Clinical, Physiological, and Psychological Correlates of the Improvement of Defecation during Menses in Women with Functional Gastrointestinal Disorders

Background/Aims: Little is known about the improvement in defecation frequently reported by women around menses. We aimed to describe clinical, physiological, and psychological correlates of this improvement in those with functional bowel disorders. Patients and Methods: We recruited 478 consecutive premenopausal adult females with no indication of gynecologic or psychiatric disease, who were attending an outpatient functional bowel disorders clinic. Patients completed a Rome III questionnaire, psychological evaluation stool form, and a 10-point Likert scale for constipation, diarrhea, bloating, and abdominal pain. These patients underwent physiological tests, anorectal manometry, and colonic transit time and were classified according to the presence or the absence of improvement in defecation during menses. The reverse selection procedure was used for model selection during multivariate logistic regression where statistically significant variables ( p < 0.01) remained in the adjusted model. Results: Ninety-seven patients (20%) reported easier defecation during menstruation. These patients were younger ( p < 0.001) but had similar body mass indices and psychological profiles as the other patients. Clinically, they only reported more frequent irritable bowel syndrome (IBS) with constipation ( p = 0.007), with harder stools ( p = 0.005) and delayed left colon transit time ( p = 0.002). No anorectal manometric parameter was different between the 2 groups. Conclusion: Improvement of constipation during menses is mainly associated with younger age and constipation-IBS phenotype and not with functional constipation.