GI symptoms may signal endometriosis

Endometriosis should be considered as a cause of gastrointestinal symptoms in female patients being investigated for irritable bowel syndrome, Australian researchers say. Gastrointestinal symptoms were nearly as common as gynaecological symptoms in women with endometriosis, according to a study of more than 350 women who underwent laparoscopy for suspected endometriosis. Of the 290 women in the study found to have endometriosis, 90% had one or more gastrointestinal symptom, yet only 7.5% of these women had gastrointestinal endometriosis, the authors reported. Bloating was the most commonly reported gastrointestinal symptom, followed by nausea, the study found. However, all gastrointestinal symptoms, including diarrhoea, vomiting, constipation and rectal bleeding, were similarly predictive of histologically confirmed endometriosis, the authors said. A total of 76 women included in the study had been diagnosed with irritable bowel syndrome, of which 79% were found to have endometriosis on laparoscopy. “To what extent this represents error in the previous diagnosis or genuine comorbidity is difficult to determine,” the authors said. Previous research suggested about a third of patients attending gynaecology clinics might have IBS. About 20% of women with IBS show an exacerbation of their symptoms around the time of menstruation, the authors also noted. “As a result, subsequent investigation of the symptoms and the ultimate diagnosis and management largely depend on which symptoms are perceived to be disruptive enough to seek medical attention,” they wrote. “In conclusion our findings show that, irrespective of any bowel involvement, gastrointestinal symptoms are nearly as frequent as gynaecological symptoms in women with endometriosis,” the authors said. The finding indicated that a diagnosis of IBS “warrants exclusion of endometriosis as an organic substrate for the symptoms”. Australian and New Zealand Journal of Obstetrics and Gynaecology Australian Doctor...