Abstract
Introduction
Endometriosis is a painful, chronic inflammatory disorder that is difficult to treat.
Studies have suggested that diet may have a therapeutic effect on chronic inflammation.
However, only limited information is available regarding the impact of diet on pain
perception in relation to endometriosis. As such, the aim of this review was to evaluate
if diet has any impact on pain perception in women suffering from endometriosis.
Materials and methods
A systematic review was conducted by searching Medline and Embase to identify randomized
controlled trials and observational studies adhering to the PRISMA and SWiM guidelines.
A table summarizing the findings was developed using the GRADE approach. Inclusion
criteria were: women of reproductive age; laparoscopically confirmed diagnosis of
endometriosis; and intervention including any type of dietary change. This review
was registered with PROSPERO on 14 November 2020 (CRD42020212314).
Results
In total, the database search identified 2185 studies; of these, six studies fulfilled
the inclusion criteria. The Newcastle–Ottawa scale and the Cochrane tool were used
to assess the studies, which were concluded to be of high quality and to have low
risk of bias. All studies had a positive impact on pain perception, with all except
one study reporting a significant reduction in pain perception, indicating that high
intake of polyunsaturated fatty acids, a gluten-free diet and a low nickel diet may
improve painful endometriosis. It was not possible to conduct a meta-analysis due to considerable heterogeneity amongst the included studies due to differences
in dietary adherence, dietary therapies, outcome measurements, populations, durations
and study designs.
Conclusion
All studies found that diet had a positive impact on pain perception among women with
endometriosis. However, the majority of available evidence on dietary interventions
in relation to endometriosis-associated pain was derived from non-randomized controlled
trials, which have multiple sources of bias. Therefore, further studies are needed
to investigate diet and its effect on pain perception in women with endometriosis.
Keywords
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Article info
Publication history
Published online: February 25, 2022
Accepted:
February 23,
2022
Received in revised form:
January 17,
2022
Received:
February 11,
2021
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
