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Endometriosis Colon and Bowel - Causes, Diagnosis & Treatment

The incidence of gastrointestinal involvement in endometriosis occurs in between 3% and 34% of women who have been diagnosed with the disease; the average rate is around 12%. The New England Journal of Medicine featured an article that stated that around 5% of all women suffer from intestinal endometriosis.

One of the variations of gastrointestinal endometriosis is that it is not uncommon in women who have gone through menopause. Generally, pelvic endometriosis does not affect women after menopause. Up to 70% of gastrointestinal endometriosis affects the rectum or sigmoid colon and the diagnosis is frequently rectal or colon cancer when the patient is first examined.

The symptoms of endometriosis are similar to other medical conditions of the pelvic region and so misdiagnosis is common when part of the gastrointestinal system is involved. Endometriosis colon and bowel are two of those that are commonly diagnosed as something else. Bowel and colon endometriosis might be initially diagnosed as Irritable Bowel Syndrome or Spastic Colon, among other disorders.

Intestinal symptoms are common in endometriosis with many patients experiencing diarrhea, constipation and pain. Unlike with other conditions, these symptoms often fluctuate with the menstrual cycle, as the endometrial lesions respond to the fluctuation of hormones. Most doctors will connect this fact with endometriosis and make the correct diagnosis. Endometriosis colon and bowel may have additional symptoms including nausea, loss of appetite, bloating, excess gas and bleeding from the rectum.

Endometriosis implants are usually on the outside surface of the bowel, colon or rectum; they may invade deep into the wall of these organs but seldom progress to the inside. However, colon and bowel symptoms might still be experienced even if there are no lesions on these organs themselves. In many cases, the symptoms are caused by irritation from endometrial lesions on adjacent organs and tissue. Sometimes, adhesions or scar tissue can pull on the bowel or constrict and twist it causing pain and other symptoms.

Colon and bowel endometriosis symptoms are not usually the only symptoms the patient feels; other endometriosis symptoms are usually also present like painful periods with heavy or irregular bleeding and pain during or after sexual intercourse. The colon and bowel symptoms are commonly worse just before a period starts when they are caused by endometriosis. Vaginal examination may be painful; the doctor might be able to feel lesions during an internal exam. The symptoms of bowel and colon endometriosis will depend on the location and severity of the implants. The severity is often defined as how deeply the disease has penetrated the bowel wall.

When the endometrial tissue has invaded the wall of the colon and bowel deeply, a considerable amount of scarring will occur; this can cause a tumor to form which may obstruct the bowel. A woman may have both deep and superficial lesions on the bowel and colon, in different areas, at the same time.

The endometrial implants of colon and bowel endometriosis often penetrate deeper and are bigger in size than implants in other areas. They seldom respond adequately to any of the drug therapies that are used to treat endometrial symptoms and so surgery is the only treatment option. Surgery to remove bowel and colon lesions can be difficult – the implants might be hard to reach and the bowel can easily be damaged during surgery.

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