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    joanna1114 posted:
    Oh my gosh right now I am sitting at work and very uncomfortable, I have been to my GYN for this pain and she says its nothing just the regular cramps, it cant be because I am 36 years old and had my first period since I was 11 years old all of a sudden when I turned 36 thats when it began to get really bad; I cant sit, stand, walk, poop, pass gas. it all hurts so bad I cant even breath. the pain is in my pelvic area, in my lower back, in my rectum, I just feel so miserable. I beleive we all should have a laparoscopy to find out if its "endo". This can not be normal at all. It's not normal so im going to go for further tests, first I will find a new GYN until I get answers I CAN NOT LIVE LIKE THIS any longer.Good luck ladies! It's your body get the answers you need. you dont have to suffer, I've had ENOUGH.
    tlkittycat1968 responded:
    Good for you taking charge of your body and finding a different doctor. That much pain is not normal and for your doctor to minimalize it like that is unprofessional.

    I hope you find the relief you need.
    Anon_6061 responded:
    I agree - time to find another doctor.

    Most cases of endometriosis start shortly after menarche so endo wouldn't seem to be a very likely possibility. I've read that endo can occur after childbirth (particularly after c-section) if some of the endometrial tissue is transferred outside of the uterus. This link says "Transfer of endometrial tissues by a surgical procedure might be the cause for endometriosis implants seen in surgical scars (for example, episiotomy or Cesarean section scars)." Of course, this may not pertain to you.

    NSAID's may be helpful in reducing inflammation and cramping in case you haven't tried taking those.

    Good luck getting a diagnosis and some pain relief!
    Jane Harrison Hohner, RN, RNP responded:
    Dear joanna: I concur with your decision (and tlkittcat's and An_6061's advice). It is compelling that your severe pelvic pain is only present during menstruation. If you have not have success with prescription strength ibuprofen-type medications one does have to wonder about endometriosis as the culprit.

    Even if the second opinion GYN does not wish to do a laproscope first thing, the endometriosis ("endo") hypothesis can be tested by a trial of endo suppression medication. Sometimes a GYN may want to try medical treatment before doing a surgical procedure. If it is endo that has invaded the muscular wall of the bowel, surgery may be the required treatment.

    MULTIPLE lit searches at the National Library of Medicine site on duration of time needed to develop bowel endo yielded this citation (emphasis mine):

    Int J Surg Case Rep. 2011;2(7):181-4. doi: 10.1016/j.ijscr.2011.06.001. Epub 2011 Jul 6.
    Sigmoid endometriosis and a diagnostic dilemma - A case report and literature review.
    Nasim H, Sikafi D, Nasr A.

    Department of Surgery, Our Lady of Lourdes Hospital, Drogheda, 1, Ard Seascann Blackrock Road, Dundalk, Co. Louth, Ireland.

    Intestinal endometriosis is often an infrequently considered diagnosis in female of childbearing age by general surgeon. There is a delay in diagnosis because of constellation of symptoms and lack of specific diagnostic modalities. Patients suffer from intestinal endometriosis for many years before they are diagnosed. Often, such patients are labelled with irritable bowel syndrome. Intestinal endometriosis has a diagnostic time delay of 8-11 years due to its non-specific clinical features and multi-system involvement.

    Our patient was a 32 years old Caucasian female who was referred to us with features of intestinal obstruction. Despite repeated clinical assessments and use of different diagnostic modalities the diagnosis was still inconclusive even after 21 days of her first presentation to primary care physician. She had an exploratory laparotomy, sigmoid colectomy, and Hartmann's procedure with a temporary colostomy with us. Histopathology confirmed endometriosis and also showed melanosis coli. She was referred to the gynaecological team for review and follow up.

    Intestinal endometriosis should be considered as a differential diagnosis in female patients of childbearing age group presenting with non-specific gastrointestinal signs and symptoms. Our patient manifested intestinal endometriosis and melanosis coli on histopathology suggesting symptoms of long duration.

    Bowel endometriosis is a less considered and often ignored differential diagnosis in acute and chronic abdomen. This condition has considerable effect on patient's health both physically and psychologically.

    Best wishes in your search for a diagnosis.

    DolphinBaby1369 replied to Jane Harrison Hohner, RN, RNP's response:
    jane - thanks for your answer on this topic it has helped me look into other issues I am having . I have had endometriosis for many years now my doctor put my on the depo- provera drug it does help but sex it still painful for me . I have had a laproscopic surgery to determine I have it as well as when I have a pap smear my obgyn says she can physically see it so there for she burns it off at that time . I don't agree when some doctors say endometriosis can only show after child bearing cause that is not true at all !
    DolphinBaby1369 responded:
    so sorry you are going through all this pain I have been there so many times . Keep trying you will find the answers you need I promise

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