EP.115/ 10 Root Causes of Bloating with Endometriosis
Last week I polled 600 of you on my Instagram and 96% of you said you suffer with bloating or what is dubbed in our community as the endobelly.
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Additionally, only 48% of you had heard of small intestine bacterial overgrowth, which is in fact a leading cause of IBS issue such as constipation, diarrhoea and bloating within the endo population.
Bloating is one of the biggest symptoms for those of us with endomertriosis, but it’s not impossible to treat. It’s not about masking the symptoms though - restricting foods to feel relief can result in more foods sensitive and nutrient deficiencies, whilst leaving the root cause to worsen over time.
So ideally, want to get to the heart of the problem. There may be a few, but once you address one of the root causes, often the others begin to improve and can become easier to treat or manage.
Another thing to note is rather than letting this episode overwhelm you, see it as a light shining on your gut health and revealing the clues that have been hidden to you for so long. Rather than feeling like you have no control, you now have control - you have knowledge and information, and you can now start creating a road map towards healing your bloating, step by step. You don’t have to investigate all of these issues - start with the one that feels the most relevant to you.
Finally, this list isn’t exhaustive but it does include some of the most common issues people with endometriosis face when it comes to their gut health.
Here’s an overview of the 10 root causes of bloating with endometriosis:
SIBO - Small intestine bacterial overgrowth is a condition where normal bacteria that should live in the large intestine, build up in the small intestine. They ferment our food causing bloating, gas, constipation and other IBS complaints. Research has shown that up to 80% of people with endo have SIBO.
Hormonal imbalances - Oestrogen dominance can cause water retention leading to bloating, which often shows up in the luteal phase or just before our periods.
Leaky gut - The gut wall is one cell thick, made of cells packed tightly together with tiny holes to allow nutrients to pass through. However, problems like SIBO, intolerances and NSAIDS can cause those holes to widen, allowing larger food particles to pass through, triggering a reaction from the immune system. This can not only cause IBS issues like bloating, but full body symptoms.
Coeliac disease - Research has found an association between endometriosis and coeliac disease and in a study of over 200 women with end, 75% experienced a reduction in symptoms after elimination gluten for 12 months. Coeliac disease can cause symptoms like bloating, cramps, diarrhea and bran fog, to name a few.
Low digestive enzymes and stomach acid - Low digestive enzymes and low stomach acid can cause undigested food to pass through the GI tract, resulting in bloating and gas as bacteria get to feast on larger particles of food.
Candida and other infections, parasites and fungi - Candida occurs in normal amounts within the body, the problem occurs when it overgrows, which can not only cause bloating, but can also cause symptoms like pelvic pain, fatigue and brain fog. Other infections, parasites and fungi can cause similar issues in the gut and body too.
Stress, rushing and not chewing food properly - To digest food, the body must be in the ‘rest and digest’ mode. When we’re stressed rushing or gulping down our food, our ‘flight or fight’ system switches on and this automatically turns off the digestion, so that other organs and systems are prioritised. Of course, the result is you now have food in your stomach not digesting, leaving it to ferment and build up in your system, causing bloating and other IBS issues.
Endo lesions and adhesions - We know that endometriosis lesions can cause swelling and inflammation, which may partially be responsible for abdominal bloating. But additionally, web like tissue called adhesions can also grow in an attempt to heal these lesions and as a result of surgery. They grow towards each other in order to knit together, and can stick to organs and the walls of the pelvis and abdomen, causing the organs to be pulled and distorted. Adhesions can also wrap around the intestines or pull them into loops, creating a build up of food and gas, and generally inhibiting digestion.
Histamine intolerance - Whilst not every histamine source claims bloating is a histamine intolerance symptom, I’m including this as some do and many clients with histamine intolerance also experience bloating with histamine flares. Histamine intolerance occurs when there is a build up of histamine in the body, either because the body cannot get rid of the histamine properly anymore or the body is making too much, this then results in reactions such as rashes, bloating, vomiting, racing heart and typical allergic reactions.
Dysbiosis - Our gut contains a huge array of bacteria that are essential for our health. However, some bacteria need to be kept in check to keep a healthy balance, and some things like antibiotics or stress can knock this balance off, allowing certain bacteria to thrive and cause problems, including bloating.
