Cycle-related Diarrhea and Dysmenorrhea are Independent Predictors of Peritoneal Endometriosis, Cycle-related Dyschezia is an Independent Predictor of Rectal Involvement

K Nicolaus, Kristin Nicolaus, Laura Reckenbeil, Dominik Bräuer, Robert Sczesny, Herbert Diebolder, Ingo B Runnebaum
Geburtshilfe und Frauenheilkunde · 2020 · vol. 80(03) , pp. 307–315 · doi:10.1055/a-1033-9588 · PMID:32139920 · PMC7056393 · W3009859195
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

Cycle-related diarrhea and dysmenorrhea predict peritoneal endometriosis, while cycle-related dyschezia predicts rectal endometriosis in patients with surgically confirmed disease.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This retrospective study analyzed data from 266 consecutive patients with histologically verified endometriosis diagnosed at a German endometriosis center (2016–2017), using questionnaires about symptom type and duration plus electronic record data on lesion locations and staging. Cycle-related diarrhea and dysmenorrhea were independently associated with peritoneal involvement, and cycle-related dyschezia was independently associated with rectal involvement in binary regression analyses. The paper notes that patients had long delays from initial symptoms to diagnosis and that symptoms can overlap with gastrointestinal conditions, which is a key caveat for symptom-based interpretation. This paper is centrally about endometriosis — it identifies cycle-related diarrhea/dysmenorrhea as predictors of peritoneal endometriosis and cycle-related dyschezia as a predictor of rectal involvement.

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Abstract

Abstract Introduction The clinical presentation of endometriosis is extremely varied. Because endometriosis symptoms may overlap with symptoms caused by gastroenterological disorders, this can lead to misdiagnosis and a considerable delay in arriving at the correct diagnosis. The aim was to evaluate the type and duration of endometriosis-related symptoms and to identify predictors for patterns of involvement depending on symptoms. Material and Method The data of 266 consecutive patients who were operated on in the Endometriosis Center between 1/2016 and 12/2017 after receiving a histologically verified diagnosis of endometriosis were recorded. In addition to recording the clinical parameters, a questionnaire was distributed to the patients, who were asked about their medical history. Infertile patients were grouped together as Group 1 and compared to non-infertile patients (Group 2). Results The response rate for returned questionnaires was 79.47% (182/229). 41.8% of patients reported that they were infertile and 91.8% reported pelvic pain. In more than ⅓ of cases in both groups, more than 10 years passed between the initial symptoms and the final diagnosis (39.4 vs. 37.5%). On average, patients consulted 2.72 (± 1.58) resp. 3.08 (± 1.72) doctors before they presented to a hospital or were referred for laparoscopic diagnostic workup (p = 0.162). Cycle-related diarrhea (odds ratio 2.707; 95% CI: 1.063 – 6.895, p = 0.037) and dysmenorrhea (odds ratio 2.278; 95% CI: 1.193 – 4.348, p = 0.013) were associated with involvement of the pelvic peritoneum, cycle-related dyschezia was associated with rectal involvement by a factor of 4.6 in binary regression analysis (odds ratio 4.659; 95% CI: 1.132 – 19.186; p = 0.033). Conclusion Cycle-related diarrhea and dysmenorrhea increase the risk probability of peritoneal endometriosis. Dyschezia increases the risk probability of rectal endometriosis.

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endometriosisdysmenorrhea

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