Bowel endometriosis happens when endometrial tissue (the tissue that lines the inside of the uterus) implants in the intestines. This can lead to symptoms like changes in bowel habits and intense abdominal pain, especially during menstruation.
This tissue can affect any part of the bowel, but it is most commonly found in the lower intestine, just above the rectum. It may also involve other pelvic organs, such as the ovaries, fallopian tubes, or bladder.
A gynecologist manages endometriosis treatment based on symptom severity and disease extent. In certain cases, surgery removes bowel lesions, combined with medications for symptom relief.
Common symptoms
The main symptoms of bowel endometriosis are:
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Pain or difficulty having a bowel movement;
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Cramping in the lower abdomen;
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Abdominal bloating;
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Abdominal pain during sexual intercourse (dyspareunia);
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Persistent diarrhea or constipation;
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Ongoing pain during menstruation;
According to the World Health Organization (WHO), endometriosis commonly causes severe menstrual pain and can affect bowel movements. These symptoms often worsen during menstruation but can occur at other times. As a result, these symptoms may be mistaken for other intestinal disorders, such as irritable bowel syndrome.
It is also common for bowel endometriosis to cause no symptoms at all. In these cases, it may be found during routine tests, such as a colonoscopy.
Also recommended: Endometriosis Symptoms (In the Bladder, Bowels or Ovaries) tuasaude.com/en/endometriosis-symptomsDoes bowel endometriosis cause gas?
Bowel endometriosis can cause gas by interfering with normal bowel movements and function.
Confirming a diagnosis
A gynecologist diagnoses bowel endometriosis by evaluating the patient's symptoms, medical history, results from a pelvic and rectal exam, and imaging tests.
Diagnostic tests
The main tests for bowel endometriosis are:
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Transvaginal, pelvic, or rectal ultrasound;
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X-ray with contrast enema;
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Magnetic resonance imaging (MRI);
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Colonoscopy;
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Videolaparoscopy.
These tests help confirm bowel endometriosis and also help rule out other conditions with similar symptoms, such as irritable bowel syndrome, appendicitis, or Crohn’s disease.
Possible causes
The exact cause of bowel endometriosis remains unknown. It occurs when endometrial tissue (the innermost lining of the uterus) implants in the intestine.
One theory is retrograde menstruation, in which endometrial cells that should be shed during menstruation flow backward and reach the intestinal wall. This process may also involve the ovaries.
Having a close relative, such as a mother or sister, with bowel endometriosis may increase the risk of developing the condition.
Main types
The main types of bowel endometriosis are:
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Superficial bowel endometriosis: endometrial cells are found only on the outer surface of the intestine;
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Deep bowel endometriosis: endometrial cells penetrate into the intestinal wall.
The type is determined by a clinician using imaging tests.
Treatment options
Treatment for bowel endometriosis should be guided by a gynecologist based on symptoms and disease severity.
The main treatments for bowel endometriosis are:
1. Surgery
Surgery is one of the main treatment options for bowel endometriosis. It may be performed by a gynecologist, gastroenterologist, and/or colorectal surgeon to remove endometrial tissue from the intestine, which can help relieve symptoms.
Most procedures are done without large incisions, using videolaparoscopy and small cuts in the abdomen.
In some situations, traditional surgery with a larger abdominal incision may be needed. This decision is typically made after assessing which parts of the intestine are affected.
2. Medications
After initial surgical treatment, ongoing treatment may be needed with medications prescribed by a gynecologist.
Examples include nonsteroidal anti-inflammatory drugs (NSAIDs), combined birth control pills or progestin-only pills, contraceptive patches, contraceptive injections, or a hormonal intrauterine device (IUD).
Regular follow-up with a gynecologist and routine testing are also important to monitor recovery and check whether endometrial tissue returns in the intestine.
Based on the US Department of Health and Human Services Office on Women’s Health, endometriosis is commonly managed with symptom-focused treatments over time, making follow-up important after treatment to reassess symptoms and response.