Kane S V, Sable K, Hanauer S B
Department of Medicine, University of Chicago, Illinois 60637, USA.
Am J Gastroenterol. 1998 Oct;93(10):1867-72. doi: 10.1111/j.1572-0241.1998.540_i.x.
Female patients with bowel disease commonly report worsening symptoms in relation to the menstrual cycle. Our aim was to determine the nature of gastrointestinal symptoms correlating with the menstrual cycle in women with inflammatory and irritable bowel disease.
This was a retrospective study involving 49 women with ulcerative colitis (UC), 49 women with Crohn's disease (CD), 46 women with irritable bowel syndrome (IBS), and 90 healthy community controls. Participants were interviewed using a questionnaire including information regarding general health, medication history, pregnancy, as well as premenstrual and menstrual symptoms. Chi2 testing and logistic regression modeling were used to test for differences in frequencies between groups and for risk analysis.
Premenstrual symptoms were reported by 93% of all women but statistically more often by patients with CD (p < 0.01). CD patients were also more likely to report increased gastrointestinal symptoms during menstruation ( < 0.01), diarrhea being the symptom reported most often. All disease groups had a cyclical pattern to their bowel habits significantly more than controls (p=0.01). Cyclical symptoms included diarrhea, abdominal pain, and constipation. Logistic regression revealed an odds ratio (OR) of 1.1 (95% CI 0.9-1.2) for experiencing bowel symptoms during the premenstrual and menstrual phases and an OR of 2.0 (95% CI 1.2-3.2) for experiencing a cyclical pattern in bowel habit changes in women with bowel disease.
The prevalence of menstrually related symptoms is high, and appears to affect bowel patterns. The physiological and clinical effects of the menstrual cycle should be taken into consideration when assessing for disease activity.
患有肠道疾病的女性患者通常报告称其症状会随着月经周期而加重。我们的目的是确定炎症性肠病和肠易激综合征女性患者中与月经周期相关的胃肠道症状的性质。
这是一项回顾性研究，涉及49名溃疡性结肠炎（UC）女性患者、49名克罗恩病（CD）女性患者、46名肠易激综合征（IBS）女性患者以及90名健康社区对照者。使用一份问卷对参与者进行访谈，问卷内容包括一般健康状况、用药史、妊娠情况以及经前和经期症状。采用卡方检验和逻辑回归模型来检验组间频率差异并进行风险分析。
所有女性中有93%报告了经前症状，但CD患者报告经前症状的比例在统计学上更高（p<0.01）。CD患者在月经期间报告胃肠道症状加重的可能性也更大（p<0.01），腹泻是最常报告的症状。所有疾病组的排便习惯都有周期性模式，显著多于对照组（p = 0.01）。周期性症状包括腹泻、腹痛和便秘。逻辑回归显示，经前和经期出现肠道症状的比值比（OR）为1.1（95%可信区间0.9 - 1.2），肠道疾病女性排便习惯出现周期性变化的OR为2.0（95%可信区间1.2 - 3.2）。
与月经相关症状的患病率很高，且似乎会影响排便模式。在评估疾病活动时应考虑月经周期的生理和临床影响。
