The authors present the case of a 39-year-old male who returned to the emergency department one month after uncomplicated diverticulitis, with the second bout of diverticulitis newly complicated by microperforation. The clinical presentation, diagnosis, and management of acute diverticulitis across the spectrum of presentations are discussed.
Background Dysmenorrhea, or painful menstrual periods, is one of the most common gynecological complaints. Most reports of uterine contractions range between moderate to severe pain, and patients often elect to cope with their discomfort without assistance from a physician. In the process, women experiencing dysmenorrhea are more likely to report absenteeism from work and school. Objectives This study measures the reported impact of dysmenorrhea on patients’ lives and elucidates a relationship between income and access to oral contraceptives. Methods Two hundred women completed a survey about their symptoms, level of pain, treatments, and the extent to which dysmenorrhea affected day-to-day obligations. Most questions were multiple-choice while others permitted several answer selections or were free response. The data was analyzed using JMP statistical software. Results Eighty-four percent of respondents reported moderate to severe pain during menstruation. This discomfort has caused 65.5% of the cohort to miss work and 68% to avoid participating in social gatherings. Pain relief medications are most often used as treatment - 143 respondents took ibuprofen, 93 took acetaminophen, and 51 took naproxen. 29.5% of respondents are prescribed birth control for cramps and blood flow. Income (p = 0.049), age (p = 0.002), and education (p = 0.002) were significant predictors for oral contraceptive pill (OCP) use. The lowest income groups were found to use OCPs at less than half the rate as the highest income respondents. Conclusion Dysmenorrhea affected most participants in the cohort with an impact that extends beyond professional obligations. Income was found to be positively correlated with increased OCP use, whereas education level was inversely correlated. Clinicians should consider how patients’ backgrounds influence their access to OCP options. An improvement on this study’s findings would be to establish a causal relationship between these demographic factors and access to OCPs.
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