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Endometriosis and irritable bowel syndrome: a systematic review and meta-analysis

Abstract

Purpose

Irritable bowel disease and endometriosis are two common diseases characterized by chronic inflammation state and recurrent abdominal pain. As a consequence of sharing of symptoms and chronic inflammation, endometriosis and IBS may coexist and be misdiagnosed and this leads to delays in diagnosis, mismanagement, and unnecessary testing. In recent years, some studies have found higher risk of IBS in women with endometriosis, compared to women without endometriosis. To provide a general overview, we performed a systematic review and a meta-analysis on published data on this issue.

Methods

By a systematic literature search selection process, 11 studies were identified for the current study: 2 prospective and 2 retrospective cohort studies, 4 case–control studies, 1 cross-sectional study and 2 clinical series.

Results

When we meta-analysed data about the prevalence of IBS in women with endometriosis, the overall OR (95%CI), compared to women without endometriosis was 3.26 (1.97–5.39) with no statistically significant heterogeneity. All three studies considering the incidence of IBS in women with a previous diagnosis of endometriosis showed about twofold greater risk among women with endometriosis than women without. Likewise, in the random effects model of the meta-analysis, the overall OR of history of IBS in women with endometriosis was 3.10 (95% CI 2.06–4.67), with no heterogeneity between three studies considered.

Conclusion

This meta-analysis provides epidemiological evidence of a link between endometriosis and IBS, highlighting two or more times higher risk of IBS in women with endometriosis compared to women without the condition.

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Data availability

All data generated and/or analysed during this study are available from the corresponding author on request.

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Funding

This study received no specific grant from any funding agency.

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Authors and Affiliations

Authors

Contributions

FC: project development, systematic literature search, selection papers, data analysis and manuscript writing. FP: conception and project development and manuscript writing. PV: conception and project development. GE: systematic literature search and acquisition data for the work. MB: systematic literature search and acquisition data for the work. PAM: systematic literature search and acquisition data for the work. SC: selection papers and data analysis. ER: selection papers and data analysis.

Corresponding author

Correspondence to Francesca Chiaffarino.

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All the authors declare that they have no conflicts of interest.

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Chiaffarino, F., Cipriani, S., Ricci, E. et al. Endometriosis and irritable bowel syndrome: a systematic review and meta-analysis. Arch Gynecol Obstet 303, 17–25 (2021). https://doi.org/10.1007/s00404-020-05797-8

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  • DOI: https://doi.org/10.1007/s00404-020-05797-8

Keywords

  • Endometriosis
  • Irritable bowel syndrome
  • Systematic review
  • Meta-analysis