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IBD, IBS and PMS

Experiencing Diarrhea or Pain During Your Period Is Not Uncommon

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Updated May 26, 2014

Abdominal Pain

Abdominal pain is a common symptom of both premenstrual syndrome (PMS) and digestive disease such as inflammatory bowel disease (IBD).

Photo © Ohmega1982

If you've found that your irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD) acts up when you have your period -- you're not alone. Many women find that they experience more severe symptoms such as diarrhea and pain before or during their menstrual cycle.

What Causes PMS Symptoms

Researchers think that this increase in symptoms has a connection to hormones. The amount of diarrhea experienced by women with both IBD and IBS increases during the days before and during their period. Two compounds are being considered for causing this effect -- prostaglandins and progesterone.

There are several different types of prostaglandins that have different functions in the body. Some, called Series 2 Prostaglandins, are associated with changes in the bowel that stimulate diarrhea during menses. They can actually stimulate pain, and interfere with absorption in the intestines. These prostaglandins could also be responsible for causing the smooth muscle in the intestine to contract, causing pain and diarrhea.

The fluctuation of hormones before and during a women's period may also be to blame. It has been theorized that the colon could be reacting to the increase or the decrease in progesterone in the body.

What Is The Treatment For PMS?

Evening primrose oil (EPO) was found to help women decrease IBS symptoms during the pre-menstrual and menstrual phases of their cycle. EPO contains an essential fatty acid called gamma linolenic acid (GLA).

The body does not produce essential fatty acids -- they can only be ingested through food. GLA and omega-3 fatty acids together produce a second type of prostaglandins, called E1 series. This type of prostaglandin helps reduce inflammation and aids in digestion.

The optimum dose of EPO per day is still unknown, but 3,000 mg to 6,000 mg of EPO (given over 3 separate doses during the day) can contain 270-540 mg of GLA. This is the amount of GLA often used in research.

EPO is generally considered safe, but it should be taken with food to avoid nausea. People with temporal lobe epilepsy should never take EPO.

Sources:

Altman G, Cain KC, Motzer S, Jarrett M, Burr R, Heitkemper M. "Increased symptoms in female IBS patients with dysmenorrhea and PMS." Gastroenterol Nurs. Jan - Feb 2006. 13 Sept 2013.

Cotterell CJ, Lee AJ, Hunter JO. Double-blind cross-over trial of evening primrose oil in women with menstrually-related irritable bowel syndrome. In Omega-6 Essential Fatty Acids: Pathophysiology and roles in clinical medicine, Alan R Liss, New York, 1990, 421–426.

Houghton LA, Lea R, Jackson N, Whorwell PJ. "The menstrual cycle affects rectal sensitivity in patients with irritable bowel syndrome but not healthy volunteers." Gut Apr 2002. 13 Sept 2013.

Parlak E, Da'li U, Alkim C, Di'ibeyaz S, Tunç B, Ulker A, Ahin B. "Pattern of gastrointestinal and psychosomatic symptoms across the menstrual cycle in women with inflammatory bowel disease." Turk J Gastroenterol Dec 2003. 13 Sept 2013.

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