Endometriosis

ExitCare ImageEndometriosis is a disease that occurs when the endometrium (lining of the uterus) is misplaced outside of its normal location. It may occur in many locations close to the uterus (womb), but commonly on the ovaries, fallopian tubes, vagina (birth canal) and bowel located close to the uterus. Because the uterus sloughs (expels) its lining every month (menses), there is bleeding whereever the endometrial tissue is located.

SYMPTOMS

Often there are no symptoms. However, because blood is irritating to tissues not normally exposed to it, when symptoms occur they vary with the location of the misplaced endometrium. Symptoms often include back and abdominal pain. Periods may be heavier and intercourse may be painful. Infertility may be present. You may have all of these symptoms at one time or another or you may have months with no symptoms at all. Although the symptoms occur mainly during menses, they can occur mid-cycle as well, and usually terminate with menopause.

DIAGNOSIS

Your caregiver may recommend a blood test and urine test (urinalysis) to help rule out other conditions. Another com­mon test is ultrasound, a painless procedure that uses sound waves to make a sonogram "picture" of abnormal tissue that could be endometriosis. If your bowel movements are painful around your periods, your caregiver may advise a barium enema (an X-ray of the lower bowel), to try to find the source of your pain. This is sometimes confirmed by laparoscopy. Laparoscopy is a procedure where your caregiver looks into your abdomen with a laparoscope (a small pencil sized telescope). Your caregiver may take a tiny piece of tissue (biopsy) from any abnormal tissue to confirm or document your problem. These tissues are sent to the lab and a pathologist looks at them under the microscope to give a microscopic diagnosis.

TREATMENT

Once the diagnosis is made, it can be treated by destruction of the misplaced endometrial tissue using heat (diathermy), laser, cutting (excision), or chemical means. It may also be treated with hormonal therapy. When using hormonal therapy menses are eliminated, therefore eliminating the monthly exposure to blood by the misplaced endometrial tissue. Only in severe cases is it necessary to perform a hysterectomy with removal of the tubes, uterus and ovaries.

HOME CARE INSTRUCTIONS

  • Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver.

  • Avoid activities that produce pain, including a physical sexual relationship.

  • Do not take aspirin as this may increase bleeding when not on hormonal therapy.

  • See your caregiver for pain or problems not controlled with treatment.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Your pain is severe and is not responding to pain medicine.

  • You develop severe nausea and vomiting, or you cannot keep foods down.

  • Your pain localizes to the right lower part of your abdomen (possible appendicitis).

  • You have swelling or increasing pain in the abdomen.

  • You have a fever.

  • You see blood in your stool.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.