I‘ll always remember the day I began my interval. I used to be simply 10 years outdated, and I used to be so scared I might performed one thing unsuitable that I hid my stained underwear in my closet. At that age, I did not know something about menstruation. When my mother discovered, she was shocked it occurred so early.
It was additionally the start of one other journey for me, though I did not realize it on the time: a decades-long battle with endometriosis and its debilitating signs.
Since that very first interval, I’ve handled a heavy movement and agonizing cramps. After I reached my early teenagers, issues received worse. I might spend days doubled over in ache, fleeing to a heat bathtub after I might for reduction. By my early 20s, I started getting what I assumed had been recurring UTIs, and I’d maintain onto the bathroom as I peed, clenching in ache.
Specialists In This Article
- Amanda Chu, MD, board-certified minimally invasive gynecologic surgeon at Seckin Endometriosis Center
- Morgan Allyn Sendzischew Shane, MD, gastroenterologist, assistant clinic professor, and director at UHealth Women’s Health Alliance
- Tamer Seckin, MD, board-certified OB/GYN, endometriosis specialist, and founding father of The Endometriosis Foundation of America
- Tiffany Pham, MD, OB/GYN and medical advisor for Flo Health
After which there have been the bowel actions: Each felt like somebody was tearing one thing out of my left facet. I might break right into a sweat and should lie down within the bathe afterward to calm myself down. Nausea would hit due to the ache, and different days, my stomach would bloat to the purpose that I appeared pregnant.
Even after telling my medical doctors that my mother had endometriosis (I might watched her undergo the identical precise signs), it took a complete of seven medical doctors over the span of 14 years for me to get an official dual-diagnosis: endometriosis and interstitial cystitis (often known as bladder ache syndrome). Up till that time, all I might ever heard from medical doctors was “nothing’s unsuitable with you,” and “that is only a regular a part of being a lady.”
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And it wasn’t till after my first surgical procedure for endometriosis that I spotted my situation and my raging intestine signs had been very intently intertwined.
How endometriosis impacts the intestine
Most of what you see about endometriosis in mainstream media has nothing to do along with your intestine. However the reality is, living with endometriosis can take over each side of your life and well being—gut health included.
Actually, the fourth basic symptom of endometriosis (after irregular intervals, painful intervals, and painful sex) is irregular bowel actions and gastrointestinal misery, in line with The Endometriosis Foundation of America. This will embrace extraordinarily painful pooping in addition to constipation, diarrhea, and bloating, often throughout menstruation.
These signs are often an indication that endometrial tissue (which often traces the uterus and sheds throughout menstruation) has grown on the intestines or bowel.
Frustratingly, intestine points from endometriosis could seem like signs of intestine circumstances like irritable bowel syndrome (IBS), Crohn’s illness, or appendicitis. However in the event you’re an individual with a uterus, endometriosis needs to be thought of as a possible trigger. (Although it usually is not—no surprise, then, that it takes seven years on common to get a correct analysis, with 6 in 10 circumstances of endometriosis going undiagnosed, per a Might 2023 assessment in Cureus.)
“Endometriosis may very well be the major reason behind your GI points, or perhaps a contributor to your signs and ache,” says Amanda Chu, MD, a board-certified minimally invasive gynecologic surgeon at Seckin Endometriosis Center (and one of many surgeons who operated on me throughout my second surgical procedure).
She notes that seeing a gastroenterologist about GI points is a good suggestion, particularly in the event that they’re your major concern, however: “If their testing is inconclusive, do not allow them to simply diagnose you with IBS,” she says. “I might be extra prone to suspect endometriosis as, in lots of circumstances, it would not seem in routine testing.”
For me, bowel points had been a high concern. After my first surgical procedure in 2018 (an ablation, the place endometrial tissue is burned off on the floor of sure organs, however not absolutely eliminated), I used to be left with horrible GI points like irregular bowel actions, chronic constipation, and stomach ache. Fortunately, my second surgical procedure with Tamer Seckin, MD, a board-certified OB/GYN, endometriosis specialist, and founding father of The Endometriosis Foundation of America, and Dr. Chu, introduced some intestine reduction.
Finally, in the event you’ve been recognized with endometriosis (or are nonetheless ready for a analysis) and your intestine points are taking up your life, let your care staff know. Advocating for your self and listening to what’s actually occurring in your physique is the one method get applicable remedy for endometriosis-related intestine points (and for the situation on the whole).
