THE MOST COMMON DISEASE YOU HAVE NEVER HEARD OF!!!!!!

Hey everyone! March is ENDOMETRIOSIS awareness month, so it's an opportunity to inform you about this disease!

Endometriosis is a gynecological condition, in which the endometrial-like tissue is found outside of the uterus in other parts of the body! It's a serious pathological condition with unbearable pains.

It is one of the most common diseases in women, but it is still unknown! It affects an estimated one in ten women during the reproductive years.

The diagnosis is difficult, that's why women in rare cases can lead to organ failure or death.

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HISTORY OF PATHOLOGY!

The first scientist who identify the condition of endometriosis (named as 'adenomyoma'), using histologic parameters of endometrial structure and activity was Thomas Cullen, in 1880.

John Sampson was the first who described Cystic ovarian endometriosis, in 1921. Because of endometriosis in women without a uterus the metaplasia theory was proposed. This theory tells that endometriosis are normal cells in an abnormal environment, but it fails to explain why progression occurs in some women only or why endometriosis is heriditary.

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In 1986 Janssens described the non pigmented subtle endometriosis.

In 1989 Cornille and Koninckx wrote an article about deep endometriosis.

Until today specialists don't know the real cause of endometriosis. There are many theories. Some of them are:

1. Retrograde Mestruation.
   Menstrual blood containing endometrial cells, flows back trough the fallobian tubes and into ovaries or into pelvic cavity. Then the endometrial cells stuck to the surfaces of pelvic organs(ovaries, behind of uterus, fallobian tubes, at the intestine, in the kidneys, in the urine system and in some rare cases can be filtered to the lungs or the brain), where they feeded from the blood, grow and continue to bleed each menstrual cycle.

2. Transformation of peritoneal cells.
   For some pathological reasons(genetic or epigenetic changes), endometrium is created in other organs of the abdomen. Those changes are causef by accident during cell division or by toxins or by mutagenic factors as radiation or viruses.

3. Immune System disorder.
   The immune system is unable to recognize and destroy endometrial tissue in other places in the body.

4. Haematogenic and lymphogenic spread.
   Haematogenic spread explains the occurence of endometriosis in the lung and on pleura. Indeed endometrial cells are found in 50% of the patients with endometriosis in the lymph nodes.

Clinically, endometriosis should be considered as three different pathologies.

1. Typical.
2. Cystic Ovarian.
3. Deep Endometriosis.

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SYMPTOMS

▪Painful Periods.
Cramping and pelvic pain. Sometimes begin before the period and extend several days into the period. Most of the times the pain is so strong that finally leads to vomiting. It may also cause lower back pain and abdominal pain.

▪ Pain during sex.
Either because the bladders are pressed or because all the organs are glued together and moving together.

▪ Pain with bowel movements or urination.
When there are cysts outside or inside of the intestines or at the urinary system.

▪ Excessive bleeding.
Cysts are also bleeding at the period

▪Infertility.
Up to 50% of women with endometriosis are infertile.
The tubes can become damaged or blocked and the ovaries often contain cysts of endometriosis and may become adherent to the uterus, bowel or pelvic side wall. Any of these anatomic distortions can result in infertility.

▪Fatigue.

▪Diarrhea.

IRRITABLE BOWEL SYNDROME(IBS): A COMMON ENDOMETRIOSIS MISDIAGNOSIS

IBS is a relatively common disorder that affects the colon. Many of the symptoms of IBS are similar to those of bowel endometriosis, such as diarrhea, consyripation, bloating, cramping and abnormal pain.

DIAGNOSIS

1. Pelvic Examination.
   The gynecologist feels with his finger areas in the pelvis for abnormalities, such as cysts.

2. Ultrasound.
   It can identify cysts in the uterus and in ovarians.

3. Magnetic Resonance Imaging(MRI).
   It is useful when further characterization of the adnexal mass is required.

4. Laboratory test CA-125.
   CA-125 is a marker of malignancy in the genetic system. It's not specific marker for endometriosis.

5. Laparoscopy.
   It is the gold standard for the diagnosis of endometriosis. During a laparoscopy, a small telescope (laparoscope) is inserted into the abdomen to look directly at the internal tissue.

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THE CLINICAL CONSEQUENCES

Endometriosis is not a recurrent disease. If removed completely there are no recurrences. New lesions however can develop.

Estrogens and Progestogens modulate chemotaxis and apoptosis in human endometrium and endometriotic cells and tissues. These endocrine and paracrine pathways are perturbed in women with this disease, contributing to inflammatory responses, abnormal tissue remodeling and disease persistence. Ultimately, they promote adhesion formation and the clinical symptoms of pelvic pain and infertility as above-mentioned.

TREATMENT

There is no absolute cure for endometriosis, but treatment can help with pain and infertility! It depends on how severe the symptoms are.

▪Hormones or Anti-inflammatories can help the women who wants to control the bleeding and pain. Sometimes endometriotic cysts can shrink in this way.

▪ Surgery is the only way to remove all endometriotic cysts and release scar tissue (adhesions). Αt an advanced stage is required to remove also the uterus and ovaries. More than 50% of women with endometriosis need multiple surgeries.

▪ Endo-type Diet.
Certain lifestyle choices can impact the progression of endometriosis and increase the risk of developing it.

In addition, patients should avoid foods that may promote inflammation in the body and lead to further pain progression of the disorder. These foods include:

1. Fatty foods.
2. Gluten.
3. Dairy foods.
4. Red Meat.
5. Sugar.
6. Soy.
7. Caffeine.
8. Alcohol.

It's healthy for them to eat more:

1. Fibrous food, such as fruits and vegetables.
2. Iron rich foods, like broccoli, beans and nuts.
3. Antioxidant rich foods, like spinach, berries, beetroot.
4. Selenium rich foods.
5. Food with Vitamins A, C, E.
6. Omega fatty acids.

At this video you can understand all the medical terminologies in this article.

Video Endometriosis from Nucleus Medical Media

This month we all show our support by wearing yellow!
It's time to end the silence!
I hope that more research will find the real cause of this disease and find other ways to treat all those women who suffer!

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Thank you for your attention!
If you like my post follow me and keep in touch for more scientific articles!
I am waiting for your comments!
@redqueen7

References

• Ενδομητρίωση, Ελληνική Μαιευτική και Γυναικολογία.(Endometriosis, Greek obstetrics and Gynaecology)

Internet Links:

•https://www.ncbi.nlm.nih.gov/m/pubmed/20673889/

•https://journals.lww.com/clinicalobgyn/Abstract/2010/06000/Endometriosis_and_Infertility.19.aspx

•https://www.endometriosis-uk.org/your-laparoscopy

•https://www.curejoy.com/content/ibs-common-misdiagnosis-for-endometriosis/?utm_medium=IAN10&utm_source=FBFeed&utm_campaign=FBAyurveda

•https://www.mayoclinic.org/diseases-conditions/endometriosis/symptoms-causes/syc-20354656