Bowel Obstruction and Endometriosis

Bowel obstruction is one of the rare complications of endometriosis.  This obstruction occurs when the intestines are restricted, which prevents normal flow of digested foods.  Blockages can be complete, allowing no food to pass through or partial, allowing very little food to pass.  This digestive problem can quickly become life threatening, requiring hospitalization or invasive surgery to repair the obstructed intestine. When hospitalization is required, a tube is inserted into the stomach or the intestines to relieve pressure and decrease vomiting. When this common protocol doesn’t relieve the bowel obstruction, surgery to remove the obstructed portion of the intestine is often the next step.

Small bowel obstructions are frequently caused by adhesions in, or surrounding the small intestines.  Adhesions are scars that develop inside the body. They can bind tissues together that should move independently of each another, causing pain or intestinal problems. Adhesions and scar tissue form naturally to help the body heal after inflammation, infection and surgery.

Endometriosis is defined as the presence of endometrial tissue which normally lines the uterus in other areas of the body.  This abnormal tissue is usually found near the ovaries, fallopian tubes and colon, but it has also been found in remote areas of the body, including the small intestines and even the brain. This misplaced endometrial tissue is often associated with adhesions that can cause debilitating pain, dysfunction, and obstructions.

Along with adhesions, endometriosis attaches to the surface of organs, muscles and connective tissue inside the body where it can bind structures together. When these tissues attach to the small intestines, they can contribute to bowel obstruction. According to the book Miracle Moms, Better Sex, Less Pain, “adhesions may be found on the outer walls of the bowel, kinking them like a garden hose or binding them to other structures in the abdomen or pelvis” (Wurn, et al).

Endometrial tissue responds to hormonal changes during the menstrual cycle. As uterine cells swell with blood, so do the endometrial growths found throughout the body. Some physical therapists speculate that since these areas are attached to the surface of other organs, those surfaces can be pulled as the endometrial tissue swells, causing pain.

When endometrial tissue attaches to the bowel, in rare cases it can cause an intestinal obstruction.  The pulling at the sites where the endometrial tissue attaches to the bowel can be strong enough to cause a kink in the bowel.  This can prevent digested foods from passing through the bowels.  Surgical removal of the endometrial tissue and removal of adhesions may allow the digested material to pass through.

Surgery for bowel obstruction is often a life saving event.  Unfortunately, the process of healing from the surgery can cause more adhesions to form with the possibility of future pain, dysfunction, or obstruction.  According to the Miracle Moms book, a manual physical therapy technique may help reduce adhesions related to endometriosis and post-surgical adhesions.