Bowel endometriosis

Bowel endometriosis occurs when endometrial-like tissue grows on the intestines, causing pain, inflammation, and digestive issues.

This condition most often affects the rectum and sigmoid colon but can involve any part of the bowel. Symptoms include constipation, diarrhea, painful bowel movements, bloating, and sometimes rectal bleeding, especially during menstruation. In severe cases, it may mimic irritable bowel syndrome or cause bowel obstruction.

What stage is bowel endometriosis?

Bowel endometriosis is typically classified as Stage 4 (Severe Endometriosis) because it involves deep tissue infiltration. Doctors categorize this form as “Deep Infiltrating Endometriosis” (DIE) since the lesions penetrate more than 5mm beneath the tissue surface.

At this advanced stage, thick scar tissue and dense adhesions often glue the bowel to the uterus or ovaries. However, a higher stage does not always mean more pain; staging strictly measures the physical spread of the disease. While Stage 4 indicates extensive organ involvement, some patients may surprisingly experience fewer symptoms than those with early-stage disease.

Bowel deep infiltrating endometriosis

Bowel deep infiltrating endometriosis occurs when endometrial tissue grows deeply into the bowel walls. This form of endometriosis can cause significant pain, especially during menstruation.

The tissue grows beyond the superficial layers, leading to chronic inflammation, scarring, and sometimes bowel obstruction. Symptoms include painful bowel movements, constipation, diarrhea, and blood in the stool.

Symptoms of bowel endometriosis

Symptoms of bowel endometriosis include painful bowel movements, bloating, constipation, diarrhea, and rectal bleeding during menstruation.

These digestive symptoms often worsen around a woman’s period, making them easy to confuse with other gastrointestinal issues. Deep pelvic pain, pain during sex, and lower back discomfort may also appear. Some women experience nausea or a feeling of incomplete bowel emptying. In severe cases, bowel endometriosis can lead to intestinal obstruction or chronic inflammation.

Symptoms vary based on the location and depth of endometrial growth. Accurate diagnosis often requires imaging or laparoscopy. Early treatment helps relieve pain and prevent long-term digestive and fertility complications.

Imaging techniques for bowel endometriosis

Imaging techniques for bowel endometriosis include transvaginal ultrasound, magnetic resonance imaging (MRI), and computed tomography (CT) scans. Transvaginal ultrasound is often used to identify ovarian endometriosis, but it may also help detect deep infiltrating endometriosis near the bowel.

MRI is particularly useful for evaluating deep infiltrating endometriosis and can provide detailed images of the bowel and surrounding tissue. CT scans are less commonly used but can be helpful for detecting bowel obstruction or complications. These imaging methods help guide treatment decisions and determine the extent of the disease.

Can bowel endometriosis be seen on a colonoscopy?

Bowel endometriosis is generally not directly visible during a colonoscopy. While colonoscopy is effective for diagnosing other bowel conditions, it may not reveal endometrial tissue growing outside the bowel. However, in some cases, a colonoscopy may detect signs of inflammation, ulcers, or other changes in the bowel lining caused by endometriosis.

To confirm bowel endometriosis, doctors typically use imaging techniques like MRI or laparoscopy, which provide better visualization of the endometrial tissue on or inside the bowel.

Surgical treatments

When it comes to surgical treatment, the main goal is to remove all of those peritoneal lesions using an excisional technique. The aim is to ensure the borders are completely free of disease. In cases of deeply infiltrating endometriosis (DIE), the surgical approach can vary quite a bit depending on how much of the rectal wall and muscles are involved.

These procedures can range from shaving (just scraping off the surface lesions), to nodulectomy (removing individual nodules), discoid resection (removing a disk-shaped piece of the bowel), and finally, more extensive procedures like anterior bowel, sigmoid, or ileocecal resection followed by end-to-end anastomosis (where affected sections of the bowel are removed and the healthy ends are reconnected).

Patients with bowel endometriosis, which often masks itself as IBS
Patients with bowel endometriosis, which often masks themselves as IBS, will often be advised to take up a specific diet to relieve such symptoms as diarrhea, constipation, nausea, and vomiting.

Endometriosis can spread to a variety of locations. It is common for patients to be unsatisfied with their endometriosis surgery when surgeons ignore their bowel symptoms and do not recognize their bowel lesions during surgery.

