Medsarticles. Medical Weblog

Most bowel symptoms are not due to the presence of endometriosis on the surface of the bowel itself, but rather are usually related to irritation from implants located on adjacent organs or tissues, such as in the Pouch of Douglas, or due to adhesions from these implants pulling on the bowel.

The range of bowel symptoms varies. The most common include diarrhoea and/or constipation, painful bowel movements, rectal pain, wind pain and abdominal bloating. Other less common bowel symptoms may include lower back pain, pain during rectal examinations, abdominal cramping, rectal bleeding, blood in the stools, urgency to open bowels, nausea and/or vomiting. These symptoms may be present throughout the month but are usually worse during menstruation. Exercise, sexual intercourse and vaginal examinations can also trigger these symptoms.

Research by the Endometriosis Association indicates that bowel symptoms are far more common than is generally acknowledged. In fact, 49% of women in its survey reported that they had experienced bowel pain prior to a diagnosis of endometriosis.

In the unusual cases where endometriosis is located on the bowel, the implants are usually confined to the outer layer of the bowel wall; it is uncommon for endometriosis to be found in the inner layer of the bowel wall. If implants are located on the bowel itself the symptoms experienced may include any of the symptoms mentioned above. In rare circumstances a partial obstruction of the bowel may develop as a consequence of scarring and adhesions from endometrial implants encircling and constricting the bowel.

Bladder symptoms-Implants on the bladder, or on adjacent organs, may cause a range of symptoms including bladder pain, blood in the urine, pain or burning when passing urine and urinary frequency.

Infertility-Infertility is one of the most common symptoms and is thought to affect approximately 30% to 40% of women with endometriosis.

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