You’ll notice in this podcast episode some themes of causes behind these root causes - many being chronic stress, antibiotics, NSAIDS and SIBO to name a few. There may be a root cause behind the root cause that you need to investigate, such as addressing adhesions so you can heal from SIBO or perhaps trying anti-inflammatory supplements so you can potentially take fewer NSAIDS, whatever it is - know that you don’t have to do it all in one go, and you can create a step-by-step road map that you can take at your own pace, to get you closer to health.
The SIBO, Endometriosis and Interstitial Cystitis Connection wth Dr. Allison Siebecker
How To Treat SIBO with Dr Allison Siebecker
Understanding The Endometriosis Belly, Part 3: SIBO Symptoms
How Do You Know When to Test for SIBO?
Hormonal imbalances
Fix Your Period with Nicole Jardim
How To Rebalance Your Hormones with Endometriosis with Nicole Jardim
PCOS, Blood Sugar and Endometriosis with Megan Hallett of Feasting for Hormonal Harmony
Five Natural Tips to Reduce Oestrogen Dominance and Balance Hormones with Endometriosis
Seven Foods to Alleviate Oestrogen Dominance with Endometriosis
Reduce Fatigue, Endometriosis Symptoms and Oestrogen Dominance with A Better Breakfast
Leaky Gut
Dr. Ruscio How To Heal Leaky Gut
Understanding The Endometriosis Belly, Part 1
Understanding The Endometriosis Belly, Part 2
“Leaky Gut” and Pelvic Pain Dr. Jessica Drummond
Coeliac disease
Risk of endometriosis in 11,000 women with celiac disease
The association between endometriosis and autoimmune diseases: a systematic review and meta-analysis
Gluten-free diet: a new strategy for management of painful endometriosis related symptoms?
Low digestive enzymes and stomach acid
Understanding The Endometriosis Belly, Part 2
Candida and other infections, parasites and fungi
Candida, Yeast and Sensitivity Test UK
Stress, rushing and not chewing food properly
Understanding The Endometriosis Belly, Part 1
Understanding The Endometriosis Belly, Part 2
Anti-inflammatory Living for Endometriosis
Endo lesions and adhesions
The Healthy Gut Podcast Ep.25: Adhesions And SIBO With Larry And Belinda Wurn
The Healthy Gut Podcast Ep.33: Visceral Mobilisation With Alyssa Tait
The Period Party Podcast: Mercier Therapy for Pelvic Related Conditions with Dr. Jennifer Mercier
The Best Surgery for Endometriosis with Dr. Andrew Cook
Histamine intolerance
The 4-Phase Histamine Reset Plan
Histamine Intolerance 101 Dr. Becky Campbell
Endometriosis, SIBO, Interstitial Cystitis and Allergies: The Histamine Connection
Dysbiosis
The Healthy Gut Podcast Ep.75: Testing Your Microbiome With Dr Jason Hawrela
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My cookbook This EndoLife, It Starts with Breakfast is out now! Get 28 anti-inflammatory, hormone friendly recipes for living and thriving with endometriosis. Order your copy here.
If you feel like you need more support with managing endometriosis, you can join Your EndoLife Coaching Programme. A 1-to-1 three month health and life coaching programme to help you thrive with endometriosis. To find out more about the programme and to discuss whether it could be right for you, email me at hello@thisendolife.com or visit my website.
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My free guide ‘Managing Endometriosis Naturally’ is perfect for anyone just starting out on this journey of managing and reducing their symptoms. Download here.
My free Endometriosis Diet Grocery List is a pdf list that includes all the foods I buy on a monthly basis, categorised into easy sections. I share my personal endometriosis diet plan, free recipe resources, recommendations to help you get started with the endometriosis diet and nutrition tips. Download here.
My free “Endometriosis Symptom Tracker” could help you begin to understand the subtle patterns in your endometriosis symptoms. As always, this guide doesn’t replace your medical treatment and is not intended to treat or cure endometriosis, but provides you with options that helped me to live well with endometriosis. Download here.
This episode is sponsored by Semaine Health, the anti-inflammatory, plant-based pain relieving supplement. Now priced at $28.99 for subscription. Shop here.