Intestinal Endometriosis, A Challenge for Gastroenterologists: A Narrative Review

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This review discusses the pathogenesis, diagnostic challenges, and treatment of intestinal endometriosis, emphasizing its importance as a differential diagnosis for gastrointestinal symptoms.

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AI-generated deep summary by claude@2026-06, 2026-06-13 · read from full text

This narrative review examines intestinal endometriosis, focusing on how ectopic, estrogen-dependent endometrial tissue in the bowel and related sites drives inflammation and contributes to chronic pain and other gynecologic features such as infertility, dysmenorrhea, dyspareunia, and irregular bleeding, often alongside cyclic changes in intestinal habits. It describes the diagnostic challenge created by the lack of a specific biomarker and the broad, nonspecific symptom spectrum, leading to frequent underrecognition or delayed diagnosis. A major limitation is that, as a narrative review, it does not present original data or a systematic evidence synthesis. This paper is centrally about endometriosis — it specifically reviews the pathogenic mechanisms, diagnostic difficulties, and management considerations of intestinal endometriosis.

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Abstract

Endometriosis is a medical condition where endometrial tissue and glands are found outside the uterine cavity: on ovaries, pelvic peritoneum, rectovaginal septum, bladder, bowel and more. The ectopic tissue is estrogen dependent and cause inflammation and immune response and is responsible for chronic pain, infertility and disability of these patients. Without a specific biomarker and with a wide range of symptoms, the diagnosis is often overlooked or delayed. Abdominal and pelvic pain together with dysmenorrhea, dyspareunia, irregular bleeding, and cyclic alteration of intestinal habits are a challenging combination of symptoms that characterise endometriosis. One of the less recognized yet significant causes of abdominal pain is intestinal endometriosis. Gastroenterologists and gynecologists must solve the intricate puzzle of gynecological, gastrointestinal and nonspecific symptoms that are present in patients with intestinal endometriosis; further managements should be decided by a multidisciplinary team. This review aims to present the pathogenic mechanisms, diagnostic challenges and treatment while highlighting the importance of recognizing intestinal endometriosis as a potential differential diagnosis in patients with gastrointestinal symptoms.
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Intestinal Endometriosis, A Challenge for Gastroenterologists: A Narrative Review DOI: https://doi.org/10.15403/jgld-6456Keywords: endometriosis, intestinal endometriosis, IBD, IBS, abdominal painAbstract Endometriosis is a medical condition where endometrial tissue and glands are found outside the uterine cavity: on ovaries, pelvic peritoneum, rectovaginal septum, bladder, bowel and more. The ectopic tissue is estrogen dependent and cause inflammation and immune response and is responsible for chronic pain, infertility and disability of these patients. Without a specific biomarker and with a wide range of symptoms, the diagnosis is often overlooked or delayed. Abdominal and pelvic pain together with dysmenorrhea, dyspareunia, irregular bleeding, and cyclic alteration of intestinal habits are a challenging combination of symptoms that characterise endometriosis. One of the less recognized yet significant causes of abdominal pain is intestinal endometriosis. Gastroenterologists and gynecologists must solve the intricate puzzle of gynecological, gastrointestinal and nonspecific symptoms that are present in patients with intestinal endometriosis; further managements should be decided by a multidisciplinary team. This review aims to present the pathogenic mechanisms, diagnostic challenges and treatment while highlighting the importance of recognizing intestinal endometriosis as a potential differential diagnosis in patients with gastrointestinal symptoms. Downloads Published How to Cite Issue Section License Copyright (c) 2025 Journal of Gastrointestinal and Liver Diseases This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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Condition tags

endometriosischronic_pelvic_paindysmenorrheadyspareuniainfertility

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

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europepmc
last seen: 2026-09-07T06:12:11.729357+00:00
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