Colorectal Surgery

Bowel Endometriosis Specialist Los Angeles

Intestinal and bowel endometriosis occurs when endometrial tissue grows on or inside the bowel, often causing pain, bloating, and digestive issues. At Surgery Group LA, serving Los Angeles and Beverly Hills, Dr. Yosef Nasseri and Dr. Moshe Barnajian collaborate with gynecologic specialists to provide comprehensive treatment. Their expertise in minimally invasive and robotic colorectal surgery ensures precise removal of lesions while preserving bowel function and promoting faster recovery.
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What is Bowel Endometriosis?

Endometriosis is a complex and often challenging medical condition that affects millions of individuals worldwide. While it primarily involves the presence of endometrial-like tissue outside the uterus, it can also impact other areas of the body, including the intestines and bowels.
Bowel endometriosis is a subtype of endometriosis where the abnormal tissue growth extends to the gastrointestinal tract. This condition can cause a range of symptoms that often overlap with those of gastrointestinal disorders, making it challenging to diagnose accurately.

What causes Bowel Endometriosis?

While the exact cause of bowel endometriosis remains unknown, experts attribute it to a complex interplay of genetic predisposition, hormonal imbalances, anatomical factors, and immune responses. Some of the factors that increase your risk of having bowel endometriosis include:

  • Genetic Predisposition: A family history of endometriosis increases the likelihood of developing bowel endometriosis.
  • Hormonal Imbalances: Hormonal factors, particularly elevated levels of estrogen, contribute to the growth of endometrial-like tissue outside the uterus. Excess estrogen encourages the attachment of these cells to the bowel’s surface, leading to inflammation and lesion formation.
  • Anatomical Factors: The anatomy of the pelvis and the proximity of the bowel to the reproductive organs play a role in the risk of bowel endometriosis. Women with a retroverted uterus (tilted backward) may be at a higher risk due to the potential for endometrial cells to more easily flow backward into the pelvis during menstruation.
  • Menstrual History: Early onset of menstruation (before age 11) and prolonged menstrual cycles are considered risk factors for bowel endometriosis.

What are the symptoms of Bowel Endometriosis?

The symptoms of intestinal and bowel endometriosis can be diverse and debilitating. These symptoms can significantly impact one’s quality of life and necessitate specialized medical attention. Individuals with bowel endometriosis may experience symptoms such as:

  • Abdominal Pain: One of the hallmark symptoms of intestinal and bowel endometriosis is chronic and often severe abdominal pain. This pain is typically cyclical, intensifying during menstruation, and may radiate to the lower back. It’s important to note that the location and severity of the pain can vary, making it challenging to attribute solely to gastrointestinal issues.
  • Bloating and Distention: Many individuals with intestinal and bowel endometriosis experience persistent bloating and abdominal distention. This can lead to discomfort and a feeling of fullness, often exacerbated around menstruation. These symptoms can mimic those of digestive disorders, further underscoring the complexity of diagnosis.
  • Altered Bowel Movements: Endometriosis can affect bowel function, resulting in irregularities in bowel movements. Some may experience diarrhea or constipation, which can alternate between menstrual cycles. These changes are often accompanied by pain and discomfort during bowel movements.
  • Rectal Pain and Discomfort: Rectal pain is another common symptom of intestinal and bowel endometriosis. This pain can occur both during bowel movements and independently, leading to discomfort and reduced quality of life. The pain can be sharp, throbbing, or achy, often correlating with the menstrual cycle.
  • Bowel Obstruction: In more severe cases, abnormal tissue growth can lead to bowel obstruction. This results from the formation of scar tissue and adhesions, causing partial or complete blockages in the gastrointestinal tract. Bowel obstruction presents as intense abdominal pain, vomiting, and an inability to pass stools.
  • Painful Intercourse: Endometriosis involving the intestines and bowels can also contribute to pain during sexual intercourse (dyspareunia). This discomfort arises from the proximity of the affected tissues to the reproductive and gastrointestinal systems.
  • Blood in Stool: In certain instances, intestinal and bowel endometriosis can cause rectal bleeding. This may be visible in the stool or as blood streaks on toilet tissue. While alarming, it’s crucial to differentiate between endometriosis-related bleeding and other potential causes
Diagnosis & Screening

How is Bowel Endometriosis diagnosed?

Diagnosing intestinal and bowel endometriosis requires a multidisciplinary approach. A thorough medical history, pelvic examinations, and advanced imaging techniques like MRI or transvaginal ultrasound may be employed. In many cases, laparoscopy, a minimally invasive surgical procedure, is necessary to definitively diagnose the condition.
Treatment

How is Bowel Endometriosis treated?

Effective management of intestinal and bowel endometriosis involves a personalized treatment plan tailored to each patient’s unique needs. Treatment options encompass medical interventions, surgical procedures, and holistic approaches. Collaborating with gynecologists and specialized colorectal surgeons is crucial to develop a comprehensive strategy.
Here are the diverse approaches we offer:

Medication-Based Strategies

Medical treatment options aim to address pain, inflammation, and hormonal imbalances associated with intestinal and bowel endometriosis.
  • Hormonal therapies such as oral contraceptives, progestins, or GnRH agonists, can help regulate the menstrual cycle and reduce tissue growth.
  • Anti-Inflammatory Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) may also provide relief from pain and discomfort.

