Differences in intensity and quality of bowel symptoms in patients with colorectal endometriosis : An observational cross-sectional study.

Abstract

Patients suffering from colorectal deep endometriosis (DE) experience gastrointestinal symptoms with almost the same frequency as gynecological pain symptoms. Preoperatively existing gastrointestinal symptoms may translate into pathological gastrointestinal quality of life index (GIQLI) and low anterior resection syndrome scores (LARS). This prospective questionnaire-based case control study aims to assess the prevalence of gastrointestinal complaints reflected by changes in LARS and GIQLI scores in patients with colorectal deep endometriosis prior to surgical treatment and compare those to ahealthy control group. The study was conducted at the Hospital St. John of God in Vienna and included atotal of 97patients with histologically confirmed colorectal DE with radical surgical treatment and 96women in whom DE was excluded via transvaginal sonography (TVS) or visually. Gastrointestinal symptoms reflected by LARS and GIQLI scores were evaluated presurgically and in controls. Atotal of 193 premenopausal patients were included in this study. Amean GIQLI of 90.7 ± 22.0 and 129.4 ± 11.1 was observed among patients and controls, respectively, showing asignificantly higher morbidity concerning gastrointestinal symptoms and decreased quality of life (QoL) compared to healthy controls (p < 0.001). The LARS score results demonstrated that 18.6% of the patients with bowel DE presented with amajor LARS and 27.8% with aminor LARS presurgically compared to 2.1% and 9.4% of control patients, respectively (p < 0.001). Patients with colorectal DE experience aquality of gastrointestinal symptoms translating into adecreased QoL and pathological GIQLI and LARS scores already presurgically. As aconsequence, these instruments should be interpreted with caution.