**7. Conclusions**

There is growing evidence that patients with cardiovascular disease suffer a higher burden of upper gastrointestinal symptoms and even that certain upper gastrointestinal complaints can induce or promote cardiovascular disease. Knowledge of how these common conditions are connected can bring forth therapeutic advantages. For instance, among patients with upper gastrointestinal symptoms, their interactions with the health care system can increase the chance of earlier diagnosis of cardiovascular conditions. Conversely, among patients with car‐ diovascular conditions, health care providers' inquiry into gastrointestinal symptoms and side effects of medications may aid in appropriate choice of therapy to enhance effectiveness and patient adherence. Additional research is needed to clarify whether the cardiovascular pa‐ tients' increased risk of upper gastrointestinal symptoms is a result of shared pathophysiology or risk factors, increased surveillance due to overlapping symptoms, or induced by the fre‐ quent need for polypharmacy among suffers of both these disease states.

### **Author details**

Craig I. Coleman1,2\*, Brendan L. Limone2 , Jeff R. Schein3 , Winnie W. Nelson3 , Joyce C. LaMori4 , Jeffrey Kluger5 and C. Michael White1,2

\*Address all correspondence to: ccolema@harthosp.org

1 Department of Pharmacy Practice, University of Connecticut School of Pharmacy, Storrs, CT, USA

2 Evidence-Based Practice Center, Hartford Hospital, Hartford, CT, USA

3 Heath Economics and Outcomes Research; Janssen Scientific Affairs, Raritan, NJ, USA

4 Translational Science, Heath Economics and Outcomes Research; Janssen Scientific Affairs, Raritan, NJ, USA

5 Department of Cardiology, Hartford Hospital, Hartford, CT, USA

### **References**

The consequences of these drug-disease interactions can be dire, with significant impact on mortality and morbidities. As many of these interactions are unknown until a large population has been using the offending medications, health care providers must remain vigilant in

There is growing evidence that patients with cardiovascular disease suffer a higher burden of upper gastrointestinal symptoms and even that certain upper gastrointestinal complaints can induce or promote cardiovascular disease. Knowledge of how these common conditions are connected can bring forth therapeutic advantages. For instance, among patients with upper gastrointestinal symptoms, their interactions with the health care system can increase the chance of earlier diagnosis of cardiovascular conditions. Conversely, among patients with car‐ diovascular conditions, health care providers' inquiry into gastrointestinal symptoms and side effects of medications may aid in appropriate choice of therapy to enhance effectiveness and patient adherence. Additional research is needed to clarify whether the cardiovascular pa‐ tients' increased risk of upper gastrointestinal symptoms is a result of shared pathophysiology or risk factors, increased surveillance due to overlapping symptoms, or induced by the fre‐

, Jeff R. Schein3

1 Department of Pharmacy Practice, University of Connecticut School of Pharmacy, Storrs,

3 Heath Economics and Outcomes Research; Janssen Scientific Affairs, Raritan, NJ, USA

4 Translational Science, Heath Economics and Outcomes Research; Janssen Scientific Affairs,

, Winnie W. Nelson3

, Joyce C. LaMori4

,

quent need for polypharmacy among suffers of both these disease states.

2 Evidence-Based Practice Center, Hartford Hospital, Hartford, CT, USA

5 Department of Cardiology, Hartford Hospital, Hartford, CT, USA

identifying potential new problems.

160 Dyspepsia - Advances in Understanding and Management

**7. Conclusions**

**Author details**

Jeffrey Kluger5

CT, USA

Raritan, NJ, USA

Craig I. Coleman1,2\*, Brendan L. Limone2

and C. Michael White1,2

\*Address all correspondence to: ccolema@harthosp.org


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**Chapter 9**

**Functional Gastrointestinal Symptoms in Women with**

Gastrointestinal symptoms are frequently encountered in women diagnosed with endome‐ triosis. Women with endometriosis appear to complain more commonly of gastrointestinal symptoms such as gastro-oesophageal reflux and dyspepsia. The psychological profile of patients with endometriosis may promote these symptoms. As a reaction to high levels of perceived stress, neuroendocrine-immune imbalance has been demonstrated in women diagnosed with endometriosis. Pharmacological agents used to treat psychological dysfunc‐ tion, and symptoms of endometriosis such as dysmenorrhoea, may lead to undesirable

Through neuroendocrine and immunological intermediaries, the gastrointestinal system may also interact with the physiology of the female genital system. These variables have directed some workers to suggest an interrelationship between both systems including the occurrence of pathology. Gastrointestinal symptoms may act as a guide to dietary modification which

It is becoming apparent that although anatomically separate, gastrointestinal symptoms do overlap with pelvic endometriosis. Endometriosis is the occurrence of endometrial tissue outside the uterus. Endometriotic deposits are mainly found on the ovaries, utero-sacral ligaments and pelvic peritoneum. Endometriosis affects one fourth of young women under the age of 30 years with an overall incidence of 7% to 10 % of women. Subfertility has been noted in 20-50% of women found to have endometriosis while more than 80% of women

> © 2013 Baron; licensee InTech. This is a paper distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

may result in improvement in the symptomatology of endometriosis.

**2. Epidemiology of gastrointestinal symptoms and endometriosis**

**Pelvic Endometriosis**

Additional information is available at the end of the chapter

Yves Muscat Baron

**1. Introduction**

gastrointestinal symptoms.

http://dx.doi.org/10.5772/56611

