How do we evaluate painful bowel movements in endometriosis?

We start by mapping your symptoms carefully—when pain happens in relation to your cycle, whether it’s with passing stool or with rectal pressure, and whether you also have constipation, diarrhea, bloating, or pelvic and urinary pain. That history helps us separate patterns that can fit endometriosis or adenomyosis from other common gastrointestinal causes, and it guides what we look for on exam.

When appropriate, we perform a focused pelvic exam and may recommend targeted imaging such as ultrasound and/or MRI to evaluate for adenomyosis and signs of deeper endometriosis, including disease that can involve the bowel. It’s important to know that normal imaging does not rule out endometriosis, especially superficial disease, so we interpret results in the context of your symptoms. If your presentation suggests overlapping GI conditions or you have concerning features, we may coordinate additional evaluation alongside gastroenterology while we complete a comprehensive pelvic assessment; you can reach out to schedule a consultation with our team to review your symptoms and next steps.