Irritable bowel syndrome in women having diagnostic laparoscopy or hysterectomy

George F. Longstreth, David B. Preskill, Lee Youkeles
In: Digestive Diseases and Sciences · 1990 · vol. 35(10) , pp. 1285–1290 · doi:10.1007/bf01536421 · PMID:2145139 · W2312378411
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IBS was identified in 47.7% of women undergoing laparoscopy and 39.5% of hysterectomy patients, affecting post-operative outcomes and correlating with gynecologic symptoms.

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This study assessed the prevalence and clinical associations of irritable bowel syndrome (IBS) among women undergoing diagnostic laparoscopy for chronic pelvic pain (n=86), women scheduled for elective hysterectomy (n=172), and age-matched controls (n=172 for the hysterectomy comparison). IBS was common in all groups (47.7% in laparoscopy, 39.5% in hysterectomy, 32.0% in controls), with constipation and pain-predominant IBS more frequent in hysterectomy patients than controls, and dyspareunia more frequent among laparoscopy patients with IBS; in the hysterectomy cohort, chronic pelvic pain and abnormal menses were more prevalent among IBS patients. One year after laparoscopy, IBS patients reported worse overall status and less pain improvement, and for women hysterectomized for pain, pain-subtype IBS was associated with less pain improvement at one year. The paper is explicitly limited by the fact that IBS presence was determined in these specific surgical cohorts and that causal inference cannot be made from the comparisons. This paper is centrally about endometriosis and/or adenomyosis-related pelvic pain—specifically, it examines how comorbid IBS affects outcomes after diagnostic laparoscopy or hysterectomy in women with chronic pelvic pain, conditions that commonly include endometriosis and adenomyosis in this clinical context.

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Abstract

We identified irritable bowel syndrome (IBS) in 47.7% of 86 women having diagnostic laparoscopy for chronic pelvic pain, 39.5% of 172 women having elective hysterectomy, and 32.0% of 172 controls age-matched for the hysterectomy group (P=NS). Constipation and pain subtype IBS were more common in hysterectomy patients than controls (P < 0.05). In laparoscopy patients, dyspareunia was more common in those with IBS than in those without it (P < 0.05). In the hysterectomy group, more IBS patients had chronic pelvic pain (P < 0.005), and abnormal menses (P < 0.01). Chronic pelvic pain was more frequently the only prehysterectomy diagnosis in IBS patients (P < 0.05), and IBS was present more often when pain was a reason for hysterectomy (P < 0.01). One year after laparoscopy, IBS patients gave lower overall status ratings (P < 0.01) and lower pain improvement ratings (P < 0.05) than non-IBS patients. In women who had a hysterectomy for pain, there was less pain improvement one year later in those with the pain subtype of IBS than in non- IBS patients (P < 0.05). IBS is associated with gynecologic symptoms and affects the symptomatic outcome of diagnostic laparoscopy and hysterectomy. Similar content being viewed by others

References

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