The symptoms are diarrhea alternating with constipation, abdominal swelling, pain during bowel movements. There may be a sense of heaviness in the perineum or rectum. Surgery is offered when no alternatives are possible
I have endometriosis. The gynecologist told me that the disease also affects the intestine. What can I do?
He replies Pierpaolo Sileridirector of the Coloproctological Surgery Unit for chronic intestinal diseases, San Raffaele Hospital, Milan
L’endometriosis the anomalous presence of endometrium, which should only line the uterine cavity, outside the uterus. Such fabric creates a chronic benign inflammation of the affected organs and tissues since, responding to hormonal stimuli, it behaves like the uterine endometrium, growing and flaking during the stages of period. Accompany the woman to the menopause and can generate persistent adhesions and fibrosis. a pathology that affects at least three million women in Italynumber underestimated due to the variability of symptoms (sometimes absent) and discovered by chance, often with mild disorders, in other cases highly disabling. Pelvic pain, especially in the peri-menstrual phase, painful menstruation, pain during sexual intercourse these are frequent signs.
Almost a third of patients may have involvement intestinalmore frequently than the sigmoid colon and the straight, rarely of the appendix or cecum and much more rarely of the ileum. In case of intestinal involvement, they are possible diarrhea alternating with constipation, abdominal swelling, abdominal pain, pain on bowel movements. There may be a sense of heaviness in the perineum or rectum. They can appear rectal bleeding. Symptoms appear or are accentuated in the peri-menstrual period. In more severe cases it can occur bowel obstruction. To complete the diagnosis of your gynecologist (abdominal and transvaginal ultrasound, magnetic resonance imaging), the colorectal surgeon proceed with an accurate history of intestinal symptoms in conjunction with the menstrual cycle and independently of it.
Proceed with a rectal examination in the peri-menstrual period and subsequently an endoscopic exam to evaluate the sigmoid colon and rectum (most frequent locations), looking for involvement of the intestinal wall by the abnormal tissue and to exclude other pathologies of the colon. There surgery it is offered when no alternatives are possible and must be performed in Reference centers and with a multidisciplinary approach. That is the technique of choice laparoscopicwhich allows a definitive diagnosis with a correct evaluation of the structures involved and conservative treatment and respectful – as much as possible – of the reproductive structures and possibly reactive and curative on the intestine.
October 27, 2023 (modified October 27, 2023 | 08:10)
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