الفهرس 
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Abstract
Endometriosis is defined as “the presence of endometrial-like tissue (glands and stroma) in ectopic locations, primarily the pelvic peritoneum, ovaries, and rectovaginal septum, which induces a chronic inflammatory reaction, scar tissue, and adhesions that may distort a woman’s pelvic anatomy”. The overall prevalence of endometriosis among the general population is estimated to be between 6% to 10% of all the women in reproductive age. Several theories have been proposed in effort to explain the disparate observations related to endometriosis pathogenesis, including the retrograde menstruation theory, metaplasia-based theory, hormonal theory, and immune dysfunction.
The revised American Society of Reproductive Medicine Classification (rASRM), which incorporates a variety of factors in order determine the stage of endometriosis. These factors include the size of the endometriotic lesions in the ovaries, peritoneum, and fallopian tubes, and the severity of adhesion at each of the aforementioned sites. The symptoms of endometriosis do not always correlate with the laparoscopic results. Although more severe clinical findings commonly correlate with more advanced rASRM stage, less severe clinical manifestation isn’t always suggestive for early stage disease. Typically, endometriosis patients present with either pelvic pain, infertility, or both. In 20–25% of the cases, the patients remain totally asymptomatic.
Initial diagnosis of endometriosis is typically made clinically based on the obtained history. Most patients with endometriosis present with totally normal physical examination. However, clinical examination is far from being diagnostic for endometriosis. Other causes of pelvic pain remain to be ruled out. Frequently ordered laboratory studies include urinalysis, Pap smear, pregnancy test, vaginal and endocervical swabs. Pelvic ultrasound scans are performed to facilitate diagnosis of an endometrioma, fibroids and ovarian cysts. The gold standard for confirming the diagnosis of endometriosis is laparoscopic inspection with histologic confirmation after biopsy. Obtaining the rASRM stage may also be achieved through the laparoscopic evaluation.
Inflammatory bowel disease (IBD) is a well-documented chronic inflammatory disease of the gastrointestinal tract. Clinically, two major subtypes of IBD are identified. These two subtypes are Crohn’s disease (CD) and ulcerative colitis (UC). The typical clinical picture of IBD is characterized by episodic abdominal pain, diarrhea, and bloody stools. Other features of IBD include apparent weight loss, mucosal inflammation, presence of blood-loss anemia, fistulas, and ulcers. Fistulas are more common than ulcers in CD. The incidence and prevalance of IBD increased over the last decades of 20th century. The cause of IBD remains unknown, but theories suggesting several possible factors linked to its pathogenesis. CD attacks typically present recurrently with watery diarrhea, abdominal pain, and fever. More advanced disease may also disrupt large enough mucosal surface that lipid absorption is troubled and steatorrhea is reported. Clinical findings alone can only be suggestive for CD. Diagnostic methods, however, include a variety of tools. Utilization of radiological imaging, endoscopic assessment, and pathology reports are crucial or confirming diagnosis of CD.
Calprotectin is mainly produced by neutrophils. It plays a role in the innate immune response. The concentration of calprotectin increases in settings of inflammation. Fecal calprotectin can serve as a marker gastrointestinal inflammation.f