Intestinal endometriosis: what it is, symptoms and treatment

Intestinal endometriosis is a disease in which the endometrium, tissue that lines the inside of the uterus, grows on the abdomen wall and reaches parts of the intestine and rectum, making it difficult to function and causing symptoms such as changes in bowel habits, in addition to pain intense abdominal pain, especially during menstruation.

When cells of the endometrium are found only on the outside of the intestine, intestinal endometriosis is called superficial, but when these cells penetrate the wall of the intestine and reach the inside, intestinal endometriosis is classified as deep.

It usually needs to be treated with surgery to reduce the amount of endometrial tissue in the intestine. However, there are also cases where the endometrial tissue has not spread much and the disease does not produce any symptoms. In these cases, treatment is easier and surgery is not always necessary, and the use of hormonal medicines can only be guided by the doctor.

Main symptoms

Some women have no symptoms, or may have only a few, such as:

• Difficulty evacuating; Pain in the belly during sexual intercourse; Pain in the lower abdomen; Persistent diarrhea; Presence of blood in the stool.

Sometimes the endometrium grows too large and can cause obstruction of the intestine, causing constipation.

The symptoms of intestinal endometriosis often worsen during menstruation, but in some cases the symptoms appear outside the menstrual period and therefore can be confused with other intestinal problems. Check out other symptoms of endometriosis.

Possible causes

The cause of intestinal endometriosis is not fully known, but during menstruation the blood with cells from the uterus can return to the tubes and spread to the other organs of the abdomen, reaching the intestinal wall probably because it is an organ very close to the uterus. Other causes may be associated with hormonal imbalance, especially the hormone estrogen.

Some doctors even associate the occurrence of intestinal endometriosis with previous surgery in the uterus, which can spread cells of the endometrium in the abdominal wall reaching the intestine.

However, people who have a close family member, such as a mother or sister with intestinal endometriosis, may be more at risk of developing the same disease.

How to confirm the diagnosis

In some cases, endometriosis can be confused with intestinal diseases such as irritable bowel syndrome, appendicitis and Crohn's disease, so to confirm the diagnosis, it is necessary to identify the location and extent of endometriosis in the intestine and it is necessary to perform some tests, such as:

• Vaginal examination: performed by a gynecologist to assess the appearance of the cervix; Transvaginal ultrasound: serves to identify the organs affected by endometriosis; Computed tomography and / or magnetic resonance imaging: to accurately assess the affected areas of the intestine; Laparoscopy or videolaparoscopy: surgery to examine the intestine and find out the exact location of endometriosis; Opaque enema: it also serves to investigate the extent of endometriosis in the intestine.

Colonoscopy is not always indicated by the gynecologist, as it is an exam that evaluates the internal part of the intestine and in most cases intestinal endometriosis occurs on the outer walls of the intestine, however, it can be requested if the doctor suspects intestinal endometriosis deep or to screen for other intestinal diseases. See about exams for diagnosis of endometriosis.

How the treatment is done

The main type of treatment used to treat intestinal endometriosis is surgery, whose tissue of the endometrium is removed from the intestinal wall, relieving symptoms and improving a woman's fertility.

Most surgeries are performed by video, but in some situations traditional surgery is necessary, depending on the severity and areas of the intestine affected by endometriosis. Check out more about surgery for endometriosis.

The gynecologist in conjunction with the digestive tract surgeon will make an assessment before surgery, as this is how they will plan the surgery and define the treatment follow-up after the surgery.

Other types of treatment may be indicated by the gynecologist, especially drugs to regulate hormones and relieve symptoms, such as pills, patches and contraceptive injections and anti-inflammatory medications.

Natural treatment options

In addition to the use of medications, other types of more natural treatments may be indicated, such as acupuncture, which stimulates the nerves and the production of certain substances in the body to relieve pain.

Eating foods containing omega-3s such as fish, nuts and extra virgin olive oil reduces inflammation and stimulates the body's defenses and thus helps to alleviate the symptoms of intestinal endometriosis.

There are natural extracts, such as turmeric and green tea, which also have an anti-inflammatory effect on the body and can improve the symptoms of intestinal endometriosis, however the treatment with extracts must be carried out under the guidance of a herbalist and under the supervision of a gynecologist.

In addition, emotional stress releases substances in the body that cause inflammation and so doing activities that reduce stress help in the treatment for intestinal endometriosis. Learn how to fight stress.

Possible complications

Even after surgery to remove tissue from the endometrium of the intestine, the disease may return, so it is necessary to follow up with a gynecologist and do regular examinations.

In some cases, women with intestinal endometriosis may also have endometriosis on the outer wall of the uterus and this makes it difficult for women to conceive. Learn more about getting pregnant in cases of endometriosis.