Poster Presentation Gastrodiet 2015

Background/Aims: Endometriosis, a chronic organic condition associated with pelvic pain and bowel symptoms, is frequently misdiagnosed as irritable bowel syndrome (IBS) for some time prior to a correct diagnosis. While management is often pharmacological or surgical, we hypothesised bowel symptoms might respond to dietary intervention. Aims: to identify a symptom phenotype that may indicate investigation for endometriosis is warranted, and to compare the responses to a low FODMAP diet (LFD) of women with both endometriosis and IBS with those with IBS alone.

Methods: A consecutive cohort attending a private IBS clinic in Christchurch NZ between 2009 and 2013 prospectively completed a questionnaire on demographics and symptoms. The cohort was grouped into those meeting Rome III criteria for IBS with and without endometriosis. A LFD was taught to all women by a trained Nurse consultant. A positive response to the LFD was determined by the patient reporting a more than 50% improvement in symptoms after 4 weeks of diet.

Results: Of 160 women with IBS, 59 (35%) had a concurrent diagnosis of endometriosis. Mean age of those with endometriosis was 28(16-65) where those without was 38(13-84) (P=0.006). A number of demographics and symptoms were more frequently reported in the group with endometriosis. A positive response to the LFD was reported in 75% of those with endometriosis compared with 51% without (P=0.003).

Conclusions:The positive response to the LFD suggests this should be an additional management strategy for endometriosis. It is not clear why the response was less in those without endometriosis. Physicians should be alerted to investigate for endometriosis when specific symptoms are reported.