Patients often receive a misdiagnosis of irritable bowel syndrome (IBS) or Crohn’s disease, as physicians mistakenly attribute their symptoms to a gastrointestinal cause. It is essential to ask whether or not a patient’s bowel symptoms are in sync with their menstrual cycle. If doctors do not ask these questions and do not alert the surgery team beforehand, the lesions will go unnoticed, unremoved, and untreated.

Get a Second Opinion

Our endometriosis specialists are dedicated to providing patients with expert care. Whether you have been diagnosed or are looking to find a doctor, they are ready to help.

Our office is located on 872 Fifth Avenue New York, NY 10065.
You may call us at (212) 988-1444 or have your case reviewed by clicking here.

Facts about bowel endometriosis

Prevalence

1 in 5 endometriosis cases infiltrate
  • deeper into the intestinal organs.

Area of Involvement

  • 90% of bowel endometriosis cases involve the rectum and sigmoid colon (large intestine), while 10% involve the appendix and ileum (the final segment of the small intestine).
  • The small bowels are least commonly involved in bowel endometriosis.
  • Patients with bowel disease may also have a higher incidence of diaphragmatic endometriosis.
  • Advanced bowel disease–which requires nodulectomy or bowel resection procedures–involves the urinary system, including the ureters and bladder.
  • Approximately 15-20% of bowel endometriosis is multi-focal (diffuse within a certain area), while the rest is multi-centered (centered in a number of different areas such as the appendix, colon, etc.).

Difficulty Diagnosing

  • MRI and CAT scans can only diagnose bowel disease in advanced cases. 
  • Nearly 50% of endometriosis cases have superficial rectovaginal involvement that cannot be detected with any form of a preoperative diagnostic test (a sonogram, MRI, CAT scan), but can be felt in a comprehensive pelvic exam and diagnosed via laparoscopic surgery.

Surgical Treatment

  • Treatment options include wide deep-excision of the surface of the peritoneum, shaving, nodulectomy, discectomy, and bowel resection.
  • Advanced cases of bowel endometriosis can benefit significantly from definitive surgery in the form of a hysterectomy.
  • An essential aspect of bowel endometriosis surgery is that the surgeon may use an automatic stapler or sew by hand.
Endometriosis lesions
Figure depicting an extreme form of bowel endometriosis.

Where does bowel endometriosis occur in the body?

In bowel endometriosis, lesions implant onto a multitude of areas outside the uterus.

  • Peritoneum: This is arguably the most common site for endometriosis lesions. Peritoneal endometriosis has the same symptoms as bowel endometriosis. Therefore, it is important to evaluate the peritoneum in any endometriosis surgery, including bowel endometriosis.
  • Cul-de-sac (pouch of Douglas): The area between the uterus and rectum, also known as the pouch of Douglas, is one of the most common sites of bowel endometriosis. In this area, the rectum and vagina face each other and are divided by the recto-vaginal septum. Endometriosis in the pouch of Douglas can cause painful bowel movements and painful sex as the inflamed affected tissue can infiltrate the outer wall of the vagina.
  • Rectum: Endometriosis can implant onto the outside of the rectum, causing severely painful bowel movements, constipation, and rectal bleeding.
  • Perirectal area: This is the area directly behind the rectum. Bowel endometriosis lesions that implant in this region cause back pain.
  • Colon and small intestines: Lesions can attach anywhere on the outside of the intestines. This can often be tricky to spot. It requires a very skilled surgeon with a keen eye to inspect the intestines by “running” through them and checking for any lesions.
  • Appendix: Often, lesions in the appendix or near the small intestine cause gas and pain on the right side (particularly the right lower quadrant).
Clinical interpretation
An inflamed rectum due to the infiltration of the posterior cul-de-sac.

What are the types of bowel endometriosis?

Overall, the lesions of the bowel can be multi-focal or multi-centered. Multi-focal means that lesions are in the same area, but there are multiple locations within that area of tissue. For example, there may be multiple lesions only in the rectum or upper vagina.

Multi-centered lesions are also in the bowels but are spread diffusely throughout the rectum, colon, and appendix. In our own clinical setting, we have found that about 10-15% of our endometriosis cases have nodules that are multi-centered. In 20% of cases, the lesions are multi-focal.

