Health Interactive Column of Friday, 23rd October 2009

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HEALTH INTERACTIVE COLUMN @ 7 YEARS

Dear Readers, with gratitude to Almighty, our column this month (October) marks its Seventh Years Anniversary. It started in October 2002. As a tradition, we normally dedicate a week to publish readers’ views and comments about the column and answer questions related to our work. We will God willing publish such on Friday, 6^th November 2009. Send your comments via our email, text message to our GSM number or post on our Blog Site.

 

Asabe asks; What is Endometriosis?

I suffered a prolonged and sustained pain for a long time as a woman of about 35 years. I move from one hospital to another in search of knowing what is wrong with me. It is more severe during my menses. Recently someone told me, I may be suffering from Endometriosis? Please I need all the information on the problem to enable me properly understand my long termed predicament.

Dr Magashi says; It is a condition where tissue similar to the lining of the uterus (the endometrial body and glands, which should only be located inside the uterus) is found elsewhere in the body.

Endometriosis lesions can be found anywhere in the pelvic cavity: on the ovaries, the fallopian tubes, and on the pelvic sidewall.

In addition, it can be found in caecarian-section scars and on the bladder, bowel, intestines, rectum. But these locations are not so common.

In even more rare cases, endometriosis has been found inside the vagina, inside the bladder, on the skin, even in the lung, spine, and brain.

Endometriosis can also cause scar tissue and adhesions to develop that can distort a woman’s internal anatomy. In advanced stages, internal organs may fuse together, causing a condition known as a “frozen pelvis.”

Some women with endometriosis may not be able to have children 

The most common symptom of endometriosis is pelvic pain. The pain often correlates to the menstrual cycle, however a woman with endometriosis may also experience pain at other times during her monthly cycle.

For many women, but not everyone, the pain of endometriosis can unfortunately be so severe and debilitating that it impacts on her life significant ways.

Pain may be felt:

1. before/during/after menstruation
2. during ovulation
3. in the bowel during menstruation
4. when passing urine
5. during or after sexual intercourse
6. in the lower back region

Other symptoms may include:

1. diarrhoea or constipation (in particular in connection with menstruation)
2. abdominal bloating (again, in connection with menstruation)
3. heavy or irregular bleeding
4. fatigue

The other well known symptom associated with endometriosis is infertility. 

There is no simple test that can be used to diagnose endometriosis, which may be why there is a diagnostic delay of up to 12 years in some healthcare settings.

At present the only reliable way to definitively diagnose endometriosis is by performing a Laparoscopy (incision through the abdomen) and to take a biopsy of the tissue. This is what is known as “the gold standard”.

However, this is an expensive, invasive proceduce. Furthermore, if the surgeon is not a specialist in endometriosis s/he may not recognise the disease, which can result in a “negative”result (ie. you may be told that you have not got endometriosis, even if you do, because the surgeon was unable to visually recognise the disease, and if no biopsy was taken). And, not everyone want to have surgery.

This makes diagnosing endometriosis a challenge, and therefore an experienced gynaecologist should be able to recognise symptoms suggestive of endometriosis through talking with the woman and obtain a history of her symptoms. For this to be effective, it is important that the woman is honest with her physician about all of her symptoms and the pattern of these.

Several different hypotheses have been put forward as to what causes endometriosis. Unfortunately, none of these theories have ever been entirely proven, nor do they fully explain all the mechanisms associated with the development of the disease. Thus, the cause of endometriosis remains unknown.

Choosing a treatment therefore comes down to the individual woman’s needs, depending on her symptoms, her age, and her fertility wishes. She should discuss these with her physician so that they, together, can determine which long term, holistic, treatment plan is best for her individual needs.

For many women, this can be a combination of more than one treatment over longer periods of time

Pain is the most common symptom for many women with endometriosis.

Pain killers include:

1. simple analgesics  e.g paracetamol)
2. compound analgesics (a combination of either aspirin or paracetamol)
3. mild narcotics 
4. narcotic analgesics 
5. non-steroidal anti-inflammatory drugs 

Endometriosis is exacerbated by oestrogen. Therefore, hormonal treatments for endometriosis are designed to attempt to temper oestrogen production in a woman’s body and such treatments may subsequently relieve her of symptoms.

Hormonal therapies may include:

1. 1.       The combined oral contraceptives
2. 2.       Progestogens

Laparoscopic surgery is the only definitive way to diagnose endometriosis. In many cases, the disease can be diagnosed and treated in the same procedure.

The success of surgery depends greatly on the skill of the surgeon and the thoroughness of the surgery . The aim is to remove all endometriotic lesions, cysts, and adhesions.

Today, most endometriosis surgery is being done through the laparoscope, although a full abdominal incision called a laparotomy may still be required in rare cases for extensive disease or bowel resections.

Although women with endometriosis are often told that hysterectomy is the “definitive” solution for endometriosis, the disease can recur even after a hysterectomy. Hysterectomy may be a very good solution for some women with endometriosis, but do know your facts before deciding on this option.

MY READOMETER

Last week (Friday, 16^th – Thursday, 22^nd October 2009), our blog address (www.healthinteractive.wordpress.com) had recorded 251 visitors, with Friday being the busiest with  58 visitors. I am glad that we witnessed daily visitation to our blog throughout the week. You can log in and not only read the latest edition and archives but can as well post questions and /or comments. Have a lovely weekend.