Which finding in history is consistent with endometriosis?

• A. A history of PID
• B. Abdominal bloating starting several days before menses
• C. Atypical Pap smear
• D. Dysmenorrhea that is unresponsive to NSAIDs

Answer: (B)

Endometriosis involves ectopic endometrial tissue that bleeds and causes inflammation in the peritoneal cavity in a cyclical pattern with the menstrual cycle. That inflammatory environment can lead to premenstrual symptoms, including abdominal bloating that starts several days before the period. So a history of abdominal bloating beginning before menses aligns with endometriosis because it reflects cycle-related inflammatory and hormonal effects on the abdomen and GI tract.

Other options point to unrelated issues (infection history like PID, a cervical screen finding, or dysmenorrhea that might occur in many conditions). While endometriosis can cause painful periods that may be hard to treat with NSAIDs, the premenstrual bloating description specifically ties to the inflammatory, cyclical nature of endometriosis.