Digestive diseases and sciences · 2026
A Previous History of Endometriosis Elevates Irritable Bowel Syndrome Risk in Middle-Aged and Older Women: A UK Biobank Cohort Study of 225,703 Participants.
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Ye Fangchen, Li Laifu, Ruan Fangyi, Wang Lianli, Ran Yan, Mei Lin, Sun Yating, Zhang Xinping, Dai Fei
Аннотация
OBJECTIVE: Endometriosis (EMT) and irritable bowel syndrome (IBS) disproportionately affect middle-aged and older women, where overlapping symptoms (e.g., chronic pelvic pain, bloating) and shared inflammatory mechanisms may drive comorbidity. However, large-scale evidence linking EMT to IBS incidence in this population remains scarce. Leveraging the UK Biobank cohort (N = 225,703), we investigate their longitudinal association to address this critical gap in women's health research.
METHOD: We sourced data on pre-existing endometriosis (EMT) status and incident IBS diagnoses from the UK Biobank. We employed multivariate Cox regression to analyze the link between baseline EMT and subsequent IBS, as well as the association with different IBS subtypes and severities. Subgroup and sensitivity analyses were also performed.
RESULT: The study population comprised 225,703 individuals, with 6379 cases (2.83%) exhibiting EMT at initial assessment and 6282 cases (2.78%) developing IBS during a median observation period of 13.8 years (IQR 13-14.5). EMT patients showed significantly elevated cumulative incidence of hypertension compared to population controls (4.61%, p < 0.001). Adjusted Cox models identified EMT as an independent predictor of IBS development (hazard ratio 1.58, 95% CI 1.38-1.82; p < 0.001). Subtype analysis revealed specific risk elevation for constipation-predominant (IBS-C) and mixed-pattern (IBS-M) variants (both p < 0.001), though no significant associations emerged for diarrhea-predominant subtypes(IBS-D). These findings persisted across sensitivity analyses and subgroup evaluations, confirming EMT's robust association with incident IBS.
CONCLUSION: Clinical data analysis revealed elevated IBS susceptibility among EMT-affected individuals relative to reference populations, with notable predisposition toward IBS-C. These findings suggest clinical relevance of EMT-IBS correlations, requiring integration of EMT status into diagnostic evaluations for gastrointestinal symptom management.
METHOD: We sourced data on pre-existing endometriosis (EMT) status and incident IBS diagnoses from the UK Biobank. We employed multivariate Cox regression to analyze the link between baseline EMT and subsequent IBS, as well as the association with different IBS subtypes and severities. Subgroup and sensitivity analyses were also performed.
RESULT: The study population comprised 225,703 individuals, with 6379 cases (2.83%) exhibiting EMT at initial assessment and 6282 cases (2.78%) developing IBS during a median observation period of 13.8 years (IQR 13-14.5). EMT patients showed significantly elevated cumulative incidence of hypertension compared to population controls (4.61%, p < 0.001). Adjusted Cox models identified EMT as an independent predictor of IBS development (hazard ratio 1.58, 95% CI 1.38-1.82; p < 0.001). Subtype analysis revealed specific risk elevation for constipation-predominant (IBS-C) and mixed-pattern (IBS-M) variants (both p < 0.001), though no significant associations emerged for diarrhea-predominant subtypes(IBS-D). These findings persisted across sensitivity analyses and subgroup evaluations, confirming EMT's robust association with incident IBS.
CONCLUSION: Clinical data analysis revealed elevated IBS susceptibility among EMT-affected individuals relative to reference populations, with notable predisposition toward IBS-C. These findings suggest clinical relevance of EMT-IBS correlations, requiring integration of EMT status into diagnostic evaluations for gastrointestinal symptom management.