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New report puts the spotlight on diagnosis and treatments for women’s chronic pelvic pain

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Women suffering from chronic pelvic pain are often misdiagnosed and better solutions are needed to recognise, differentiate and treat conditions such as endometriosis and irritable bowel syndrome (IBS) according to The Gut Foundation.

With up to 25 per cent1 of Australian women living with chronic pelvic pain, The Gut Foundation assembled an expert panel*, to identify the common symptoms and recommend action to manage endometriosis, irritable bowel syndrome (IBS) and chronic pelvic pain (CPP).

The experts have produced a report entitled Understanding Endometriosis, Irritable Bowel Syndrome and Chronic Pelvic Pain which provides succinct information about the symptoms, diagnosis and recommended treatments.

This is the first time a report has examined the common confusion and symptom crossover between these debilitating illnesses affecting so many Australian women.

Professor Terry Bolin OAM, the President and Founder of The Gut Foundation, says these all too common health concerns are notoriously tricky to diagnose as there are so many overlapping symptoms.

“As it may take time to reach the correct diagnosis, it is entirely reasonable to treat the symptoms in the interim,” says Professor Bolin. “As pain is a problem, an anti-spasmodic is probably more helpful than non-steroidal drugs or simple analgesics. We also often advise women to increase their fibre intake to overcome constipation and to avoid foods that can cause bloating. A simple herbal preparation like Iberogast can also be helpful.

“In a telephone survey2 of 1295 female patients aged 18 to 49, half of the respondents were affected by bloating. In 17 per cent, it was disabling from a work or social viewpoint and it was commonly associated with constipation,” says Professor Bolin.

In an Australian study3 of women with suspected endometriosis, 90 per cent had gastrointestinal symptoms and about 20 per cent had previously been diagnosed with IBS. Bloating was the most common gastrointestinal symptom, followed by nausea, constipation, diarrhoea, vomiting and rectal bleeding.

A summary of 13 different studies4 concluded that women with endometriosis are two or three times more likely to also have IBS compared to women without endometriosis.

“We were inspired to create the report when we realised that there really wasn’t anything available that summarised the commonalities between endometriosis, IBS and CPP, so we wanted to produce a document that would be useful not only to those affected, but also to the medical practitioners and organisations trying to alleviate these women’s suffering,” says Professor Bolin.

The Understanding Endometriosis, Irritable Bowel Syndrome and Chronic Pelvic Pain report is available as a free download from The Gut Foundation’s website or in printed format.

About The Gut Foundation 

Founded by the Gastroenterological Society of Australia in 1983, The Gut Foundation was created to help in the prevention of disease through research and education.

The Foundation is a not-for-profit organisation specialising in research and education into all aspects of gastrointestinal and digestive health, for both the public and fellow medical practitioners.

The Gut Foundation works with researchers and health professionals all over Australia, to build awareness, improve community understanding, educate, improve screening for digestive diseases, improve standards in practice and research and to engage in and encourage scientific research in relation to digestive disease.

The Board is made up of Gastroenterologists and a number of professionals from various fields, that are dedicated to improving the digestive health of all Australians through the treatment and prevention of gastrointestinal diseases and conditions including: bowel cancer, coeliac disease, inflammatory bowel disease, irritable bowel syndrome, malnutrition, reflux, diarrhoea, bloating and constipation.

Sources:

  1. Evans S. Management of persistent pelvic pain in girls and women. Australian Family Physician 2015; 44: 454-459.
  2. Bolin TD. Understanding Gas & Bloating. Why can’t I do my jeans up at night? NSW: The Gut Foundation, 2011.
  3. Maroun P et al. Relevance of gastrointestinal symptoms in endometriosis. Aust N Z J Obstet Gynaecol 2009; 49: 411–414.
  4. Saidi K et al. A systematic review and meta-analysis of the associations between endometriosis and irritable bowel syndrome. Eur J Obstet Gynecol Reprod Biol 2020; 246: 99–105.
  5. American College of Obstetricians and Gynaecologists, Endometriosis
    https://www.acog.org/patient-resources/faqs/gynecologic-problems/endometriosis
  6. Enck P et al. Irritable bowel syndrome. Nat Rev Dis Primers 2016; 2: 16014.
  7. Evans S. Management of persistent pelvic pain in girls and women. Australian Family Physician 2015; 44: 454-459.
  8. Gut Foundation. Irritable bowel syndrome. Diagnosis and management.
  9. Jean Hailes Foundation. Pelvic pain. https://www.jeanhailes.org.au/news/pelvic-pain-know-the-differences-and-when-to-seek-help
  10. Mayo Clinic. Chronic pelvic pain in women. https://www.mayoclinic.org/diseases-conditions/chronic-pelvic-pain/symptoms-causes/syc-20354368 
  11. Saidi K et al. A systematic review and meta-analysis of the associations between endometriosis and irritable bowel syndrome. Eur J Obstet Gynecol Reprod Biol 2020; 246: 99–105.
  12. Zondervan KT et al. Endometriosis. Nat Rev Dis Primers. 2018; 4: 9.
  13. The Obstetrician & Gynaecologist https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1111/tog.12241
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