Evidence for an Association Between Endometriosis and Allergic and Non-allergic Food Hypersensitivity Is Lacking.

Jocelyn O'Malley,Marina Iacovou,Sarah J Holdsworth-Carson

doi:10.3389/frph.2021.726598

Abstract

Endometriosis effects up to 1 in 9 women, and can be a severe and debilitating disease. It is suggested that there is a link between endometriosis and allergic hypersensitivities, including allergic and non-allergic food hypersensitivity. Best practice for managing endometriosis symptoms is holistic and includes broad multi-disciplinary care. Therefore, improving our understanding of common endometriosis comorbidities, including allergic and non-allergic food hypersensitivity, will assist in improving patient quality of life. This mini-review with systematic approach aims to explore the literature for evidence surrounding an association between endometriosis and allergic and/or non-allergic food hypersensitivity from the last 20 years. Of the 849 publications identified, five fulfilled the inclusion criteria. Only one publication reported a statistically significant increased risk for non-allergic food hypersensitivity in patients with endometriosis (P = 0.009), however, the endometriosis group was not uniform in diagnostic criteria and included individuals without laparoscopically visualized disease. No studies elucidated a statistically significant link between allergic food hypersensitivity alone and endometriosis. Therefore, based on a small number of studies with limited research quality, evidence does not support the existence of a link between endometriosis and allergic or non-allergic food hypersensitivity. Sufficiently powered evidence-based research is required, including information which better characterizes the patient's endometriosis symptoms, importantly the gastrointestinal sequalae, as well as specific allergic and non-allergic food hypersensitivities and method of diagnoses. Unequivocally confirming a link between endometriosis and food hypersensitivities is an essential step forward in dispelling the many myths surrounding endometriosis and improving management of disease.

Highlights

Endometriosis is a common gynecological condition defined by the presence of endometrial-like tissue outside the uterus, which causes scarring and chronic inflammation [1]
The studies suggest an increase in non-allergic food hypersensitivity in women with endometriosis in comparison to those without, this was not of statistical significance
Allergic food hypersensitivity grouped with other allergies Non-allergic food hypersensitivity

Summary

Introduction

Endometriosis is a common gynecological condition defined by the presence of endometrial-like tissue outside the uterus, which causes scarring and chronic inflammation [1]. The pathophysiology of endometriosis remains elusive and is undoubtedly complex, with both genetic and environmental risk factors involved [2]. The original theory first opined by Sampson [3] was that of retrograde menstruation causing displacement of endometrial fragments into the peritoneal cavity. This explains extrauterine endometrial-like tissue, it does not give the full pathogenesis, as retrograde menstruation occurs in more than 80% of women [4]. A greater understanding of the pathophysiology, risk factors, best diagnosis, and treatment pathways are required to better support women with endometriosis

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