Gut health and endometriosis
Endometriosis and gut health is a topic I find so interesting, from the perspective of a nutritionist to-be and as a patient.
Our gut and our microbiome, are implicated in so many diseases and disorders from stress through to IBS (1). IBS or irritable bowel syndrome is so common in women with endometriosis, it suggests there is a connection. Endometriosis can also affect the structure of our digestive organs (because of adhesions), so this is another issue to consider.
What do endometriosis and IBS have in common?
Both endometriosis and IBS show a state of chronic low-grade inflammation (2). Dysbiosis (or an imbalanced microbiome) and intestinal inflammation are seen in both patients with IBS and endometriosis (2).
Dysbiosis is linked with increased intestinal permeability - also known as leaky gut. As a result of leaky gut, bacterial endotoxins can move from the gut to the peritoneal fluid. In fact, patients with endometriosis show a much higher concentration of bacterial toxins known as lipopolysaccharides (2).
Can improving gut health help endometriosis?
Given women with endometriosis have a much greater chance of having IBS or gut issues, it would make sense to suggest that improving your gut health and microbiome, can provide symptom relief.
I've been on a journey of improving my gut health for some time, let me tell you it's not a linear journey - there will be ups and downs. Since I had surgery and changed my diet, my endo symptoms (such pain and heavy bleeding) aren't frequent these days. However, I still do get IBS symptoms like bloating from time to time - this is because I have SIBO (small intestine bacterial overgrowth). SIBO is a common cause of IBS (3).
How do I improve my gut health?
Improving your gut health can be done through diet, supplements and lifestyle changes. The approach you take really depends on what you're experiencing. If you have SIBO (which is diagnosed via breath testing) then you'll need to address that through diet and anti-microbials (either antibiotics or herbal medicine). Not everyone agrees that anti-microbials are needed, but it's best to see a qualified health practitioner to work through the best approach for you.
Addressing structural issues that could be affecting digestion may also help. On and off for the past few years I've had visceral mobilisation and osteopathic treatments to assist with my posture and adhesions from endometriosis. This work has also helped with my abdominal sensitivity that's developed from having endometriosis and IBS.
If you have IBS but not SIBO; then diet, prebiotics and probiotics may help. The approach you take depends what symptoms you're experiencing. Reducing stress is important and should help with improving symptoms.
Starting out with a food diary and getting to know what foods (or stressors) trigger your symptoms is a great way to start. Working with a health practitioner on a diet tailored for you, with a treatment plan will set you on a path to healing your gut (and hopefully feeling much better).
Some of the diets that are commonly used for healing the gut are the Low FODMAP diet, the SIBO specific diet, Paleo and the Ketogenic diet. Personally I don't believe in strictly following diets, I prefer to use them as a guide but then tailor them accordingly - we're all different after all. There's no one size fits all when it comes to nutrition.
If you have endometriosis leave a comment. Let me know if you experience gut issues and what helps relieve your symptoms.
Yours in health,
Meredith x
References
https://www.mdpi.com/2076-2607/7/1/14/Rinninella, E., Raoul, P., Cintoni, M., Franceschi, F., Abele, G., Miggiano, D., … Mele, M. C. (2019). What is the Healthy Gut Microbiota Composition ? A Changing Ecosystem across Age , Environment , Diet , and Diseases. https://doi.org/10.3390/microorganisms7010014
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.org/10.1016/j.dld.2017.12.017
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. Retrieved from ://www.ncbi.nlm.nih.gov/pmc/articles/PMC5495893/