Pain during bowel movements as a symptom of endometriosis

How common is the symptom Pain during bowel movements among people with endometriosis?

84,35% of people with endometriosis reported Pain during bowel movements as a symptom of endometriosis in our survey.

How common is the symptom Pain during bowel movements among people with endometriosis compared to the non-affected group?

18,65% of people with endometriosis suffer from the symptom Pain during bowel movements very strong compared to a prevalence of 0,63% among non-affected individuals.
The following table shows the symptom Pain during bowel movements in people with endometriosis compared to non-affected individuals. The scale ranges from 1 (not at all) to 5 (very strong).

Symptom Pain during bowel movements in endometriosis - comparison with control group

Pain during bowel movements in endometriosis
(n = 1732)
15,65%
13,51%
24,13%
28,06%
18,65%
Pain during bowel movements in non-affected individuals
(n = 159)
60,38%
24,53%
10,06%
4,40%
0,63%

Tabular comparison of the prevalence of Pain during bowel movements

Symptom severity Endometriosis Non-affected Comparison
not at all 15,65% 60,38% -44,73%
slightly 13,51% 24,53% -11,02%
moderate 24,13% 10,06% 14,07%
strong 28,06% 4,40% 23,66%
very strong 18,65% 0,63% 18,02%

Symptoms that could be related to Pain during bowel movements

Based on the datasets, we calculated the Kendall correlation. The following symptoms could be related to Pain during bowel movements.

Symptom name Correlation
Verstopfung moderate correlation (36,00%)
Pain during urination moderate correlation (34,00%)
Blood in stool moderate correlation (30,00%)
Flatulence weak correlation (26,00%)
Abdominal pain outside the lower abdomen weak correlation (26,00%)
Exhaustion / Fatigue weak correlation (24,00%)
Bloated belly / Endo-Belly weak correlation (23,00%)
Pain after intercourse weak correlation (22,00%)
Nausea weak correlation (20,00%)
Urge to urinate without passing urine weak correlation (20,00%)
Kidney pain weak correlation (20,00%)
Back pain weak correlation (20,00%)

Pain during bowel movements in endometriosis

In endometriosis, cells that closely resemble those inside the uterus, known as the uterine lining (endometrium), implant in other parts of the body. These endometriosis lesions are particularly common in the pelvis, that is, on the uterus and ovaries, but also on the wall between the vagina and rectum (rectovaginal septum) and in the large intestine. The rectum is the final segment of the intestine. The rectum therefore also includes the anal canal and ends at the sphincter muscle. The endometriosis lesions, like the endometrium in the uterus, are subject to the female hormonal cycle. Accordingly, over the course of the cycle the lesions first build up and then break down, so that, analogous to menstrual bleeding, they bleed. Depending on their location, the blood is then either discharged externally through the rectum during bowel movements, bleeds into the abdominal cavity, or collects within tissue. If the blood cannot be drained directly out of the body, cysts or adhesions may develop. These lead to inflammation, nerve irritation, and space-occupying masses. Mechanical restrictions can also arise in the rectal area. All of these factors can result in pain during bowel movements.

Endometriosis lesions in the rectal area or the wall between the vagina and rectum usually cause cycle-dependent pain. Over time, however, due to adhesions, chronic pain can also develop. Diagnosis of bowel endometriosis involves consulting a gastroenterologist to rule out other intestinal diseases. After taking your medical history, a manual examination is performed first, followed by an ultrasound of the vagina and rectum. Treatment depends on the location and extent of the lesions and on your specific symptom profile. Whether bowel endometriosis should be treated surgically must be carefully weighed. Because there is evidence that such bowel surgery may lead to complications affecting fertility, women who wish to have children need individualized counseling. 

Did you know that you can also have a big influence on endometriosis symptoms yourself? In the Endo App you learn self-management techniques for endometriosis and find many interactive exercises to relieve symptoms.