Can Uterine Fibroids Cause Diarrhea?
Uterine fibroids do not typically cause diarrhea; instead, they cause constipation through posterior fibroid pressure on the rectum. 1, 2
Gastrointestinal Symptoms Associated with Fibroids
The bowel-related symptoms from uterine fibroids are specifically related to mechanical compression rather than altered bowel motility:
- Constipation is the characteristic bowel symptom caused by posterior fibroids compressing the rectum 1, 2
- Bulk symptoms from fibroids include pressure, pain, and fullness affecting the pelvis and surrounding structures 1, 3, 2
- The mechanism is direct mechanical compression of pelvic organs by enlarged fibroids 4, 5
Why Diarrhea Is Not a Fibroid Symptom
The documented symptom profile of fibroids consistently describes constipation, not diarrhea:
- The cardinal symptoms are menorrhagia, dysmenorrhea, pelvic pain and pressure, urinary urgency and frequency, and constipation 1
- Fibroids cause symptoms through increased uterine size leading to abdominal distension, urinary frequency or urgency, and constipation 5
- No major guidelines or research evidence links fibroids to diarrhea as a presenting symptom 1, 4, 5
Clinical Pitfall to Avoid
If a patient with known fibroids presents with diarrhea, investigate alternative diagnoses rather than attributing it to the fibroids. Consider:
- Coexisting gastrointestinal pathology (irritable bowel syndrome, inflammatory bowel disease, infectious causes)
- Medication side effects if the patient is on fibroid treatments
- Other gynecologic conditions that may coexist with fibroids
The presence of diarrhea in a woman with fibroids warrants evaluation for causes unrelated to the fibroids themselves, as the mechanical compression from fibroids produces the opposite effect on bowel function.