Differences in intensity and quality of bowel symptoms in patients with colorectal endometriosis : An observational cross-sectional study

Patients suffering from colorectal deep endometriosis (DE) experience gastrointestinal symptoms with almost the same frequency as gynecological pain symptoms. Preoperatively existing gastrointestinal symptoms may translate into pathological gastrointestinal quality of life index (GIQLI) and low anterior resection syndrome scores (LARS). This prospective questionnaire-based case control study aims to assess the prevalence of gastrointestinal complaints reflected by changes in LARS and GIQLI scores in patients with colorectal deep endometriosis prior to surgical treatment and compare those to a healthy control group.

The study was conducted at the Hospital St. John of God in Vienna and included a total of 97 patients with histologically confirmed colorectal DE with radical surgical treatment and 96 women in whom DE was excluded via transvaginal sonography (TVS) or visually. Gastrointestinal symptoms reflected by LARS and GIQLI scores were evaluated presurgically and in controls.

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 < 0.001). The LARS score results demonstrated that 18.6% 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, respectively (p < 0.001).

Patients with colorectal DE experience a 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. Similar content being viewed by others

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The authors thank Ayman Tammaa MD, Alexander Krell MD and Friedrich Reh MD for their assistance leading to the writing of this paper during the patient recruitment phase of the current study. Author information Authors and Affiliations Contributions L. M. Reh: study design, execution and analysis, manuscript writing; E. Darici: study design, execution and analysis; E. Montanari: study design, execution and analysis; B. Senft: statistical analysis; J. Keckstein: study design, manuscript writing; B. Dauser: study design, manuscript writing; G. Hudelist: study design, manuscript writing. All authors approved the final manuscript. Corresponding author Ethics declarations Conflict of interest L. M. Reh, E. Darici, E. Montanari, J. Keckstein, B. Senft, B. Dauser, and G. Hudelist declare that they have no competing interests. Ethical approval The study was approved on 17 November 2020 by the ethics committee/IRB of the Hospital St. John of God in Vienna, Austria. Additional information Publisher’s Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Lena Maria Reh and Ezgi Darici contributed equally to this work. Rights and permissions About this article Cite this article Reh, L.M., Darici, E., Montanari, E. et al. Differences in intensity and quality of bowel symptoms in patients with colorectal endometriosis. Wien Klin Wochenschr 134, 772–778 (2022). https://doi.org/10.1007/s00508-022-02088-x Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s00508-022-02088-x