследственной предрасположенности к КРР и «симптомов тревоги». Это делает необходимым проведение колоноскопии всем больным с подозрением на СРК.

Заключение

Заключение. В перечень заболеваний, требующих проведения дифференциального диагноза у больных с подозрением на СРК, следует обязательно включать КРР.

 

 

Aim

Aim. To justify the need to include colorectal cancer (CRC) in the circle of differential diagnostic search for suspected irritable bowel syndrome (IBS).

Background

Background. In accordance with the latest Rome IV criteria for IBS, its diagnosis is mainly based on the assessment of clinical symptoms and objective examination data with a very limited list of additional studies. In this case, colonoscopy for suspected IBS is performed only in patients aged over 50 years old, provided a hereditary predisposition to CRC and the “alarm symptoms” are detected. It has been recently shown that CRC can proceed under the “mask” of IBS. However, colorectal and rectal tumours are often found in patients younger than 50 years old in the absence of hereditary predisposition to CRC and “anxiety symptoms”. This makes it necessary to conduct colonoscopy for all patients with suspected IBS.

Conclusion

Conclusion. The list of diseases requiring differential diagnostics in patients with suspected IBS should always include CRC.

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