For those women of reproductive age who are experiencing digestive issues, there may be another cause besides irritable bowel syndrome (IBS).

Endometriosis can cause many of the same kinds of digestive issues symptoms, but be overlooked with the assumption it’s just IBS. This crossover of symptoms can lead to endometriosis related symptoms being misdiagnosed for years.

By understanding the connection, more can be done to help with these digestive issues. Working with a nutritionist can help you gain relief and better management of these kinds of symptoms. All while having a better understanding of their true causes.

What is Endometriosis?

Endometriosis is a chronic inflammatory disease affecting 10 to 15% of women of reproductive age. It is characterized by the growth of tissues that mimic the lining of the uterus (endometrium) and grow in other parts of the body outside of the uterus, such as the ovaries, fallopian tubes, gastrointestinal tract, and even the lungs. 

Symptoms of endometriosis include: 

  • Infertility
  • Painful periods
  • Pelvic pain
  • Painful urination and/or bowel movements
  • Pain with intercourse 
  • Cyclic bloating or “endo belly”
  • Cyclic diarrhea, constipation, nausea, vomiting 

You may be noticing that some of these symptoms are distinctively digestive issues that can easily be attributed to a condition like IBS, without considering the endometriosis possibility contributing to it.

Endometriosis and Digestive Issues

Research also shows that the odds of having IBS are three times higher among patients with endometriosis compared with healthy controls.

Bloating is fairly normal and expected, leading up to the menstrual cycle. However, those with endometriosis experience much more extreme bloating that is often referred to as “endo belly”. 

Painful bloating can also occur with IBS, however it tends to not be directly related to the menstrual cycle and triggered in response to factors like stress, certain foods, and gut motility issues. Individuals with IBS also tend to experience changes in bowel habits such as constipation, diarrhea or alternating between the two. 

One way to help identify if your symptoms may be related to endometriosis is to start tracking your symptoms and when you experience them. If you notice a relation to greater symptoms that coincide with your menstrual cycle, then there’s a good chance they are connected.

So how can knowing this connection between endometriosis and digestive issues help? This knowledge enables us to use nutrition-based strategies to bring relief to both endometriosis and IBS related symptoms.

How Nutrition Can Help

Nutrition can play a role in endometriosis symptoms as well as digestive symptoms (with or without IBS). Increasing fiber intake by eating plenty of fruits, vegetables and other plant foods can help reduce excess estrogen, promote healthy bowel movements, and reduce inflammation. Consuming sources of anti-inflammatory omega-3 fats like salmon, chia seeds, and sardines can also be helpful for supporting digestive health and reducing endometriosis pain and progression

Understanding the connection and crossover between endometriosis and digestive conditions like IBS is important for receiving an accurate diagnosis and care. It can take an average of ten years for an individual with endometriosis to be diagnosed! Building a supportive care team that includes an OBGYN and possibly a gastroenterologist can be extremely helpful for symptom management and quality of life. Working with a dietitian or nutritionist can also be helpful for building a supportive nutrition plan to help with reducing inflammation, digestive issues, and pain. 


Our expert nutritionists are here to take an integrative, holistic approach to your health, including helping to support balanced hormones and overall gut health. 

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By, Chelsea Hemmenway, MS, CN, NBC-HWC

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Nichols, L. Hendrickson-Jack, L. Real Food for Fertility. Fertility Food Publishing, 2024. 

Velho RV, Werner F, Mechsner S. Endo Belly: What Is It and Why Does It Happen?-A Narrative Review. J Clin Med. 2023 Nov 19;12(22):7176. doi: 10.3390/jcm12227176. PMID: 38002788; PMCID: PMC10671958.