Overlapping Conditions in Women With Irritable Bowel Syndrome

Margaret Heitkemper; Monica Jarrett


Urol Nurs. 2005;25(1):25-31. 

In This Article

Abstract and Introduction

Irritable bowel syndrome is a common and often unpredictable disorder with an increased incidence among women. It is characterized by abdominal pain associated with constipation-diarrhea. Recent research, current theories about etiology and pathophysiology, diagnosis, management, and overlapping conditions such as interstitial cystitis and chronic pelvic pain are discussed.

Irritable bowel syndrome (IBS) is one of the most common gastrointestinal disorders diagnosed in the United States. IBS is characterized by abdominal pain and alterations in bowel patterns (such as diarrhea, constipation). It is estimated that 10% to 17% of the general population are affected by varying degrees of symptoms. These symptoms account for absences from school, missed work, reduced productivity, diminished quality of life, as well as tremendous costs associated with treating this disorder.

In 2000, the direct and indirect costs of diagnosis and symptom management of IBS were estimated to be $1.66 billion, making it not only costly to the individual but also to the health care system (Levy et al., 2001; Sandler et al., 2002). Leong and colleagues (2003) found that the total health care expenditures per year for the individual with IBS were $4,527 as compared to $3,276 for an age and gender-matched control in 1998. Excess surgeries are among the undesirable health care events related to an IBS diagnosis (Feld et al., 2003). In addition to health care utilization, the impact of IBS has been measured in the poorer quality of life of patients as well as missed work/school and reduced productivity (Motzer, Hertig, Jarrett, & Heitkemper, 2003; Whitehead, Burnett, Cook, & Taub, 1996).

In most countries, including the United States, the prevalence of IBS is approximately 2 to 2.5 times greater in women than men (Camilleri & Choi, 1997). This imbalance has prompted clinicians and investigators to examine factors that account for gender differences in IBS (for review see Chang & Heitkemper, 2002). Such studies have demonstrated that women with IBS are more likely to report a history of constipation whereas men are more likely to report diarrhea. In addition, women with IBS are more likely than men to report extra-intestinal disorders including migraine headaches, bladder discomfort, dyspaurenia, and chronic pelvic pain (Lee, Mayer, Schmulson, Chang, & Naliboff, 2001). The focus of this article is to explore current thinking related to the etiology and pathophysiology of IBS along with its relation to other pelvic organ conditions especially chronic pelvic pain (CPP) and interstitial cystitis (IC). Finally, diagnosis and management of IBS will be discussed.


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