It seems as though gut health is implicated in so many diseases, and endometriosis is no exception.
Endometriosis and irritable bowel syndrome (IBS) seem to go hand-in-hand with many women who have endometriosis reporting this. In fact, one study found IBS is five times higher in women with endometriosis compared to women without endometriosis (1).
So why do women with endometriosis have a higher incidence of IBS?
Because the cause of endometriosis (or IBS, for that matter) isn’t fully understood it makes it difficult to pinpoint an exact reason. However, there are a few contributing factors that could lead to IBS in women with endometriosis:
- The adhesions that occur with endometriosis (and surgery) have the potential to alter the structure of our digestive organs and can cause many of the symptoms associated with endometriosis and IBS (2).
- Both endometriosis and IBS are a chronic state of inflammation, which involves dysbiosis (an impaired or imbalanced microbiome) and increased gut permeability (aka leaky gut) (3). In fact, intestinal inflammation and alterations to gut flora is seen in women with endometriosis and IBS (3). As a result of leaky gut, bacterial endotoxins can move from the gut to the peritoneal fluid. Women with endometriosis show increased levels of toxins in their peritoneal fluid known as lipopolysaccharides which can cause inflammation (3).
- Stress is a major factor to consider in in both conditions. Chronic stress can contribute to both endometriosis and IBS in a myriad of ways, some of which include; impaired gut motility (our ability to move food along the GI tract), increased gut inflammation, lowered progesterone, suppression of the immune system and it can influence our perception of pain (4).
How do I improve my gut health and my endometriosis?
Given the importance of gut health including the detoxification of hormones through the liver for endometriosis, it makes sense to suggest that improving gut health should improve both IBS and endometriosis symptoms.
So where to begin? Reducing stress is a good place to start. Finding the root cause will help prioritise treatment. The prevalence of small intestine bacterial overgrowth (SIBO) in IBS patients is estimated to be high, present in approximately two thirds of patients (5). If SIBO is detected (currently it’s diagnosed through breath testing) then it is usually addressed through diet, nutraceuticals and possibly herbal antimicrobials. If SIBO isn’t the cause then a different strategy can be adopted through diet and supplements such as prebiotics and probiotics.
There are a range of different diets that can help the symptoms of both endometriosis and IBS; a well-known diet is the Low FODMAP diet which works by reducing certain sugars which aren’t well absorbed in the intestine and can cause gut symptoms such as bloating and abdominal pain.
Endometriosis and IBS are chronic conditions and while there’s currently no cure, the symptoms can definitely be treated. Working with a nutritionist is a good place to start, they can create a tailored diet, carry out testing where needed to identify nutrient deficiencies and other imbalances within the body and treat as needed.
Head to The Healing Yogi for more information on endometriosis and gut health.
- Schomacker, M. L., Hansen, K. E., Ramlau-Hansen, C. H., & Forman, A. (2018). Is endometriosis associated with irritable bowel syndrome? A cross-sectional study. European Journal of Obstetrics & Gynecology and Reproductive Biology, 231, 65–69. doi:10.1016/j.ejogrb.2018.10.023
- Tabibian, N., Swehli, E., Boyd, A., Umbreen, A., & Tabibian, J. H. (2017). Abdominal adhesions: A practical review of an often overlooked entity. Annals of medicine and surgery (2012), 15, 9–13. doi:10.1016/j.amsu.2017.01.021
- Viganò, D., Zara, F., & Usai, P. (2018). Irritable bowel syndrome and endometriosis: New insights for old diseases. Digestive and Liver Disease, 50(3), 213–219. doi:10.1016/j.dld.2017.12.017
- Yaribeygi, H., Panahi, Y., Sahraei, H., Johnston, T. P., & Sahebkar, A. (2017). The impact of stress on body function: A review. EXCLI journal, 16, 1057–1072. doi:10.17179/excli2017-480
- Borghini, R., Donato, G., Alvaro, D., & Picarelli, A. (2017). New insights in IBS-like disorders: Pandora's box has been opened; a review. Gastroenterology and hepatology from bed to bench, 10(2), 79–89.
Meredith is a Nutrition student at Endeavour College Brisbane. Meredith is a yoga teacher and is passionate about developing recipes that support a healthy gut. Meredith shares her gut and endometriosis friendly recipes on thehealingyogi.com and on Instagram @healingyogi. Meredith is also a volunteer at qendo.org.au where she supports anyone affected by endometriosis.
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