Adenomyosis often comes with many unpleasant symptoms. This includes bloating, colloquially known as “adenomyosis belly”. This blog aims to answer the question – why does bloating occur with adenomyosis?
A bit of a recap – adenomyosis is a uterine condition. It occurs when endometrial tissue grows in the muscle wall of the uterus (myometrium), and uterine walls. Key symptoms include heavy bleeding (heavy periods), sometimes abnormal menstrual bleeding, pelvic pain, pain during menstruation, painful intercourse and an enlarged uterus. This enlarged or bulky uterus often causes a feeling of uterine heaviness, or abdominal pressure. At the time of writing this blog, the only cure for adenomyosis is a hysterectomy (removal of the uterus). It can take people many years to get an accurate diagnosis of adenomyosis or endometriosis. It can be diagnosed via TVUS (transvaginal ultrasound) or MRI (magnetic resonance imaging), which should be carried out by medical professionals well-trained in diagnosing this.
Read more about causes, symptoms of adenomyosis and treatment for adenomyosis here
Bloating is common both across endometriosis, adenomyosis and irritable bowel syndrome (IBS). The larger uterus can put pressure on the surrounding organs. This includes the digestive system and bladder. This leads to the symptoms of constipation or diarrhoea, added abdominal discomfort, and frequent urination. The exact cause of bloating in adenomyosis is unknown, however there are a few theories that aim to explain why this occurs.
Adenomyosis can cause chronic inflammation in the uterine tissues. Inflammation can lead to the release of certain chemicals and substances that affect the gastrointestinal tract, causing bloating. A specific one of these are prostaglandins. Prostaglandins are inflammatory compounds that act like hormones in the body. These are released an various points in the menstrual cycle, and during labour. These assist with the shedding of the uterine lining during periods, help with ovulation, and contractions in labour. Having adenomyosis, an inflammatory condition increases the amount of circulating prostaglandins. Prostaglandins are involved in the contraction and relaxation of smooth muscle (the type of muscle in the uterus and bowels). When prostaglandin production increases, so too does symptoms such as bloating, gas, and changes to the bowels.
Adenomyosis is influenced by hormonal fluctuations, particularly oestrogen. Oestrogen levels can be higher in women with adenomyosis. Hormonal imbalances can affect the gastrointestinal system, leading to bloating and other digestive symptoms.
A key symptom of adenomyosis is a “bulky” uterus. Given that endometrial tissue grows into the muscle layer of the uterus – it makes sense! Unfortunately, this bulky, and large uterus can cause some issues with the digestive system too. Adenomyosis-related inflammation and hormonal imbalances can affect the normal function of the intestines, leading to changes in bowel movements and increased gas production. These disturbances in the gastrointestinal system can contribute to bloating.
Whilst these are horrible and inconvenient symptoms, the good news is that tailored dietary strategies can improve this significantly!
While nutrition cannot cure adenomyosis, adopting a healthy diet and making some dietary modifications may help manage bloating symptoms associated with adenomyosis, and reduce adenomyosis symptoms.
What foods to include to reduce adenomyosis bloating:
1. Eat a well-balanced diet: Focus on consuming a variety of nutrient-dense foods, including fruits, vegetables, whole grains, lean proteins, and healthy fats. A balanced diet provides essential nutrients and supports overall health, which may help reduce bloating symptoms.
2. Increase fibre intake: Adequate fibre intake promotes regular bowel movements and helps prevent constipation, which can contribute to bloating. Include fibre-rich foods like fruits, vegetables, whole grains, legumes, and nuts in your diet. It might be helpful to increase your fibre intake gradually and drink plenty of water to avoid digestive discomfort.
3. Eat smaller, frequent meals: Consuming smaller, more frequent meals rather than large, heavy meals can help prevent excessive stretching of the stomach and reduce bloating. Additionally, chewing food thoroughly and eating slowly can aid in digestion.
4. Stay hydrated: Drink an adequate amount of water throughout the day. Proper hydration can help maintain regular bowel movements and prevent constipation, which can contribute to bloating.
Foods to reduce for adenomyosis bloating:
1. Reduce salt intake: Now don’t get me wrong, I am a real salt queen myself, however excessive salt intake can cause fluid retention and worsen bloating. Limit your consumption of processed foods, fast food, and salty snacks. Instead, opt for fresh, whole foods and flavour your meals with herbs, spices, extra virgin olive oil, or lemon juice.
2. Minimize gas-producing foods: Some foods are known to produce more gas in the digestive system, leading to bloating. These may include beans, lentils, broccoli, cabbage, onions, carbonated beverages, and certain artificial sweeteners (such as xylitol, or sorbitol). Observe your body’s response to different foods. It might be helpful to record your symptoms after eating these foods, and book in to see a dietitian trained in this area, to help you manage this.
3. Avoid trigger foods: There is a strong link between those with adenomyosis or endometriosis and IBS (irritable bowel syndrome). Food intolerances or sensitivities can contribute to bloating. Common triggers include gluten, lactose, and FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols). Keeping a food diary or working with a dietitian can help identify and eliminate trigger foods from your diet.
It’s important to listen to your body and find what works best for you. If you have specific dietary concerns or require personalized advice, it’s recommended to consult with a dietitian who can provide individualized guidance based on your needs and preferences.
