Dyschezia is a term used to describe painful bowel movements. Many conditions can cause dyschezia. It can be a symptom of endometriosis, a condition that affects females.

Endometriosis happens when tissue similar to the uterine lining grows outside the uterus. It can grow on the intestines and digestive system, causing pain during bowel movements.

People with bowel endometriosis may also have diarrhea, bloating, constipation, and rectal bleeding.

Read more to learn about the link between endometriosis and dyschezia, how common it is, and how to manage it.

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Yes, endometriosis can cause painful bowel movements (dyschezia).

This may happen if endometriosis grows on the digestive system. With endometriosis, endometrial tissue grows on organs and structures in the pelvis and abdominal cavity. This can damage organs and cause pain and inflammation.

Having dyschezia does not always mean a person’s endometriosis is severe. Symptoms do not always correspond to stage.

For example, a person with advanced endometriosis may have few symptoms, while a person with early stage endometriosis may have very painful symptoms.

The American Society of Reproductive Medicine has a staging system for endometriosis, developed in 2012. Doctors classify endometriosis in stages 1–4 depending on the location, depth, amount, and size of endometrial tissue present.

StageCategoryFeatures
1minimalThere are isolated implants and no significant adhesions.
2mildThere are superficial implants on the peritoneum and ovaries with no significant adhesions.
3moderateThere are multiple implants that are superficial and deeply invasive. Adhesions may be present in the tubes and ovaries.
4severeThere are multiple superficial and deep implants and large ovarian endometriomas.

Doctors also group endometriosis type based on which areas it affects.

When endometriosis penetrates the bowel wall, doctors call it deeply infiltrative endometriosis. According to a 2020 paper, over two-thirds of people with this type of endometriosis experienced dyschezia.

Doctors would characterize endometriosis in the bowel as stage 4, or severe. This means that while some people with dyschezia may have stage 4 endometriosis, not all people with dyschezia are at stage 4. A person can have early stage endometriosis and still experience painful bowel movements.

According to the Office on Women’s Health (OASH), around 11% of females ages 15–44 years in the United States have endometriosis.

The exact number of people with endometriosis affecting the intestines or bowel is unknown. However, a 2014 study found that up to 37% of those with endometriosis experienced problems with their bowel.

Stage 4 endometriosis is uncommon. According to a 2015 study, it accounted for around 6% of cases.

Not all people experience symptoms associated with bowel endometriosis. However, alongside pain during bowel movements, they may experience:

These symptoms may worsen during menstruation.

There is no cure for endometriosis. However, people can manage the condition with treatment methods, including medication, hormonal contraception, and surgery. Treatment will depend on where the endometriosis is and how severe it is.

Learn more about treatment options for endometriosis.

Medication

If endometriosis pain and dyschezia are mild, a doctor may suggest nonsteroidal anti-inflammatory drugs such as ibuprofen (Advil).

Hormonal birth control is often the next step in treatment. This can both slow the endometriosis growth and ease some symptoms.

A doctor may also prescribe a gonadotropin-releasing hormone agonist. This is a medication that makes the body stop producing the hormones that cause ovulation, which induces temporary menopause. It can preserve a person’s fertility, so when they stop taking it, they have a better chance of conceiving.

For individuals who are trying to become pregnant, a doctor may recommend fertility medications or treatment to help them conceive.

The OASH notes there is some anecdotal evidence to suggest that complementary therapies, such as acupuncture or supplements, may be beneficial for the symptoms of bowel endometriosis. However, there are no studies supporting this. These complementary and natural remedies are not a replacement for hormonal treatments.

Surgery

If hormone therapy does not relieve a person’s symptoms, a doctor may recommend surgery. This is typically a minimally invasive surgery, called a laparoscopy, performed through several small incisions.

There are three surgical options available for bowel endometriosis:

  • Rectal shave: A surgeon will cut endometrial tissue off the bowel. They may also repair the bowel. This procedure sometimes results in some endometrial tissue remaining, which means symptoms may return.
  • Disc resection: A surgeon will remove deeply embedded endometrial nodules from the bowel wall. They remove a disc from the wall and close the hole with stitches or staples.
  • Segmental resection: If endometriosis severely affects the bowel, a surgeon will remove an entire segment of the bowel. Then they will join the two ends of the remaining bowel back together (anastomosis).

Surgeries come with risks. These may include:

  • leakage from the bowel after surgery
  • leakage from the bowel into the vagina
  • damage to the bladder and ureters, requiring a temporary catheter

Side effects from surgery may also include needing to empty the bowels more frequently.

If a person has dyschezia and other symptoms of endometriosis, they should contact a doctor.

A doctor can evaluate a person’s symptoms and medical history, and may diagnose the person with endometriosis. Additionally, they can check for other possible causes of the symptoms.

Endometriosis is a common condition affecting more than 1 in 10 females in the U.S.

While endometriosis tissue often grows in the pelvic area, it can also grow on the intestines and bowel. This can cause symptoms such as dyschezia, constipation, diarrhea, and pain.

There is no cure for endometriosis. However, pain medication, hormonal therapy, and surgery may help to reduce and manage symptoms.