Had I not sought out specialists like Dr. Seckin and Dr. Chu, I do not know the place I might be as we speak besides (most certainly) bedridden and nonetheless trying to find solutions.
Advocating for your self and listening to what’s actually occurring in your physique is the one technique to get applicable remedy for endometriosis-related intestine points.
5 intestine points that will truly be indicators of endometriosis
Bloating (aka, “endo stomach”)
Whereas not a medical time period, “endo stomach,” or stomach swelling, is a typical symptom of endometriosis. It could actually final for hours, days, or weeks, trigger discomfort and ache, and might even make you look pregnant or severely swollen. Medical doctors do not actually know the precise reason behind this symptom, however they imagine it has to do with irritation and hormone modifications, per the Cleveland Clinic.
“Endometriotic lesions (i.e., endometrial tissue) rising near the bowel or on the bowel itself may cause GI points like bloating,” says Tiffany Pham, MD, OB/GYN and medical advisor at Flo Health.
Larger-than-usual ranges of the hormone-like substance prostaglandins (which is typical for individuals with endo) may have an effect on the bowels and their functioning, provides Dr. Pham.
Not everybody with endometriosis will get “endo stomach,” however in the event you do, it could have bodily and psychological well being results, like low shallowness and physique picture points, in line with a September 2022 article within the International Journal of Behavioral Medicine.
Belly ache (and painful bowel actions)
That is one more hallmark symptom of endometriosis, which may really feel like stabbing or cramping ache in your decrease stomach. For me, ache comes and goes relying on what I eat, whether or not I am on my interval, and different elements like stress.
Individuals with endometriosis could have fixed stomach ache or pelvic ache, which regularly worsens throughout menstruation, per UCLA Health. This implies endometriosis might trigger stomach ache that isn’t all the time essentially related along with your menstrual cycles.
One other time this stomach ache could spark up? While you’re attempting to have a bowel motion. (Extra on this under.)
Constipation
Many individuals with endometriosis have persistent constipation, per The Endometriosis Foundation of America, particularly in case your lesions are near your cul-de-sac (space between the uterus and rectum) or rectum. I nonetheless take care of constipation post-surgery, however I principally imagine it is attributable to my interstitial cystitis meds.
“The factor with girls’s anatomy is that each one components are situated in the identical zip code, so to talk,” says Morgan Allyn Sendzischew Shane, MD, gastroenterologist and director at UHealth Women’s Health Alliance. So when you will have decrease stomach points or pelvic ache, it may very well be intestine, urinary, or reproductive-related—every kind of issues, she provides.
Dr. Shane says hormones like estrogen and progesterone can impact intestine motility, i.e., how usually you “go.” Because of this, individuals with endometriosis could have extreme constipation or diarrhea alongside ache, bloating, and nausea, she provides.
Diarrhea
Endometriosis may have the reverse impact on intestine motility, leading to diarrhea. Earlier than my second surgical procedure, anytime I ate a very inflammatory meal (like one with purple meat or dairy), or was going by means of a period-related flare, I’d get extraordinarily painful diarrhea.
As soon as once more, that is doubtless attributable to prostaglandins. Whereas anybody who will get a interval could discover themselves pooping extra usually round their time of month (aka, the period poops), the possibilities are even greater in these with endometriosis, as they usually produce greater ranges of prostaglandins, says Dr. Pham.
Principally, the uterine contractions felt throughout your interval (due to prostaglandins) can have an effect on your close by intestine, particularly when you have endometrial tissue rising in your intestines.
Nausea and vomiting
Some individuals could really feel barely nauseous round their interval, however for these with endometriosis, the insufferable ache might trigger them to full-on throw up. In the event you’re throwing up (or consistently really feel such as you’re on the verge of it) round your interval due to the ache, this can be an endometriosis purple flag. I might usually throw up after I had different excessive bowel points occurring, like diarrhea.
Whereas nausea can occur as a typical PMS symptom for these with out endometriosis (attributable to hormone modifications, per Nemours TeensHealth), nausea and vomiting with endometriosis are often attributable to ache, per the Endometriosis Foundation of America.
Find out how to inform the distinction between endometriosis and non-related intestine points
“Endometriosis generally impacts the intestine, inflicting gasoline, bloating, diarrhea, constipation, and painful and even bloody bowel actions,” says Dr. Chu. “Sadly, these signs are additionally nonspecific to endometriosis.”
