Association between Endometriosis, Irritable Bowel Syndrome and Eating Disorders: ENDONUT Pilot Study

J Clin Med. 2022 Sep 29;11(19):5773. doi: 10.3390/jcm11195773.


Alexandra Aupetit 1Sébastien Grigioni 2 3 4Horace Roman 5Moïse Coëffier 2 3 4Amélie Bréant 6Clotilde Hennetier 6Najate Achamrah 2 3 4


Author information

1Department of Gastroenterology, Rouen University Hospital, 37 Boulevard Gambetta, 76000 Rouen, France.

2Department of Nutrition, Rouen University Hospital, 37 Boulevard Gambetta, 76000 Rouen, France.

3INSERM UMR 1073 «Nutrition, Inflammation and Gut-Brain Axis Dysfunction», Normandie University, 76000 Rouen, France.

4Clinical Investigation Center CIC 1404, INSERM, Rouen University Hospital, 76000 Rouen, France.

5Multidisciplinary Franco-European Institute of Endometriosis, Clinique Tivoli-Ducos, 91 Rue de Rivière, 33000 Bordeaux, France.

6Department of Gynecology, Rouen University Hospital, 37 Boulevard Gambetta, 76000 Rouen, France.


Background and aim: Irritable bowel syndrome (IBS), eating disorders (ED) and endometriosis share common pathophysiological mechanisms, involving alterations of the gut-brain axis. The aim of the ENDONUT pilot study was to investigate an association between these three diseases by screening for IBS and ED in patients with endometriosis.

Method: We included patients from the CIRENDO cohort (Inter-Regional North-West Cohort of women with ENDOmetriosis) with a recent documented diagnosis of endometriosis of less than 4 years, regardless of age, date of onset of symptoms, type of endometriosis (digestive or not), with or without endometriosis-related digestive surgery. Validated questionnaires were used to screen for IBS (Rome IV, Francis score), ED (SCOFF-F, EAT-26), and anxiety/depression (HAD). Anthropometric data and lifestyle habits were also collected. The primary composite endpoint was SCOFF-F and ROME-IV scores.

Results: Among 100 patients meeting inclusion criteria, 54 patients completed all the questionnaires. Of these, 19 had a positive SCOFF-F score (35.2%), 26 had a positive ROME-IV score (48.1%), and 14 patients (25.9%) had both a positive SCOFF-F score and a positive ROME-IV score (p = 0.006). Patients with positive SCOFF-F and ROME-IV scores had significantly higher HAD-anxiety and depression scores (p < 0.05).

Conclusion: These results suggest a significant association between IBS, ED and endometriosis. The prevalence of IBS and ED in our population is higher than in the general population. Larger studies are needed to confirm these results, to better understand this triad, and to improve the diagnostic and multidisciplinary therapeutic management of these patients.



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