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What is Bowel Endometriosis?

When the tissue that makes up the lining of the uterus (womb), called endometrium, grows outside the uterus, it is called endometriosis. When endometriosis is present in parts of the bowel, it is called bowel endometriosis. This can be painful and cause rectal bleeding around the time of menstruation.

Depending on the level of penetration of the endometrial cells into the bowel, bowel endometriosis can be classified into two categories:

  • Superficial Bowel Endometriosis: Endometrial cells are present on the outer surface of the bowel and have not grown deeper into the bowel.
  • Deep Bowel Endometriosis: Here, the endometrial cells have grown deeper into the bowel walls, sometimes resulting in the narrowing of the bowel and forming lumpy “nodules.”
While immensely helpful for improving quality of life and controlling the symptoms, treatment options, including surgery, cannot guarantee that the condition will not recur.

What are the Symptoms of Bowel Endometriosis?

The common symptoms of bowel endometriosis include:
  • Severe pain during menstruation is referred to as dysmenorrhoea.
  • Severe pain during bowel movements is referred to as dyschezia.
  • Severe pain during intercourse is referred to as dyspareunia.
  • Menstrual bleeding accompanied by bleeding from the anus (where stool, or poo, exits the body)
  • Mucus discharge during bowel movements

This condition can also affect mental health, often leading to depression.

Bowel endometriosis symptoms mimic those of Irritable Bowel Syndrome (IBS), resulting in misdiagnosis. If you experience these symptoms before and during your period, it indicates that you may have bowel endometriosis. If endometriosis symptoms are present with gastrointestinal issues, bowel endometriosis should be suspected.

When Should You Seek Medical Help?

If you are experiencing any or all of the listed bowel endometriosis symptoms, it is recommended that you consult your GP, who can refer you to appropriate specialists. This condition can affect your ability to undertake everyday activities and your mental well-being. There are various treatment methods, including surgical procedures, that can be used to effectively manage symptoms.

Many women internally normalise their symptoms and do not seek medical treatment out of embarrassment or other reasons. If you think you may have bowel endometriosis, getting evaluated by a specialist and choosing a suitable treatment plan can help significantly improve your quality of life.

What Causes Bowel Endometriosis?

Bowel endometriosis does not have a specific cause that has been identified. One theory that has been proposed is that it may be caused by “retrograde menstruation.” If the menstrual blood travels back into the body via fallopian tubes (tubes that connect the uterus and the ovaries) instead of exiting the body, it is called retrograde menstruation. Since menstrual blood contains the lining of the uterus, this can explain the presence of this tissue outside of the uterus.

How is Bowel Endometriosis Diagnosed?

The doctor will begin by carefully listening to your symptoms, concerns, and detailed medical history. It will be helpful if you keep track of your daily symptoms. This will allow the doctor to confirm if the symptoms flare up before and during your period.

The doctor will also need to conduct a physical examination of your vagina and rectum to feel for any abnormalities. If these steps indicate that you may have bowel endometriosis, imaging tests like an ultrasound or MRI will be performed to get a clearer picture of the suspected bowel endometriosis.

While these imaging techniques can be helpful, only a laparoscopic examination (where a small incision is made in the abdomen and a medical instrument with an attached camera is inserted to look at the bowel) can reveal the full extent of the condition.

What are the Treatment Options for Bowel Endometriosis?

Bowel endometriosis symptoms can be managed effectively using non-surgical and surgical treatment options.

1. Non-Surgical Treatment Options for Bowel Endometriosis

  • Painkillers:

    Pain-relieving medication is prescribed to manage the severe pain that bowel endometriosis patients experience. Various medications may be recommended, ranging from non-prescription drugs to more potent painkillers such as codeine. If the painkiller is known to cause constipation, laxatives may be prescribed to facilitate easier bowel movements.

  • Hormone Therapy:

    .Some hormone medications stop the release of eggs from the ovary and induce menopause-like symptoms. This slows down the growth of endometrial cells due to suppressed hormonal activity and stimulation. Hormone therapies can also be contraceptives or non-contraceptives

  • Complementary Treatment:
    Despite the lack of scientific research or evidence to back it, many individuals have claimed alleviation from their symptoms using complementary therapies like acupuncture and other natural remedies.

2. Surgical Treatment Options for Bowel Endometriosis

  • Rectal Shaving:

    Rectal shaving is a procedure used to treat superficial bowel endometriosis (where the growth is present only on the surface of the bowel). The endometriosis growth or nodule is shaved off the bowel without removing any part of the bowel. 

  • Disc Resection:

    Disc resection involves removing a disc from the bowel containing the endometriosis nodules. The resultant hole is sewn or stapled shut. This procedure is used to treat deep bowel endometriosis in a smaller area of the bowel, which does not call for removing an entire section of the bowel.

  • Segmental Bowel Resection and Re-anastomosis:

    Segmental resection treats deep bowel endometriosis where the growths or nodules are present across a larger area or, in some cases, have penetrated the bowel, causing it to narrow. The entire affected section of the bowel is removed, and the remaining healthy ends are rejoined, called re-anastomosis.

Your surgeons will take you through the benefits and risks of each treatment option in detail to enable you to make an informed and educated decision.

Why choose the Leicester Bowel Clinic?

Book a consultation with us to get treatment for your condition..

At Leicester Bowel Clinic, we focus on bowel health and conditions, digestive issues, and cancer care. Our clinic offers minimally invasive procedures for bowel problems, ensuring effective results and patient comfort. We aim to provide personalised care for our patients and offer the latest treatments for hernias, bowel conditions and rectal disorders.

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Leicester Bowel Clinic at Spire Hospital

  • Wednesdays evenings (Mr Runau) from 6:00 pm until 9:00 pm at: Spire Leicester Hospital Gartree Road Leicester LE2 2FF
  • To arrange an appointment directly with the Spire Leicester Hospital, please call the booking line on 0116 2653685

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Frequently Asked Questions

01. Can bowel endometriosis be cured?

While several treatment options are available for effective management and minimisation of bowel endometriosis symptoms, none of them can guarantee non-recurrence. However, these treatment options can be helpful in greatly improving your quality of life.

02. What happens if bowel endometriosis is left untreated?

Leaving bowel endometriosis untreated can result in worsening symptoms. The longer it is left untreated, the more difficult the treatment process will be. Early diagnosis and a suitable treatment plan can prevent potential complications and bring the symptoms under control.

03. What does bowel endometriosis pain feel like?

Some patients diagnosed with bowel endometriosis have described the pain as “sharp” or “burning” and compared it to razor blade cuts. Others have reported a dull, aching sensation. Symptoms vary greatly between each case. Hence, it is important to seek professional advice from a specialist for a precise diagnosis and treatment of the condition.

04. Can bowel endometriosis be seen on an ultrasound?

One of the imaging tests that may be recommended to diagnose bowel endometriosis is an ultrasound. Depending on the results, further tests, like an MRI scan, may be necessary. While these minimally invasive imaging tests can help diagnose bowel endometriosis, its full extent can be confirmed only via laparoscopy (internal examination through a small incision in the abdomen using a medical instrument with an attached camera).