What Happens to Your Body When You Have Bowel Endometriosis

Understanding Bowel Endometriosis

Bowel endometriosis is a form of endometriosis in which tissue that resembles the lining of the uterus (endometrium) grows on or inside the bowels. While endometriosis usually affects the ovaries or pelvic organs, bowel involvement can occur in about 5%–12% of cases. This type often causes painful bowel movements, abdominal discomfort, and digestive issues that resemble conditions like irritable bowel syndrome (IBS).

Types of Bowel Endometriosis

There are two main categories of bowel endometriosis depending on how deeply the tissue invades:

Superficial bowel endometriosis: Lesions grow only on the outer surface of the bowel. These can progress into deeper forms over time.
Deep bowel endometriosis: One of the most severe types, where lesions penetrate the bowel wall. This often requires more intensive treatment.

Common Symptoms

Symptoms of bowel endometriosis can vary but often become worse during menstrual periods. Typical signs include:

Persistent abdominal cramps and pelvic pain
Bloating, sometimes called “endo belly”
Constipation or diarrhea
Painful bowel movements
Rectal bleeding

Because these symptoms mimic digestive disorders, bowel endometriosis is frequently misdiagnosed or diagnosed late.

Causes and Mechanisms

The exact cause of bowel endometriosis remains unclear. The condition occurs when endometrial-like tissue swells and bleeds during each menstrual cycle but cannot exit the body. This trapped tissue causes inflammation, scar tissue, and adhesions that may tether the bowels to surrounding organs. Hormonal and genetic factors may also contribute.

Risk Factors

Certain factors may increase the likelihood of developing bowel endometriosis:

Family history of endometriosis
Menstrual cycles shorter than 27 days
Periods lasting more than seven days
Never having given birth
Conditions that block menstrual blood flow

Bowel endometriosis most often appears in people in their 30s and 40s.

How It Is Diagnosed

Diagnosing bowel endometriosis can be challenging because symptoms overlap with other digestive and gynecological conditions. Methods include:

Pelvic exam to check for lumps, nodules, or pain
Transvaginal ultrasound to detect cysts or lesions
MRI scans for detailed pelvic imaging
Barium enema X-ray to examine the colon
Laparoscopy (gold standard): a minimally invasive surgery that allows doctors to see and biopsy lesions directly

Despite these tools, many patients wait an average of 7–9 years before receiving a proper diagnosis.

Treatment Options

While there is no cure for bowel endometriosis, treatments aim to relieve symptoms and improve quality of life.

Pain medication: OTC drugs like ibuprofen or naproxen can ease cramps but don’t stop lesion growth.
Hormone therapy: Birth control pills, IUDs, or GnRH agonists may reduce or pause menstruation, slowing the activity of endometrial-like tissue.
Surgery: Laparoscopic surgery may remove lesions and scar tissue. Surgeons often try to preserve bowel function by removing only affected tissue layers.
Counseling: Chronic pelvic pain can impact mental health, so therapy or support groups are often recommended.

Mental Health Impact

Living with bowel endometriosis can lead to anxiety, depression, and stress due to ongoing pain and infertility challenges. Seeking psychological support and stress-management strategies can make day-to-day life more manageable.

Prevention and Lifestyle Support

Endometriosis cannot be fully prevented, but some lifestyle adjustments may reduce risks or ease symptoms:

Limit alcohol and caffeine, which may raise estrogen levels
Stay physically active to balance hormones
Maintain a fiber-rich diet to prevent constipation
Use hormonal birth control if recommended by a doctor

Related Conditions

Bowel endometriosis may increase the risk of several other health issues, including:

Anxiety and depression due to chronic pain
Infertility caused by blocked fallopian tubes or ovarian adhesions
Irritable bowel syndrome (IBS) with overlapping digestive symptoms
A slightly elevated risk of ovarian cancer
Surgical complications such as bowel leakage or abscesses (though rare)

Living With Bowel Endometriosis

Although bowel endometriosis is a long-term condition, many people find relief with proper treatment and self-care. After menopause, symptoms usually lessen naturally. Day-to-day management may include: