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Focusing on pelvic pain in women
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And in half of cases, pelvic pain has multiple sources, said Hage, speaking at a seminar last week sponsored by Redlands Community Hospital.
The pain sources, Hage said, break down as follows:
Urologic - 30 percent
Gastrointestinal - 30 percent
Gynecological - 20 percent
Musculoskeletal - 15 percent
Psychological - 5 percent
Endometriosis is a common denominator among many cases. Irritable bowel syndrome, inflammation of the bladder, are also fairly common, said Hage, who is an OB/GYN surgeon at Redlands Community Hospital.
Endometriosis is growth of the type of tissue that lines the uterus also growing on the outside of the uterus, including around the abdomen and pelvis.
"Growth of these tissues on the outside of the uterus can result in painful periods, severe cramps, chronic pelvic pain as well as other symptoms, including urinary and gastrointestinal, depending on the severity of the disease," Hage said.
In diagnosis of the chronic pain, it's important to rule out cancer as a possible cause early in the search, as outcomes improve the quicker cancer treatment begins, he said.
In cases where musculoskeletal cases are suspected, Hage said he may refer a patient to a physical therapist.
Karen Branden, a Loma Linda-based physical therapist specializing in women's health issues, said that particularly in older women, pelvic pain can be traced to the relaxation of muscles, which results in more weight being borne on internal organs.
But that can happen in young women as well, she said.
"They literally rest their weight on the ligaments," she said.
In cases where pain has a psychological cause, 50 percent of the patients have a history of being abused, either sexually, physically or verbally, Hage said.
Where surgery is required to solve the problem, Hage said he will often recommend using the da Vinci robotic system.
The machine helps Hage and other surgeons perform major operations with incisions of minimal size, reducing blood loss, pain, length of hospital stay and shortens the recovery time of when the patient can return to normal activities.
Additional information:
Alternative Treatment for Endometriosis Information
Endometriosis : Learn About Endometriosis Symptoms, Treatment , & More
Endometriosis - treatment options - Better Health Channel.
Endometriosis : Treatments and drugs - MayoClinic.com
Endometriosis : Treatment & Medication - eMedicine Pediatrics: Surgery
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