Deep nodule infiltration of the bowels
Deep nodule infiltration of the bowels.

Diagnosing bowel endometriosis

  • Pelvic exam with sonogram: This clinical form of testing cannot provide a formal diagnosis of endometriosis. However, it can be helpful for your surgeon to assess points of tenderness. By performing a rectovaginal exam, an experienced surgeon can identify the specific locations of rectal tenderness. This coupled with sonographic imaging can provide a presumptive diagnosis as to whether or not the rectum and in turn, the bowels are involved.
  • Imaging tests: Additional tests like an MRI and a dual contrast CT scan are necessary to evaluate the condition of the ureters, higher bowels, and appendix. The appendix is one of the first organs that, bowel endometriosis infiltrates. For this reason, it can be a key finding in presumptively diagnosing endometriosis before surgery.
  • Laparoscopy: In order to formally diagnose and treat bowel endometriosis, laparoscopic surgery must be performed in the operating room. During this procedure, the surgeon makes small incisions into the abdomen. This allows them to insert operating instruments and a laparoscope (small camera). They then use this to visualize and evaluate the inner abdominal anatomy. Using this technique, a highly skilled surgeon can navigate through the bowels, which include the sigmoid colon, small intestines, and appendix, and thoroughly inspect them for any endometriosis lesions. They will then excise these lesions or completely resect parts of the bowels depending on the severity of the disease. They perform all of this under laparoscopic visualization, ensuring minimal invasive surgery and optimal recovery.
Excision Surgeon Dr.Seckin

Why is bowel endometriosis often misdiagnosed?

Bowel symptoms are some of the most prominent endometriosis symptoms, even in adolescents. Endometriosis symptoms will often start with bowel symptoms (diarrhea, constipation, etc.), causing patients to seek a gastroenterologist, who will likely attribute the symptoms to IBS, appendicitis, Crohn’s disease, or even colon cancer.

These diagnoses are made without biopsy samples or a pathology report. Instead, patients go on to receive multiple colonoscopies and endoscopies and are often diagnosed without a full evaluation of what may really be the underlying cause of their symptoms. For these reasons, we consider an IBS diagnosis without evaluation for endometriosis a “dump diagnosis” for a patient’s bowel dysfunction and pain, particularly if they have symptoms that coincide with their period.

Patients who receive such a misdiagnosis also receive the wrong treatment and experience persistent symptoms, only to find out, years later, that they had endometriosis all along. In some instances, patients can go five to 10 years without treatment, sometimes missing the prime reproductive years of their life.

What to expect the days after the surgery?

Following bowel endometriosis surgery, you can expect your bowels to be very sensitive. You may need a few days to rest before resuming normal function. Below are just a few of the common complications that may arise for a few days following bowel endometriosis surgery, along with suggestions to help relieve these symptoms.

Abnormal and painful bowel movement: The first bowel movement following bowel endometriosis surgery can often cause pain and discomfort. While some physicians recommend the use of narcotic pain medications in these instances, we have found that narcotics cause constipation. We instead advise drinking at least 64 ounces of water a day and sometimes even a mild stool softener, such as Colace, if needed. We also recommend keeping your diet light for the first few days to give your body the time it needs to recover. This could include broths, jell-O, and other easily digested food.

Bloatedness causing back and shoulder soreness: Back pain is a common complication that can arise temporarily following bowel endometriosis surgery. Lesion removal, or simply bloatedness can cause this. During bowel endometriosis surgery, your abdomen will be filled with gas in order to lift the abdominal walls away from the cavity to get a better view of the bowels. After surgery, some of this gas will remain, but there are some remedies for relieving this. 

Bowel endometriosis after hysterectomy

Bowel endometriosis can persist or develop after hysterectomy, especially if endometrial tissue remains outside the uterus.

A hysterectomy removes the uterus but may not eliminate endometrial implants on the intestines or other pelvic organs. If the ovaries remain, hormonal activity can continue to stimulate these implants, causing pain and digestive symptoms. Even after ovary removal, residual endometriosis may still trigger inflammation and scarring.

Common signs include bloating, bowel discomfort, and painful bowel movements. Diagnosis often requires imaging or laparoscopy, as symptoms mimic other gastrointestinal issues. Effective treatment may involve hormonal therapy or surgical excision. Post-hysterectomy monitoring is essential for managing long-term endometriosis symptoms.

