Pathogenesis of bowel endometriosis

Paul J. Yong, Mohamed A. Bedaiwy, Alotaibi F, Fahad Alotaibi, Fahad T. Alotaibi, Michael S. Anglesio
Best practice & research. Clinical obstetrics & gynaecology · 2020 · vol. 71 , pp. 2–13 · doi:10.1016/j.bpobgyn.2020.05.009 · PMID:32646752 · W3033163995
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This paper investigates the mechanisms underlying the development of endometriosis in the bowel.

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Abstract

The pathogenesis of bowel endometriosis is multifactorial. There is a predilection for disease of the rectum/sigmoid colon because refluxed endometrium is more likely to settle in the pouch of Douglas and its movement is delimited by the sigmoid colon, in addition to the close proximity of the rectum/sigmoid to posterior extrinsic uterine adenomyosis and to ovarian endometriomas. Once situated, deep bowel endometriosis has features of invasion, angiogenesis, and fibrosis (repeated tissue injury and repair), with emerging research on oxidative stress and the microbiome. Furthermore, deep bowel endometriosis is associated with neurogenesis and/or the recruitment of local nerve fibers and is capable of invading existing nerves, which in turn may also promote fibrosis. Recently, somatic cancer driver mutations (e.g., in KRAS) were identified in deep bowel endometriosis, which may play a role in the genetic/epigenetic theory of endometriosis. In the future, it is possible that bowel endometriosis could be classified based on molecular features.

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Condition tags

endometriosisbowel_endometriosis

MeSH descriptors

Adenomyosis Endometriosis Neoplasms Endometrium Female Humans Rectum

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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Cited by (24)

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License: CC0 · commercial use OK