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American woman treated for bowel endometriosis at Mumbai hospital

Doctors say she had history of severely painful periods, constipation, bloating

A 35-year-old woman from the U.S. has been successfully treated for a dangerous type of bowel endometriosis at ACI Cumballa Hill Hospital in Mumbai.

The patient from Boston had a large endometriosis nodule in the mid and upper rectum almost resulting in occlusion, and inability to conceive due to significant endometriosis and adenomyosis. The woman, who complained of chronic period pain, constipation, and bloating, has resumed her daily routine now and is also scheduled to undergo an IVF treatment soon in her country.

Dr. Abhishek Mangeshikar, consultant laparoscopic and robotic gynaecologist with the hospital, said the patient had a history of severely painful periods and severe constipation and bloating. “Her ultrasound examination revealed a large endometriosis nodule in the mid and upper rectum almost resulting in occlusion. These findings were corroborated by an MRI.”

Bowel endometriosis, Mr. Mangeshikar said, could be seen when tissues similar to the uterine lining grew on the bowel or intestine. “It is the most common type of extra pelvic endometriosis. About 12% of cases affect the rectum and sigmoid colon. In India, an estimated 25 million patients suffer from endometriosis. We have treated 80 patients over the past year with advanced endometriosis and almost 60% had bowel involvement.”

In this particular case, delaying treatment could cause intestinal obstruction which could become a life-threatening complication because the patient would be unable to pass stools and the intestine would eventually perforate leading to severe complications such as sepsis and possibly death.

“The surgery is not only useful in improving quality of life and reducing pain but also in improving fertility. Since she was scheduled to return to the U.S., I reached out to her doctors there with her findings and they couldn’t take on the case due to its complexity. She too contacted several doctors in the U.S., but received the same answer and finally decided to extend her stay in India,” Dr. Mangeshikar added. The procedure went on for seven hours.

The woman said that the first two days of her menses were petrifying. She would change pad from time to time but still find herself with a sordid bloody pool on the bed, and the pain gave her nightmares.

“I felt as if my pain threshold was low and suffered in silence. My family was supportive and helped me with hot water bottles, painkillers, and even sympathy that I would be fine. But no one had really heard of endometriosis; also, it was the last thing on my mind. I was physically, mentally, and emotionally disturbed. I was just looking out for ways to end my suffering. Finally, the sufferings seem to have ended for me,” she said.

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