Multidisciplinary approach is the only effective treatment

THE timely diagnosis and effective treatment of endometriosis is an important factor when it comes to the management of chronic pelvic pain and endometriosis.

This is the word from gynaecologist Dr Gary Solomon of Netcare Greenacres in Nelson Mandela Bay, Demi Puttergill's doctor.

"Endometriosis is a very real disease. Timely diagnosis and the right multidisciplinary team will help you understand and manage your chronic suffering and bring hope into your life," he said.

The chronic disease occurs when the uterine tissue grows outside the uterus. "Endometriosis is a chronic condition which results from tissue from the lining of the uterus settling and growing in areas outside the cavity of the uterus. This tissue responds to the normal hormonal changes women undergo on a monthly cycle which results in a vicious cycle of pain and suffering," he explained.

As a result, women with endometriosis suffer severe pain and heavy painful menstrual bleeding. The pain may be related to sexual intercourse, bowel and urinary function. This normally occurs cyclically but as the disease progresses, it may become constant.

He said proper treatment was needed.

"There is hope, however, depending on the patients needs and wishes. Treatment is a combination of surgery, medical hormonal treatment and supportive treatment.

"Each patient's treatment must be individualised as their needs and the extent of the disease differs," he said.

Solomon said "all females irrespective of their age are at risk of developing this disease as in the case of Demi who is 14 years old", and that it was extremely difficult to manage for a number of reasons:

• A delay of approximately five years before getting a medical opinion. This was often because patients were not aware of what was normal and what was not. Adolescents are often told by their family that their period pains are "normal" or that "women are born to suffer like we all did"! However, this is "absolutely not true".

• A delay of five or more years before a definitive diagnosis, which is also often due to lack of awareness and understanding of endometriosis even by medical personnel.

• Pain and suffering consumes their lives as the disease progresses. Endometriosis is often associated with depression, absenteeism, loss of employment and marital discord with a loss of quality of life.

• There is often pain killer overuse which starts a vicious cycle of bowel symptoms which may be diagnosed as irritable bowel syndrome. These patients tend to bleed more than usual which aggravates the problem.

• Management of the disease depends on the patient's specific problems, age and fertility desire, so there is no one treatment applicable to all.