Gynecological presentations in patients with irritable bowel syndrome possible relation to premenstrual syndrome.

The objective was to assess the impact of symptoms suggestive of irritable bowel syndrome (IBS) in women attending the Obstetrics and Gynecology Clinics with lower abdominal and pelvic pain. A cross-sectional study was conducted in the Department of Obstetrics & Gynecology and Department of Gasteroenterology Assiut University Hospital Assiut. A total of 112 women in reproductive age attending the Obstetrics and Gynecology Clinic complaining of lower abdominal and pelvic pain were recruited. A separate interviews and clinical examinations were done for each patient in Obstetrics and Gynecology and Gasteroenterology Departments. The findings were blinded to all authors before analysis of the results. According to the findings patients were allocated to the following two groups: group I (47 patients 42%) had symptoms suggestive of IBS and group II (65 patients 58%) had no symptoms suggestive of IBS. A firm gynecological diagnosis was reached only in 5 (10.6%) women in group I compared with 17 (26%) in the group II (P < 0.01). Premenstrual syndrome (PMS) was reported in 31 women (66%) in group I compared with 33 women (50.6%) in group II (P < 0.01). Dysmenorrhea dyspareunia mastalgia and low back pain were reported in 61.7% 59.6% 63.0% and 59.0% in group I compared with 52.0% 26.0% 49.0% and 57.0% in group II respectively (P < 0.01 < 0.001 < 0.01 = 0.5). IBS is a significant cause of lower abdominal and pelvic pain in patients attending gynecological clinics especially in PMS. This may indicate a diffuse disorder of smooth muscle affecting the bowel and genitourinary tract. (authors)