What causes bowel symptoms in endometriosis patients?
In the great majority of patients, endometriosis is not found directly on the bowel. In general, fewer than 10-15% of patients actually have endometriosis directly on their bowel. When endo is found on the bowel, approximately 90% have superficial or localized disease. This disease can usually be effectively removed with simple laparoscopic excision, much as it would be removed from any other surface affected with endometriosis. The serosal or outer layer of the bowel can often be peeled off leaving the muscularis or muscular portion of the bowel undamaged. Occasionally, a portion of the muscularis must also be excised to ensure complete treatment of the endo. In these cases, the muscularis is oversewn laparoscopically. This just means one or more reinforcing sutures are placed to maintain the integrity of the bowel wall. One to two percent of our patients require more significant surgery for their bowel endometriosis. These patients may have large segments of bowel involved with deepe