Severe pain with bowel movement

Severe pain with bowel movements can be a symptom of several conditions, including endometriosis, anal fissures, hemorrhoids, or irritable bowel syndrome (IBS).

In the case of endometriosis, pain often worsens during menstruation and may be linked to bowel endometriosis, where tissue grows on or around the intestines or rectum. This can cause cramping, rectal pressure, and sharp pain during defecation. Hemorrhoids and anal fissures typically cause burning or stabbing pain and may result in visible blood. IBS-related pain is often relieved after a bowel movement and accompanied by bloating or changes in stool consistency.

Frequently Asked Questions

Does bowel endometriosis require surgery?

Bowel endometriosis may require surgery, especially if other treatments, such as medication, do not effectively manage symptoms. Surgery is often recommended when there is significant pain, bowel obstruction, or other complications that impact daily life. 
The surgery aims to remove the endometrial tissue or adhesions affecting the bowel, which can help alleviate symptoms and improve function. In severe cases, surgical intervention may also help prevent further damage to the bowel or other organs.

Can bowel endometriosis cause constipation or diarrhea?

Yes, it’s absolutely true that bowel endometriosis can swing both ways, leading to both constipation and diarrhea. When that endometrial-like tissue invades the wall of your intestines, it really throws a wrench in normal bowel function. It does this through a combination of inflammation, scarring, and even mechanical narrowing.
In areas where those lesions dig particularly deep, the resulting scar tissue can actually constrict the bowel. Think of it like a squeeze in a hose; this slows down the passage of stool and, you guessed it, results in constipation. On the flip side, sometimes the irritation is more superficial. These implants can simply aggravate the bowel lining, increasing fluid secretion and muscle contractions. When that happens, you might find yourself dealing with bouts of diarrhea.

What foods should I avoid with bowel endometriosis?

When you’re dealing with bowel endometriosis, it’s really smart to steer clear of foods that can crank up inflammation and make your gut symptoms even worse. Think about it: highly processed stuff – things like those packaged snacks, fast food, and refined carbohydrates – often come loaded with additives and unhealthy fats.
These are notorious for promoting inflammation, which means they’re likely to make your pelvic and intestinal discomfort much more prone to flaring up. Likewise, loading up on red meat and other animal products high in saturated fat can also fuel those inflammatory pathways, potentially increasing your pain and bloating in the bowel.

Is endometriosis of the bowel serious?

It’s really important to know that endometriosis on your bowel isn’t just a minor issue; it can actually be quite serious. That misplaced tissue, growing on your intestines, can cause a whole lot of pain, sometimes even a bowel obstruction, and truly impact your digestive system.
Think of it this way: that tissue triggers ongoing inflammation, scarring, and sticky adhesions, which makes it genuinely hard for your intestines to work as they should. This can show up as painful bowel movements, constipation, and, in some rare cases, even some bleeding. If left alone, it can unfortunately lead to further complications and damage to your bowel. The good news is, there are treatments available, often involving medications or surgery, depending on what you’re experiencing.

How do you treat endometriosis in the bowel?

When it comes to treating endometriosis in the bowel, we usually look at a combination of approaches, often involving both medication and surgery.
If things are more severe, surgery might become necessary. The goal here is to physically remove the endometrial tissue or any adhesions that are causing problems for your bowel. Depending on how extensive the endometriosis is, this could be anything from a less invasive laparoscopic procedure to a more involved open surgery.

What are the risks of bowel endometriosis surgery?

Bowel endometriosis surgery is one of the most difficult procedures to perform. It requires great experience and meticulous attention to detail, as a surgeon must go through the entirety of the intestines, from the rectum to the small intestines. For these reasons, bowel endometriosis surgery is the riskiest of any other endometriosis surgery.
In our experience, nearly one out of 20 cases (5%) experienced complications following surgery, including bloatedness, gassiness, and abdominal and rectal pain. While this is a very promising recovery number for a procedure that only a select few can perform. We feel it is very important for the patient to be aware of the potential risks.

Can diet relieve the symptoms of bowel endometriosis after surgery?

Diet and lifestyle changes can be complementary measures in the treatment of bowel endometriosis, particularly before and after surgery. Endometriosis causes widespread inflammation leading to constipation, diarrhea, abnormal gas, and bloating. Therefore, patients may experience some symptom relief if they consume an anti-inflammatory diet.

