Symptoms of bowel endometriosis

Abstract

Patients affected by bowel endometriosis usually complain pain and intestinal symptoms including dyschezia, cyclic bowel alterations, abdominal cramping, feeling incomplete evacuation, stool fragmentation, passage of mucus with the stools and rectal bleeding. The characteristic and intensity of these symptoms depend on the location of the nodules, their size and the degree of stenosis of the intestinal lumen. However, the intestinal symptoms are not only the consequence of infiltration of endometriosis in the intestinal wall, but they are also caused by the cyclic micro-hemorrhages and inflammation within endometriotic lesions and by the distortion of the anatomy that may lead to abnormal angulations of the digestive tract. Significant narrowing of the intestinal lumen occurs in a minority of patients with bowel endometriosis and it may cause subocclusive or occlusive symptoms (such as abdominal distention, diffuse or moderate abdominal pain, vomiting, no gas or stool passing). The development of colonic ischemia in the upstream dilated bowel may cause perforation with subsequent peritonitis and sepsis.