Relation of endometriosis and neuromuscular disease of the gastrointestinal tract: new insights.
OBJECTIVE
To investigate the neuromuscular activity of the gastrointestinal tract by antroduodenal manometry in women with endometriosis documented by laparoscopy, to assess the effects of diet and drug therapy on symptoms, and to assess the bacterial overgrowth that is commonly associated with these nerve diseases.


METHODS
Prospective, open-label study.


METHODS
A clinical center for the care of women's health.


METHODS
Fifty women with endometriosis documented by laparoscopy and gastrointestinal tract symptoms characterized by chronic abdominal pain, nausea, vomiting, early satiety, bloating and distention, and altered bowel habits.


METHODS
Motility of the gastrointestinal tract was recorded and bacterial overgrowth was assessed. Treatment consisted 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).


RESULTS
All 50 women showed a characteristic motility change (ampulla of Vater-duodenal wall spasm, a seizure equivalent of the enteric nervous system). Forty of the women showed bacterial overgrowth. There was a significant reduction in the total symptom score after 8 weeks of treatment.


CONCLUSIONS
This study suggests that endometriosis and gastrointestinal tract symptoms are a result of the dysfunction of hollow organs. Correction of the biochemical imbalance of the eicosanoid system and the hypersecretion of insulin that results from excessive intake of glycemic carbohydrates and lack of essential fatty acids significantly decreases symptoms in patients with endometriosis and associated neuromuscular disease of the gastrointestinal tract.
Mathias
J R
JR
Woman's Hospital of Texas, Houston 77054, USA.
Franklin
R
R
Quast
D C
DC
Fraga
N
N
Loftin
C A
CA
Yates
L
L
Harrison
V
V
D000328:Adult; D002998:Clonazepam / Q000627:therapeutic use; D004032:Diet; D004715:Endometriosis / Q000178:diet therapy / Q000188:drug therapy / Q000503:physiopathology*; D015525:Fatty Acids, Omega-3 / Q000378:metabolism; D005260:Female; D018755:GABA Agonists / Q000627:therapeutic use; D005767:Gastrointestinal Diseases / Q000178:diet therapy / Q000188:drug therapy / Q000503:physiopathology*; D005769:Gastrointestinal Motility / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D006859:Hydrogen; D010535:Laparoscopy; D008365:Manometry; D016065:Myoelectric Complex, Migrating / Q000502:physiology; D009468:Neuromuscular Diseases / Q000178:diet therapy / Q000188:drug therapy / Q000503:physiopathology*; D011963:Receptors, GABA-A / Q000187:drug effects / Q000502:physiology
D015525:Fatty Acids, Omega-3; D018755:GABA Agonists; D011963:Receptors, GABA-A; D002998:Clonazepam; D006859:Hydrogen