All about bowel endometriosis: Symptoms, treatment and precautions

Endometrial growth on the bowel can cause significant pain during bowel movements, especially during menstruation when the tissue is most inflamed. (Image: Canva)

Bowel endometriosis is a condition where endometrial tissue, typically found lining the uterus, grows on the bowel. This abnormal growth can lead to a range of symptoms, including chronic pelvic pain, painful bowel movements, abdominal pain, bloating, diarrhea, constipation, and rectal bleeding, particularly during menstruation.

Diagnosis often involves medical history, physical exams, imaging tests, colonoscopy, and laparoscopy. Treatment options include pain relief, hormonal therapy, and, in severe cases, surgery to remove the endometrial tissue. Managing bowel endometriosis usually requires a multidisciplinary approach to alleviate symptoms and improve the quality of life for those affected.

Symptoms of bowel endometriosis

Pain

Pelvic pain: Chronic pelvic pain is a hallmark of bowel endometriosis, typically worsening during menstruation due to hormonal changes triggering inflammation and irritation of the endometrial tissue, says Noida-based Dr Manisha Kadam.

Abdominal pain: This pain can occur independently of menstrual cycles, resulting from the endometrial tissue irritating the bowel and surrounding organs.

Painful bowel movements: Endometrial growth on the bowel can cause significant pain during bowel movements, especially during menstruation when the tissue is most inflamed.

Pain during intercourse: Deep penetration during intercourse can aggravate endometrial tissue on the bowel, leading to significant pain and discomfort.

Gastrointestinal symptoms

Diarrhea or constipation: Bowel endometriosis can disrupt normal bowel function, causing alternating or persistent episodes of diarrhea and constipation.

Bloating and nausea: Hormonal changes during menstruation can exacerbate bloating and nausea, often making these gastrointestinal symptoms more pronounced.

Rectal bleeding: The presence of endometrial tissue on the bowel can lead to bleeding during menstruation, noticeable as rectal bleeding.

Other symptoms

Fatigue: Chronic pain and inflammation associated with bowel endometriosis can lead to persistent fatigue, impacting daily activities and quality of life.

Infertility: Endometriosis can affect reproductive organs, potentially leading to infertility due to tissue damage and inflammation impacting fertility.

Diagnosis

Medical history and physical exam: Discuss symptoms and perform a pelvic exam, suggests Dr Kadam.

Imaging tests

Ultrasound: Can detect large endometriotic cysts.

MRI: Provides a more detailed image of the extent of endometriosis.

Colonoscopy: To examine the inside of the colon if bowel symptoms are significant.

Laparoscopy: A surgical procedure to visualize and biopsy endometriotic lesions.

Treatment

Hormonal therapy

Birth control pills: To regulate or stop menstruation.
GnRH agonists: To reduce estrogen levels and shrink endometriosis.
Progestins: To reduce endometrial tissue growth.

Surgical treatment

Laparoscopy: To remove endometriotic tissue.
Bowel resection: In severe cases, part of the bowel may need to be removed.

Lifestyle and home remedies

Dietary changes: High-fibre diet to ease bowel symptoms.
Regular exercise: To help reduce pain and improve overall well-being.
Stress management: Techniques like yoga, meditation, and counseling.

Alternative treatments

Acupuncture: Can help in pain relief.Herbal supplements: Some women find relief with certain herbs, though scientific evidence is limited.

When to see a doctor

If there is persistent pelvic pain, severe gastrointestinal symptoms, especially during menstruation. If the symptoms not relieved by over-the-counter medications. If there are concerns about fertility.