Helpful strategies to put an end to endometriosis

Endometriosis specialist and surgeon Dr. Brooke Thigpen is bringing new awareness to the complexity of this painful disease and what patients need to know today to get relief.

In a recent webinar hosted by the Endometriosis Foundation of Houston, Thigpen and Baylor Medicine colorectal surgeon Dr. Punam Amin discussed endometriosis surgery and why a multidisciplinary approach matters.

“One of the most important things to recognize about endometriosis is that it can involve so many different organ systems,” said Thigpen, a part of the Endometriosis Center at Baylor College of Medicine and an excision surgeon with expertise in removing tissue impacted by endometriosis.

“At our center, we see patients with classic, broad symptoms, from pelvic pain to painful periods. We see gastrointestinal symptoms like bloating or painful bowel movements. We see bladder symptoms such as painful urination or frequent urination.”

“That’s what makes diagnosis so difficult – and treatment so complex.”

So, what can patients do?

Get diagnosed by an endometriosis specialist.

“By the time patients get to us, they’ve often been to different specialists but still don’t know what’s causing their symptoms,” Thigpen said. “The Endometriosis Center was created to provide the answers patients need and the specialty care endometriosis requires.”

“For example, the majority of my patients have GI symptoms. That can be bloating, nausea with their cycle, pain with bowel movements, constipation or diarrhea. Those symptoms can happen because endometriosis is causing inflammation in the pelvic cavity that is irritating the bowel, versus endometriosis being directly on the bowel,” Thigpen explained.

Have specialized diagnostic testing.

To diagnose the extent of the disease, patients undergo an endometriosis MRI – an MRI of the pelvis that uses IV contrast, she explained. “We also use a vaginal and rectal gel for improved contrast, helping us identify endometriosis in surrounding organs such as the bowel or bladder.”

“Our radiologists are really cued in on what to look for, compared to those who aren’t reading endometriosis MRIs regularly. We also meet monthly with our radiologists to review cases and compare MRI findings with surgery findings to continually improve the detection of lesions preoperatively.”

Consider your treatment options.

Treatment at the center may start with simple management strategies. “Patients can try birth control pills or hormones to help manage their symptoms. Unfortunately, many times they don’t respond well or relief is temporary,” noted Thigpen. Ultimately, these patients require surgery.

“We perform a technique called endometriosis excision surgery to remove the endometriosis lesions, using the Da Vinci robotic system for better visualization and more precise dissection,” Thigpen said.

Choose a center with a multidisciplinary approach.

Endometriosis surgery is even more challenging when other organs are involved. “When endometriosis lesions are on the bowel or bladder, we rely on our Baylor Medicine colorectal or urology colleagues to help us treat these complex cases surgically,” Thigpen said. “Together, we plan and perform a combined surgery with the goal of completely removing the patient’s endometriosis while preserving or improving fertility whenever possible.”

Ensure your surgeon is an excision surgery expert.

“Consult with an expert – someone focused on treating endometriosis every day,” she advised. “Make sure your surgeon is not only fellowship trained in minimally invasive gynecologic surgery but also extensively trained in excision surgery.”

Participate in pelvic floor physical therapy.

“Pelvic floor physical therapy is a big part of treatment. In patients with endometriosis, the pelvic floor muscles are chronically contracted or tightened in response to the chronic pain. Over time, that can worsen your endometriosis pain. Pelvic floor therapy can help retrain your muscles and relax the tightness, reducing your pain,” Thigpen said.

Help find a cure.

“Research is underway both here at Baylor and across the country,” responded Thigpen. “Today, Baylor researchers are studying endometriosis tissue samples to better understand the disease at a cellular level, the first step in developing medication specific to the disease.” Patients can also help find a cure by participating in and supporting endometriosis research.

Make an appointment.

To schedule an appointment at the Endometriosis Center, call 832-826-7500. To make a referral, visit the Baylor College of Medicine Obstetrics and Gynecology website.

By Sharon Dearman, a writer with the Department of Obstetrics and Gynecology