Endometriosis in patients with irritable bowel syndrome: Specific symptomatic and demographic profile, and response to the low FODMAP diet

Judith S. Moore, Peter G. Gibson, Peter R. Gibson, Gibson PR, Richard E. Perry, Perry RE, Rebecca Burgell, Rebecca E Burgell, Burgell RE
The Australian & New Zealand journal of obstetrics & gynaecology · 2017 · vol. 57(2) , pp. 201–205 · doi:10.1111/ajo.12594 · PMID:28303579 · W2596491620
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Women with concurrent endometriosis and IBS experience a distinct symptom profile and show a significantly improved response to a low FODMAP diet compared to women with IBS alone.

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Abstract

BACKGROUND: Women with endometriosis are frequently misdiagnosed with irritable bowel syndrome (IBS) for some time before a correct diagnosis is made. Visceral hypersensitivity is a key feature in both conditions. AIMS: To determine if there are distinct symptom patterns in women with IBS and endometriosis, and to determine the response of these women to a low FODMAP diet in comparison to those with IBS alone. MATERIALS AND METHODS: A retrospective analysis of prospectively collected data from women attending a specialist IBS service in Christchurch New Zealand. Data from those who met Rome III criteria for IBS were sorted into two groups: concurrent endometriosis and those with IBS alone. Demographics and symptom patterns were identified from a prospective questionnaire. A low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) diet was taught to all women as the primary therapeutic intervention. Responses to the diet were noted against their ultimate disposition. RESULTS: Of the 160 women who met Rome III criteria for IBS, 36% had concurrent endometriosis. The presence of dyspareunia (P > 0.0001), referred pain (P = 0.005), bowel symptoms exacerbated by menstruation (P = 0.0004) and a family history of endometriosis (P = 0.0003) were associated with concurrent endometriosis. Seventy two percent of these women reported a >50% improvement in bowel symptoms after four weeks of a low FODMAP diet compared with 49% in those with no known endometriosis (P = 0.001, odds ratio 3.11, 95% CI, 1.5-6.2). CONCLUSIONS: Women with concurrent endometriosis and IBS report a unique symptom phenotype. The low FODMAP diet appears effective in women with gut symptoms and endometriosis.

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Condition tags

dyspareuniaendometriosischronic_pelvic_painirritable_bowel_syndrome

MeSH descriptors

Endometriosis Irritable Bowel Syndrome Irritable Bowel Syndrome Adolescent Adolescent Adult Adult Aged Aged Aged, 80 and over Aged, 80 and over Back Pain Back Pain Back Pain Disaccharides Disaccharides Disaccharides Dyspareunia Dyspareunia Dyspareunia

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (22)

Cited by (50)

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