Gastrointestinal Pain in Endometriosis
Endometriosis is a common gynecological problem affecting women in their reproductive age. It never occurs before puberty and it usually resolves after menopause.
Endometriosis is a gynecological condition characterized by the growth of the endometrial tissue outside of the uterus. There are two types of endometriosis: internal endometriosis and external endometriosis. The internal endometriosis occurs when the endometrial tissue grows inside of the myometrium, while the external endometriosis occurs when the endometrial tissue grows outside of the uterus. It can spread in different body parts, but usually, the ovaries, the bladder, the rectum and the peritoneum are affected.
Signs and symptoms of endometriosis depend on the location of the endometrial tissue, rather than from its size.
Characteristic signs and symptoms of endometriosis include:
- severe pelvic pain, which tends to get worse during menstrual periods
- irregular menstrual periods and prolonged menstrual periods
- constipation altered with diarrhea
- blood coming from the rectum when the bowels are affected
- painful urination
- urge to urinate as well as a presence of blood in the urine when the bladder is affected
According to different studies, visceral syndrome is extremely common among women diagnosed with endometriosis and it could be intensifying with pain. It is well known that endometriosis frequently causes pelvic pain. As the endometrial tissue tends to grow usually inside of the pelvis and in the abdominal cavity, inflammations and tissue adherences are also common. Apart from the genital pain that women with endometriosis experience, especially while having sexual intercourse, gastrointestinal symptoms are also prevalent even without having an irritable bowel syndrome. Urinary tract symptoms, as mentioned before are very common as well. All these symptoms present a major burden for women diagnosed and suffering from endometriosis. Recurrence of these problems with every menstrual cycle and their tendency to get worse with time is disabling for these women. Hospital treatment is also often required, affecting the normal life of these women in their families, work, and society.
From the visceral syndrome group of medical disorders, bowel, and bladder problems are more common. Irritable bowel syndrome and interstitial cystitis are seen more often.
Altered visceral sensory functions involve both peripheral and central sensitization and may represent a significant factor in endometriosis-associated visceral dysfunction and pain. Pelvic pain due to endometriosis is a chronic pain. It also presents a complex disorder which is usually hard to understand. Pain arising from the pelvic organs like the uterus, the ovaries, fallopian tubes, bladder, kidneys as well as from rectum is defined as visceral pain. Such pain results from visceral pain receptors (nociceptors) present in various organs located inside the female pelvis.
Laparoscopy as a treatment option for endometriosis can sometimes ease the visceral pain as it consists in getting rid of the endometrial tissue that is growing outside of the uterus as well as from the adhesions created between the organs inside of the pelvis and abdominal cavity.
