Zeitschrift für Frauengesundheit
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Psychosomatic Interactions in Irritable Bowel Syndrome, Endometriosis, and Healthy Subjects: An Experience Sampling Method Study

Van Barneveld. E*, Vork. L, Lim. AC, Van Hanegem. N, Van Osch. FHM, Bongers. MY, Leue. C, Kruimel. JW

Purpose: Irritable bowel syndrome (IBS) and endometriosis are characterized by recurrent abdominal pain and interfere with quality of life. This study aimed to compare the association between affect and abdominal symptoms in endometriosis, IBS, and healthy controls (HC) using the Experience Sampling Methodology.
Methods: We included 34 endometriosis patients, 26 IBS patients and 55 HC. All participants were non-pregnant, ≥ 18 years. For seven days, participants completed up to 10 randomly assigned momentary assessments (MA) per day on a smartphone app. MA included abdominal symptoms and affective state on an 11-point Numeric Rating Scale. Associations were analyzed by linear mixed models.
Results: Abdominal pain and gastro-intestinal symptoms were comparable between IBS and endometriosis patients but mean scores were significantly higher compared to HC. Stress levels were comparable between all groups. However, endometriosis patients reported higher scores for ‘feeling dispirited’ and lower scores for positive affect compared to IBS and HC. In all groups, abdominal symptoms and affective symptoms seemed associated with functional limitation in daily life. However, direct associations between abdominal pain and affective symptoms seemed stronger in IBS and endometriosis patients compared to HC.
Conclusion: There is a large overlap of patient-reported somatic and affective symptoms in IBS and endometriosis. By use of the ESM, it is possible to analyze direct associations between somatic and affective symptoms in individual patients, potentially providing self-insight in coping styles and more individualized and tailored treatment.