Bowel endometriosis is the most common type of extra pelvic endometriosis affecting Indian women. Delaying treatment could lead to sepsis and possibly death.

Endometriosis is a condition in which the endometrium (the tissue that lines the inside of the uterus or womb) grows outside of the uterus. It is a common gynecological condition affecting an estimated 25 million patients in India. In most cases, endometriosis involves your ovaries, fallopian tubes and the tissue lining your pelvis. Bowel endometriosis is the most common type of extra pelvic endometriosis. It happens when tissues similar to the uterine lining grow on the bowel or intestine. About 12% of bowel endometriosis cases affect the rectum and sigmoid colon. Extrapolating that 12% would mean 3 million Indian people assigned female at birth suffers from bowel endometriosis.

Reproductive health problems are on the rise amid the Covid-19 pandemic, according to doctors at ACI Cumballa Hill Hospital, Mumbai. They said the hospital has treated 80 patients over the last year with advanced endometriosis and almost 60% had bowel involvement. They cautioned that delaying treatment could cause intestinal obstruction which could become a life-threatening complication because the patient would be unable to pass stools and the intestine would eventually perforate leading to severe complications such as sepsis and possibly death.

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Symptoms and treatment

Bowel endometriosis could cause symptoms like constipation, painful periods, and bloating. It can also affect fertility in women.

Surgery is not only useful at improving quality of life and reducing pain but also improves fertility. In a publication by Roman et al, 80 % of patients treated for bowel endometriosis had successful pregnancy outcomes in the first year or two after the surgery. Out of that 80%, 2/3rds conceived naturally! So, do not ignore this condition, seek timely treatment.

American woman successfully treated for bowel endometriosis in India

A team of doctors headed by Dr Abhishek Mangeshikar, a consultant laparoscopic and robotic gynaecologist at ACI Cumballa Hill Hospital, successfully diagnosed and treated a 35-year-old American woman with a dangerous type of bowel endometriosis. She had a large endometriosis nodule in the mid and upper rectum almost resulting in occlusion, and inability to conceive due to significant endometriosis and adenomyosis.

The patient who complained of chronic period pain, constipation, and bloating has resumed her daily routine now and is scheduled to undergo an IVF treatment soon in the US. The patient from Boston MA had endured the symptoms that hampered her daily activities for most of her adult life. She took medication and even tried home remedies, but her pain continued to worsen.

Finally, she underwent a surgery at ACI Cumballa Hill Hospital on 20th July 2021, which helped her get rid of the pain and suffering.

Dr Mangeshikar said, “The patient had a history of severely painful periods as well as severe constipation and bloating. Her ultrasound examination revealed a large endometriosis nodule in the mid and upper rectum almost resulting in occlusion. These findings were further corroborated by MRI.”

“An exploratory laparoscopy for excision of endometriosis with segmental resection anastomoses of the rectum was carried out to treat a frozen pelvis with excision of endometriosis and resection of the rectum which showed involvement of about 10cms of length. The procedure lasted for 7 hours, and the patient underwent surgery with minimal blood loss and was discharged on post-op Day 7 without even a week after her surgery. She is already back in the US and will undergo her IVF procedures as scheduled.”

“It is important that these diagnoses are not missed. There is a need to dramatically improve the diagnostics and standard of care for these patients,” he added.

Doctors eye new drug that could end the monthly agony for women with endometriosis


This post first appeared on The Health Site

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