When endometriosis implies also nodules or adhesions/lesions on the bowel, doctors could opt for “bowel resection” during surgery. For this, you need a team of well-trained doctors: surgeon/gynaecologist and a colorectal surgeon. (1)
During surgery, the main doctor excises adhesions, solves the ovarian cysts etc., and the colorectal surgeon cuts the part of the colon which is affected by endometriosis and then makes sure everything is alright from this point of view.
In more severe cases (when the nodule is too close from the rectum or that part is too affected by endometriosis), doctors could decide for a temporary colostomy bag. (2)
Bowel or rectovaginal endometriosis is one of the most severe forms of endometriosis and it needs a team of doctors, specialised in this type of interventions
In 2016, I went through such surgery, when I was operated in Timisoara, Romania for endometriosis stage IV, with a bowel resection (8 cm) because of the multiple endometriosic lesions and a 4.5 cm nodule.
The recovery after this surgery can differ from patient to patient, depending on the number of years she experienced endometriosis symptoms before, if one of her prior symptoms was constipation, if she experienced endometriosis symptoms from the teenage years, from her first periods etc.
I make this clarifications because the recovery time and type is rarely related to the actual surgery and it is not only about the “patient’s body” but about her whole endometriosis track.
A lot of patients have asked me lately about the downsides of the endometriosis surgery with a bowel resection, about those manifestations that can be very stressful. I decided to write more about my experience with that part, what I experienced, what I did and I believe you should also implement and know in order to be well and hopeful.
I mention once again that my articles do not replace the doctor’s consult or treatment, but I strongly believe they can be very useful both to patients and doctors of different specialists because no matter how much you study you cannot experiment and understand otherwise how an endometriosis woman really lives and feels.
1. Constipation and defecation problems
Besides the fact that, before the surgery, the nodule was localized on the colon and obstructed and pressed that area for so long, during surgery, the surgeon’s manoeuvres are quite important: they opt for discoid or tubular resection, they “tie” the colon with some clips, they do that afterwards test to see if the colon is working etc.
What I am trying to say is that all these problems are somehow understandable.
Before the last surgery, the one from 2016, I confronted constipation. After surgery, for about 2-3 months things were even worse, even with laxatives. Several months before the surgery I had discovered Magnesium Citrate, a mild supplement, also with a laxative effect that helped a lot. In my opinion the best form of Magnesium comes from Doctor's Best.
Initially, my doctor recommended me castor oil for constipation, with no effect, so I told him about Magnesium Citrate and he agreed to take it and afterwards, even recommended it to some other patients too.
For constipation, I chose the next “natural remedies for constipation” which were, in fact, foods or diet tips that helped me a lot:
- in the morning, for breakfast, mix in a bowl 1 cup of gluten free oatmeal, 1 cup of warm coconut/almond milk, 1 teaspoon of honey, 1 grated apple, some walnuts and coconut oil. Of course, not all the time I had all the ingredients but the oatmeal, milk, honey and apple are “a must”.
- sweet potatoes (roasted or boiled), avocado and cooked tomatoes helped me every time (but not in excess, as they can give stomach issues afterwards).
- regular meals, at 4-5 hours distance with healthy snacks between. It’s important not to eat in a hurry or when stressed.
- avoid those foods that you are intolerant too (before or after the surgery – see below more info).
No matter these remedies, remember that, if you are in this category of patients with a more difficult recovery, the first 2-3 months are “the patience” months. Therefore, do your best to help your body and be patient.
Another important aspect here is that if you take birth control pills these can worsen the constipation too, so talk to your doctor and see what you could do.
The doctors that operated me were always telling me that “in 1 year, my colon will recover almost completely”. First, I did not believe them, but indeed after 8-9 months from the surgery I started to feel much better.
2. More frequent stools, not very quantitative
Believe me, after a bowel resection, you will research a lot about constipation, stools, forms of the stools etc. Don’t panic, it’s normal; soon life will be about other things too. In the first months after surgery you could confront this symptom too: you need to go to the bathroom very often, but the stools are not very quantitative. The same thing can happen with the bladder, especially if you also had some adhesions on your bladder and ureters, like I did. Again, all these might be the effects of the surgery.
If your doctors assure you that inside the things are normal and the problem is not major (like urinary incontinence, LARS syndrome etc.), then just be patient and remember others have gone through the same things.
3. Weakness, lack of energy
After such surgery, it is normal to feel weak, dizzy and without energy. Again, if your blood tests are fine, I would say to ask your doctor if you could take a multivitamin supplement.
I would like to mention here also about a vitamin C supplement ( but do not take it until you don’t ask your family physician). Vitamin C is great for wounds, imparis adhesions formations, helps in recovering after a surgery, skin, tissues, but also for immunity and energy. For years I have been taking 1 g of vitamin C , every day, in the first part of the day, and after meals. I really feel is one of the best supplements for endometriosis. One of the best supplements with vitamin C I have tried are from Now or Doctor's Best. (3) (4)
4. You develop food allergies or intolerances to foods you could eat before surgery
Right after my surgery (I had like a month from the surgery) I ate a little bit of eggplant salad with 1 raw tomato. I was sick for a week, with indigestion, vomiting and pains all over my belly.
Therefore, my advice here would be to take care with food 2-3 months after surgery because, besides the actual excision of the endometriosis lesions, the doctors “worked” a lot on the bowl too.
I can eat eggplant now, but in moderation and to be honest I try to avoid them. If you know you are more sensitive on this gastro intestinal side, avoid for some months eggplants, raw foods and anything that can cause side effects. Let’s do not forget there is a studies correlation between IBS and endometriosis so be cautious.(5)
For this particular problem, I recommend you or your doctors to read more about systemic enzymes, especially about the ones I wrote about here.
Now, 4 years after my surgery, I can tell you that you must tell your doctors all your symptoms and worries. If they assure you that everything is all right, remember your situation will get better in time.
Besides, let’s do not forget there are some lucky patients who recover very well and fast even after an endometriosis surgery with a bowel resection. Therefore, if you are right before this type of surgery, be optimistic, maybe you are one of them. And if not, remember the above words and recommendations, hold on a little and remember others have gone through hell too, just like you, and succeeded to find the way out.
Resources or scientific links that certify what I am telling in the article