Visceral syndrome in endometriosis patients.

Objective: Pain related to bowel and bladder function is seen more often in endometriosis. This study explored whether employed endometriosis patients experience multiple visceral symptoms more often than reference women without the disease.

Study Design: In a cohort study, 610 patients with diagnosed endometriosis and 751 reference women completed an electronic survey based on the EHP-30 questionnaire. Percentages were reported for all data. Principal component analysis was used to find underlying structures of correlations among variables, and Cronbach's alpha reliability analysis was used to demonstrate internal consistency of each scale. The level of statistical significance was set at p<0.025 in all the analyses.

Results: Principal component analysis pointed at a specific visceral symptom-complex relating to the abdominal organs. This correlation was called "visceral syndrome" and consisted of the seven symptoms; "abdominal pain with no relation to menstruation", "pain during urination", "pain during defecation", "constipation or diarrhea", "irregular bleeding", "nausea or vomiting" and "feeling tired/lack of energy", with a Cronbach's alpha value α=0.85. More women with endometriosis than reference women suffered between five and seven symptoms from the visceral syndrome (22.7% vs. 2.7%) and more women with endometriosis compared to women with pain from other conditions suffered between five and seven symptoms from the visceral syndrome (22.7% vs. 3.2%).

Conclusion: These data indicate that a significant number of endometriosis patients suffer from a specific symptom correlation, which is uncommon in women without the disease. These findings and previous data may suggest the occurrence of a visceral syndrome in endometriosis.