Endometriosis and irritable bowel syndrome: Is there a connection?

Endometriosis and Irritable Bowel Syndrome (IBS) are two very common medical conditions that affect a huge section of women, teenage girls, and some menopausal women too. Although these two are distinct conditions, most women experience these issues concurrently. Women who have endometriosis are said to be three times more likely to catch IBS in comparison to women without endometriosis.

Both these conditions show similar symptoms, and sometimes, doctors may misdiagnose one condition when the patient has the other.

Health Shots reached out to Dr Pooja Vyas Bansal, Consultant (Obstetritian and Gynaecologist), Cloudnine Group of Hospitals, Navi Mumbai, Mumbai, to get a deeper insight into these conditions and how they are related.

What is endometriosis?

Endometriosis is a chronic condition in which the cells that look like the uterus lining, called endometrial cells, grow outside the uterus in other organs like the fallopian tubes and ovaries.

This tissue can also grow in the bowel, which can lead to the patient showing IBS-like symptoms. So yes, endometriosis and gut health can be linked.

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“Bowel endometriosis, meaning the bowel involvement in endometriosis, happens in stage 4 endometriosis,” says Dr Bansal.

What is IBS?

IBS is a chronic intestinal disorder that leads the patient to show abdominal symptoms. These include constipation, diarrhea, or both, bloating and abdominal cramping, to name a few.

What are the symptoms of both these conditions?

As mentioned earlier, endometriosis and IBS show common symptoms. In some cases, endometriosis can even masquerade as IBS, and this overlap can present a challenge for doctors who try to diagnose the source of pain and discomfort in the patient.

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To this, Dr Bansal adds, “Symptoms may include pain in the abdomen and cramping. But, endometriosis has got more symptoms, including painful intercourse and painful periods. It may even cause excess bleeding, difficulty in urination and defecation, chronic pelvic pain, and infertility. So, these are the differentiating symptoms between the two conditions.”

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Diagnosis of endometriosis

As per Dr Bansal, the diagnosis of endometriosis can be done with the help of an ultrasound to check the presence of any chocolate (menstrual blood) or endometriotic cyst in the ovary. An MRI scan can also be helpful, but a definite diagnosis can be only done by a hysteroscopic examination which is a goal standard for diagnosis of endometriosis.

Alongside, doctors don’t just rely on a single test to diagnose any of these two conditions.

While diagnosing IBS, doctors may examine the blood tests of the patient to check the presence of any inflammatory compounds that could point to gluten or lactose intolerance. A stool sample can also be asked for to check for any blood or infectious organisms. In some cases, an upper endoscopy can also be done to have a better view of the lining of the esophagus, stomach, and colon to recognize any irregularities.

Treatment options

The treatment of endometriosis depends on the outcome the doctors are looking at. If minimizing the pain is the motive, then the patient can be put on medications that can curb the effect of pain.

Hormonal management medications are also available. And in cases, there is no pain relief and the fertility of the patient is in the picture, then the best treatment is to perform laparoscopic surgery.

To treat IBS, doctors can prescribe medications such as anti-depressants, antidiarrheals, and medications to help cure constipation. Additionally, doctors can also recommend therapy to a patient if stress causes IBS flare-ups.