Why can a colonoscopy not diagnose bowel endometriosis?

Whereas inflammation of the bowel caused by IBS materializes exclusively within the intestines. Inflammation caused by bowel endometriosis occurs when lesions attach to the outside of the bowels. Procedures such as colonoscopies and endoscopies can only examine the inside of the bowels.
They are, therefore, unable to identify inflammation caused by endometriosis. Laparoscopic surgery is the only way to formally and definitively diagnose bowel endometriosis.

What happens when endometriosis spreads to the bowels?

When endometriosis spreads to the bowels, endometrial-like tissue infiltrates the intestinal walls, causing chronic inflammation and scar tissue formation. This invasive growth typically targets the rectum or sigmoid colon, creating deep nodules that thicken the bowel wall.
As these lesions bleed during your menstrual cycle without an exit, they create sticky adhesions that can fuse loops of intestine together. This physical distortion results in severe pain during bowel movements, cycle-dependent constipation, and potentially partial bowel obstruction in advanced cases.

Can endometriosis cause bloody stool?

Yes, endometriosis can cause bloody stool if the tissue grows on or near the bowel. This condition, known as bowel endometriosis, occurs when endometrial-like tissue attaches to the intestines or rectum. During menstruation, this tissue can bleed, leading to symptoms such as bloody stool, painful bowel movements, diarrhea, or constipation. The blood in stool is typically dark and may appear during the menstrual period. While rare, this form of endometriosis can be serious and is often mistaken for gastrointestinal issues.

Can endometriosis cause diarrhea during period?

Yes, endometriosis is a common cause of severe diarrhea and digestive distress during menstruation. This happens partly because the endometrial tissue releases prostaglandins, which relax smooth muscles in the gut. These chemicals cause your intestines to contract faster, leading to loose stools. Furthermore, if endometrial lesions grow directly on the bowel or rectum, they create localized inflammation. This specific set of symptoms, often accompanied by bloating, is frequently called “endo belly.”

Will a hysterectomy cure bowel endometriosis?

No, a hysterectomy typically does not cure bowel endometriosis. This procedure only removes the uterus, but endometriosis lesions exist outside of it. If the disease has infiltrated your bowel walls, removing the uterus leaves those painful lesions behind. The symptoms, such as painful bowel movements and rectal bleeding, will likely persist after the surgery. True relief requires excision surgery, where a specialist skillfully cuts out the endometriosis tissue directly from the intestines. While a hysterectomy stops menstruation, it does not remove the active disease growing on your other organs.

Can bowel endometriosis cause mucus in stool?

Yes, finding mucus in your stool is a frequent symptom of bowel endometriosis. This occurs when endometrial tissue implants on or penetrates the wall of the rectum or colon. The presence of these foreign lesions causes significant inflammation and irritation in the digestive tract. In response, your bowel produces excess mucus to protect its lining from this irritation. You may notice this clear or yellowish jelly-like substance coating your stool, especially during your menstrual cycle.

What diet can help relieve bowel endometriosis symptoms?

There are many diets that may help. However, it is important to understand that every patient is unique and will respond differently. There is no one diet for endometriosis. Consulting with your doctor or nutritionist when making a dietary change and recording the effects of dietary changes on your symptoms may be useful in determining a diet that is appropriate for you.

One study found that a low FODMAP diet can be highly beneficial in relieving the symptoms of bowel dysfunction in endometriosis patients. FODMAP is an acronym for “fermentable oligosaccharides, disaccharides and monosaccharides, and polyols”. Some human GI tracts poorly absorb foods containing these molecules – mainly carbohydrates, with the exception of polyols (alcohol). Generally, a low FODMAP diet consists of low carbohydrates and gluten in order to reduce inflammation.

Sugar and carbohydrates are harmful in many conditions including endometriosis, inflammatory diseases, auto-immune diseases, bacterial and yeast infections, and cancer. Sugar nourishes these conditions and worsens their associated symptoms. In the case of bacteria or yeast infections, it worsens the infection itself.

