Bowel endometriosis occurs if the lining of the uterus grows in the intestines. Treatments for bowel endometriosis may include surgery and medications.

Endometriosis is a condition in which the lining of the uterus grows outside of the uterus. Bowel endometriosis occurs if the endometrial tissue grows in the bowels.

Endometrial tissue grows and bleeds with each menstrual cycle. The tissue cannot leave the body in the same way as the uterus lining can though, so it causes pain and health problems.

This article looks at what bowel endometriosis is, its symptoms, diagnosis, and treatment options.

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Endometriosis most commonly affects the ovaries, fallopian tubes, and areas surrounding the uterus, but can also occur in other areas of the body, including the bowels.

According to 2021 research, bowel endometriosis most commonly affects the rectum and sigmoid colon, which is the “S-shaped” section of the large intestine.

The shape of the intestines may make it more likely for endometrial tissue to collect there.

According to a 2020 article, bowel endometriosis may occur in 5–12% of people with endometriosis. Up to 90% of bowel endometriosis involves the rectum and sigmoid colon.

Symptoms of bowel endometriosis may include:

Pelvic pain that happens at regular intervals may suggest endometriosis.

Some people may not experience any symptoms of bowel endometriosis. Fertility challenges are also a common symptom of endometriosis.

According to the National Association for Continence (NAFC), surgery is the most common type of treatment for bowel endometriosis. Surgery may significantly relieve symptoms.

There are different types of surgical procedures depending on the severity and specific location of bowel endometriosis:

  • Segmental bowel resection: A surgeon will remove the section of the intestines affected with endometriosis and rejoin the remaining sections. People may have this procedure for large areas of endometriosis.
  • Rectal shaving: A surgeon will shave off the area of endometriosis from the bowel. This leaves the intestines intact and may be suitable for smaller endometrial growths.
  • Disk resection: A surgeon will cut out the area of endometriosis in a disk shape, then close up the incision. This procedure may be suitable for small but deep areas of endometriosis.

Other treatments may include hormone therapy, such as hormonal birth control or progesterone injections, and pain relief medications.

A 2021 article recommends progestogens as the first-line medication for treating symptoms of bowel endometriosis.

Progestogens are drugs that mimic the effects of progesterone in the body. According to the research, they are generally effective, well-tolerated, and safe.

Counseling may also be an important part of treatment, as endometriosis may impact mental health.

To diagnose bowel endometriosis, a doctor may carry out the following:

  • imaging tests to look for signs of endometriosis, such as ultrasound or MRI scans
  • a colonoscopy, which involves inserting a thin tube with a camera into the rectum to examine the colon
  • a laparoscopy, which involves inserting a thin tube with a camera into a small incision in the abdomen to examine the pelvic organs
  • a barium enema, which is a specialized X-ray of the colon

According to a 2020 article, medical treatment may help improve symptoms of bowel endometriosis. Endometrial growths that are deeper within the bowel wall may be more difficult to resolve.

Long-term medical treatment may have side effects and may affect fertility, although stopping treatment may cause symptoms to return.

Medical treatment may be effective for endometriosis, although between 5–59% of people may continue to experience painful symptoms.

Endometriosis may recur after surgical treatment, although the estimates of this vary between 6–67%. This may be due to endometrial tissue remaining after surgery or genetic mutations.

The type of surgery may affect how likely bowel endometriosis is to return. Segmental bowel resection may make endometriosis less likely to return, while endometriosis is more likely to return after rectal shaving.

Endometriosis may affect fertility and may increase the risk of miscarriage and ectopic pregnancy.

This section answers some frequently asked questions about bowel endometriosis.

How do you get rid of endometriosis in the bowel?

Although there is currently no cure for endometriosis, surgery can remove areas of bowel endometriosis.

Segmental bowel resection may have a lower risk of endometriosis recurring compared to other procedures.

How do you know if endometriosis has spread to your bowel?

Bowel endometriosis may have similar symptoms as irritable bowel syndrome, but with bowel endometriosis, symptoms may be cyclical and worsen with the menstrual cycle.

People may also have general symptoms of endometriosis, such as painful menstruation and intercourse.

What happens if endometriosis is left untreated?

Without treatment, endometriosis symptoms may cause health problems and negatively impact quality of life.

Treatment may help prevent endometriosis from progressing and lessen long-term symptoms.

How do you stop endometriosis from progressing?

According to a 2020 article, it is not clear how endometriosis progresses. The rate of progression may depend on the depth and extent of the endometrial growth.

Early diagnosis and treatment may help slow or stop endometriosis from progressing.

Bowel endometriosis occurs if the lining of the uterus grows in the intestines. It may cause painful menstruation and gastrointestinal symptoms.

Although there is currently no cure for endometriosis, treatments may help relieve symptoms and may include medications or surgery.