Navigating Symptoms: Endometriosis or Other Issues?
Greetings! I’m a 30-year-old female weighing approximately 185 pounds. I've been shedding some pounds, thanks to my ongoing use of semaglutide for more than a year, maintaining the same dosage for at least the past six months. In addition, I’m prescribed diamox, metformin, qulipta, along with a couple of psychiatric medications; the only adjustment to my prescription has been with latuda, fluctuating between doses of 60, 40, and then back to 60. Earlier this year in April, I underwent a laparoscopy, which identified minor lesions of endometriosis close to my bladder. My surgeon performed ablation on these lesions; however, they didn’t evaluate my bladder, determine the stage of the endometriosis, nor conduct a biopsy, leaving me uncertain about the severity of my condition. Lately, I've been experiencing intermittent pelvic cramps, significant bloating that can be quite painful, lower back discomfort, alternating episodes of diarrhea and constipation, and bouts of nausea. In the last month, I’ve dealt with two urinary tract infections for which I’ve taken antibiotics, yet the symptoms persist. Although my urine culture returned negative, there were signs of red blood cells in my most recent test. I find myself urinating four to five times each bathroom visit, with only a few minutes before the urge returns. Currently, I have a Mirena IUD and I’m not pregnant. I will be consulting with a new gynecologist in September about these distressing symptoms, though I can't shake the feeling that it might just be irritable bowel syndrome (IBS), which often feels out of my control. It’s odd how abruptly these issues have surfaced, leaving me uncertain about my next steps. I’ve contemplated reaching out to a gastroenterologist for an appointment, but I hesitate to undergo extensive testing only to find out I’m lactose intolerant or have IBS—conditions I could manage myself to some extent. Despite significantly reducing my dairy intake, the discomfort persists. Additionally, I have a diagnosis of celiac disease. I’m hoping to gain some clarity on whether there are particular paths I should explore, specialists I ought to consult, or specific tests I should consider. Any guidance would be appreciated! Thank you!
Answers (1)

8/25/2025, 10:53:48 PM
OpenHealth AI
It's understandable to feel uncertain and distressed given your symptoms and medical history. The interplay between endometriosis, gastrointestinal issues, and urinary symptoms can be complex. Your symptoms, including pelvic cramps, bloating, changes in bowel habits, and urinary urgency, could be related to several conditions, including ongoing effects of endometriosis, IBS, or recurrence of bladder issues.
Explanation
Endometriosis can cause abdominal and pelvic pain, and its presence near the bladder may contribute to urinary symptoms. Meanwhile, IBS can lead to various gastrointestinal symptoms, such as alternating diarrhea and constipation. The presence of frequent urinary urgency could also suggest a bladder-related issue, possibly exacerbated by the endometriosis or recurrent infections, especially considering the red blood cells in your urine.
Next Steps
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Track Symptoms and Triggers: Start keeping a detailed diary of your symptoms, noting the severity, triggers (like certain foods), and their relation to your menstrual cycle. This will help identify patterns and guide discussions with your new specialists.
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Consult Your New Gynecologist: During your upcoming appointment in September, openly discuss your symptoms, particularly pelvic pain and urinary issues. Request a thorough evaluation, including possible imaging or a review of endometriosis in relation to your bladder.
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Consider Gastroenterology Evaluation: Since you have experienced significant gastrointestinal symptoms, scheduling an appointment with a gastroenterologist could provide clarity. Express your concerns about IBS and any eating patterns that might be causing discomfort. They may suggest tests such as a colonoscopy or specialized tests for IBS.
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Review Medications: Discuss with your healthcare provider whether any medications, including those for psychiatric conditions, could contribute to your gastrointestinal or urinary symptoms.
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Dietary Management: Given your diagnosis of celiac disease, ensure strict adherence to a gluten-free diet, and consider working with a dietitian who specializes in IBS and celiac disease to explore dietary choices and further reduce discomfort.
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Hydration and Self-Care: Stay well-hydrated, as dehydration can exacerbate gastrointestinal and urinary issues. Gentle exercise and stress-relief techniques, like yoga or mindfulness, may help alleviate some of your symptoms.
By systematically approaching these aspects, you can gain better insight into managing your symptoms and determining the best course of action for your health. Stay hopeful; with the right support and management, you can work towards feeling better. Let me know if you have further questions!
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