One technique to inform the distinction? Take note of the timing of your signs. In the event that they correlate along with your menstrual cycle, they’re doubtless linked to endo.
Dr. Chu says you must also examine whether or not you will have hallmark endometriosis signs not associated to the intestine, together with:
- Heavy menstrual bleeding
- Dysmenorrhea (painful intervals not absolutely relieved by meds)
- Painful intercourse
- Unexplained infertility
“These would assist level a affected person within the route of a major gynecologic situation,” she provides.
Find out how to handle gut-related endometriosis signs
Not everybody with endometriosis could have intestine points. Actually, 20 to 25 p.c of individuals with endometriosis are asymptomatic—often known as silent endometriosis, in line with a 2010 assessment within the Journal of Assisted Reproduction and Genetics.
That stated, in the event you do have gut-related signs, there are some things you are able to do to assist handle them—whether or not or not you have had surgical procedure to your endometriosis. This is what the consultants advocate:
Maintain a meals diary
This will really feel tedious once you’re coping with excessive ache, however belief me, realizing which meals trigger your intestine signs to flare up may be extraordinarily beneficial.
“Sadly, there is not any particular food plan to advocate to endometriosis sufferers; now we have to comprehend that everybody’s intestine microbiome, genetics, and surroundings is exclusive,” says Dr. Chu. “I’d urge individuals to begin a meals diary to grasp their private signs.”
Dr. Chu additionally recommends attempting to chop again on meals generally identified to trigger abdomen upset, like caffeine, alcohol, processed meals, and meals excessive in refined sugar, to see if that helps.
Rule out any underlying GI problems
Seems, it is doable to have endometriosis and a separate GI dysfunction on the similar time. Actually, individuals with endometriosis are at a three times higher risk of growing concurrent GI circumstances like IBS, says Dr. Pham.
That will help you distinguish between a GI situation and endometriosis, it could be useful to see a gastroenterologist—particularly in case your intestine points occur frequently and intervene along with your every day life. They’ll run assessments (like stool samples, blood assessments, colonoscopies, or CT scans) to slim down the trigger and deal with it correctly.
Assemble a staff of health-care professionals
The most effective issues you are able to do for your self is to assemble a staff of medical doctors who can present complete care and assist. My staff consists of a urologist and two endometriosis specialists who work collectively to assist me handle my signs and supply me the absolute best care. Your staff could look completely different, although, and will embrace primary-care docs, OB/GYNs, gastros, and even registered dietitians.
“It is essential to get a staff on board who’s there to handle your considerations,” says Dr. Shane. “That always begins with specialists with whom you are feeling snug speaking all of your signs, and who’re conversant in endometriosis.”
From there, your staff will help deal with your signs one after the other, whether or not they be bodily, psychological, and even emotional.
When to see a physician
If you have already got endometriosis and your intestine points are getting extra intense, let your physician know. They’ll refer you to a gastroenterologist, or advocate surgical procedure to ease endometriosis signs. In the event you’ve already had ablation surgical procedure (like I did), ask your physician about excision surgical procedure, the place they take away as a lot endometrial tissue rising exterior the uterus as doable.
In case your physician is not listening to your considerations, do not be afraid to get a second opinion. That is what I did, and fortunately, my new staff took me critically and carried out the excision surgical procedure. I nonetheless take care of the occasional constipation, however general, my intestine well being has considerably improved since that surgical procedure.
And eventually, if you have not been formally recognized with endometriosis however assume you will have it, talk to your doctor. If they do not hear or take you critically, write down all of your signs, together with intestine points, then schedule an appointment with a physician who makes a speciality of endometriosis to debate your considerations.
The underside line
Endometriosis can positively trigger GI points, and people could usually be the primary warning signal (aside from painful intervals) that one thing could also be off. As a result of endometriosis remains to be a largely misunderstood (and underdiagnosed) situation, it is essential you encompass your self with the suitable kind of assist—together with a staff of medical professionals that may deal with all completely different elements of the illness.
In different phrases, do not simply go to an OB/GYN; they’re usually not skilled within the complexities of this situation. Discover an endometriosis specialist, in the event you can.
And keep in mind: For many individuals, myself included, it takes a number of years to get an official analysis. Do not be afraid to face up for your self alongside the way in which, and to proceed to advocate to your care.
If you wish to discover a specialist however aren’t positive the place to begin, listed here are some free on-line assets that may assist:
