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Functional bowel disorders in patients with pelvic organ prolapse and incontinence       12/08/05 12:10 PM Edit Reply Quote Heather Reged: 12/09/02 Posts: 7799 Loc: Seattle, WA American Journal of Obstetrics and Gynecology Volume 193, Issue 6 , December 2005, Pages 2105-2111 doi:10.1016/j.ajog.2005.07.016 Copyright © 2005 Mosby, Inc. All rights reserved. Transactions from the 31st Annual Scientific Meeting of the Society of Gynecologic Surgeons Functional bowel and anorectal disorders in patients with pelvic organ prolapse and incontinence John E. Jelovsek MD, , Matthew D. Barber MD, MHS, Marie Fidela R. Paraiso MD and Mark D. Walters MD Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Gynecology and Obstetrics, The Cleveland Clinic Foundation, Cleveland, OH Objective The purpose of this study was 1) to determine the prevalence of functional bowel and anorectal disorders as defined by the Rome II criteria in patients with advanced pelvic organ prolapse (POP) and urinary incontinence (UI), and (2) to determine if the extent of prolapse on gynecologic examination is related to the subtypes of constipation or any functional anorectal pain disorder. Study design Three hundred and two consecutive female subjects presenting to a tertiary urogynecology clinic were enrolled. Demographic, general medical, and physical examination information, including POPQ measurements and a standardized sacral neurologic evaluation, were collected. The prevalence of functional disorders of the bowel, rectum, and anus as defined by the Rome II criteria were collected using the Rome II Modular questionnaire. Relationships of functional disorders to various components of the vaginal examination were reviewed. Results Thirty-six percent (108/302) met the criteria for constipation, including the following subtypes: 19% outlet constipation, 5% functional constipation, 5% constipation predominant irritable bowel syndrome (IBS), and 7% IBS-outlet. Nineteen percent (56/302) of subjects had IBS or 1 of its subtypes. Functional diarrhea was seen in 6% (17/302), fecal incontinence in 19% (58/302), and anorectal pain disorders in 25% (77/302). After controlling for age, parity, diabetes, constipating medications, and previous pelvic surgery, there were no differences in the prevalence of constipation or any of its subtypes between patients with UI and those with stage 3 or 4 POP. Fecal incontinence was independently associated with UI (adjusted odds ratio [OR] 6.3; 95% CI 2.6–19.1), but not advanced POP. Neither overall stage of POP nor stage of posterior vaginal prolapse was significantly associated with any of the functional bowel disorders, including constipation and its subtypes. Perineal body measurement was significantly longer in patients with outlet type constipation (mean 3.5 ± 0.6 cm vs 3.1 ± 0.9 cm, P < .01) and in those with proctalgia fugax (mean 3.4 ± 1.0 vs 3.1 ± 0.8, P < .05). Conclusion There is a high prevalence of constipation and anorectal pain disorders in women with urinary incontinence and pelvic organ prolapse. However, patients with stage 3 or 4 pelvic organ prolapse have similar rates of constipation compared with those with urinary incontinence. Constipation and its subtypes are not related to the stage of pelvic organ prolapse. It appears that either constipation is not a significant contributor to prolapse, or constipation contributes equally to the development of both urinary incontinence and pelvic organ prolapse. Key words: Pelvic organ prolapse; Urinary incontinence; Constipation; Functional bowel disorders Presented at the 31st Annual Meeting of the Society of Gynecologic Surgeons, April 4-6, 2005, Rancho Mirage, CA. Reprint requests: John E. Jelovsek, MD, The Cleveland Clinic Foundation, Department of Gynecology and Obstetrics, 9500 Euclid Avenue/A81, Cleveland, OH 44195. American Journal of Obstetrics and Gynecology Volume 193, Issue 6 , December 2005, Pages 2105-2111 http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6W9P-4HPHP0W-1H&_user=10&_handle=V-WA-A-W-ZE-MsSAYVW-UUA-U-AABZBCUYWV-AABBEBAZWV-CAYVDDUYD-ZE-U&_fmt=summary&_coverDate=12%2F31%2F2005&_rdoc=43&_orig=browse&_srch=%23toc%236688%232005%23998069993%23612735!&_cdi=6688&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=1ccf1c0d7e537286309144d801f02208 -------------------- Heather is the Administrator of the IBS Message Boards. She is the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook! Print     Remind Me     Notify Moderator

