The endometrium, which normally forms in the internal surface area of the uterus, can also form on the surfaces of certain other organs and internal structures. This is an unusual occurrence which is referred to in the medical world as endometriosis. The formation of endometrium outside of the uterus is referred to as endometrial implants. This unusual formation of endometrial implants can invade even the bowel system, which is then referred to as gastrointestinal or intestinal endometriosis.
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The outside walls of the intestines are the usual places where endometrial implants are detected. It starts of as small tissue patches, but when left undetected for long, it can grow and begin to penetrate through the walls and involve the insides of the intestines as well. At this stage, the symptoms become severe and unpleasant. Women with mild-to-moderate endometriosis conditions usually tend to suffer from this type of endometriosis too; but with bowel symptoms being common for other gastrointestinal disorders as well, it generally goes undetected for long. By this time the endometriosis condition would have become a serious one.
Symptoms of Gastrointestinal Endometriosis
- Constipation or diarrhea
- Severe stomach cramps
- Loss of appetite
- Nausea and vomiting
- Difficult bowel movements
- Gassy feeling and abdominal bloating
- Blood in stools
These symptoms are more apparent during or just before menstruation commences. When intestinal endometriosis is mild, no symptoms are actually apparent.
The development of intestinal endometriosis is found to follow distinct and clear patterns. The lower end of the sigmoid colon is usually affected by this, followed by last portion of the small intestines. The initial portion of the large intestine and the appendix can get affected too.
Diagnosing Intestinal Endometriosis
A colonoscopic examination or x-rays of the GI tract usually are not helpful in detecting intestinal endometriosis. This is because the endometrial implants stay usually on the muscular walls of the intestines and do not infiltrate the entire length of the intestines.
In the case of rectal endometriosis, trans-vaginal or trans-rectal sonography is a valuable imaging technique in detecting it. However, an accurate diagnosis can only be obtained by performing a laparoscopic examination. This needs to be conducted by a skilled professional who will be able to identify the different appearances of endometriosis, and are aware of the exact intestinal places which usually get affected by this condition.
Intestinal Endometriosis Treatment
The use of hormone therapy fails to provide favorable results in treating this endometriosis type, especially when the disorder has reached an advanced stage.
Surgical management of intestinal endometriosis is the usual route chosen for treating this condition. Generally during a laparoscopic examination, when endometrial implants are found, thermal ablation or mechanical excision of the adhesions and implants encountered will be carried out. A CO2 laser is used to vaporize the abnormally placed endometrial tissues, without actually damaging any of the structures found below this abnormal tissue layer. This method is generally helpful in removing deeply embedded endometrial implants.
In the case of implants affecting only the surface of the intestinal organs, then mostly a shave excision will be carried out. This needs skilled hands ensuring that no normal tissues are damaged or injured.
When endometriosis is deeply infiltrative and has affected multiple areas of the intestines, then an open surgery is usually warranted for its successful removal.
There are effective treatment methods available for curing intestinal endometriosis. A physician consultation will help in identifying the best method of treatment and choosing the best team to carry out the same.