Luscombe Georgina M, Markham Robert, Judio Mirari, Grigoriu Ariadna, Fraser Ian S
Department of Obstetrics and Gynaecology, Queen Elizabeth II Research Institute for Mothers and Infants, The University of Sydney, Australia.
J Obstet Gynaecol Can. 2009 Dec;31(12):1159-71. doi: 10.1016/s1701-2163(16)34377-8.
To explore the association between the symptom of abdominal bloating and the diagnosis of endometriosis.
Twenty-six patients with endometriosis diagnosed by laparoscopy and 25 women without endometriosis were recruited to a case-control study. Subjects completed detailed questionnaires regarding perception of abdominal bloating, bloating-related symptoms, and effect on lifestyle. Abdominal girth was measured three times daily for one whole menstrual cycle, as were ratings of perceived abdominal bloating severity and discomfort. Experiences of abdominal and gastrointestinal symptoms were compared.
A significantly larger proportion of women with endometriosis than control subjects experienced abdominal bloating (96% vs. 64%). In women with abdominal bloating, the following were more common in those who had endometriosis: associated severe discomfort (30% vs. 0%), wearing loose clothes during bloating (87% vs. 38%), and simultaneous hand swelling (30% vs. 6%). The experiences of cyclically related diarrhea and constipation were more frequent with endometriosis. While there were significant changes in bloating and discomfort ratings across the menstrual cycle, there was a trend towards a difference between the control subjects and unmedicated endometriosis groups only in how the pattern of bloating severity fluctuated across the cycle. Lower abdominal girth measurements changed significantly across menstrual cycle phases. Control and unmedicated endometriosis groups differed significantly in girth changes across the menstrual cycle, controls experiencing much less variation. Compared with the unmedicated endometriosis group, women receiving hormonal treatment had higher bloating severity ratings and discomfort scores, but there was no objective difference in abdominal girth.
Painful abdominal bloating appears to be common in women with endometriosis and causes considerable symptomatic distress.
探讨腹胀症状与子宫内膜异位症诊断之间的关联。
招募了26例经腹腔镜诊断为子宫内膜异位症的患者和25例未患子宫内膜异位症的女性进行病例对照研究。受试者完成了关于腹胀感知、腹胀相关症状以及对生活方式影响的详细问卷。在整个月经周期中，每天测量三次腹围，同时记录感知到的腹胀严重程度和不适感评分。比较腹部和胃肠道症状的发生情况。
与对照组相比，子宫内膜异位症患者中经历腹胀的比例显著更高（96%对64%）。在有腹胀的女性中，以下情况在患有子宫内膜异位症的患者中更为常见：伴有严重不适（30%对0%）、腹胀时穿宽松衣服（87%对38%）以及同时手部肿胀（30%对6%）。与子宫内膜异位症相关的周期性腹泻和便秘更为频繁。虽然整个月经周期中腹胀和不适感评分有显著变化，但仅在腹胀严重程度在周期中的波动模式方面，对照组与未接受药物治疗的子宫内膜异位症组之间存在差异趋势。下腹部围度测量在月经周期各阶段有显著变化。对照组和未接受药物治疗的子宫内膜异位症组在月经周期中的围度变化有显著差异，对照组的变化要小得多。与未接受药物治疗的子宫内膜异位症组相比，接受激素治疗的女性腹胀严重程度评分和不适感得分更高，但腹围没有客观差异。
疼痛性腹胀在子宫内膜异位症女性中似乎很常见，并会引起相当大的症状困扰。