Entire thread Gender / Hormones Heather 07/14/03 01:57 PM Pain management in women is often overlooked and ineffective Heather 02/16/15 04:42 PM Women, Hormones and IBS Heather 03/11/14 02:09 PM Fennel is an effective herbal drug for menstrual pain Heather 08/27/13 11:29 AM Constipation and Risk of Cardiovascular Disease among Postmenopausal Women Heather 08/03/11 03:58 PM Differences in Gastrointestinal Symptoms According to Gender in Rome II Positive IBS and Dyspepsia Heather 03/11/10 01:51 PM Gender-related differences in prepulse inhibition of startle in irritable bowel syndrome Heather 03/11/10 01:48 PM No evidence of sex differences in heritability of irritable bowel syndrome Heather 03/31/08 11:36 AM Acupuncture for the treatment of pain from a gender perspective. Heather 03/31/08 11:27 AM The menstrual cycle and its effect on inflammatory bowel disease and irritable bowel syndrome Heather 11/07/07 02:35 PM Irritable Bowel Syndrome Is More Common in Women Regardless of the Menstrual Phase Heather 11/07/07 02:31 PM Pelvic floor dysfunction and IBS in patients with interstitial cystitis. Heather 10/10/07 12:33 PM Women with IBS have abnormal pain modulation Heather 10/10/07 12:01 PM Anxiety or Depression with IBS Affects More Women Than Men Heather 09/24/07 11:31 AM Colonoscopies more difficult and painful for women and people with IBS Heather 09/24/07 11:22 AM Role of gender and early childhood in constipation Heather 09/13/07 11:09 AM Changes in Bowel Function: Pregnancy and the Puerperium Heather 03/01/07 01:39 PM Drugs for gastrointestinal disorders in pregnant women. Heather 05/13/06 03:20 PM Functional bowel disorders in patients with pelvic organ prolapse and incontinence Heather 12/08/05 12:10 PM Sex specific alterations in autonomic function among patients with irritable bowel syndrome Heather 11/12/05 01:16 PM Women With Interstitial Cystitis at Risk for Irritable Bowel Syndrome and Depression Heather 09/22/05 04:39 PM Women and Men Perceive Pain Differently Heather 09/13/05 12:55 PM Overlapping Conditions in Women With Irritable Bowel Syndrome Heather 04/24/05 03:58 PM Bowel habit in irritable bowel syndrome in women: Defining an alternator Heather 04/10/05 06:18 PM Recognition and treatment of irritable bowel syndrome among women with chronic pelvic pain Heather 03/28/05 12:18 PM Irritable bowel syndrome, chronic pelvic inflammatory disease and endometriosis Heather 02/19/05 05:43 PM A gene for diarrhoea-predominant IBS in women? Heather 11/28/04 02:21 PM Autonomic Cardiovascular Responses Are Impaired in Women With Irritable Bowel Syndrome Heather 09/12/04 03:41 PM Abdominal Bloating: Relation to Rectal Hypersensitivity and Menstrual Cycle Heather 06/27/04 01:55 PM Catching Colon Cancer in Women Can Be Tough Heather 04/13/04 03:32 PM Women More Sensitive to Pain Than Men Heather 04/13/04 03:31 PM Gender Differences In Brain Response To IBS Pain Heather 11/18/03 03:32 PM After Menopause, IBS Lessens in Women Heather 11/04/03 03:34 PM Is hormone replacement therapy associated with an increased risk of irritable bowel syndrome? Heather 07/25/03 11:43 AM Sleep disturbance influences gastrointestinal symptoms in women with irritable bowel syndrome. Heather 07/18/03 01:00 PM Symptoms across the menstrual cycle in women with irritable bowel syndrome. Heather 07/18/03 12:58 PM Does a physically active lifestyle improve symptoms in women with irritable bowel syndrome? Heather 07/18/03 12:54 PM Relation between hysterectomy and the irritable bowel Heather 07/18/03 11:48 AM Diagnosis and management of IBS, constipation, and diarrhea in pregnancy. Heather 07/18/03 11:47 AM Physician perception of IBS management in women and men. Heather 07/15/03 06:38 PM Gender issues in the management of IBD and IBS Heather 07/15/03 06:11 PM Gender differences in gut transit Heather 07/15/03 06:07 PM Bowel dysfunction in postmenopausal women. Heather 07/15/03 06:04 PM Irritable Bowel Syndrome Worse During Periods Heather 07/14/03 03:25 PM Sex-related differences in IBS patients: Central processing of visceral stimuli Heather 07/14/03 02:40 PM

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