The Impact of Pelvic Floor and Lower Gastrointestinal Symptoms on Quality of Life in Women With Systemic Sclerosis.
Systemic sclerosis (SSc) patients with gastrointestinal (GI) involvement have a lower quality of life (QoL) and while the impact of upper GI symptoms on QoL in SSc patients has been described few data exist on the presence and impact of lower gastrointestinal (LGI) and pelvic floor symptoms in SSc. Our goal was to assess the prevalence of these symptoms in women with SSc and evaluate their impact on QoL. A secondary hypothesis was that the impact of LGI symptoms on QoL is mediated by depression.



Women with SSc (n=175) attending an outpatient scleroderma clinic completed multiple validated questionnaires. Pelvic floor and LGI symptoms included fecal incontinence (FI), urinary incontinence (UI), dual incontinence (DI), chronic constipation, diarrhea, and pelvic pain. The Student t tests adjusted for multiple comparisons were used to evaluate group differences at the 0.05 level.



Complete data were available for 160 women. FI was reported by 65, UI by 64, DI by 40, chronic constipation by 94, diarrhea by 82, and pelvic pain by 35 of SSc patients. Overall QoL was reduced in SSc patients with FI (0.96 vs. 0.63; P=0.007), UI (0.96 vs. 0.65; P=0.01), DI (1.11 vs. 0.67; P=0.002), and pelvic pain (1.01 vs. 0.70; P=0.04). Antidepressant use was reported by 26%. The negative impact on QoL in patients with pelvic floor symptoms was partially mediated by depression.



Women with SSc suffer from an increased prevalence of LGI and pelvic floor symptoms including FI, UI, diarrhea, constipation, and pelvic pain and this effect seems to be partially mediated by depression.
*Division of Gastroenterology †Division of Rheumatology, Mayo Clinic, Scottsdale, AZ.
Sarah B
SB
Umar
Leroy
L
Griffing
Heidi
H
Garcia
Amy E
AE
Foxx-Orenstein
John K
JK
DiBaise
Michael D
MD
Crowell
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003248:Constipation / Q000453:epidemiology / Q000209:etiology; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D003967:Diarrhea / Q000453:epidemiology / Q000209:etiology; D005242:Fecal Incontinence / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D059952:Pelvic Floor Disorders / Q000453:epidemiology* / Q000209:etiology; D017699:Pelvic Pain / Q000453:epidemiology / Q000209:etiology; D015995:Prevalence; D011446:Prospective Studies; D011788:Quality of Life; D012595:Scleroderma, Systemic / Q000503:physiopathology* / Q000523:psychology; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult