S646 Endometriosis Is Associated With Higher Healthcare Utilization and Upper Gastrointestinal Symptoms

Introduction: Endometriosis is a common gynecologic disease with primary symptoms of abdominopelvic pain, painful menses, and abnormal menstrual bleeding. Ninety percent of patients experience gastrointestinal (GI) symptoms, including constipation, bloating, and nausea/vomiting. Thus, patients can be unsure of the origin of their symptoms and may first seek care for digestive issues, delaying diagnosis and treatment for endometriosis. We sought to compare digestive complaints and healthcare utilization (HCU) among women seen in an outpatient GI clinic with endometriosis/adenomyosis (GYN) to those without (GI). Methods: A retrospective chart review was completed including adult women seen in the outpatient GI clinic at a tertiary care center between 2011-2022. Data collected from the electronic medical record included: demographics, GI diagnoses (ICD-10 codes), and HCU (number of outpatient visits, ED visits, hospitalizations, phone encounters, abdominal surgeries). Two group comparisons were described using t-tests for continuous variables and medians and quartiles for variables with non-normal distributions. Results: There were 6,736 patients: mean(SD) age=53.8(16.8) years, 78.2% White, 84.9% Non-Hispanic. The GYN group had more ED visits, phone encounters and abdominal surgeries than the GI group (P< 0.001). The GYN group were significantly more likely to have abdominal pain (RUQ, epigastric, etc.), abdominal distension, nausea, change in bowel habits, and gastroparesis (Table 1). The GI group significantly less likely to be seen for Crohn’s, autoimmune hepatitis, and liver disease (P< 0.001). Conclusion: Women with endometriosis/adenomyosis have higher rates of healthcare utilization and are more likely to be seen for GI complaints including upper abdominal pain, nausea, and distension. This may be related to underlying visceral sensitivity in the abdominopelvic region, though additional study is necessary to understand the etiology and characteristics of digestive complaints in endometriosis. It is important to screen for gynecologic conditions in women presenting for evaluation of digestive symptoms (Figure 1).Figure 1.: ICD-10 diagnoses by group. Table 1. - Comparison of healthcare utilization between groups Healthcare Utilization Control Endometriosis N Statistics N Statistics Outpatient Visits, median [Q1, Q3] 3,500 2.0 [1.00, 4.0] 3,236 2.0 [1.00, 4.0] Outpatient Visits, median (min, max) 3,500 2.0 (0.00, 122.0) 3,236 2.0 (0.00, 6.00) ED Visits, median [Q1, Q3]*** 3,500 0.00 [0.00, 3.00] 3,236 2.0 [0.00, 5.0] ED Visits, median (min, max) 3,500 0.00 (0.00, 88.0) 3,236 2.0 (0.00, 327.0) Hospitalizations, median [Q1, Q3] 3,500 0.00 [0.00, 1.00] 3,236 0.00 [0.00, 2.00] Hospitalizations, median (min, max) 3,500 0.00 (0.00, 66.0) 3,236 0.00 (0.00, 147.0) Phone encounters, median [Q1, Q3]*** 3,500 0.00 [0.00, 1.00] 3,236 1.00 [0.00, 2.0] Phone encounters, median (min, max) 3,500 0.00 (0.00, 195.0) 3,236 1.00 (0.00, 70.0) Abdominal surgeries, median [Q1, Q3]*** 3,500 0.00 [0.00, 0.00] 3,236 3.00 [1.00, 6.00] Abdominal surgeries, median (min, max) 3,500 0.00 (0.00, 61.0) 3,236 3.0 (0.00, 5.0) ***P<0.001.