Endometriosis and irritable bowel syndrome: a systematic review and meta-analysis

Purpose Irritable bowel disease and endometriosis are two common diseases characterized by chronic inflammation state and recurrent abdominal pain. As a consequence of sharing of symptoms and chronic inflammation, endometriosis and IBS may coexist and be misdiagnosed and this leads to delays in diagnosis, mismanagement, and unnecessary testing. In recent years, some studies have found higher risk of IBS in women with endometriosis, compared to women without endometriosis. To provide a general overview, we performed a systematic review and a meta-analysis on published data on this issue.

By a systematic literature search selection process, 11 studies were identified for the current study: 2 prospective and 2 retrospective cohort studies, 4 case–control studies, 1 cross-sectional study and 2 clinical series.

When we meta-analysed data about the prevalence of IBS in women with endometriosis, the overall OR (95%CI), compared to women without endometriosis was 3.26 (1.97–5.39) with no statistically significant heterogeneity. All three studies considering the incidence of IBS in women with a previous diagnosis of endometriosis showed about twofold greater risk among women with endometriosis than women without. Likewise, in the random effects model of the meta-analysis, the overall OR of history of IBS in women with endometriosis was 3.10 (95% CI 2.06–4.67), with no heterogeneity between three studies considered.

This meta-analysis provides epidemiological evidence of a link between endometriosis and IBS, highlighting two or more times higher risk of IBS in women with endometriosis compared to women without the condition. Similar content being viewed by others Data availability All data generated and/or analysed during this study are available from the corresponding author on request.

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J Gastroenterol 46:421–431. https://doi.org/10.1007/s00535-011-0379-9 Funding This study received no specific grant from any funding agency. Author information Authors and Affiliations Contributions FC: project development, systematic literature search, selection papers, data analysis and manuscript writing. FP: conception and project development and manuscript writing. PV: conception and project development. GE: systematic literature search and acquisition data for the work. MB: systematic literature search and acquisition data for the work. PAM: systematic literature search and acquisition data for the work. SC: selection papers and data analysis. ER: selection papers and data analysis. Corresponding author Ethics declarations Conflict of interest All the authors declare that they have no conflicts of interest. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions About this article Cite this article Chiaffarino, F., Cipriani, S., Ricci, E. et al. Endometriosis and irritable bowel syndrome: a systematic review and meta-analysis. Arch Gynecol Obstet 303, 17–25 (2021). https://doi.org/10.1007/s00404-020-05797-8 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s00404-020-05797-8