No Answers? Could It Be Intestinal Endometriosis?
If you have landed on this site it is quite likely that you either have IBD or many of the symptoms and are searching for answers. Part of the problem in obtaining an accurate diagnosis is that IBD can mimic many other diseases, making it harder to pinpoint exactly where the problem lies. Many women are misdiagnosed with things like "irritable bowel syndrome" or "spastic colon" before failed treatments lead them to additional testing.
What if you have been through all of the testing, basic treatments and still have not found any answers? There may be one more illness that has very similar symptoms: intestinal endometriosis. The symptoms of intestinal endometriosis include: nausea, loss of appetite, diarrhea, increased gas, bloating, crampy abdominal pain, painful bowel movements, sharp stabbing rectal pain and rectal bleeding associated with menstrual periods. The problem is that it isn't always found during the standard GI testing.
Endometriosis occurs when tissue that normal lines the uterus migrates and implants in other areas. Normally these implants are found in the pelvic cavity and they grow, break down and bleed in the same way the lining of the uterus does each month. This can cause a lot of pain depending on where the implants occur. Symptoms of endometriosis apart from GI involvement include: pain before and during periods, pain with intercourse, lower back pain, heavy or irregular periods, painful urination during menstruation, fatigue and infertility. Women with endometriosis may have some or all of these symptoms.
Treatments for endometriosis are vastly different than the way other GI diseases are treated and focuses on using hormones or surgery to treat the disease. Birth control pills, progestins, gonadotropin-releasing hormone agonist (GnRH-a), danazol, or aromatase inhibitors are examples of some of the hormonal treatments for endometriosis. They all have vary degrees of success and side effects. Laparoscopic surgery is the only way to diagnose endometriosis and is also used to help remove implants and lessen pain in many patients. When all of these treatments fail some patients may turn to hysterectomy.
The New England Journal of Medicine estimates that as many as 5% of all women have intestinal endometriosis (1). Dr. David Redwine notes that it is still fairly rare in that only about 27% of the difficult endometriosis cases he has seen have GI involvement (2). That having been said, if you have symptoms that are still unresolved and think it could be endometriosis it may be worth discussing with your GI and gynecologist.