History of abuse in women with gastrointestinal disorders - sexual and physical abuse - Tips From Ot

Date: March, 1991

Studies have shown a high prevalence of sexual and physical abuse in patients referred for chronic complaints such as headache and pelvic pain. To determine the prevalence of a history of sexual or physical abuse, or both, among women in a referral-based practice, Drossman and colleagues conducted a survey of patients seen in a university gastroenterology clinic over a two-month period.

Patients were asked to complete a questionnaire about their symptoms and health care utilization, and possible history of abuse. Physicians recorded a primary diagnosis for each patient and indicated whether the disorder was functional or organic and whether the patient had ever mentioned a history of sexual or physical abuse.

Of 206 women who completed the questionnaire, 89 (44 percent) reported a history of sexual or physical abuse in childhood or adulthood. A significant correlation was found between physical and sexual abuse: 11 of the 12 women who had been physically abused had also been sexually abused. Almost one-third of abused women reported that they had never discussed the subject with anyone. Abused patients were more likely than other patients to report pelvic pain and multiple somatic symptoms, and they also had undergone a greater number of surgical procedures.

A history of abuse was more common in patients with functional disorders than in patients with organic disorders. Patients with functional disorders also reported more chronic or recurrent abdominal pain and a greater number of lifetime surgical procedures.

Because of the high prevalence of sexual and physical abuse reported by the women in this study, the authors suggest that physicians inquire about a history of abuse in patients who report chronic pain or a number of symptoms and who overuse health care services. (Annals of Internal Medicine, December 1, 1990, vol. 113, p. 828.)

COPYRIGHT 1991 American Academy of Family PhysiciansCOPYRIGHT 2004 Gale Group

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