# Endo

## Symptoms
* extreme and painful quantities of gas after eating
* painful movement of stool through the bowels
* very bloated lower abdomen (iileum?)
* pain while urinating around menstruation, and sometimes when bloated--this is relieved instantly by massaging the pelvis (bladder?) very deeply. Feels like I'm releasing adhesions...but this has to be repeated monthly at least (maybe twice during menstruation)
* sigmoid colon (?lower left part of descending colon) feels tender, and massaging is also feels a bit better, like massaging the lower pelvis. (maybe due to impacted feces in december it's more sensative?)
* rectal prolaps? I have something that pokes out after I try to defecate--noticed it in July 2018; I did a lot of walking and it hurt, researched and learned that if it's not severe doctors will recommend just pressing it back in. So I did that, and continue to do so; it becomes more noticable when I have so much gas and the feeling that I need to have a bowel movement though (I worry that I'm making it worse just by sitting on the toilet, as it pops out without straining.)
* stopped eating because of the pain; still had a lot of gas (probably from a snack the night before)--but it passed along with with some sort of 'gel'. Almost colorless (after drinking two glasses of water). I have never ever had blood in my stool, which I see mentioned a lot with this.
* "bowel specialist says that what she tends to see is the endo creating a kink in the colon, so it's a sharp bend and also thinner which gets worse every month when the endo is swollen" https://www.reddit.com/r/Endo/comments/bm5ovk/scared_i_may_be_developing_endo_on_my_bowels_what/
* before this month (July) I usually had constipation or...at least a backup of faeces, usually would not be hard when it finally passed...right before/with my period (as well as excessive gas). Based on this might be important: https://www.reddit.com/r/endometriosis/comments/b73gti/what_are_your_bowel_symptoms_with_endo/ejprg40?utm_source=share&utm_medium=web2x&context=3
> bowels were being pulled out of alignment by endo scar tissue. I had it in a bunch of places including blocking my left ureter (almost lost that kidney due to that) and a “mass effect” in the cul-de-sac/Pouch of Douglas/low point in the pelvic area where this stuff can accumulate. So te bowel issue was one of the many things fixed in my 2nd but proper lap with excision!

After going to the ER in December due to bowel backup (that felt as bad as the twisted ovary; I was pretty close to passed out on the floor,) I've had more digestive pain and discomfort, particularly bad are times when I feel like I have to defecate constantly.

I want to
1. learn if the pain is due to endo growth on the bowel, and if so where, how bad (I perfer to try without surgery, but if it's growing through the bowel of course I want to stop it bfore it gets too bad)
2. and/or if there are adhesions from the previous surgery which cause pain?

insulin + endo relationship?
hormone IGF-1, produced by macrophages, is higher in mice with endometrosis: https://theconversation.com/research-check-have-scientists-found-the-cause-of-endometriosis-120665
"endo on my ligaments around my uterus, which can exacerbate bowel symptoms apparently" https://www.reddit.com/r/Endo/comments/enjtmv/endo_sufferers_with_bowel_symptoms_need_advice/

## Treatments

* chinese med Gui-Zhi-Fu-Ling-Wan (some studies, might reduce lesions?)
* systemic enzymes (reduce scar tissue and adhesions?)
* Bromelain
* serrapeptase
* Nattokinase
* deep massage to get rid of scar tissue/adhesions (add details)
* N-acetyl-cysteine to shrink endo? (need to research+ read https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3662115/)
* turmeric (with black pepper) -- how much to have any effect? mechanism is reducing estrogen or...? (if estrogen then there are probably more effecive ways) https://www.sciencedirect.com/science/article/abs/pii/S0753332217346838 < paywall; according to <https://thedietologist.com.au/popular-supplements-for-endometriosis/>: '[reduces] inflammation, reducing vascularization of the tissue, stopping these endometriosis cells proliferating.'
* Bowel endo specialist http://endopaedia.info/subtype2.html
* surgons, techniques to avoid adhesions after https://www.reddit.com/r/Endo/comments/6pfk0p/has_anyone_had_diagnosed_endometriosis_in_the/dpjirrr?utm_source=share&utm_medium=web2x&context=3
* Is it possible to get access to trials? this seems to work: "Transrectal high-intensity focused ultrasound (HIFU) for management of rectosigmoid deep infiltrating endometriosis" https://pubmed.ncbi.nlm.nih.gov/31788875/
* Same thing, with a specific brand: "HIFU With Focal One® of Posterior Deep Infiltrating Endometriosis Lesions With Intestinal Involvement"
https://ichgcp.net/clinical-trials-registry/NCT03613298
* No difference in results from surgery, except(!) no scarring (thus no adhesions...) https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/1471-0528.14737
* clinical trials of HIFU? lists "University Medical Center Utrecht" as having this treatement available -- how to find out? https://www.fusfoundation.org/diseases-and-conditions/womens-health/endometriosis-uterine
* ECGC shows a lot of promise https://academic.oup.com/humrep/article/29/8/1677/2913977?login=true

Current Treatment
* paracetemol (and previous surgery)
* Fasting
* From july 30, intermittent fasting + systemic enzymes
* from August 6 dry fasting for 5 days
* August 12 till now, 3-4 serrapeptase, 1 nattokinase, 1 'super enzyme' pill with a mix of others, two times a day.
* From Aug 28, ECGC from a source that rigourously tests their entric coating + add piperine (hopefully the combo is enough to make it as effective as injections used in studies). 1 500mg pill per day.
* From Aug 28, 600mg N-acetyl-cysteine 3 times a day, three days per week (following the reasoning from this study as https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3662115/)
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