title: Gastrointestinal symptoms before and during menses in women with IBD.
abstract: BACKGROUND
  It is believed that women with inflammatory bowel disease (IBD) have heightened symptoms around their menses. However, there is little information regarding normative changes and which symptoms emerge in relation to menses.
  
  
  OBJECTIVE
  To determine the relationship between gastrointestinal and other symptoms and menses in a population-based cohort of women with IBD vs. healthy women.
  
  
  METHODS
  Women enrolled in the University of Manitoba IBD Research Registry who were between 18 and 65 years were mailed a survey. A control group of adult women were recruited through out-patient gynaecology clinics. Participants were asked to consider their menstrual periods in the recent several months and report on symptoms 1-5 days prior to and during the days of their menses.
  
  
  RESULTS
  There were 151 premenopausal women with Crohn's disease (CD), 87 with ulcerative colitis (UC) and 156 premenopausal controls. Mean age of menses onset was similar in all three cohorts and the percentage in each group with regular menstrual periods was similar. Premenstrually, abdominal pain was less commonly reported in UC (36.8%) than CD (51%, P = 0.034) and controls (57.6%, P = 0.002). Premenstrually, and during menses diarrhoea was more commonly reported in CD (47.7% and 59.6% respectively) than UC (26.4% P = 0.001 and 42.5%, P = 0.01 respectively) and controls (24.4%, P < 0.0001 and 28.2%, P < 0.0001 respectively). Premenstrually, women with CD (46%) vs. UC (26%) were more likely to report worsening of their IBD symptoms (P = 0.0007), but there was no difference between CD (47%) and UC (39%) for reporting worsening during menses (P = 0.24).
  
  
  CONCLUSIONS
  Compared to healthy women, women with IBD had similar symptom experiences premenstrually, except that those with CD were more likely to have increased diarrhoea premenstrually. During menses, women with CD or UC were more likely to experience diarrhoea than healthy controls.
authors.affiliation: The University of Manitoba IBD Clinical and Research Centre, University of Manitoba, Winnipeg, MB, Canada.
authors.forename: M T
authors.initials: MT
authors.lastname: Bernstein
authors.forename: L A
authors.initials: LA
authors.lastname: Graff
authors.forename: L E
authors.initials: LE
authors.lastname: Targownik
authors.forename: K
authors.initials: K
authors.lastname: Downing
authors.forename: L A
authors.initials: LA
authors.lastname: Shafer
authors.forename: P
authors.initials: P
authors.lastname: Rawsthorne
authors.forename: C N
authors.initials: CN
authors.lastname: Bernstein
authors.forename: L
authors.initials: L
authors.lastname: Avery
mesh_terms: D015746:Abdominal Pain / Q000503:physiopathology*; D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D015331:Cohort Studies; D003093:Colitis, Ulcerative / Q000503:physiopathology*; D003424:Crohn Disease / Q000503:physiopathology*; D003967:Diarrhea / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008598:Menstruation / Q000502:physiology*; D008875:Middle Aged; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult