In March we raise our voices for endometriosis awareness month, and IBS awareness month. Gastrointestinal symptoms are common among people with endometriosis. Unsurprisingly, there is an overlap between symptoms of endometriosis and IBS, and endometriosis and gut symptoms.
Let’s rewind for a moment and have a little recap….
What is IBS?
Irritable Bowel Syndrome (IBS) is a functional bowel disorder. This is diagnosed using a symptom criteria and after excluding other gastrointestinal disease such as coeliac disease and inflammatory bowel disease.
IBS is estimated to affect up to 15% of the population worldwide, however it often goes undiagnosed. The cause of IBS is unknown (just like endo!). Some proposed factors include:
- Altered gastrointestinal motility
- Visceral hypersensitivity
- Low grade inflammation
- Alterations in the gut microbiota
- Impaired perception and processing of information by the brain
There is a large overlap between symptoms of endometriosis and IBS. Some of these key symptoms include:
- Visceral hypersensitivity
- Bloating and discomfort abdominally
- Diarrhoea or constipation
- Pain during bowel movements
- Pain in the pelvic region
- Nausea
Differentiating between the two conditions can be difficult, as it can be hard for women to determine if pain is uterine in nature or from the bowels. This increases the occurrence of missed, and delayed diagnosis of endometriosis. This can be a cause for concern as delayed diagnosis can leave women feeling unheard, and contribute to a reduced quality of life and reduced mental health. IBS is thought to be more common in women with endometriosis, contributing to increased pelvic pain.
When deciding on whether a person may be experiencing IBS or endometriosis, it is important to screen for signs of endometriosis that are NOT present in IBS such as:
- Painful periods
- Heavy periods, and bleeding irregularly through the cycle
- Back Pain
- Pain with sex (either on entry or deep penetrating pain)
- Fertility Struggles
- Family history of endometriosis
Why do those with endometriosis experience gut symptoms?
But WHY do endo warriors experience gut symptoms? Basically endometriosis growths (endometriomas) increase prostaglandin release. Prostaglandins are also involved in the contraction and relaxation of the gut muscles (i.e. your bowels). If we put these together, an inflammatory response occurs in the uterus (increasing prostaglandin release), and this hormone is INCREASED in those with endometriosis, impacting the gut two-fold.
It’s no wonder endo warriors experience inconsistent bowels!
What can we do to combat gut symptoms associated with endometriosis?
Low FODMAP diet
A study by Monash University revealed that patients with IBS and endometriosis respond BETTER to the low FODMAP diet than those with IBS alone. The low FODMAP diet is a restriction on consumption of all fermentable carbohydrates for a short period of time. This diet is recommended for those with IBS as it has evidence to reduce digestive symptoms of IBS such as bloating, pain, and altered bowel habits. Whilst this is not for everyone, as you can see there is definitely some strong research to support it’s use.
Fibre education
Fibre is key in managing any bowel symptoms. It becomes even more of a key concern in endometriosis. Fibre assists with removing excess oestrogen. This occurs as oestrogen binds to fibre, and this assists with an decreased reabsorption of oestrogen in the bowels. This was found in a study where vegetarian women were found to have more regular bowel movements, which lead to an increased removal of oestrogen, and a decreased concentration of oestrogen in the body. As endometriosis is an oestrogen fuelled condition, this can help many endo sufferers! Some key sources of fibre include wholegrains, legumes, lentils, fruits and vegetables.
Anti-inflammatory diet
One of the key cornerstones of endometriosis, is inflammation. Nutrition can play a key role in counteracting impacts of inflammation in the body. An anti-inflammatory diet assists with bowel symptoms as it is generally high in fibre, varied, and colourful. The more colour that comes from our diet (specifically fruits, and vegetables) the higher antioxidant intake we take in. This can improve symptoms associated with endometriosis such as gut symptoms, and pain associated with endo.
Navigate your triggers
Each person with endometriosis will present with different symptoms. Some will be okay with caffeine, or alcohol (gut symptoms wise), others will run the other way!
Seek help
It can be really tough navigating endometriosis, and gut symptoms alone. Having an empathetic and knowledgeable health team behind you can take away some of the burden. Work with a dietitian trained in endometriosis and IBS to pinpoint your individual triggers and to improve symptom management.
Book in here for a Discover package to manage your symptoms.
