Differences in intensity and quality of bowel symptoms in patients with colorectal endometriosis: a case-control study.

Lena Maria Reh, Ezgi Darıcı, Eliana Montanari, J. Keckstein, B Senft, Bernhard Dauser, Gernot Hudelist
In: Geburtshilfe und Frauenheilkunde · 2022 · vol. 82(06) , pp. S43 · doi:10.1055/s-0042-1750225 · W4285608560
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This case-control study found that colorectal deep endometriosis patients reported gastrointestinal symptoms that correlated with lower quality of life and increased low anterior resection syndrome scores.

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⚙ AI-generated deep summary by claude@2026-07, 2026-07-14 · read from full text ⓘ

This prospective questionnaire-based case-control study assessed gastrointestinal symptom burden in 97 premenopausal patients with histologically confirmed colorectal deep endometriosis (DE) scheduled for radical surgery and compared them with 96 healthy control women without DE, using presurgical LARS and GIQLI scores. Patients had significantly lower GIQLI scores (90.7 ± 22.0) than controls (129.4 ± 11.1), indicating worse gastrointestinal quality of life, and LARS scores showed more pathological bowel function prior to surgery (major LARS 18.5% vs 2.1% in controls; minor LARS 27.8% vs 9.4%). A key limitation explicitly noted is that differences in the extent of other DE sites and the extent of colorectal DE could further influence GI symptom scores. This paper is centrally about endometriosis — it specifically evaluates baseline bowel symptoms and GIQLI/LARS scores in colorectal deep endometriosis patients compared with controls.

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Abstract

Background Patients suffering from colorectal deep endometriosis (DE) experience gastrointestinal (GI) symptoms with almost the same frequency as gynaecological pain symptoms. Preoperatively existing GI symptoms may translate into pathological Gastrointestinal Quality of Life Index (GIQLI) and Low Anterior Resection Syndrome (LARS) scores.
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Background

Patients suffering from colorectal deep endometriosis (DE) experience gastrointestinal (GI) symptoms with almost the same frequency as gynaecological pain symptoms. Preoperatively existing GI symptoms may translate into pathological Gastrointestinal Quality of Life Index (GIQLI) and Low Anterior Resection Syndrome (LARS) scores.

Objective

This study aims to assess the prevalence of GI complaints reflected by changes in LARS and GIQLI scores in patients with colorectal DE prior to surgical treatment and compare those to a healthy control group. Design Prospective questionnaire-based case control study Settings Tertiary referral centre for endometriosis, Department of Gynaecology of the Hospital St. John of God in Vienna, Austria Patients The study included a total of 97 patients with histologically confirmed colorectal DE with radical surgical treatment and 96 women in which DE was excluded via transvaginal sonography (TVS) by an expert sonographer or visually during a previous caesarean section within 12 months of inclusion. Main outcome measures Gastrointestinal symptoms reflected by LARS and GIQLI scores were evaluated presurgically and in controls.

Results

A total of 193 premenopausal patients were included in this study. A mean GIQLI of 90.7 ± 22.0 and 129.4 ± 11.1 was observed among patients and controls, respectively, showing a significantly higher morbidity concerning gastrointestinal symptoms and decreased quality of life (QoL) compared to healthy controls (p <.001). The LARS score results demonstrated that 18.5% of the patients with bowel DE presented with a major LARS and 27,8% with a minor LARS presurgically compared to 2.1% and 9.4% of control patients (p <.001).

Limitations

Differences in extent of other DE sites and extent of colorectal DE may lead to further changes in GI symptoms.

Conclusion

Patients with colorectal DE experience a high intensity and quality of gastrointestinal symptoms translating into a decreased QoL and pathological GIQLI and LARS scores already presurgically. As a consequence, these instruments should be interpreted with caution in a postoperative setting and should routinely be evaluated presurgically in order to evaluate baseline values of changes in bowel function in women undergoing colorectal surgery for DE. Publication History Article published online: 10 June 2022 © 2022. Thieme. All rights reserved. Georg Thieme Verlag Rüdigerstraße 14, 70469 Stuttgart, Germany

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endometriosis

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