High and low FODMAP foods

Food Category High FODMAP foods Low FODMAP food alternatives
VegetablesAsparagus, artichokes, onions(all), leek bulb, garlic, legumes/pulses, sugar snap peas, onion and garlic salts, beetroot, Savoy cabbage, celery, sweet cornAlfalfa, bean sprouts, green beans, bok choy, capsicum (bell pepper), carrot, chives, fresh herbs, choy sum, cucumber, lettuce, tomato, zucchini
FruitsApples, pears, mango, nashi pears, watermelon, nectarines, peaches, plumsBanana, orange, mandarin, grapes, melon
Milk and dairyCow’s milk, yogurt, soft cheese, cream, custard, ice creamLactose-free milk, lactose-free yogurts, hard cheese
Protein sourcesLegumes/pulses, red meatMeats, fish, chicken, tofu, tempeh
Breads and cerealRye, wheat-containing bread, wheat-based cereals with dried fruit, wheat pastaGluten-free bread and sourdough bread, rice bubbles, oats, gluten-free pasta, rice, quinoa
Biscuits (cookies) and snacksRye crackers, wheat-based biscuitsGluten-free biscuits, rice cakes, corn thins
Nuts and seedsCashews, pistachiosAlmonds (<10 nuts), pumpkin seeds

Our approach

About one in four of our endometriosis cases involve the bowels. This is a bit higher than the normal number of bowel endometriosis cases in the average endometriosis patient. For this reason, we take both great pride and care in surgically treating bowel endometriosis.

Having practiced our endometriosis laparoscopic surgery technique for several decades. Our team has great skill in handling even the most complex cases of bowel endometriosis with minimally invasive techniques.

Running the bowels

Once we make incisions into the abdomen and insert a laparoscope, we first check the appendix and ileum of the small intestine, as these are common sites in which bowel endometriosis lesions often implant.

We then meticulously and thoroughly unwind the intestines (run the bowels) and insert a rectal probe with a manipulator. This mobilizes the intestines, making them accessible to examine and operate on. Then, we identify and remove suspected endometriosis lesions.

Repairing the bowels

A good surgeon must have a tremendous amount of experience in repairing the bowels, rectum, and sigmoid colon. This is arguably the most difficult part of bowel endometriosis surgery.

Many endometriosis lesions are difficult to remove without cutting into the mucosa, especially when the lesions are at the muscular level. In other words, these nodules are transmural with full-thickness involvement (buried within the muscular tissue), and will thus require distortion of the normal bowel anatomy so that the lesions can be removed. This will then require anatomical repair.

air leak
Once sutures are in place, an “air leak” (flat tire) test is conducted to ensure there is no leakage in the newly restored bowels and that the sutures are properly intact.

Over the years, we have mastered the technique of proper restoration of the bowels’ original function following lesion removal. We perform all necessary restoration, reconstruction, and repair of the organs that have been operated on.

We then test the function of the intestines using an “air leak” test (or flat tire test). During this technique, we submerge the bowels in water and methylene blue dye. Then, we apply pressure to the area to push air into the intestine and ensure there is no leakage of the newly restored organs and the sutures are properly intact.

More complex cases

Sometimes, more extensive bowel surgery is necessary. When an infected organ or area of tissue is diffusely involved, segmental resection and anastomosis may be necessary. This is a procedure we use to cut into the bowel to remove areas of diffuse endometriosis.

We then reattach the bowels to their newly restored anatomy. Other versions of this include serosal/peritoneum excision, nodulectomy, and disk and segmental excision. At times we may even end up doing multi-centered surgery, which involves rectal resection, sigmoid resection, ileocecal resection, and anastomosis. So, we can end up using three different resection techniques with anastomosis in order to thoroughly treat the multiple organ involvement that bowel endometriosis can cause.

What is our method of “team surgery?”

Endometriosis is a multiple-organ disease. This means that it can affect organs such as the bowels, bladder, diaphragm, and even the lungs and kidneys. For this reason, teamwork is a necessary component of our approach. Bowel endometriosis is particularly complex and requires a multidisciplinary surgical team to provide the best quality care to our patients. During these surgeries, Dr. Seckin and the teamwork with a team of highly skilled laparoscopic surgeons.

The colorectal and urology specialists on our team have worked with us for many years. They have extensive experience in performing surgeries alongside Dr. Seckin. Our philosophy of endometriosis team practice ensures a high surgical volume of diversification and knowledge. This is crucial to minimize postoperative complications and increase the opportunity for a successful outcome.

