Media ReleaseFrom: Wiley-Blackwell
Endometriosis in patients with irritable bowel syndrome: Specifi c symptomatic and demographic profile, and response to the low FODMAP diet
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.