RELATION OF ENDOMETRIOSIS AND NEUROMUSCULAR DISEASE OF THE GASTROINTESTINAL-TRACT - NEW INSIGHTS

Objective: To investigate the neuromuscular activity of the gastrointe stinal tract by antroduodenal manometry in women with endometriosis do cumented by laparoscopy, to assess the effects of diet and drug therap y on symptoms, and to assess the bacterial overgrowth that is commonly associated with these nerve diseases. Design: Prospective, open-label study. Setting: A clinical center for the care of women's health. Pat ient(s): Fifty women with endometriosis documented by laparoscopy and gastrointestinal tract symptoms characterized by chronic abdominal pai n, nausea, vomiting, early satiety, bloating and distention, and alter ed bowel habits. Intervention(s): Motility of the gastrointestinal tra ct was recorded and bacterial overgrowth was assessed. Treatment consi sted of dietary changes, including reduction of glycemic carbohydrates , balancing with omega 9 oils, elimination of foods with caffeine and tyramine, and addition of omega 3 fatty acids, as well as drug therapy with clonazepam (0.25 mg 3 times per day). Result(s): All 50 women sh owed a characteristic motility change (ampulla of Vater-duodenal wall spasm, a seizure equivalent of the enteric nervous system). Forty of t he women showed bacterial overgrowth. There was a significant reductio n in the total symptom score after 8 weeks of treatment. Conclusion(s) : This study suggests that endometriosis and gastrointestinal tract sy mptoms are a result of the dysfunction of hollow organs. Correction of the biochemical imbalance of the eicosanoid system and the hypersecre tion of insulin that results from excessive intake of glycemic carbohy drates and lack of essential fatty acids significantly decreases sympt oms in patients with endometriosis and associated neuromuscular diseas e of the gastrointestinal tract. (Fertil Steril(R) 1998;70: 81-8. (C)1 998 by American Society for Reproductive Medicine.).