Endometriosis and irritable bowel syndrome: a dilemma for the gynaecologist and gastroenterologist

Key content Chronic pelvic pain has a significant impact on health services, accounting for 20% of gynaecological referrals. The overlap between irritable bowel syndrome and endometriosis, two of the leading causes of chronic pelvic pain, should not be overlooked. Visceral sensitivity has been demonstrated in both conditions, further highlighting their similarities. Close communication between gastroenterologists and gynaecologists should help to distinguish the causative condition and improve management. Learning objectives To understand the aetiology, pathology, clinical presentation and current national guidance on endometriosis and irritable bowel syndrome. To increase awareness of visceral hypersensitivity and its significance. To appreciate the importance of good history taking in the approach to women with chronic pelvic pain, to distinguish between causative and incidental conditions. Ethical issues Are we unnecessarily posing risks and false diagnoses on a significant proportion of women with chronic pelvic pain? Is it reasonable to have such a varied investigative approach to such women, depending on who they are first referred to?