[Holistic treatment of endometriosis].

IF 1.1 4区 医学 Q3 ANESTHESIOLOGY Schmerz Pub Date : 2023-12-01 Epub Date: 2023-08-25 DOI:10.1007/s00482-023-00747-0
Sylvia Mechsner
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Abstract

Background: The pain phenomena caused by endometriosis are manifold. In addition to nociceptive pain there is also a nociplastic reaction with central sensitization. Atypical symptoms, such as acyclic lower abdominal pain, radiating pain, nonspecific bladder and intestinal complaints or even depression increasingly occur in addition to the classical cyclic complaints, such as severe dysmenorrhea, cyclic lower abdominal pain, dyspareunia, dysuria and dyschezia. Due to the diffuse range of symptoms, affected patients often consult not just gynecologists but also specialists from other disciplines (internal medicine, gastroenterology, orthopedics, pain therapy, psychology etc.).

Objective: The complexity of endometriosis is presented. The resulting approaches to multimodal interdisciplinary holistic treatment are described.

Results: Interdisciplinary concepts should be involved in the optimal treatment of endometriosis patients along with hormonal and surgical treatment, mostly under the supervision of a gynecologist and pain management, dietary changes, psychological support and physiotherapeutic management should also be included. This article provides an overview of possible treatment strategies for chronic symptomatic endometriosis.

Conclusion: Based on multimodal treatment strategies and regarding the complex pathophysiological alterations of this disease, the complex complaints that significantly impair the quality of life of endometriosis patients can be greatly improved.

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【子宫内膜异位症的整体治疗】。
背景:子宫内膜异位症引起的疼痛现象是多种多样的。除了伤害性疼痛外,还有中枢致敏的伤害性反应。非典型症状,如严重痛经、周期性下腹痛、性交困难、排尿困难、精神障碍等经典周期性主诉之外,越来越多地出现非周期性下腹痛、放射性疼痛、非特异性膀胱和肠道主诉甚至抑郁等非典型症状。由于症状的广泛性,受影响的患者通常不仅要咨询妇科医生,还要咨询其他学科的专家(内科、胃肠病学、骨科、疼痛治疗、心理学等)。目的:介绍子宫内膜异位症的复杂性。描述了由此产生的多模式跨学科整体治疗方法。结果:子宫内膜异位症患者的最佳治疗应涉及跨学科的概念,除了激素和手术治疗外,主要是在妇科医生的监督下,疼痛管理,饮食改变,心理支持和物理治疗管理也应包括在内。本文综述了慢性症状性子宫内膜异位症的治疗策略。结论:针对子宫内膜异位症复杂的病理生理改变,采用多模式治疗策略,可显著改善严重影响患者生活质量的复杂主诉。
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来源期刊
Schmerz
Schmerz 医学-临床神经学
CiteScore
2.00
自引率
20.00%
发文量
64
审稿时长
6-12 weeks
期刊介绍: Der Schmerz is an internationally recognized journal and addresses all scientists, practitioners and psychologists, dealing with the treatment of pain patients or working in pain research. The aim of the journal is to enhance the treatment of pain patients in the long run. Review articles provide an overview on selected topics and offer the reader a summary of current findings from all fields of pain research, pain management and pain symptom management. Freely submitted original papers allow the presentation of important clinical studies and serve the scientific exchange. Case reports feature interesting cases and aim at optimizing diagnostic and therapeutic strategies. Review articles under the rubric ''Continuing Medical Education'' present verified results of scientific research and their integration into daily practice.
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