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When it’s not deep endometriosis—bowel dysmotility in a patient with endometriosis: A case report and review

Background: Patients who present to a gynecologist often describe concurrent bowel symptoms, which may or may not be related to their gynecologic diagnosis. Despite the common association of these symptoms with gynecologic diseases, such as deep endometriosis, these symptoms may also be caused by non-gynecologic conditions, including primary chronic constipation. Objective: To outline the principle of diagnostic bias and educate gynecologists on the topic of primary chronic constipation. Methods/results: We present the case of a 38-year-old woman with chronic pelvic pain and constipation. She was diagnosed with primary chronic constipation in the setting of deep endometriosis affecting the bowel, and managed surgically, leading to great improvement in her quality of life. Conclusion: Gynecologists should consider alternative non-gynecologic conditions when formulating their differential diagnosis of patients presenting with bowel symptoms.