Bowel Adhesiolysis

Bowel Adhesiolysis

The bowel can be affected by endometriosis within the pelvic and abdominal area, with the penetration happening in two main ways:

• Superficial Endometriosis – Exists on the bowel surface.
• Deep Infiltrating Endometriosis – Pierces through the bowel wall.

In some situations, the nodules along the recto-vaginal axis may begin as superficial endometriosis but eventually come to infiltrate through the bowel wall.

Symptoms of Bowel Endometriosis

Symptoms of bowel endometriosis tend to mimic irritable bowel syndrome (IBS) but are usually cyclical, becoming worse before and during menstruation. If you suspect bowel endometriosis, it may be worth monitoring your symptoms to spot cyclical patterns.

These are common symptoms:

• Dyschezia (pain on passing stools)
• Deep dyspareunia (painful intercourse in the pelvic area)
• Rectal bleeding with menstruation (occasionally)

If you have these symptoms, see a healthcare provider for evaluation and diagnosis.

Diagnostic Methods for Bowel Endometriosis

A doctor will employ a mixture of the following diagnostic methods:

• Vaginal exam
• Ultrasound imaging
• Sigmoidoscopy and/or laparoscopy – Tests used to inspect the bowel and abdominal cavity.
• CT and/or MRI scans– Used if deep endometriosis is suspected.

Treatment for Bowel Endometriosis

Treatment of bowel endometriosis is based on symptom severity and individual treatment preferences. Pain relief medication and hormonal treatments can be used to control symptoms. If left untreated, symptoms can continue or worsen over time. Some people find complementary therapies useful, although these approaches are not supported by conclusive scientific evidence.

Surgical Treatment for Bowel Endometriosis

Surgery is frequently the best cure for bowel endometriosis. The nature of surgery will vary depending on the extent and site of the condition. Surgical procedures can be done through laparoscopy (minimal scarring) or open surgery, and sometimes repeated procedures are necessary.

Three basic surgical options are:

• Segmental Resection and Re-anastomosis – Removal of the diseased segment of the bowel with subsequent reconnection of the ends of the remaining intestine.
• Discoid Resection – Excision of limited, localized sites of involved bowel with closure of the defect.
• Shaving Technique – Shaving of superficial endometriotic implants with maintenance of bowel integrity. This technique can result in residual endometriosis.

Postoperative Recovery and Considerations

Patients’ post-procedure will need pain control and possibly a urinary catheter for a short time. Recovery time depends on the procedure done:

• Laparoscopic surgery – Hospital discharge typically occurs in 4 to 7 days.
• Open surgery– Hospital stay can take 8 to 12 days.

Bowel function can be transiently changed, especially following a complete resection (re-anastomosis). With time, bowel function usually recovers, and with dietary modification, post-operative symptoms can be effectively controlled.

If bowel endometriosis is suspected or if advice on treatment is needed, refer to a clinician for a personalized diagnosis and management plan.

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