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.
Source
Department of Surgery, Our Lady of Lourdes Hospital, Drogheda, 1, Ard Seascann Blackrock Road, Dundalk, Co. Louth, Ireland.
Abstract
INTRODUCTION:
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.PRESENTATION OF CASE:
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.
DISCUSSION:
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.
CONCLUSION:
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.
Yours,
Jane