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 I used to be simply 10 years outdated, and I used to be so scared I might finished one thing incorrect that I hid my stained underwear in my closet.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 understand it on the time: a decades-long battle with endometriosis and its debilitating signs.
Since that very first interval, I’ve handled a heavy move and agonizing cramps. After I reached my early teenagers, issues received worse. I might spend days doubled over in ache, fleeing to a heat tub once I may for reduction. By my early 20s, I started getting what I believed have been recurring UTIs, and I might 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 Heart
- Morgan Allyn Sendzischew Shane, MD, gastroenterologist, assistant clinic professor, and director at UHealth Ladies’s Well being Alliance
- Tamer Seckin, MD, board-certified OB/GYN, endometriosis specialist, and founding father of The Endometriosis Basis of America
- Tiffany Pham, MD, OB/GYN and medical advisor for Flo Well being
After which there have been the bowel actions: Every one felt like somebody was tearing one thing out of my left aspect. I might break right into a sweat and must lie down within the bathe afterward to calm myself down. Nausea would hit due to the ache, and different days, my abdomen would bloat to the purpose that I appeared pregnant.
Even after telling my docs that my mother had endometriosis (I might watched her undergo the identical precise signs), it took a complete of seven docs over the span of 14 years for me to get an official dual-diagnosis: endometriosis and interstitial cystitis (also referred to as bladder ache syndrome). Up till that time, all I might ever heard from docs was “nothing’s incorrect with you,” and “that is only a regular a part of being a girl.”
And it wasn’t till after my first surgical procedure for endometriosis that I spotted my situation and my raging intestine signs have been very carefully intertwined.
How endometriosis impacts the intestine
Most of what you see about endometriosis in mainstream media has nothing to do together with your intestine. However the reality is, dwelling with endometriosis can take over each side of your life and well being—intestine well being included.
Actually, the fourth basic symptom of endometriosis (after irregular intervals, painful intervals, and painful intercourse) is irregular bowel actions and gastrointestinal misery, in accordance with The Endometriosis Basis of America. This could embody extraordinarily painful pooping in addition to constipation, diarrhea, and bloating, normally throughout menstruation.
These signs are normally an indication that endometrial tissue (which normally 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 should you’re an individual with a uterus, endometriosis ought to be thought-about as a possible trigger. (Although it usually is not—no marvel, then, that it takes seven years on common to get a correct analysis, with 6 in 10 instances of endometriosis going undiagnosed, per a Might 2023 evaluation in Cureus.)
“Endometriosis may very well be the major explanation for 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 Heart (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 more likely to suspect endometriosis as, in lots of instances, it would not seem in routine testing.”
For me, bowel points have 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 totally eliminated), I used to be left with horrible GI points like irregular bowel actions, power constipation, and belly ache. Fortunately, my second surgical procedure with Tamer Seckin, MD, a board-certified OB/GYN, endometriosis specialist, and founding father of The Endometriosis Basis of America, and Dr. Chu, introduced some intestine reduction.
Finally, should 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 group 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 normally).
Had I not sought out specialists like Dr. Seckin and Dr. Chu, I do not know the place I might be in the present day besides (more than likely) bedridden and nonetheless trying to find solutions.
Advocating for your self and listening to what’s actually occurring in your physique is the one approach 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 belly swelling, is a standard symptom of endometriosis. It may final for hours, days, or weeks, trigger discomfort and ache, and may even make you look pregnant or severely swollen. Docs do not actually know the particular explanation for 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 could cause GI points like bloating,” says Tiffany Pham, MD, OB/GYN and medical advisor at Flo Well being.
Greater-than-usual ranges of the hormone-like substance prostaglandins (which is typical for folks with endo) may also have an effect on the bowels and their functioning, provides Dr. Pham.
Not everybody with endometriosis will get “endo stomach,” however should you do, it might probably have bodily and psychological well being results, like low shallowness and physique picture points, in accordance with a September 2022 article within the Worldwide Journal of Behavioral Drugs.
Belly ache (and painful bowel actions)
That is yet one more hallmark symptom of endometriosis, which might 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 components like stress.
Folks with endometriosis could have fixed belly ache or pelvic ache, which regularly worsens throughout menstruation, per UCLA Well being. This implies endometriosis may trigger belly ache that isn’t at all times essentially related together with your menstrual cycles.
One other time this belly ache could spark up? While you’re attempting to have a bowel motion. (Extra on this beneath.)
Constipation
Many individuals with endometriosis have power constipation, per The Endometriosis Basis 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 largely imagine it is because of my interstitial cystitis meds.
