P214 Inflammatory bowel disease and endometriosis: is there a relationship?
M. Fortuna*1, A. Variola2, R. Montanari2, G. Ruffo3, P. Bocus4, A. Geccherle2
1Sacro Cuore Don Calabria Hospital, Multispecialistic Centre for Recto-Perineal Diseases (IBD Unit), Department of Gastroenterology, Negrar (Vr), Italy, 2Sacro Cuore Don Calabria Negrar Hospital, Multispecialistic Centre for Recto-Perineal Diseases (IBD Unit), Department of Gastroenterology, Negrar (VR), Italy, 3Sacro Cuore Don Calabria Negrar Hospital, Department of General Surgery, Negrar (VR), Italy, 4Sacro Cuore Don Calabria Negrar Hospital, Department of Gastroenterology - Endoscopy, Negrar (VR), Italy
Endometriosis is a debilitating disease defined as the presence of ectopic endometrial tissue in extrauterine sites. It affects 3%–4% of Italian women of reproductive age. Amongst them, only 2.7%–3% of patients (pts) suffer from intestinal endometriosis. Recently, a potential association between endometriosis and inflammatory bowel disease (IBD) has been hypothesised. Our aim is to assess the prevalence of endometriosis in our cohort of IBD pts compared with the general population and to investigate putative links between the diseases.
In total, 598 pts presented to the IBD unit at Negrar Hospital (Vr-Italy) from January 2008 to October 2014 (298 females and 300 males). From this group we retrospectively recruited women with endometriosis. Diagnosis of endometriosis was based on laparoscopic, instrumental and histological evaluation. We recorded the following data: age, endometriosis localisation, hormonal therapy, timing of diagnosis, and presence of autoimmune diseases.
Amongst 298 women, 9 were affected by endometriosis (prevalence 3%; mean age 39 years old, range 27–55; 4 with Crohn’s disease [CD]; 5 with ulcerative colitis [UC]). Further, 5/9 of them (3 CD and 2 UC) had intestinal endometriosis localisation (prevalence: 55%), with the sigmoid colon and rectum being the most commonly involved areas. In addition, 6/9 pts had been diagnosed endometriosis before IBD (range 2–7 years before). All of them were using long-lasting hormonal therapy. In 2/9 pts, intestinal endometriosis and CD occurred simultaneously. In 3/9 pts, we recorded the coexistence of other autoimmune diseases (2 pts with coeliac disease and a woman with positive anticardiolipin antibodies).
In our cohort, endometriosis prevalence is similar to the general population. However, our results suggest that amongst IBD pts, an increased prevalence of intestinal endometriosis can be found. Endometriosis treatment with hormonal therapy may increase the risk of development of IBD. In these pts, detection of other autoimmune disorders reflects a possible link in the pathogenesis of both diseases, probably because of common immunological and inflammatory features.