Gastrointestinal symptoms in abused nonpatient women.

BACKGROUND

Severely abused nonpatient women report a high number of gastrointestinal (GI) symptoms and GI syndromes. Little is known about whether the abuse‒symptom relationship varies across different life, social, and community conditions.

OBJECTIVE

To comparatively assess the timing, type and severity of physical and/or sexual abuse and GI symptoms of nonpatient women who contacted a lawyer for legal support with those who sought shelter in antiviolence centers.

SUBJECTS AND METHODS

Forty-six lawyer controls (LCs) (aged 29-80 years) and 67 women (aged 18-58 years) sheltered in antiviolence (V) centers completed an identical anonymous questionnaire with medical and abuse sections. The severity of abuse was assessed with the 0-6 Abuse Severity Measure (ASM). The associations between abuse characteristics and the number of symptoms were assessed with the Poisson regression model.

RESULTS

Among the LC women, 65% experienced physical and/or sexual abuse in childhood and/or adulthood, whereas 100% of the V women did. In both groups, most women experienced combined sexual and physical abuse in childhood and adulthood. The ASM was < 2 in 57% of the LC and 18% of the V women. LC and V women reported an average of 4.9 and 4.6 GI symptoms, respectively. In both groups, women who had been both sexually and physically abused reported a greater number of GI symptoms. Childhood and adulthood abuse were associated with more GI symptoms only in V women. LC women with ASM > 2 reported more GI symptoms than those with an ASM of < 2 (median; IQR: 6.5; 3-11 vs 3; 1-7, p = 0.002). V women with ASM > 5 reported significantly more GI symptoms than control women with ASM < 5 (median; IQR: 6; 4-8 vs 4.5; 2-8, p < 0.001).

CONCLUSIONS

In abused "nonpatient" women, the combination of physical and sexual abuse, childhood and adulthood abuse and higher severity scores were associated with a greater number of GI symptoms, irrespective of the social and economic setting.