Endometriosis and IBD: Two Case Reports and Narrative Review of the Literature

Abstract

Endometriosis is a chronic inflammatory disease caused by the presence of ectopic endometrium-like tissue in extrauterine sites (ovaries, uterosacral ligaments, fallopian tubes or peritoneum), affecting up to 10% of young women. Clinical manifestations are heterogeneous, varying from asymptomatic to dysmenorrhea, dyspareunia, infertility or chronic pain. Gastrointestinal (GI) symptoms are reported by patients affected by endometriosis, including abdominal pain, pain during defecation, constipation, diarrhea, nausea, weight loss or obstructive crisis. Inflammatory bowel diseases (IBD) are a group of idiopathic, chronic disease including Crohn’s disease (CD) and ulcerative colitis (UC). Different Authors suggested an association between endometriosis and IBD, reporting different clinical cases, with different scenarios and outcomes. Involvement of GI tract can complicate pelvic endometriosis in 3-37% of cases and the differential diagnosis with inflammatory bowel disease (IBD) represents a challenge for the physicians. Here, we describe two clinical cases of young women affected by IBD associated to endometriosis, underling the importance of differential diagnosis and the impact of these two pathologies on patients’ quality of life.