Bowel endometriosis

Although the incidence of endometriosis involving the bowel wall is difficult to quantify it is not rare in women who have already been diagnosed for deep endometriosis to involve the bowel. Some studies have suggested that the incidence of bowel endometriosis is between 3 – 37 %. The big difference in the quoted incidence may reflect that a large number of women undergo laparoscopy for the diagnosis of endometriosis yet unless surgeon specifically looks for bowel involvement of the disease it is often missed.

Different parts of the bowel can be affected with wide degree of disease severity. The most commonly rectum (lowest end of the large bowel) is affected. Small superficial deposits may go unnoticed as they can be asymptomatic. Larger nodules which infiltrate the bowel wall can cause adhesions, scarring or even bowel narrowing. This type of nodule tends to infiltrate surrounding organs as well like vagina, uterus (womb) and pelvic side walls. The symptoms vary depending on severity and localisation of the endometriotic nodule.

What is Rectovaginal endometriosis (RV endometriosis)?

RV endometriosis is diagnosed when endometriotic deposits are localised in-between the rectum and posterior wall of the vagina. The nodule can be superficial to both organs or infiltrate any of them.

Extensive endometriosis involving the large bowel