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Periods worsen irritable bowel symptoms

March 11, 2002

Having a period significantly worsens symptoms of irritable bowel syndrome (IBS) and lowers pain thresholds, finds research in Gut.

A tiny balloon catheter was inserted into the rectum of 29 women with IBS, all aged between 21 and 44. This was serially inflated during the four different stages of the menstrual cycle to detect changes in sensitivity and other sensations, such as urge. The women were also asked to keep a general symptom diary and their levels of anxiety and depression were assessed.

Abdominal pain and bloating were significantly worse when the women had their period compared with most other phases of the cycle. Bowel habits became more frequent and the women tended to report lower general well-being, although there was no evidence that they were more depressed or anxious at this time.

Their rectal sensitivity was also significantly increased at the time of their period, more so than during any other phase of their cycle. The balloon distension needed to induce urge and discomfort were all lower. But there were no differences in motility or rectal tension and pressure, suggesting that the increased sensitivity was independent of any other bowel changes.

The authors conclude that women with IBS respond differently to hormonal cycles than women without the syndrome. They suggest that the guts of women with IBS, which are already acutely sensitive, may be further sensitised by other triggers such as hormones.

British Medical Journal (BMJ)

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