Endo Belly or IBS Bloat – Which one is it?

Have you been diagnosed with both Irritable Bowel Syndrome (IBS) and Endometriosis?

It can be common to be diagnosed with both conditions. In fact, women with endometriosis are twice as likely to have an IBS diagnosis compared to women without endo (1).

Gastrointestinal (GI) symptoms are nearly as prevalent as gynaecological symptoms in women with endometriosis, as shown in a study involving 355 women. Among those with confirmed endometriosis, 90% experienced GI symptoms, with bloating being the most common (2).

IBS and Endo have many overlapping symptoms such as abdominal pain, diarrhoea, constipation, visceral hypersensitivity, nausea and bloating. For more information about the link between endometriosis and IBS, read my previous blog post.

If you’ve been diagnosed with both conditions, this symptom overlap can often make it difficult to determine whether bloating is linked to endometriosis (and often referred to as endo belly) or IBS.

So, how can you tell the difference? This blog post will be exploring the key characteristics, causes and tips for managing endo belly and IBS bloating so that you can feel better equipped when managing both conditions.

What is Endo Belly?

Endo belly is a term used to describe bloating specific to endometriosis, a condition where tissue similar to the uterine lining grows outside the uterus. This can cause inflammation, scarring, and adhesions that contribute to bloating and abdominal distension.

Causes of Endo Belly:

• Inflammation: Endometriosis can cause chronic inflammation in the pelvic area, leading to swelling and abdominal distension.

• Hormonal Fluctuations: Hormone changes during the menstrual cycle can trigger water retention and bloating in people with endometriosis.

• Scar Tissue and Adhesions: Endometriosis can create scar tissue, or adhesions, that pull on organs and cause digestive symptoms similar to bloating.

Characteristics of Endo Belly:

• Endo belly bloating tends to follow your menstrual cycle, peaking around the time of your period and can last for several days afterwards.

• It is typically localised to the pelvic region but it can also cause cause abdominal distension.

• It often comes with other endometriosis symptoms like pelvic pain and pressure, fatigue, and nausea.

What is IBS Bloating?

IBS is a functional gastrointestinal disorder that affects the large intestine. Bloating is a hallmark symptom of IBS and is typically linked to abnormal gut motility, hypersensitivity, and changes in gut bacteria.

Causes of IBS Bloating:

• Gas Production: Foods that are harder to digest, such as those high in FODMAPs (fermentable carbohydrates), can lead to excess gas production in people with IBS.

• Gut Hypersensitivity: People with IBS often experience heightened sensitivity in the digestive tract, which can make even minor gas build up feel intensely uncomfortable.

• Bacterial Imbalance: Imbalances in gut bacteria, or dysbiosis, may increase gas production, leading to IBS bloating.

• Stress: Anxiety, depression, and stress can disrupt the balance of gut bacteria and the gut-brain axis, which controls digestion and gut sensitivity. Stress hormones like cortisol alter gut motility, often speeding up or slowing down digestion, which can lead to symptoms such as diarrhoea or constipation.

Characteristics of IBS Bloating:

• It involves the entire abdomen, occurs randomly, and fluctuates throughout the day, often worsening after meals.

• It often resolves within a few hours and may feel better after passing gas or a bowel movement.

• It's typically accompanied with other IBS symptoms like digestive discomfort, and changes in bowel habits such as diarrhoea, and/or constipation.

Could the low FODMAP diet help to manage my IBS bloat and endo belly?

A 2017 Monash University study looked at the effectiveness of a low FODMAP diet on symptom management among women with IBS alone or in conjunction with endometriosis. The findings showed that 72% of women with endometriosis and IBS had more than 50% improvements in bowel symptoms after four weeks on the low FODMAP diet (3).

What is the low FODMAP Diet?

Some types of carbohydrates, which are poorly absorbed in the small intestine, can contribute to IBS-type symptoms. These carbohydrates are called FODMAPs, which are Fermentable, Oligo-saccharides, Di-saccharides, Mono-saccharides And Polyols. A low FODMAP diet involves eliminating certain carbohydrates for several weeks.

It is important to remember it is not suitable for everyone and there are other options to improve endometriosis and IBS symptoms (as discussed below). However, if you've have been diagnosed with endometriosis and IBS, and you're struggling with bowel symptoms, it's important to work with a FODMAP trained dietitian so that you can get the right support and guidance to make the most appropriate changes for you.

Other Ways To Manage Endo Belly

• Eat lots of anti-inflammatory foods: Ongoing studies strongly suggest that a Mediterranean style, anti-inflammatory diet can help reduce inflammation. This means eating lots of fruits, vegetables, whole grains, healthy fats, and lean proteins. You can find more about this way of eating by downloading my free Endo Ebook here.

• Stay hydrated: Drinking plenty of water can help reduce bloating and inflammation associated with endometriosis. Aim to stay hydrated throughout the day, and limit your intake of caffeine and alcohol, which can exacerbate symptoms.

• Heat Therapy: Heat packs on the abdomen can provide relief from discomfort caused by endo belly. Heat can help soothe muscle tension and reduce pain.

• Rest and Self-Care: Endo belly can be exhausting. Listening to your body and resting when needed can help you cope with the fatigue that often accompanies endo belly.

Other Ways to Manage IBS Bloating

• Eat Slowly: Eating too quickly can lead to swallowing air, which contributes to bloating. Take time to chew food thoroughly.

• Stay hydrated: keeping hydrated helps your digestion run smoothly and can alleviate symptoms, especially if constipation is an issue.

• Try to be active every day: whether it’s a brisk walk, an exercise class or yoga, find an activity you enjoy.

  
  

• Stress less: stress can be a big IBS trigger. Techniques like mindfulness, meditation, and even simple deep-breathing exercises can be effective in managing symptoms.

• Track your symptoms: a food and symptom diary is a useful tool to identify any trigger foods which might be making your IBS symptoms worse.

When to See a Healthcare Provider

If you haven't been diagnosed with IBS, and you've been experiencing symptoms, it's important that you discuss these with your GP or healthcare provider. He/she can investigate and diagnose IBS, and rule out any other conditions such as crohn's disease, coeliac disease, which could indicate underlying digestive issues.

Key Takeaways

While bloating and endo belly may seem similar at first, they have distinct causes and characteristics. By learning about and understanding these differences you can make targeted nutrition and lifestyle changes to manage your symptoms and find relief.

Are you looking for some support with a low FODMAP diet? Or maybe you’d like to explore how diet can help you manage your endometriosis and IBS symptoms? If you'd to discuss these further, feel free to book your free 20-minute Discovery Call with me here, or you can also email me: laura@nurture-for-life.com

References

1. Mather, R., et al., Polycystic ovary syndrome is associated with an increased prevalence of irritable bowel syndrome. Digestive Diseases and Sciences. 2010. Apr;55(4):1085-9.

2. Maroun P., et al., Relevance of gastrointestinal symptoms in endometriosis. Australia and New Zealnd Journal of Obstetrics and Gynaecology. 2009. Aug;49(4):411-4.

3. Moore JS., et al., Endometriosis in patients with irritable bowel syndrome: Specific symptomatic and demographic profile, and response to the low FODMAP diet. Australia and New Zealand Journal of Obstetrics and Gynaecology. 2017 Apr;57(2):201-5.