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The Relationship Between Incontinence, Breathing Disorders, Gastrointestinal Symptoms, and Back Pain in Women: A Longitudinal Cohort Study

Smith, Michelle D. PhD*; Russell, Anne MMedStat; Hodges, Paul W. PhD*

doi: 10.1097/AJP.0b013e31828b10fe
Original Articles

Objectives: Recent studies suggest a relationship between incontinence, respiratory disorders, gastrointestinal (GI) symptoms, and back pain (BP). However, causality is difficult to infer. This longitudinal study aimed to determine whether the presence or development of one disorder increases risk for the development of another.

Methods: Women from the Australian Longitudinal Study on Women’s Health were divided into subgroups; those with no BP (n=7259), no incontinence (n=18,480), no breathing problems (including allergy) (n=15,096), and no GI symptoms (n=17,623). Each subgroup was analyzed to determine the relationship between the development of the absent condition and the presence or development of the other conditions. Factors with a previously identified relationship with BP were included in analysis.

Results: Women with pre-existing and/or newly developed incontinence (prevalence ratios [PR]: 1.26 to 2.12) and breathing problems (PR: 1.38 to 2.11) had an increased risk for the development of BP, and women with pre-existing and newly developed BP were more likely to develop incontinence and breathing problems (PR: 1.18 to 2.44 and 1.53 to 2.62, respectively). The presence of GI symptoms was also identified as a risk factor for the development of these conditions.

Discussion: This study provides evidence of a relationship between BP, incontinence, respiratory problems, and GI symptoms in which the presence of one symptom is associated with the development of another. This suggests that common factors may contribute to the development of symptoms across this range of conditions.

*Centre of Clinical Research Excellence in Spinal, Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia

School of Population Health, The University of Queensland, Herston, Qld, Australia

P.W.H. is supported by the National Health and Medical Research Council of Australia, Canberra, ACT. The research on which this paper is based was conducted as part of the Australian Longitudinal Study on Women’s Health based at The University of Newcastle and The University of Queensland. The Australian Longitudinal Study on Women’s Health is funded by the Commonwealth Department of Health and Ageing. The authors declare no conflict of interest.

Reprints: Michelle D. Smith, PhD, Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Qld 4072, Australia (e-mail: m.smith5@uq.edu.au).

Received August 24, 2012

Accepted January 31, 2013

© 2014 by Lippincott Williams & Wilkins