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Associations and gastrointestinal symptoms in women with endometriosis in comparison to women with irritable bowel syndrome : a study based on a population cohort

Stark Junkka, Sofie and Ohlsson, Bodil LU (2023) In BMC Gastroenterology 23(1).
Abstract

Background: Endometriosis and irritable bowel syndrome (IBS) have similar symptoms, pathogenesis, and risk factors. These diagnoses often coexist and are frequently misdiagnosed leading to diagnostic delays. This study of a population-based cohort aimed to investigate associations relating to endometriosis and IBS and to compare gastrointestinal symptoms between endometriosis and IBS. Method: The study cohort included women from the Malmö Offspring Study with information about endometriosis and IBS diagnoses from the National Board of Health and Welfare. The participants answered a questionnaire about lifestyle habits, medical and drug history, and self-reported IBS. The visual analog scale for IBS was used to estimate gastrointestinal... (More)

Background: Endometriosis and irritable bowel syndrome (IBS) have similar symptoms, pathogenesis, and risk factors. These diagnoses often coexist and are frequently misdiagnosed leading to diagnostic delays. This study of a population-based cohort aimed to investigate associations relating to endometriosis and IBS and to compare gastrointestinal symptoms between endometriosis and IBS. Method: The study cohort included women from the Malmö Offspring Study with information about endometriosis and IBS diagnoses from the National Board of Health and Welfare. The participants answered a questionnaire about lifestyle habits, medical and drug history, and self-reported IBS. The visual analog scale for IBS was used to estimate gastrointestinal symptoms the past 2 weeks. Endometriosis diagnosis and self-reported IBS were used as dependent variables to study associations with age, body mass index (BMI), education, occupation, marital status, smoking, alcohol habits, and physical activity using logistic regression. Mann-Whitney U Test or Kruskal-Wallis tests were used to calculate the differences in symptoms between groups. Results: Of the 2,200 women with information from medical records, 72 participants had endometriosis; 21 (29.2%) of these had self-reported IBS. Of the 1,915 participants who had answered the questionnaire, 436 (22.8%) had self-reported IBS. Endometriosis was associated with IBS (OR:1.86; 95%CI:1.06–3.26; p = 0.029), as well as with age 50–59 years (OR:6.92; 95%CI:1.97–24.32; p = 0.003), age ≥ 60 years (OR:6.27; 95%CI:1.56–25.17; p = 0.010), sick leave (OR:2.43; 95%CI:1.08–5.48; p = 0.033), and former smoking (OR:3.02; 95%CI:1.19–7.68; p = 0.020). There was an inverse association with BMI (OR:0.36; 95%CI:0.14–4.91; p = 0.031). IBS was associated with endometriosis (OR:1.77; 95%CI:1.02–3.07; p = 0.041) and sick leave (OR:1.77; 95%CI:1.14–2.73; p = 0.010), with a tendency to association with smoking (OR:1.30; 95%CI:0.98–1.72; p = 0.071). When excluding participants using drugs associated with IBS, the condition was associated with current smoking (OR:1.39; 95%CI:1.03–1.89; p = 0.033) and inversely with age 50–59 years (OR:0.58; 95%CI:0.38–0.90; p = 0.015). There were differences in the gastrointestinal symptoms between IBS and healthy participants, but not between endometriosis and IBS or healthy participants. Conclusion: There were associations between endometriosis and IBS, without differences in gastrointestinal symptoms. Both IBS and endometriosis were associated with smoking and sick leave. Whether the associations reflect causality or depend on common risk factors and pathogenesis remains to be determined.

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author
and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Endometriosis, Gastrointestinal symptoms, Irritable bowel syndrome, Lifestyle habits, Sociodemographic factors
in
BMC Gastroenterology
volume
23
issue
1
article number
228
publisher
BioMed Central (BMC)
external identifiers
  • pmid:37400789
  • scopus:85163844081
ISSN
1471-230X
DOI
10.1186/s12876-023-02861-w
language
English
LU publication?
yes
id
f1eab99d-e43e-4116-952f-c3feaa4b824f
date added to LUP
2023-08-25 12:25:23
date last changed
2024-04-20 01:48:16
@article{f1eab99d-e43e-4116-952f-c3feaa4b824f,
  abstract     = {{<p>Background: Endometriosis and irritable bowel syndrome (IBS) have similar symptoms, pathogenesis, and risk factors. These diagnoses often coexist and are frequently misdiagnosed leading to diagnostic delays. This study of a population-based cohort aimed to investigate associations relating to endometriosis and IBS and to compare gastrointestinal symptoms between endometriosis and IBS. Method: The study cohort included women from the Malmö Offspring Study with information about endometriosis and IBS diagnoses from the National Board of Health and Welfare. The participants answered a questionnaire about lifestyle habits, medical and drug history, and self-reported IBS. The visual analog scale for IBS was used to estimate gastrointestinal symptoms the past 2 weeks. Endometriosis diagnosis and self-reported IBS were used as dependent variables to study associations with age, body mass index (BMI), education, occupation, marital status, smoking, alcohol habits, and physical activity using logistic regression. Mann-Whitney U Test or Kruskal-Wallis tests were used to calculate the differences in symptoms between groups. Results: Of the 2,200 women with information from medical records, 72 participants had endometriosis; 21 (29.2%) of these had self-reported IBS. Of the 1,915 participants who had answered the questionnaire, 436 (22.8%) had self-reported IBS. Endometriosis was associated with IBS (OR:1.86; 95%CI:1.06–3.26; p = 0.029), as well as with age 50–59 years (OR:6.92; 95%CI:1.97–24.32; p = 0.003), age ≥ 60 years (OR:6.27; 95%CI:1.56–25.17; p = 0.010), sick leave (OR:2.43; 95%CI:1.08–5.48; p = 0.033), and former smoking (OR:3.02; 95%CI:1.19–7.68; p = 0.020). There was an inverse association with BMI (OR:0.36; 95%CI:0.14–4.91; p = 0.031). IBS was associated with endometriosis (OR:1.77; 95%CI:1.02–3.07; p = 0.041) and sick leave (OR:1.77; 95%CI:1.14–2.73; p = 0.010), with a tendency to association with smoking (OR:1.30; 95%CI:0.98–1.72; p = 0.071). When excluding participants using drugs associated with IBS, the condition was associated with current smoking (OR:1.39; 95%CI:1.03–1.89; p = 0.033) and inversely with age 50–59 years (OR:0.58; 95%CI:0.38–0.90; p = 0.015). There were differences in the gastrointestinal symptoms between IBS and healthy participants, but not between endometriosis and IBS or healthy participants. Conclusion: There were associations between endometriosis and IBS, without differences in gastrointestinal symptoms. Both IBS and endometriosis were associated with smoking and sick leave. Whether the associations reflect causality or depend on common risk factors and pathogenesis remains to be determined.</p>}},
  author       = {{Stark Junkka, Sofie and Ohlsson, Bodil}},
  issn         = {{1471-230X}},
  keywords     = {{Endometriosis; Gastrointestinal symptoms; Irritable bowel syndrome; Lifestyle habits; Sociodemographic factors}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Gastroenterology}},
  title        = {{Associations and gastrointestinal symptoms in women with endometriosis in comparison to women with irritable bowel syndrome : a study based on a population cohort}},
  url          = {{http://dx.doi.org/10.1186/s12876-023-02861-w}},
  doi          = {{10.1186/s12876-023-02861-w}},
  volume       = {{23}},
  year         = {{2023}},
}