Effect of endometriosis on bowel physiology

  • Research type

    Research Study

  • Full title

    Effect of deep infiltrating endometriosis on bowel physiology and bowel symptoms: a prospective study of symptoms, bowel transit, anorectal physiology and MRI defaecography

  • IRAS ID

    290777

  • Contact name

    Arvind Vashisht

  • Contact email

    arvind.vashisht@nhs.net

  • Sponsor organisation

    University College London Hospitals NHS Trust

  • Duration of Study in the UK

    2 years, 4 months, 1 days

  • Research summary

    Endometriosis is a disease caused by the cells which usually line the womb existing outside the womb, usually in the abdominal cavity. Deep infiltrating endometriosis (DIE) can invade the womb, bowel and bladder, causing severe pain and infertility, significantly impacting quality of life. It is also associated with bowel symptoms including constipation, diarrhoea, and painful bowel motions. As a result, many patients with endometriosis receive a diagnosis of irritable bowel syndrome (IBS). It is unknown whether endometriosis and IBS are associated diseases, or if endometriosis patients tend to be misdiagnosed as having IBS. IBS shares many symptoms in common with endometriosis but does not have an identifiable cause. Surgical removal of DIE reduces bowel symptoms, but surgery does not help IBS. The diagnosis of IBS in some endometriosis patients may therefore be a misdiagnosis, which may contribute to delays in the recognition and treatment of endometriosis.

    This study aims to investigate whether the presence of endometriosis has an effect on the functioning (physiology) of the bowel, and how this relates to patients' symptoms. Patients with unexplained bowel symptoms who have been referred to the gynaecology department with suspected endometriosis will be offered to participate in this study, as well as some women with bowel symptoms who are not suspected to have endometriosis.

    Participants will be asked about their symptoms using questionnaires, and will undergo 3 tests of bowel physiology - MRI defaecography, anorectal physiology and bowel transit studies. Some participants will have DIE diagnosed by their MRI, and some will not. We can then compare the bowel physiology and symptoms in those who have DIE to those who don't to see what effect DIE has on bowel physiology and symptoms. Some participants may have surgery, and we will repeat these tests after surgery to see if bowel physiology and symptoms change.

  • REC name

    West Midlands - South Birmingham Research Ethics Committee

  • REC reference

    22/WM/0117

  • Date of REC Opinion

    24 May 2022

  • REC opinion

    Favourable Opinion