Lifestyle Guidance

Complementary lifestyle modifications can be beneficial in conjunction with medical and surgical treatments.
  • Lifestyle Modifications: Incorporating a balanced diet rich in anti-inflammatory foods, staying physically active, practicing stress management techniques (such as yoga or meditation), and maintaining a healthy body weight can contribute to overall well-being and symptom management.

What surgical interventions are used to treat Bowel Endometriosis?

For severe cases, surgical intervention may be recommended. Robotic or Laparoscopic excision or resection of endometriotic lesions can provide relief from pain and improve overall gastrointestinal function.
  • Laparoscopic Surgery – Minimally Invasive Approach: Often referred to as minimally invasive surgery or “keyhole” surgery, is one approach for treating intestinal and bowel endometriosis. This advanced technique involves making small incisions through which a laparoscope (a thin, lighted tube with a camera) and surgical instruments are inserted. This allows surgeons to visualize the affected areas and perform precise interventions with minimal tissue disruption.
  • Robotic Surgery (Preferred Approach at SGLA): Robotic-assisted surgery brings a new level of precision to the treatment of bowel endometriosis. Surgeons control robotic arms with remarkable dexterity, navigating the intricate landscape of the abdomen. The high-definition 3D visualization ensures meticulous removal of endometriotic lesions and scar tissue, minimizing damage to healthy tissue.
  • Excision of Endometriotic Lesions: This process involves carefully dissecting the abnormal tissue while preserving the surrounding healthy tissue. Excision aims to eliminate the source of pain and inflammation and restore normal organ function.
  • Adhesion and Scar Tissue Removal: Intestinal and bowel endometriosis can lead to the formation of adhesions (abnormal tissue connections) and scar tissue. These adhesions can cause organs to stick together, contributing to pain and digestive complications. With robotic-assisted surgery, surgeons can delicately navigate intricate anatomical structures to remove adhesions and scar tissue facilitating effective removal of endometriosis while preserving healthy tissue.
  • Bowel Resection: In cases where endometriosis has caused significant damage to the bowel, a bowel resection may be necessary. This procedure involves removing the affected segment of the intestine and reconnecting the healthy portions. While it’s a more extensive surgical intervention, bowel resection can be effective in cases of severe obstruction or tissue damage. In such instances, the robotic approach offers precision in reconnecting the intestines, reducing the risk of complications.
Coping Strategies

What to know about Living with Bowel Endometriosis?

Living with intestinal and bowel endometriosis can be emotionally and physically challenging. Developing coping strategies, seeking support from peers or support groups, and engaging in open communication with healthcare providers are essential components of managing the condition effectively.
Prognosis

What to expect with Bowel Endometriosis?

While treatment can alleviate symptoms, it’s essential to recognize that intestinal and bowel endometriosis can recur. Regular follow-up appointments with healthcare professionals are vital to monitor the condition’s progression and adapt treatment plans accordingly. By understanding the symptoms, seeking timely medical attention, and exploring the available resources, individuals can take proactive steps towards better health and improved quality of life.

Minimally Invasive Procedures

Frequently Asked Questions

How can I tell if my symptoms are caused by hemorrhoids?

Symptoms like itching, swelling, and occasional bleeding during bowel movements may indicate hemorrhoids. A professional evaluation can confirm the diagnosis.

Are there lifestyle changes that can help prevent hemorrhoids?

Colorectal is a collective term that refers to the colon, rectum, and anus. Similarly, colorectal cancer refers to cancer that originated in the colon or rectum. Colorectal surgeons like Dr. Nasseri and Dr. Barnajian are experts in the surgical and nonsurgical treatment of colon and rectal problems. They have completed extensive training to specialize in the diagnosis, treatment, and repair of disorders affecting these areas, in addition to full training in general surgery.

How long does it take for hemorrhoid treatments to work?

Colorectal is a collective term that refers to the colon, rectum, and anus. Similarly, colorectal cancer refers to cancer that originated in the colon or rectum. Colorectal surgeons like Dr. Nasseri and Dr. Barnajian are experts in the surgical and nonsurgical treatment of colon and rectal problems. They have completed extensive training to specialize in the diagnosis, treatment, and repair of disorders affecting these areas, in addition to full training in general surgery.

Do all hemorrhoids require medical treatment?

Colorectal is a collective term that refers to the colon, rectum, and anus. Similarly, colorectal cancer refers to cancer that originated in the colon or rectum. Colorectal surgeons like Dr. Nasseri and Dr. Barnajian are experts in the surgical and nonsurgical treatment of colon and rectal problems. They have completed extensive training to specialize in the diagnosis, treatment, and repair of disorders affecting these areas, in addition to full training in general surgery.

Can untreated hemorrhoids lead to complications?

Colorectal is a collective term that refers to the colon, rectum, and anus. Similarly, colorectal cancer refers to cancer that originated in the colon or rectum. Colorectal surgeons like Dr. Nasseri and Dr. Barnajian are experts in the surgical and nonsurgical treatment of colon and rectal problems. They have completed extensive training to specialize in the diagnosis, treatment, and repair of disorders affecting these areas, in addition to full training in general surgery.

What are some signs that I might need hemorrhoid surgery?

Colorectal is a collective term that refers to the colon, rectum, and anus. Similarly, colorectal cancer refers to cancer that originated in the colon or rectum. Colorectal surgeons like Dr. Nasseri and Dr. Barnajian are experts in the surgical and nonsurgical treatment of colon and rectal problems. They have completed extensive training to specialize in the diagnosis, treatment, and repair of disorders affecting these areas, in addition to full training in general surgery.

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