The association between body mass index (BMI) and the severity of endometriosis, pelvic pain, and frequency of gastrointestinal symptoms in patients with endometriosis

• No correlation was found between BMI and endometriosis severity, pelvic pain severity, or gastrointestinal symptoms in our study. • Constipation and dyschezia were the most common gastrointestinal symptoms among endometriosis patients. • Gastrointestinal symptoms, especially constipation, were more prevalent in severe stages of endometriosis, highlighting the need for focused management of these symptoms in advanced cases. Previous studies on the relationship between body mass index (BMI), endometriosis severity, and pelvic pain have reported conflicting results. While some indicate an inverse association between BMI and disease incidence, others suggest a direct link with disease severity. The relationship between BMI and gastrointestinal (GI) symptoms in endometriosis remains unclear. This study aimed to assess the association between BMI, endometriosis severity, pelvic pain, and the prevalence of GI symptoms. This retrospective cross-sectional study reviewed records of women diagnosed with endometriosis at Avicenna Infertility Clinic and a gynecologist’s office between 2015 and 2022. Data on BMI, pelvic pain severity, GI symptoms, and laparoscopic findings were extracted and analyzed using SPSS. Data from 258 patients were analyzed. BMI and pelvic pain did not differ significantly between mild/moderate and severe endometriosis (P = 0.18 and P = 0.24). GI symptoms were more frequent in severe cases, with constipation being the only symptom showing a significant difference (P < 0.01). Constipation and dyschezia were the most common GI symptoms overall, while nausea/vomiting was reported only in severe cases (5.2%). BMI showed no significant correlation with GI symptoms or pelvic pain severity. BMI was not associated with endometriosis severity, pelvic pain, or GI symptoms. Constipation and dyschezia were the most prevalent GI complaints, and constipation was significantly more common in severe stages of endometriosis.