Abstract Introduction Endometriosis is a chronic inflammatory condition with symptoms far beyond the gynecologic organs. A 63 year old patient presented to my clinic after seeing 4 clinicians for menopause management, pelvic floor therapy, two dieticians, and gastroenterology. Despite numerous evaluations, no one was able to determine the cause of chronic constipation, abdominal pain, and bloating. A 32 year old patient presented with severe ovulation pain and dyspareunia. The pain was unrelieved with combined hormonal contraception. The patient also had significant gastrointestinal symptoms that did not improve with conservative management. A 36 year old patient presented with abnormal uterine bleeding, attributed to leiomyomas, and constipation on her periods. Her gastrointestinal symptoms were unrelieved with numerous hormonal treatments and conservative management. Objective I describe the successful identification of endometriosis using a screening tool. Methods The Endometriosis Self-Assessment Tool for Patients (Cho & Yoon, 2021) was utilized to assess each of these patients. All three patients had a score greater than 50, the proposed cut-off to assume endometriosis is present. All three patients were referred to an endometriosis excision specialist and were found to have endometriosis on their rectum. All three patients found relief from gastrointestinal symptoms post-operatively. Patients were then referred back to me for ongoing, multi-modal integrative care of their endometriosis. The patients were managed using hormonal and non-hormonal medications, physical therapy, diet and lifestyle interventions, and complementary therapies. Results The Endometriosis Self-Assessment Tool for Patients (Cho & Yoon, 2021) was utilized to accurately identify three patients with endometriosis. Conclusions Chronic constipation, gastrointestinal symptoms, and abdominal pain may be the only obvious symptoms of endometriosis. A validated screening tool would be useful for the gynecologic provider to identify and refer patients at risk of endometriosis. More research to validate this proposed screening tool is needed. Disclosure No.
L Medhus (Sun,) studied this question.