How to Treat Bowel Endometriosis: A Comprehensive Guide

Bowel endometriosis, a complex and severe variant of endometriosis, is a condition best navigated with a deep understanding of its details. This guide aims to shed light on the various aspects of bowel endometriosis, from its origins to symptoms, diagnostic approaches, and treatment options, to empower those affected.

What is Bowel Endometriosis?

Endometriosis, a chronic health disorder predominantly affecting women in their reproductive years, is characterized by the growth of endometrial-like tissue, which usually lines the uterus in regions outside the uterus. This misplaced tissue prompts an inflammatory reaction, leading to distressing symptoms. When this aberrant tissue growth takes place on or inside the bowels, the condition is referred to as bowel endometriosis.

How Common is Bowel Endometriosis?

While the exact prevalence of bowel endometriosis remains uncertain, it’s estimated to occur in 5-15% of all endometriosis cases. Predominantly, it manifests on the rectum or sigmoid colon but can also affect the appendix or small intestine.

Read More:

Recognizing the Symptoms

Symptoms of bowel endometriosis may not always be apparent, especially in the early stages of the disease. However, as the condition progresses, women may experience discomfort associated with their menstrual cycle, sexual intercourse, bowel movements, and even infertility.

Symptoms commonly associated with bowel endometriosis include:

  • Painful Bowel Movements: This is often accompanied by constipation or diarrhea.
  • Rectal Bleeding: This symptom, which is more uncommon, usually occurs during menstruation.
  • Infertility: Some women may experience difficulty conceiving.
  • Pelvic Pain: Chronic pelvic pain is a common symptom associated with endometriosis, often more severe during menstruation or ovulation.
  • Painful Intercourse: This is often due to the endometriosis lesion causing a distortion of the pelvic anatomy.

It’s important to note that bowel endometriosis can sometimes mimic symptoms of other gastrointestinal conditions, like irritable bowel syndrome (IBS), making it challenging to diagnose.

Diagnosing Bowel Endometriosis

A comprehensive diagnosis of bowel endometriosis usually involves a combination of physical examination, medical history analysis, and advanced imaging techniques. The diagnostic process may include:

  • Physical Examination: This includes a manual check for growths in the rectum or vagina.
  • Imaging Tests: These can include ultrasound, MRI, colonoscopy, and barium enema.
  • Laparoscopy: This surgical procedure is considered the gold standard for diagnosing endometriosis, as it allows for visual examination of the uterus, ovaries, and other pelvic structures. And surgeons can take samples for histopathology evaluations.

Read More: Understanding Bowel Endometriosis

Treating Bowel Endometriosis: An Overview

Treatment for bowel endometriosis is complex and multifaceted. It requires a personalized approach, taking into account the severity of the disease, the patient’s age, fertility goals, and personal preferences. The primary treatment options include:

  • Hormonal Therapy: This involves medications that control estrogen levels, which can influence the progression of endometriosis. These medications can help manage pain and other symptoms.
  • Pain Management: Over-the-counter or prescription nonsteroidal anti-inflammatory drugs (NSAIDs) may be recommended to help alleviate pain.
  • Surgery: Surgical interventions aim to remove as much endometrial tissue as possible while preserving organ function.

Surgical Treatment Options

Surgery is typically the primary treatment for bowel endometriosis, particularly for severe cases. The goal of surgery is to remove endometrial implants without compromising the functionality of the organs involved. There are three main surgical options:

  • Segmental Bowel Resection: This involves removing the section of the bowel affected by endometriosis and reconnecting the healthy portions. This option is often recommended for larger areas of endometriosis.
  • Rectal Shaving: This procedure involves shaving off the endometriosis from the top of the bowel without removing any portion of the intestines. It’s often used for smaller areas of endometriosis.
  • Disc Resection: In this procedure, a surgeon cuts out a small disk where the endometriosis lesions appear and then closes the remaining hole.

Understanding the Risks of Surgery

Surgery for bowel endometriosis is a complex procedure associated with certain risks. These can include short-term complications such as infection, leakage of bowel content during the postoperative healing phase, peritonitis, and septicaemia. Long-term risks might include bowel dysfunction, characterized by frequency, urgency, and incontinence.

Read More: Finding an Excision Specialist: What you Need to Know

Hormone Treatment Options

Although hormonal treatments cannot halt the progression of endometriosis, they can help manage symptoms. Hormonal treatments for bowel endometriosis can include birth control pills, progestin injections, or, less favorably, gonadotropin-releasing hormone (GnRH) agonists.

Read more: What are the long-term side effects of Lupron?

Managing Symptoms and Quality of Life

Bowel endometriosis can significantly impact the quality of life of those affected. However, with appropriate treatment and management strategies, many women affected by this condition can lead fulfilling lives. Communication with your healthcare team, lifestyle modifications, and psychological support can all contribute to improving the quality of life.


Understanding how to treat bowel endometriosis is crucial for managing this complex and often painful condition. With the right approach, it’s possible to mitigate symptoms, improve fertility outcomes, and enhance the quality of life for those affected. If you suspect you have bowel endometriosis, it’s important to speak with a healthcare provider who can guide you through the diagnostic process and treatment options. With the right knowledge and resources, you can navigate this challenging condition and find a path to improved health and well-being.


Bowel Endometriosis

Notify of

Inline Feedbacks
View all comments

Latest Endometriosis Articles

Join our newsletter

Your information will be used to communicate with you and will not be shared with any 3rd party