Endometriosis is the migration of endometrial tissue, the tissue that lines the inside of the uterus, to areas outside the uterus. Endometriosis affects the gastrointestinal (GI) tract in at least 5 percent of cases, the New England Journal of Medicine estimates, according to reproductive endocrinologist Michael Birnbaum, M.D. Symptoms depend on the area of endometrial implantation and usually worsen during menstruation, when the tissue sheds and bleeds just like the endometrial lining. Surgery is used both to diagnose and treat endometriosis.
Pain is common all types of in endometriosis and generally worsens during menstrual periods. Endometriosis in the GI tract can cause abdominal, bowel or rectal pain. Women with GI endometriosis may feel pain when sitting, passing gas, having a bowel movement or during sex. Endometriosis in the ileum, the lower part of the small intestine, can cause right-sided pain that mimics appendicitis.
Around 70 percent of endometriosis affects the lower part of the intestine, the large intestine, known as the colon, or the sigmoid colon, which attaches to it, Dr. Birnbaum states. Rectal bleeding that occurs during menstruation is diagnostic for intestinal endometriosis. Endometriosis on the bowel can cause either diarrhea or constipation. Tenesmus, a feeling that the bowel isn’t completely emptied after defecation, and dyschezia, difficulty defecating, may occur, lead author Melih Paksoy reported in the November 6, 2005 issue of the Mt. Sinai Journal of Medicine entitled “Intestinal Obstruction Due to Rectal Endometriosis.” Diarrhea and constipation may alternate.
Constipation worsens if a bowel obstruction develops, and if complete intestinal blockage occurs, no stool is passed. Complete bowel obstruction can lead to perforation of the colon and possible peritonitis, an infection of the abdominal cavity, according to Paksoy. Scar tissue, or adhesions, can also cause severe bowel obstruction. Severe cases of bowel obstruction may require resection or removal of part of the bowel that’s irreversibly damaged; this may occur in 1 to 2 percent of women with endometriosis of the G tract, surgeon Ken Sinervo, M.D. of the Center for Endometriosis Care states.
Endometriosis causes a number of abdominal symptoms. Common symptoms of endometriosis are feeling full after eating a small amount, bloating, cramping, nausea, vomiting (rarely) and decreased appetite