“The factor with girls’s anatomy is that each one components are positioned in the identical zip code, so to talk,” says Morgan Allyn Sendzischew Shane, MD, gastroenterologist and director at UHealth Ladies’s Well being Alliance. So when you may have decrease belly points or pelvic ache, it might be intestine, urinary, or reproductive-related—all types 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, folks with endometriosis could have extreme constipation or diarrhea alongside ache, bloating, and nausea, she provides.
Diarrhea
Endometriosis may also 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 crimson meat or dairy), or was going by means of a period-related flare, I might get extraordinarily painful diarrhea.
As soon as once more, that is possible because of prostaglandins. Whereas anybody who will get a interval could discover themselves pooping extra usually round their time of month (aka, the interval poops), the possibilities are even larger in these with endometriosis, as they usually produce larger 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 you probably have endometrial tissue rising in your intestines.
Nausea and vomiting
Some folks could really feel barely nauseous round their interval, however for these with endometriosis, the insufferable ache may trigger them to full-on throw up. For those who’re throwing up (or continuously really feel such as you’re on the verge of it) round your interval due to the ache, this can be an endometriosis crimson flag. I might usually throw up once I had different excessive bowel points occurring, like diarrhea.
Whereas nausea can occur as a typical PMS symptom for these with out endometriosis (because of hormone modifications, per Nemours TeensHealth), nausea and vomiting with endometriosis are normally because of ache, per the Endometriosis Basis of America.
Find out how to inform the distinction between endometriosis and non-related intestine points
“Endometriosis generally impacts the intestine, inflicting fuel, bloating, diarrhea, constipation, and painful and even bloody bowel actions,” says Dr. Chu. “Sadly, these signs are additionally nonspecific to endometriosis.”
One approach to inform the distinction? Take note of the timing of your signs. In the event that they correlate together with your menstrual cycle, they’re possible linked to endo.
Dr. Chu says you must also verify whether or not you may have hallmark endometriosis signs not associated to the intestine, together with:
- Heavy menstrual bleeding
- Dysmenorrhea (painful intervals not totally relieved by meds)
- Painful intercourse
- Unexplained infertility
“These would assist level a affected person within the course of a major gynecologic problem,” she provides.
Find out how to handle gut-related endometriosis signs
Not everybody with endometriosis can have intestine points. Actually, 20 to 25 % of individuals with endometriosis are asymptomatic—also referred to as silent endometriosis, in accordance with a 2010 evaluation within the Journal of Assisted Copy and Genetics.
That stated, should 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’ve got had surgical procedure to your endometriosis. This is what the specialists advocate:
Hold a meals diary
This will likely really feel tedious if you’re coping with excessive ache, however belief me, realizing which meals trigger your intestine signs to flare up might be extraordinarily priceless.
“Sadly, there is not any particular weight-reduction plan to advocate to endometriosis sufferers; we now have to comprehend that everybody’s intestine microbiome, genetics, and atmosphere is exclusive,” says Dr. Chu. “I might urge folks to start out 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 issues
Seems, it is doable to have endometriosis and a separate GI dysfunction on the identical time. Actually, folks with endometriosis are at a thrice larger threat of creating concurrent GI circumstances like IBS, says Dr. Pham.
That can assist you distinguish between a GI problem and endometriosis, it might be useful to see a gastroenterologist—particularly in case your intestine points occur repeatedly and intrude together with your each day life. They will run exams (like stool samples, blood exams, colonoscopies, or CT scans) to slender down the trigger and deal with it correctly.
Assemble a group of health-care professionals
Among the finest issues you are able to do for your self is to assemble a group of docs who can present complete care and assist. My group consists of a urologist and two endometriosis specialists who work collectively to assist me handle my signs and supply me the very best care. Your group could look totally different, although, and will embody primary-care docs, OB/GYNs, gastros, and even registered dietitians.
“It is essential to get a group on board who’s there to handle your issues,” says Dr. Shane. “That always begins with specialists with whom you are feeling comfy speaking all of your signs, and who’re acquainted with endometriosis.”
From there, your group will help sort out your signs one after the other, whether or not they be bodily, psychological, and even emotional.
When to see a health care provider
If you have already got endometriosis and your intestine points are getting extra intense, let your physician know. They will refer you to a gastroenterologist, or advocate surgical procedure to ease endometriosis signs. For those who’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 issues, do not be afraid to get a second opinion. That is what I did, and fortunately, my new group took me critically and carried out the excision surgical procedure. I nonetheless take care of the occasional constipation, however total, my intestine well being has considerably improved since that surgical procedure.
And eventually, if you have not been formally recognized with endometriosis however suppose you may have it, speak to your physician. 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 health care provider who makes a speciality of endometriosis to debate your issues.
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 correct kind of assist—together with a group of medical professionals that may deal with all totally 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, should 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 best way, and to proceed to advocate to your care.
If you wish to discover a specialist however aren’t positive the place to start out, listed here are some free on-line assets that may assist:
