Both irritable bowel syndrome and some gynecological diseases can give rise to lower abdominal pain, which may result in diagnostic confusion.
Disorders such as endometriosis and chronic pelvic inflammatory disease can be diagnosed definitively only by laparoscopy, which is seldom undertaken in the gastroenterological setting.
Dr Lea, Dr Bancroft and Dr Whorwell undertook a study in order to compare the symptomatology of irritable bowel syndrome with that of laparoscopically confirmed chronic pelvic inflammatory disease and endometriosis.
The researchers administered a symptom questionnaire to 50 women with irritable bowel syndrome and 51 gynecological patients (30 patients with endometriosis, 21 patients with chronic pelvic inflammatory disease).
| Patients with irritable bowel syndrome suffered significantly more upper abdominal pain and colicky pain|
|European Journal of Gastroenterology and Hepatology|
As the symptoms of the 2 gynaecological conditions were so similar, the research team combined the groups for the purposes of comparison with irritable bowel syndrome.
The researchers found that patients with irritable bowel syndrome suffered significantly more upper abdominal pain, colicky pain and exacerbation of pain by food or stress.
They also experienced more disturbances of bowel habit, distension and nausea.
In contrast, the researchers found that the only gynecological features that were more common in the gynecological patients were intermenstrual bleeding, premenstrual exacerbation of pain and forniceal tenderness.
Dr Whorwell concluded, "The presence of gastrointestinal symptomatology, especially bowel dysfunction, in a woman with lower abdominal pain is suggestive of irritable bowel syndrome."
"However, the history may not be so helpful in detecting gynaecological disease."