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Increased Symptoms in Female IBS Patients With Dysmenorrhea and PMS

Altman, Gaylene PhD, RN; Cain, Kevin C. PhD; Motzer, Sandra PhD, RN, FAHA; Jarrett, Monica PhD, RN; Burr, Robert PhD; Heitkemper, Margaret PhD, RN, FAAN


Women with irritable bowel syndrome often report premenstrual distress syndrome and dysmenorrhea. A descriptive, four-group comparison design was used to compare the symptoms and psychological distress levels of women with irritable bowel syndrome (age 18–45 years) with and without dysmenorrhea and premenstrual distress syndrome. Data from three studies on women with irritable bowel syndrome (n = 226) collected between 1995 and 2004 were combined. Of these, 38 had self-reported irritable bowel syndrome with dysmenorrhea and premenstrual distress syndrome, 59 had irritable bowel syndrome with premenstrual distress syndrome, 15 had irritable bowel syndrome and dysmenorrhea, and the remaining 114 had irritable bowel syndrome only.

Participants completed the Symptom Checklist-90 Revised and a symptom diary. Pain symptoms and computed scales of anxiety, depression, anger, and cognitive difficulties were compared during the luteal phase, menses phase, and for the change from luteal to menses phases. Premenstrual distress syndrome and dysmenorrhea had a strong impact on uterine cramping at menses, and a weaker effect on other pain symptoms at both luteal and menses phases. Premenstrual distress syndrome was associated with higher depression, anger, and cognitive problems at both luteal and menses phases; however, it was not associated with a greater increase from luteal to menses phases for any symptoms other than uterine cramping. The multiple symptoms reported by women with both irritable bowel syndrome and premenstrual distress syndrome suggest that this group may be particularly challenging to treat and may require a multicomponent (e.g., education, diet, relaxation, cognitive restructuring) approach.

Gaylene Altman, PhD, RN, is Associate Professor; Kevin C. Cain, PhD, is Research Scientist in the Office of Nursing Research; in the Research Office; Sandra Motzer, PhD, RN, FAHA, is an Associate Professor; Monica Jarrett, PhD, RN, is an Associate Professor; Robert Burr, PhD, is a Research Associate Professor; and Margaret Heitkemper, PhD, RN, FAAN, is Professor and Chair, Biobehavioral Nursing and Health Systems, University of Washington School of Nursing, Seattle.

Correspondence to: Gaylene Altman, PhD, RN, Biobehavioral Nursing and Health Systems, University of Washington School of Nursing, P.O. Box 357260, Seattle, WA 91895. (e-mail:

Received June 21; accepted August 9, 2005.

© The Society of Gastroenterology Nurses & Associates 2006. All Rights Reserved.