Debby come in complaining about chronic pelvic pain during her menstruation. What makes her condition worst are her untreated symptoms. The doctors she has already seen told her her pain is related to extra heavy menstruation flow and her test would come back negative. This is having an direct effect on her reproductive system, because she has been unsuccessful in conceiving. Due to the lack of research in endometriosis make it difficult to diagnosis since the symptoms are almost like other pelvic diseasea The first step with this patient to do a complete pelvic exam , also order lab s to test for cell CA-125, uterine ultrasound. Base on the finding of the test we can determine of this patient has endometriosis.
Endometriosis is a condition that affects lot of women during reproductive years. Patients ...view middle of the document...
When the endometrial cells go to other parts of the body it can cause scaring, swelling, bleeding in the wrong area. Such then the patient will experience the symptom reported such as pain during menstruation cycle. The tissue is trying to detach from the organ it attached to, then causing internal bleeding. Testing a patient for CA 125 serum can help determine the level of tissue and disease in the patient. CA 125 is a protein cell that can form tumors in the body. To rule out cancer. When the cell attach itself to inside of the body it cannot leaving the body instead it shed and acts the same way as in the uterus. Inside the uterus the cell tissue can break down and release when unused monthly, but on other tissues in the body it can scar and leave painful tissue lesions on the scars. This explains the pain the patient is complaining about is due to lesions from the scar after the tissue sheds. These lesions can developed outside the uterus in the pelvic cavity and in some cases on the bladder, bowel. Ultrasound can help diagnosing, inflammation in the pelvic outside the uterus. Doctor would consider using laparoscopy to diagnose, which can be invasive for the patient, but help create a treatment plan. Most patient are treated with hormonal drug treatment, pain treatment and surgery hysterectomy to treat endometriosis.
I had the opportunity to attend a ACOG seminar on Endometriosis. It sad to see how so many woman can go a life time of pain and never diagnosis with endometriosis. The health care providers have very little understanding of the disease. For most patient with pain in the pelvic area, surgery Laparoscopy abdomen in can be the only way to find the endo tissue scarring lesions. As a medical provider the step I would take in diagnosis a woman is taking a complete history. Offer the patient hormone treat, pain management and life style changes to help control disease progression.