How common does endometriosis affect the bowels and where? The exact incidence is unclear but may occur in 5-15% of all cases of endometriosis. The sites where endometriosis occurs are the rectum, the sigmoid, the appendix and the small bowels.
Small bowel and appendiceal endometriosis
Small bowel or appendiceal involvement is rare and does not always cause symptoms. Usually, non-specific symptoms, such as recurrent pain and abdominal bloating, can accompany this type of endometriosis.
Bowel Endometriosis Diagnosis
Endometriosis impacts 10%-12% of women of childbearing age. Doctors tend to diagnose it in women who are in their 30s. Your doctor will start by asking about your symptoms and medical history.
Less commonly, endometriosis can affect the bowel in the abdomen and pelvis. The endometriosis can be superficial (on the surface of the bowel) or deep and invade into the bowel wall and surrounding tissue. The most common site for deep endometriosis is in the space between the rectum and vagina.
If pain and bowel symptoms are severe, and/ or where fertility is a major consideration, surgery for removal of the affected bowels may be advised.
As mentioned, colonoscopy is a very poor tool for diagnosing bowel endometriosis. This is because a colonoscopy looks on the inside of your bowel. However, the majority of bowel endometriosis growths occur on the outside of the bowel and only rarely penetrates beyond the bowel's mucus layer (inner layer).
A small bowel obstruction can result in symptoms such as stomach pain, nausea, and difficulty passing gas or stool, among other things. A bowel obstruction, if left untreated, can cause pressure to build up in the abdomen, potentially leading to a bowel perforation (a hole in the bowel).
Diagnosing bowel endometriosis typically begins with an overall physical exam, including a manual check for growths in the vagina or rectum. It also frequently requires one or more imaging tests, including ultrasound, MRI, colonoscopy, laparoscopy, or barium enema.
These lesions, whether putting pressure on the outside of the intestines or stiffening the rectum, can cause a great deal of pain, especially during the menstrual period.
In the recent years, the ultrasound detection rate of endometriosis foci of the bowel has increased (high sensitivity and specificity) [8, 9], with accuracy rates as high as other imaging techniques [10, 11].
There is no known way to prevent endometriosis. There is no cure, but its symptoms can be treated with medicines or, in some cases, surgery. It causes a chronic inflammatory reaction that may result in the formation of scar tissue (adhesions, fibrosis) within the pelvis and other parts of the body.
Deeply infiltrative endometriosis is a rare but severe form of endometriosis.
If obstruction of the bowel or urinary tract occurs due to infiltration of endometriosis, urgent surgical management plays a vital role in minimalizing the loss of organ function.
In endometriosis, tissue similar to the uterine lining grows elsewhere in the body. This can cause severe pain as well as bleeding between periods. Conversely, IBS is a disorder of the digestive system that can cause abdominal pain, bloating, and changes in bowel habits.
Endometriosis can cause GI symptoms similar to those of IBS, including abdominal pain and cramping. These conditions require different treatment approaches, so it's important to know if you do, in fact, have both, or if shared symptoms are instead due to endometrial lesions in the bowel.
In some instances of bowel endometriosis, women remain asymptomatic, with 5% of the larger lesions remaining symptom free and in whom surgical resection is probably not indicated. Symptoms may improve with medical treatment; however, deep infiltrating lesions are less likely to resolve.
It may take you up to four weeks to recover from the operation. You may feel very tired during this time, so it is important that you rest. It may take up to six months to see any improvement in your symptoms.
Painful symptoms are treated by surgically removing the endometrium tissue from the bowels. It is important to seek care from experienced and highly skilled colon and rectal surgeons for this procedure, such as those at the Weill Cornell Medicine Colon and Rectal Surgery Division.
Endometriosis is not a fatal condition. However, experts do associate it with certain conditions and complications that may be life threatening. These include ectopic pregnancy, mental health concerns, and small bowel obstruction.
Constipation. Diarrhoea. Nausea. Stomach gurgling — you may notice your stomach making sounds, such as gurgling, or feel as if it's bubbling or fluttering inside.
Endometriosis is a chronic condition that causes symptoms such as severe abdominal pain, irregular menstruation, and infertility. Some people report weight gain as a symptom of endometriosis, which may be attributed to abdominal bloating or treatments for the disease. Pain may indirectly contribute to weight gain.