Endometriosis and Digestive Issues: What’s the Connection?
By Alyssa Chavez
Nutritional Therapy Practitioner, Endo Warrior
When we think of endometriosis, digestive issues may not be the first thing that comes to mind. But the truth is that endometriosis and digestive issues go hand in hand. Endometriosis is often thought to be a women’s reproductive issue. So why then do so many women also experience IBS-type symptoms like diarrhea and constipation, extreme bloating (aka “endo belly”), and pain with bowel movements? Why do studies show that in fact upwards of 90% of women with endo experience digestive symptoms? There is no way this is a coincidence if you ask me!
How do endometriosis and digestive issues even connect?
I’m so glad you asked! This is one of the connections I find so fascinating, I could talk about it all day long.
Endometriosis is, at its root, an immune dysfunction. This comes along with a strong component of inflammation since inflammation is caused by an immune response. Pain and fatigue are major symptoms of inflammation…sound familiar to anyone?
Knowing this, it is important to note that 70% of the immune system lives in your gut. So let’s break this down. In a normally functioning gut, there is a single cell lining which provides a barrier. It allows digested nutrients broken down from food to enter the bloodstream so that they can be delivered wherever they may need to go in the body.
What often happens is that the single-cell lining gets damaged. Then instead of being a protective barrier, it begins to allow large food particles through to the bloodstream. Your immune system then perceives this as a threat and attacks. This is commonly known as leaky gut.
So how does this come back to endo again?
When leaky gut occurs, more and more large food particles pass through the gut barrier and the immune system has to react on a regular basis. Now, your immune system is like an army. It only has so many forces available at any given time. So when all of those soldiers are off fighting food particles, there may not be enough available for a little job like cleaning up endometrial-like tissue in the abdomen that ends up becoming an endometrial lesion.
When this happens on a regular basis, it is known as chronic. Chronic immune stimulation leads to chronic inflammation. This can snowball into systemic inflammation, which is what we see with endometriosis.
How does this relate to my endometriosis and digestive issues like bloating, diarrhea, and constipation?
Another common gut issue that women with endo experience is dysbiosis. This is an overgrowth of opportunistic bacteria, fungi, or parasites. Inside of your large intestine are millions of these microorganisms. And when it is well-balanced, this is actually good for you. These microbiota help you digest food that your digestive system cannot and bring you enormous health benefits.
Basically, this whole thing goes wrong when things get out of balance. The bad bacteria can start to outnumber the good. Then instead of getting benefits from these incredible microorganisms, we end up instead with symptoms like bloating, diarrhea, constipation, and even fatigue and pain.
This also activates the immune system, calls on those already weary troops, and adds to the chronic systemic inflammation in our bodies.
Wow! So what can we do about it?
This is my very favorite part because there is so much we can do about it! Step one here involves pinpointing food sensitivities. So we know about leaky gut and how that can be an issue. If leaky gut is present, we know that your body is mounting an immune response to certain foods. But which ones??
There are two ways to figure this out. One is to do an elimination diet, something like AIP, where you eliminate all potentially triggering foods for a period of time and then slowly reintroduce to see which ones you react to. This is totally doable, but of course takes a lot of time and patience and can end up with you removing more foods than you really need to.
Alternatively, what I like to do with my clients is run an MRT food sensitivity test. This is a blood test that scans for multiple types of immune reactions and therefore is more accurate and can pick up with a higher sensitivity rate than most tests on the market. This can give a great picture of what foods are triggering your immune system.
Remember, the goal here is NOT to remove foods forever, but to remove foods for a short time while also focusing on healing the gut.
I love doing a full gut healing protocol with my clients, but a great starting point is to supplement with collagen powder and sip on bone broth. These have wonderful healing properties for your damaged gut lining!
What about those pesky bacteria contributing to my endometriosis and digestive issues?
This one gets a little trickier and is definitely something I would work with a practitioner to address. Someone like a naturopath, functional medicine doctor, or Restorative Wellness Practitioner like myself who has specific training in gut healing modalities would be a great fit.
The process basically involves doing an eradication protocol using targeted supplements and at the same time using dietary strategies to feed the good bacteria and avoid feeding the bad. At the same time, you want to be using strategies to reseed the gut with good bacteria so that moving forward you can calm down your body’s immune response and inflammation and provide a healthier environment.
My final thoughts
I hope this brings to light for you how so many of the symptoms you are experiencing may be connected. I know for myself when I first was learning about endometriosis, I thought it was all about painful periods. What I know now is that it is truly a full body disease.
When we are thinking about healing your body, we are really looking at healing the full body from the inside out. This also means calming your nervous system, nourishing your body with plenty of nutrients, and caring for every part of yourself.
Much love to you on your endo journey!
If you’re looking for further support and information, you can visit my web site where you can find plenty of free resources, my weekly blog and information about my 1:1 coaching program, Thrive with Endo.
You can also reach me via email at alyssa@wholewomanwellness.net
References:
Luscombe, Georgina M; Markham, Robert; Judio, Mirari; Grigoriu, Ariadna; Fraser, Ian S. (2009). Abdominal bloating: an under-recognized endometriosis symptom. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/20085682/
Chiaffarino, Francesca; Cipriani, Sonia; Ricci, Elena; Mauri, Paola Agnese; Esposito, Giovanna; Barretta, Marta; Vercellini, Paolo; Parazzini, Fabio. (2021). Endometriosis and irritable bowel syndrome: a systematic review and meta-analysis. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/32949284/
Svensson, Agnes; Brunkwall, Louise; Roth, Bodil; Orho-Melander, Marju; Ohlsson, Bodil. (2021). Associations Between Endometriosis and Gut Microbiota. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8289757/
Donnez, Jacques; Cacciottola, Luciana. (2022). Endometriosis: An Inflammatory Disease That Requires New Therapeutic Options. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8836207/
Pahwa, Roma; Goyal, Amandeep; Jialal, Ishwarlal. (2022). Chronic Inflammation. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK493173/
Romm, Aviva, MD. (2021). Hormone Intelligence. New York, NY: HarperCollins Publishers.
Nutritional Therapy Association (2021). Digestion Module Materials [Video and PDF Documents].