A study by Baylor University looked at a group of women with endometriosis and found they had increased frequency of contractions within the muscle layer of the intestine, which can be related to the production of prostaglandins and other substances by the endometrial implants. (Prostaglandins are produced in the endometriosis and then released into the surrounding tissues, blood vessels, and lymphatic tissue.) This occurrence may also account for cramping and intestinal symptoms in women who have endometriosis in places besides the intestines.
Furthermore, the same study had another odd conclusion: Women with endometriosis also had reactive hypoglycemia (a drop in blood sugar) during a glucose tolerance test, even though the women had normal insulin levels.
Two possible reasons for this conclusion are
1 Women with endometriosis may be more sensitive to the actions of insulin than women without endometriosis.
1 Nerves that help control the actions of the intestines may overreact to the amount of insulin present.
Eying where endometriosis attacks the targe intestine
Endometriosis is more common in the large intestine and can show up there in many different ways. The following list shows the areas where endometrio-sis can invade your large intestines and the symptoms it causes.
1 The pelvic portion. Endometriosis most often affects the pelvic portion, including the sigmoid colon (last section of the large intestine) and the rectum. Meanwhile, the retroperitoneal (the length of intestine that passes under the abdominal cavity covering, or peritoneum) part of the large intestine can be shielded from endometriosis by this peritoneum.
The definition of true large intestine endometriosis is the presence of deeply infiltrating endometrial-like glands and stroma more than 5 millimeters under the peritoneum. However, shallower endometriosis on the intestine can still cause symptoms as severe as the deeper disease.
1 The nerves. Some studies have shown that deep endometriosis most often affects the area along the nerves in the large intestine, which may be the reason for the common symptoms of cramping and contractions of the intestines. These cramps and contractions are the cause of constipation and diarrhea that often accompany a patient's period.
1 The lumen. When endometriosis penetrates deep into the intestine, it can bleed into the lumen (the open, interior area of the intestine that leads to the outside of your body) and cause bleeding with bowel movements. This bleeding can be bright red or darker in color, depending on the location of the endometriosis.
il Near the uterus and cervix. Pain during sex can also be a characteristic of large intestine endometriosis due to the proximity of the uterus and cervix to the large intestine (these organs actually touch each other). The movement of these organs during intercourse can cause irritation and stretching of adhesions between them. (Refer to Chapter 3 for more about the relationship of the intestine to the uterus and cervix.)
I The junction with the small intestines. Endometriosis near the junction of the small and large intestines can result in right-side pain that can imitate appendicitis. In fact, you can have endometriosis inside your appendix! Because the appendix is a relatively common place to find endometriosis and the symptoms are similar, some women have had an appendectomy because of the confusion. Adhesions can also attach the intestines to other nearby structures and cause pain there as well.
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