How do we ensure a thorough bowel endometriosis surgery?

We strongly believe in increasing the quality of endometriosis surgery by removing endometriosis from every anatomical location including the bowel, bladder, nerves, and ureters. Many surgeons strictly focus on the reproductive system in cases of endometriosis. However, we believe in conducting a thorough examination of the abdominal anatomy in its entirety, which includes the bowels.

A margin-free, complete excision without leaving any disease behind is the gold standard that our team practices. It is also important to not leave behind any scar tissue. This way the patient has a higher chance of recovery and symptom relief. There are also several key components and ideals we uphold in all of our endometriosis surgeries, in order to give the patient the best quality of care that they deserve.

Our main components

Deep excision:

One of the main reasons excision surgery is the preferred method of lesion removal is that it removes each lesion in its entirety. Methods of fulguration and laser ablation present a risk of harming surrounding healthy tissue.

They also only remove lesions superficially. This increases a patient’s risk of symptom recurrence. “Deep excision” removes each lesion out of the tissue’s entirety while preserving the borders of the surrounding healthy tissue.

Cold excision:

Techniques of laser ablation and fulguration often rely on heat and electricity to destroy lesions. These are often unnecessary uses of powerful energy sources that damage the surrounding healthy tissue, while only removing lesions superficially.

This is why we thoroughly believe in “cold excision,” or excision surgery that stresses the use of minimal to no electricity.

Pathology report:

Using excision surgery, we are able to preserve removed lesions. Then we send them to a pathology lab, where a pathologist examines them under a microscope.

This is a crucial component of our surgeries, as it is the best way to formally diagnose endometriosis. It also allows us to gain a better understanding of its possible spread and growth. Many other surgical methods are unable to generate a pathology report as they destroy the endometriosis tissue.

Minimally invasive surgery:

We ensure our patients that our surgeries, even those as complex and thorough as bowel endometriosis excision surgery’ are performed with the most comprehensive care, ensuring minimal invasion and the best chance of symptom relief and recovery.

Experience and skill:

At the Seckin Endometriosis Center (SEC), we have been training for decades to surgically treat different types of endometriosis cases through laparoscopy. Bowel endometriosis is no exception. Over time, we have gathered the skill and knowledge that is necessary for complex treatment options such as surgical excision of bowel endometriosis.

The result

Bowel endometriosis surgeries require a surgeon to complete meticulously demanding tasks such as running the entirety of the intestines to inspect for endometriosis lesions and reconstructing, repairing, and restoring the bowels after they have been operated on.

We have learned that such surgery does not only require great experience but also calls for keen attention to detail. Only through meticulous surgical execution can a surgeon remove endometriosis from the bowels. By removing these lesions, we provide our patients with the highest chance of recovery and symptom relief. 

Patient story

Bowel endometriosis usually occurs in less than 20% of all endometriosis cases. However, in our practice, nearly one in every four patients show signs of possible bowel endometriosis. We have a number of bowel endometriosis stories from patients who underwent bowel excision and resection surgery.

Meet Patrice M. She was rushed to the ER due to an ovarian cyst bursting in her right ovary, only to find that her endometriosis had spread to her bowels. Read more stories of patients who had endometriosis surgery after their disease spread to the bowels in our testimony section.

Get a Second Opinion

Our endometriosis specialists are dedicated to providing patients with expert care. Whether you have been diagnosed or are looking to find a doctor, they are ready to help.

Our office is located on 872 Fifth Avenue New York, NY 10065.
You may call us at (646) 960-3080 or have your case reviewed by clicking here.

Dr. Seckin is an endometriosis specialist and women’s reproductive health advocate. He has been in private practice for over 30 years at Lenox Hill Hospital with a team of highly skilled personnel.

Dr. Seckin specializes in advanced laparoscopic procedures and is recognized for his expertise in complex cases of deep infiltrating endometriosis of the pelvis. He is particularly dedicated to performing fertility-preserving surgeries on cases involving the ovaries.

He has developed patented surgical techniques, most notably the “Aqua Blue Excision” technique for a better visualization of endometriosis lesions. His surgical techniques are based on precision and microsurgery, emphasizing organ and fertility preservation, and adhesion and pain prevention.

Dr. Seckin is considered a pioneer and advocate in the field of endometriosis.