Irritable bowel undetected in pelvic pain patients

Irritable bowel syndrome (IBS), which is marked by bloating, pain, constipation and diarrhea, often goes unrecognized and, therefore, untreated, in women with chronic pelvic pain, according to a new report.

This is of concern to the authors of the report who point out that treatment of IBS may relieve the overall Abdominal pain experienced by these women.

Chronic pelvic pain is a syndrome "loosely defined by a long duration of pain in the pelvis," Dr. Rachel E. Williams and colleagues from the University of North Carolina at Chapel Hill explain in the American Journal of Obstetrics and Gynecology this month.

It affects 12 percent to 25 percent of women at any point in time and 33 percent to 39 percent of women during their lifetime. Roughly one third of women with chronic pelvic pain have IBS.

To see if IBS is being recognized and treated among these women, the investigators surveyed 987 new patients attending a chronic pelvic pain clinic over about a 7-year period.

They report that 35 percent of the women met standard criteria for IBS, yet 40 percent did not receive a diagnosis of IBS from her physician. Furthermore, IBS treatments were not recommended to 67 percent of women with IBS.

This survey indicates that doctors are "missing an opportunity to treat symptoms of IBS, another syndrome with chronic pain in the abdominal region," the authors say. Currently, researchers do not know why IBS and chronic pelvic pain are associated. "If we recognize and treat IBS, pelvic pain may also be reduced," the authors say.

They also point out that this survey was conducted in a pelvic pain clinic. "In a more general gynecology office, it is likely that diagnosis and treatment of IBS are even worse," they write.

SOURCE: American Journal of Obstetrics and Gynecology, March 2005.