The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index.
Symptoms across the menstrual cycle in women with irritable bowel syndrome
Abstract
OBJECTIVE: The purpose of this study was to describe the patterns of GI, somatic, and psychological symptoms across the menstrual cycle in women with irritable bowel syndrome, and to determine whether symptoms differed by oral contraceptive use or predominant bowel pattern. METHODS: A daily diary was used to assess symptoms across one menstrual cycle. Repeated-measures analysis of covariance, controlling for age and body mass index, was used to compare patterns of symptoms across the menstrual cycle by oral contraceptive use and predominant bowel pattern (diarrhea, constipation, alternating). Data from control women are presented for comparison. RESULTS: For somatic and psychological as well as GI symptoms, women with irritable bowel syndrome had higher symptom severity than did controls. Women with irritable bowel syndrome using oral contraceptives had lower cognitive, anxiety, and depression symptoms (p < 0.05, but not significant after multiple comparison adjustment), but no differences were seen for most symptoms of irritable bowel syndrome. All symptoms except diarrhea were highest in the alternating group and lowest in the diarrhea group, with the constipation group either intermediate or close to the alternating group. This pattern was significant after multiple comparisons adjustment for GI symptoms, and trending toward significance (p < 0.05, but not significant after multiple comparison adjustment) for menstrual, sleep, and cognitive symptoms. The strongest menstrual cycle effect was seen in somatic and menstrual symptoms. The pattern of symptoms over the menstrual cycle did not differ by predominant bowel pattern or by oral contraceptive use. CONCLUSIONS: Many of the symptoms examined differed by predominant bowel pattern and menstrual cycle phase, not just the GI symptoms. The menstrual cycle variation was similar regardless of oral contraceptive use or predominant bowel pattern.
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“In a review, Unruh 155 found that, compared to men, women are more likely to experience recurrent pain, more severe pain, more frequent pain, and longer-lasting pain.”
From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [155]
Citations
Cites
A sharper Bonferroni procedure for multiple tests of significance
HOCHBERG, Y. (1988) · Biometrika · doi:10.1093/biomet/75.4.800 · Cited by 4,829
Irritable bowel syndrome in general practice: prevalence, characteristics, and referral
Thompson, W. G., Heaton, K. W., Smyth, G. T., & Smyth, C. (2000) · Gut · doi:10.1136/gut.46.1.78 · Cited by 477
A Patient Questionnaire to Identify Bowel Disease
Talley, N. J., Phillips, S. F., Melton, L. J., Wiltgen, C., & Zinsmeister, A. R. (1989) · Annals of Internal Medicine · doi:10.7326/0003-4819-111-8-671 · Cited by 444
The functional gastrointestinal disorders
Olden, K. W. (1997) · General Hospital Psychiatry · doi:10.1016/s0163-8343(96)00109-0 · Cited by 437
Gastrointestinal transit: The effect of the menstrual cycle
Wald, A., Van Thiel, D. H., Hoechstetter, L., Gavaler, J. S., Egler, K. M., Verm, R., Scott, L., & Lester, R. (1981) · Gastroenterology · doi:10.1016/0016-5085(81)90263-8 · Cited by 397
Factorial invariance across gender for the primary symptom dimensions of the SCL‐90
Derogatis, L. R., & Cleary, P. A. (1977) · British Journal of Social and Clinical Psychology · doi:10.1111/j.2044-8260.1977.tb00241.x · Cited by 366
Influence of gender and menopause on gastric emptying and motility
Hutson, W. R., Roehrkasse, R. L., & Wald, A. M. (1989) · Gastroenterology · doi:10.1016/0016-5085(89)90758-0 · Cited by 304
Aggarwal, A., Cutts, T. F., Abell, T. L., Cardoso, S., Familoni, B., Bremer, J., & Karas, J. (1994) · Gastroenterology · doi:10.1016/0016-5085(94)90753-6 · Cited by 297
Sato, N., Miyake, S., Akatsu, J., & Kumashiro, M. (1995) · Psychosomatic Medicine · doi:10.1097/00006842-199507000-00004 · Cited by 288
Evidence for exacerbation of irritable bowel syndrome during menses
Whitehead, W. E., Cheskin, L. J., Heller, B. R., Robinson, J. C., Crowell, M. D., Benjamin, C., & Schuster, M. M. (1990) · Gastroenterology · doi:10.1016/0016-5085(90)91079-l · Cited by 262
Research works printed but not linked: 7
- Donker GA, 1999, Br J Gen Pract, 49, 787
- Crowell MD, 1994, Am J Gastroenterol, 89, 1973
- Hinds J., 1989, Am J Gastroenterol, 84, 123
- Thompson W., 1989, Gastroenterol Int, 2, 92
- Drossman D., 2000, Rome II
- Jackson N., 1994, Dig Dis Sci, 39, 2607, 10.1007/BF02087697 · DOI
- Eliakim R., 2000, J Reprod Med, 45, 781
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Ercolani, M., & Agostini, A. (2010) · Springer eBooks · doi:10.1007/978-88-470-1469-5_11
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Legato, M. J. (2007) · CRC Press eBooks · doi:10.1201/9781420043013.ch2
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Baron, Y. M. (2014) · Wageningen Academic Publishers eBooks · doi:10.3920/978-90-8686-767-7.029
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Myung, D., Kim, H. R., & Joo, Y. (2015) · Korean Journal of Gastroenterology · doi:10.4166/kjg.2015.66.2.127
Lee, L., & Mullin, G. E. (2007) · CRC Press eBooks · doi:10.1201/9781420043013.ch13
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Ballou, S., & Keefer, L. (2013) · Wiley eBooks · doi:10.1002/9781394260454.ch21
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Metadata
- Authors
- Heitkemper, M. M., Cain, K. C., Jarrett, M. E., Burr, R. L., Hertig, V., & Bond, E. F.
- Affiliations
- University of Washington (US)
- Venue
- The American Journal of Gastroenterology
- Published
- 2003-02
- Volume
- 98
- Issue
- 2
- Pages
- 420-430
- ISSN
- 0002-9270 (ISSN-L)
- 1572-0241
- OpenAlex
- W2000031817
- Cited by
- 165
- References
- 32
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 4 · 2023: 3 · 2022: 5 · 2021: 6 · 2020: 7 · 2019: 10 · 2018: 6 · 2017: 6 · 2016: 14 · 2015: 5 · 2014: 8 · 2013: 7 · 2012: 9
- FWCI
- 6.31
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Nursing Research (R01NR004142, NR04142, NR04101)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Health and Development
- Keywords
- irritable bowel syndrome, menstrual cycle, oral contraceptives, constipation, diarrhea, somatic symptoms, psychological symptoms, anxiety, depression, cognitive symptoms, sleep symptoms, gastrointestinal symptoms
- MeSH terms
- Adult, Colonic Diseases, Functional, Constipation, Contraceptives, Oral, Diarrhea, Dysmenorrhea, Female, Humans, Menstrual Cycle, Premenstrual Syndrome, Case-Control Studies
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