Uterine fibroids are non-cancerous growths that develop in or around the uterus, also known as the womb. They are made up of muscle and fibrous tissue, and their sizes can vary from as small as a pea to as large as a melon. While many women with fibroids experience no symptoms, some do, and a common concern is whether these growths can affect bowel function. Uterine fibroids can cause bowel problems.
Understanding Fibroids and Their Location
Uterine fibroids are benign tumors that frequently arise in women during their reproductive years. Their impact depends on their size, number, and precise location within or on the uterus. Fibroids can grow in the muscle wall (intramural), just under the uterine lining (submucosal), or on the outside surface (subserosal). When fibroids grow on the back of the uterus, particularly subserosal fibroids, or become very large, they can exert pressure on nearby organs like the colon and rectum.
Bowel Symptoms Linked to Fibroids
Fibroids can manifest in various bowel-related symptoms, often due to their proximity to the digestive tract. Constipation is a frequently reported symptom, where fibroids pressing on the colon or rectum can impede the normal passage of stool. This pressure can also lead to a feeling of incomplete bowel evacuation, even after a bowel movement.
Bloating and increased gas can occur, as fibroids may disrupt gas movement. Painful bowel movements or a general feeling of rectal pressure or discomfort can also occur. Less commonly, fibroids might lead to changes in bowel habits such as diarrhea or alterations in stool caliber.
Mechanisms of Bowel Disruption
The primary way fibroids disrupt bowel function is through direct mechanical pressure. Large fibroids, particularly those located on the posterior wall of the uterus, can press against the rectum or colon. This compression can obstruct or slow down the movement of stool through the intestines, leading to constipation and difficulty with evacuation.
Large fibroids can also alter the normal pelvic anatomy, potentially causing kinking or narrowing of parts of the bowel. They may also compress nearby nerves that supply the bowel, which can result in altered sensation or function.
Fibroids can also cause localized inflammation, which might indirectly affect bowel motility and contribute to digestive discomfort. Changes in blood flow within the pelvic region due to fibroid pressure on blood vessels can also impact the gastrointestinal tract, leading to symptoms like bloating or altered bowel habits.
Seeking Diagnosis and Treatment
If you are experiencing persistent or worsening bowel symptoms, especially when accompanied by other fibroid indicators such as heavy menstrual bleeding or pelvic pain, seek medical consultation. A healthcare provider can conduct a pelvic exam and may order imaging tests like an ultrasound or MRI to diagnose fibroids and differentiate fibroid-related bowel issues from other potential causes.
Treatment for fibroids often leads to the resolution or significant improvement of associated bowel symptoms. For mild symptoms, watchful waiting might be recommended. Certain medications can be prescribed to manage symptoms or temporarily shrink fibroids.
Minimally invasive procedures like uterine fibroid embolization (UFE), which blocks the blood supply to the fibroids, or myomectomy, the surgical removal of fibroids while preserving the uterus, are also options. In some cases, a hysterectomy, which involves removing the uterus, may be considered, especially for very large fibroids or severe bleeding. While awaiting treatment, dietary changes, such as increasing fiber intake and drinking plenty of water, can help manage constipation, but these measures do not address the underlying fibroids.