Background & Aims

Gastroenterologic symptoms often are reported by adults with endometriosis, leading to unnecessary diagnostic tests or complicated treatment. We investigated associations between endometriosis and irritable bowel syndrome (IBS) in adolescents and whether concurrent pain disorders affect these.

Methods

We collected data from within The Women’s Health Study: Adolescence to Adulthood, which is a US longitudinal study of premenopausal females with and without endometriosis. Our study cohort included participants younger than 21 years enrolled from 2012 to 2018. Participants completed an extensive health questionnaire. Those with IBS based on a self-reported diagnosis or meeting Rome IV diagnostic criteria were considered cases and those without IBS were controls. Subjects without concurrent gastrointestinal disorders or missing pain data (n = 323) were included in the analyses. We calculated adjusted odds ratios using unconditional logistic regression.

Results

More adolescents with endometriosis (54 of 224; 24%) had comorbid IBS compared with adolescents without endometriosis (7 of 99; 7.1%). The odds of IBS was 5.26-fold higher among participants with endometriosis than without (95% CI, 2.13–13.0). In girls with severe acyclic pelvic pain, the odds of IBS was 35.7-fold higher in girls without endometriosis (95% CI, 4.67–272.6) and 12-fold higher in girls with endometriosis (95% CI, 4.2–36.3), compared with no/mild pain. For participants with endometriosis, each 1-point increase in acyclic pain severity increased the odds of IBS by 31% (adjusted odds ratio, 1.31; 95% CI, 1.18–1.47).

Conclusions

In an analysis of data from a longitudinal study of girls and women with and without endometriosis, we found significant associations between endometriosis and IBS, and a linear relationship between acyclic pelvic pain severity and the odds of IBS. Increased provider awareness and screening for IBS and endometriosis will improve patient outcomes and increase our understanding of these complex disorders.

中文翻译：

---

青少年肠易激综合征诊断与子宫内膜异位症的重叠

背景与目标

患有子宫内膜异位症的成年人通常会报告胃肠道症状，导致不必要的诊断测试或复杂的治疗。我们调查了青少年子宫内膜异位症和肠易激综合征 (IBS) 之间的关联，以及并发疼痛疾病是否会影响这些。

方法

我们从“女性健康研究：青春期到成年期”中收集了数据，这是一项针对患有和不患有子宫内膜异位症的绝经前女性的美国纵向研究。我们的研究队列包括从 2012 年到 2018 年招募的年龄小于 21 岁的参与者。参与者完成了一份广泛的健康问卷。那些基于自我报告诊断或符合罗马 IV 诊断标准的 IBS 被认为是病例，而那些没有 IBS 的被认为是对照。没有并发胃肠道疾病或缺失疼痛数据的受试者 (n = 323) 被纳入分析。我们使用无条件逻辑回归计算了调整后的优势比。

结果

与没有子宫内膜异位症的青少年（99 人中的 7 人；7.1%）相比，患有子宫内膜异位症的青少年更多（224 人中的 54 人；24%）患有 IBS。患有子宫内膜异位症的参与者患 IBS 的几率比没有子宫内膜异位症的参与者高 5.26 倍（95% CI，2.13-13.0）。相比之下，在患有严重非周期性盆腔痛的女孩中，没有子宫内膜异位症的女孩患 IBS 的几率高 35.7 倍（95% CI，4.67-272.6），而患有子宫内膜异位症的女孩患 IBS 的几率高 12 倍（95% CI，4.2-36.3）无/轻度疼痛。对于患有子宫内膜异位症的参与者，非周期性疼痛严重程度每增加 1 分，IBS 的几率就会增加 31%（调整后的优势比，1.31；95% CI，1.18-1.47）。

结论

在对患有和不患有子宫内膜异位症的女孩和女性的纵向研究数据进行分析时，我们发现子宫内膜异位症与 IBS 之间存在显着关联，并且非周期性盆腔疼痛严重程度与 IBS 几率之间存在线性关系。提高提供者对 IBS 和子宫内膜异位症的认识和筛查将改善患者的预后并增加我们对这些复杂疾病的理解。