Background and aims:Gastro-intestinal(GI)symptoms are often experienced by healthy women during menstruation.An increased frequency of GI symptoms during menses has also been reported in women with irritable bowel syn...Background and aims:Gastro-intestinal(GI)symptoms are often experienced by healthy women during menstruation.An increased frequency of GI symptoms during menses has also been reported in women with irritable bowel syndrome or inflammatory bowel disease(IBD);however,IBD patients with restorative proctocolectomy and ileal pouch-anal anastomoses(IPAA)have not been studied.We aimed to examine the association between GI symptoms before and during menses in patients with IPAA,and to assess factors for exacerbation of GI symptoms in those patients.Methods:Adult women recorded in the Pouchitis Registry were invited to participate in a mailed survey.Participants reported on GI symptoms 1–5 days prior to-(pre-menses)and during the days of their menses in recent months.Demographic and clinical variables were obtained through the survey and chart review.Results:One hundred and twenty-eight(21.3%)out of 600 women with IPAA responded to the survey questionnaire.Fortythree(33.5%)were excluded for reasons including post-menopausal(n=25),hysterectomy(n=14)and use of contraceptives(n=4).Abdominal pain(P=0.001),diarrhea(P=0.021),and urgency(P=0.031)were more commonly reported during menses than pre-menses by the participants.Only a history of painful menses was significantly associated with increased GI symptoms during menses for patients with ileal pouch(odds ratio=5.67;95%confidence interval:1.41–22.88;P=0.015).Conclusion:GI symptoms such as abdominal pain,diarrhea,and urgency are commonly associated with menses in patients with ileo-anal pouch.Painful menses may be associated with worsening of GI symptoms.展开更多
Gender-related physiological variations in gastrointestinal(GI)symptomatology have been observed in women of reproductive age.Many women experience cyclical changes in GI symptomatology during their menstrual cycle,pa...Gender-related physiological variations in gastrointestinal(GI)symptomatology have been observed in women of reproductive age.Many women experience cyclical changes in GI symptomatology during their menstrual cycle,particularly alteration in their bowel habits.Physiological studies of healthy women during the menstrual cycle showed a prolonged GI transit time during the luteal phase,either in the oro-cecumroute or in the colon.Worsened GI symptoms,such as abdominal pain,bloating or diarrhea are observed in patients with irritable bowel syndrome(IBS)during menses.This may be due to elevated prostaglandin levels during menses,with an enhanced perception of viscera-somatic stimuli resulting in nausea,abdominal distension and pain.Also patients with IBS or IBD demonstrate a cyclical pattern more closely related to their bowel habits than healthy controls.Women with inflammatory bowel disease(IBD)also have exacerbated symptoms during menses;however,it is unclear whether this relates to physiological variation or disease exacerbation in IBS or IBD.Studies examining the association of the menstrual cycle and GI symptomatology in patients with IBS or IBD,have not yet clarified the underlying mechanisms.Moreover medications—such as non-steroidal anti-inflammatory drugs and oral contraceptive pills used for dysmenorrhea and menstrual migraine in those patients have not well been controlled for in the previous studies,which can contribute to further bias.Understanding changes in GI symptomatology during the menstrual cycle may help to determine the true extent of disease exacerbation and proper management strategy.展开更多
文摘Background and aims:Gastro-intestinal(GI)symptoms are often experienced by healthy women during menstruation.An increased frequency of GI symptoms during menses has also been reported in women with irritable bowel syndrome or inflammatory bowel disease(IBD);however,IBD patients with restorative proctocolectomy and ileal pouch-anal anastomoses(IPAA)have not been studied.We aimed to examine the association between GI symptoms before and during menses in patients with IPAA,and to assess factors for exacerbation of GI symptoms in those patients.Methods:Adult women recorded in the Pouchitis Registry were invited to participate in a mailed survey.Participants reported on GI symptoms 1–5 days prior to-(pre-menses)and during the days of their menses in recent months.Demographic and clinical variables were obtained through the survey and chart review.Results:One hundred and twenty-eight(21.3%)out of 600 women with IPAA responded to the survey questionnaire.Fortythree(33.5%)were excluded for reasons including post-menopausal(n=25),hysterectomy(n=14)and use of contraceptives(n=4).Abdominal pain(P=0.001),diarrhea(P=0.021),and urgency(P=0.031)were more commonly reported during menses than pre-menses by the participants.Only a history of painful menses was significantly associated with increased GI symptoms during menses for patients with ileal pouch(odds ratio=5.67;95%confidence interval:1.41–22.88;P=0.015).Conclusion:GI symptoms such as abdominal pain,diarrhea,and urgency are commonly associated with menses in patients with ileo-anal pouch.Painful menses may be associated with worsening of GI symptoms.
文摘Gender-related physiological variations in gastrointestinal(GI)symptomatology have been observed in women of reproductive age.Many women experience cyclical changes in GI symptomatology during their menstrual cycle,particularly alteration in their bowel habits.Physiological studies of healthy women during the menstrual cycle showed a prolonged GI transit time during the luteal phase,either in the oro-cecumroute or in the colon.Worsened GI symptoms,such as abdominal pain,bloating or diarrhea are observed in patients with irritable bowel syndrome(IBS)during menses.This may be due to elevated prostaglandin levels during menses,with an enhanced perception of viscera-somatic stimuli resulting in nausea,abdominal distension and pain.Also patients with IBS or IBD demonstrate a cyclical pattern more closely related to their bowel habits than healthy controls.Women with inflammatory bowel disease(IBD)also have exacerbated symptoms during menses;however,it is unclear whether this relates to physiological variation or disease exacerbation in IBS or IBD.Studies examining the association of the menstrual cycle and GI symptomatology in patients with IBS or IBD,have not yet clarified the underlying mechanisms.Moreover medications—such as non-steroidal anti-inflammatory drugs and oral contraceptive pills used for dysmenorrhea and menstrual migraine in those patients have not well been controlled for in the previous studies,which can contribute to further bias.Understanding changes in GI symptomatology during the menstrual cycle may help to determine the true extent of disease exacerbation and proper management strategy.
