IBD risk raised in endometriosis patients
MedWire News: Women with the chronic condition endometriosis have an increased long-term risk for ulcerative colitis (UC) and Crohn's disease, demonstrate study findings published in the journal Gut.
The research suggests there is "a genuine association between the diseases, which may either reflect common immunological features, or an impact of endometriosis treatment with oral contraceptives [OC] on risk of inflammatory bowel disease (IBD)," say lead author Tine Jess (Statens Serum Institut, Copenhagen, Denmark) and team.
IBD and endometriosis share immunologic abnormalities with other autoimmune diseases, and endometriosis may cause bowel pain and tissues changes similar to those seen in Crohn's disease.
To investigate the relationship between IBD and endometriosis further, the researchers examined data from a national register of 37,661 Danish women who were admitted to hospital with endometriosis between 1977 and 2007.
Compared with the general population, women with endometriosis were significantly more likely to be diagnosed with any form of IBD, with a standardized incidence ratio (SIR) of 1.5. The SIRs for UC and Crohn's disease were 1.5 and 1.6, respectively.
Indeed, women were significantly more likely to be diagnosed with IBD even 20 years after developing endometriosis, with SIRs of 1.5 and 1.8 for UC and Crohn's disease, respectively.
When the researchers examined data only for women whose endometriosis had been confirmed by surgery, the association between endometriosis and UC and Crohn's disease became stronger, with SIRs of 1.8 and 1.7, respectively.
"A diagnosis of either endometriosis or IBD should not lead to the other diagnosis being disregarded and, hence, should not disqualify further clinical examination of patients with persisting abdominal or gynaecological symptoms," write Jess et al.
They suggest that further research is warranted to determine whether the IBD phenotype differs between patients with and without endometriosis.
Noting that previous research has suggested a potential link between OC use and increased risk for IBD, the team recommends that this association be examined further, especially with regard to patients with endometriosis.
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By Lynda Williams