Department of Psychology, University of Central Florida, Orlando, FL, 32816, USA.
College of Medicine, University of Central Florida, 6850 Lake Nona Blvd, Orlando, FL, 32827, USA.
BMC Gastroenterol. 2023 Nov 21;23(1):406. doi: 10.1186/s12876-023-03036-3.
Women experience more severe gastrointestinal (GI) symptoms compared to men. The onset of puberty and the menstrual cycle may influence these differences. Additionally, health anxiety is an important construct that has been shown to play a role in increased symptomatology across many medical conditions. Using standardized clinical measures often employed to assess disorders of gut-brain interaction (DGBI) we aimed to identify differences of GI functioning across menstrual cycle phases and to evaluate the role of health anxiety in this relationship.
Six hundred three participants completed a survey including functional GI assessment scales (PROMIS-GI®), an abdominal pain scale and map, and a health anxiety measure. They were grouped by menstrual cycle phases (Menses, Follicular, Early-Luteal, and Premenstrual) based on self-reported start date of most recent period. Multivariate analyses of covariance were conducted to identify differences between menstrual cycle phase and scores on the symptom scales. Heath anxiety was included as a covariate in all analyses.
No significant differences were found between menstrual cycle group and PROMIS-GI scores. Higher GI-symptom and pain levels were found as health anxiety increased. Pain in the hypogastric region of the abdomen was significantly higher during the Menses phase when compared to Early-Luteal and Premenstrual phases. A subset of participants with DGBI diagnoses demonstrated significantly higher GI-symptom severity on several PROMIS-GI scales when compared to matched controls who did not have those diagnoses. In addition, participants with DGBI diagnoses reported significantly greater pain across multiple abdominal regions than their non-diagnosed counterparts.
GI symptom levels as measured by the PROMIS-GI scales in otherwise healthy women were not dependent on menstrual cycle phase. Yet, the PROMIS-GI scales were sensitive to symptom differences in women with DGBI diagnoses. Overall, this study demonstrated that the PROMIS-GI measures are unlikely to be affected by gynecological functioning in healthy young women. We argue that the abdominal pain map is an essential addition to classification and diagnosis.
与男性相比，女性经历更严重的胃肠道（GI）症状。青春期和月经周期的开始可能会影响这些差异。此外，健康焦虑是一个重要的结构，已被证明在许多医疗条件下增加症状学中发挥作用。使用标准化的临床措施，通常用于评估肠-脑相互作用障碍（DGBI），我们旨在确定月经周期各阶段 GI 功能的差异，并评估健康焦虑在这种关系中的作用。
603 名参与者完成了一项调查，包括功能性胃肠道评估量表（PROMIS-GI®）、腹痛量表和地图以及健康焦虑量表。他们根据最近一次经期的自我报告开始日期分为月经周期阶段（经期、卵泡期、早期黄体期和经前期）。进行多元协方差分析，以确定月经周期阶段和症状量表评分之间的差异。健康焦虑被包括在所有分析中作为协变量。
月经周期组与 PROMIS-GI 评分之间未发现显著差异。随着健康焦虑的增加，GI 症状和疼痛水平升高。与早期黄体期和经前期相比，腹部下腹部疼痛明显更高。与没有这些诊断的匹配对照组相比，具有 DGBI 诊断的参与者在几个 PROMIS-GI 量表上的 GI 症状严重程度明显更高。此外，与非诊断参与者相比，具有 DGBI 诊断的参与者报告的多个腹部区域疼痛明显更大。
否则健康女性的 PROMIS-GI 量表测量的 GI 症状水平不受月经周期阶段的影响。然而，PROMIS-GI 量表对具有 DGBI 诊断的女性的症状差异敏感。总体而言，这项研究表明，在健康年轻女性中，PROMIS-GI 测量不太可能受到妇科功能的影响。我们认为腹部疼痛地图是分类和诊断的重要补充。
