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

The Australian & New Zealand journal of obstetrics & gynaecology
April 1, 2017
Judith S Moore et al. (4 authors)
Journal ArticleHuman Study
Study Details

Study Goal

The researchers aimed to determine if women with IBS and concurrent endometriosis exhibit distinct symptom patterns and how they respond to a low-FODMAP diet compared to those with IBS alone.

Results Summary

The study found that 72% of women with IBS and endometriosis reported >50% improvement in bowel symptoms after four weeks on a low-FODMAP diet, compared to 49% in those with IBS alone. The diet appeared particularly effective for women with gut symptoms and endometriosis.

Population

Women meeting Rome III criteria for IBS, with a subset having concurrent endometriosis.

Effective Dosage

Not specified

Duration

4 weeks

Interactions

None mentioned

Extracted Claims (6)
InterventionDirectionEndpointPopulationDosageImpactClaim #
low FODMAP diet
decrease
bowel symptoms
women with concurrent endometriosis and IBS
>50% improvement
reported a >50% improvement
#1
low FODMAP diet
decrease
bowel symptoms
women with no known endometriosis
49%
reported a >50% improvement
#2
-
increase
dyspareunia
women with concurrent endometriosis
P > 0.0001
were associated with
#3
-
increase
referred pain
women with concurrent endometriosis
P = 0.005
were associated with
#4
-
increase
bowel symptoms exacerbated by menstruation
women with concurrent endometriosis
P = 0.0004
were associated with
#5
-
increase
family history of endometriosis
women with concurrent endometriosis
P = 0.0003
were associated with
#6
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.

Medical Subject Headings (MeSH)
AdolescentAdultAgedAged, 80 and overBack PainDisaccharidesDyspareuniaEndometriosisFemaleHumansIrritable Bowel SyndromeMenstruationMiddle AgedMonosaccharidesOligosaccharidesPelvic PainRetrospective StudiesSurveys and QuestionnairesSymptom AssessmentSymptom Flare UpYoung Adult
Study Links
Quality Scores
SafetyNot Assessed
Efficacy85/10
Quality75/10
Citation Metrics
Total Citations75
Citations/Year9.4
Relative Citation Ratio4.30
NIH Percentile91.2%
Research Impact Scores
APT Score0.95
Weight Score2.10
Normalized Score0.69
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