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 I used to be simply 10 years outdated, and I used to be so scared I would finished one thing improper that I hid my stained underwear in my closet. At that age, I did not know something about menstruation. When my mother came upon, she was shocked it occurred so early.
It was additionally the start of one other journey for me, though I did not comprehend it on the time: a decades-long battle with endometriosis and its debilitating signs.
Since that very first interval, I’ve handled a heavy circulate and agonizing cramps. After I reached my early teenagers, issues bought worse. I would spend days doubled over in ache, fleeing to a heat tub once 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 Middle
- 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 facet. I would break right into a sweat and need to 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 regarded pregnant.
Even after telling my docs that my mother had endometriosis (I would watched her undergo the identical actual 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 (often known as bladder ache syndrome). Up till that time, all I would ever heard from docs was “nothing’s improper 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 noticed 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 together with your intestine. However the reality is, residing with endometriosis can take over each side of your life and well being—intestine well being included.
In reality, the fourth elementary symptom of endometriosis (after irregular durations, painful durations, and painful intercourse) is irregular bowel actions and gastrointestinal misery, in line with The Endometriosis Basis of America. This will embrace extraordinarily painful pooping in addition to constipation, diarrhea, and bloating, normally throughout menstruation.
These signs are normally an indication that endometrial tissue (which normally strains 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 case you’re an individual with a uterus, endometriosis needs to be thought of as a possible trigger. (Although it typically 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 Could 2023 evaluation in Cureus.)
“Endometriosis may very well be the major reason 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 Middle (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 would 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, power 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 Basis of America, and Dr. Chu, introduced some intestine reduction.
In the end, in case you’ve been recognized with endometriosis (or are nonetheless ready for a analysis) and your intestine points are taking on your life, let your care crew know. Advocating for your self and listening to what’s actually happening in your physique is the one means get applicable therapy for endometriosis-related intestine points (and for the situation typically).
Had I not sought out specialists like Dr. Seckin and Dr. Chu, I do not know the place I would be immediately besides (most definitely) bedridden and nonetheless trying to find solutions.
Advocating for your self and listening to what’s actually happening in your physique is the one strategy to get applicable therapy for endometriosis-related intestine points.
5 intestine points which will really 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 might probably final for hours, days, or weeks, trigger discomfort and ache, and may even make you look pregnant or severely swollen. Medical doctors do not actually know the precise reason for this symptom, however they consider it has to do with irritation and hormone adjustments, 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 Well being.
Larger-than-usual ranges of the hormone-like substance prostaglandins (which is typical for folks 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 case you do, it may well have bodily and psychological well being results, like low vanity and physique picture points, in line 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 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 frequently worsens throughout menstruation, per UCLA Well being. This implies endometriosis might trigger stomach ache that isn’t at all times essentially related together with your menstrual cycles.
One other time this stomach ache could spark up? Whenever you’re making an attempt to have a bowel motion. (Extra on this under.)
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 principally consider it is attributable to my interstitial cystitis meds.
“The factor with girls’s anatomy is that each one elements 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’ve gotten decrease stomach points or pelvic ache, it could possibly be intestine, urinary, or reproductive-related—all types of issues, she provides.
Dr. Shane says hormones like estrogen and progesterone can affect intestine motility, i.e., how typically you “go.” Consequently, folks 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 via 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 typically round their time of month (aka, the interval poops), the possibilities are even greater in these with endometriosis, as they typically produce greater ranges of prostaglandins, says Dr. Pham.
Mainly, 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 might trigger them to full-on throw up. For those who’re throwing up (or continually 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 would typically throw up once I had different excessive bowel points happening, like diarrhea.
Whereas nausea can occur as a typical PMS symptom for these with out endometriosis (attributable to hormone adjustments, per Nemours TeensHealth), nausea and vomiting with endometriosis are normally attributable to ache, per the Endometriosis Basis of America.
Tips on 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 strategy 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 doubtless linked to endo.
Dr. Chu says you must also test whether or not you’ve gotten hallmark endometriosis signs not associated to the intestine, together with:
- Heavy menstrual bleeding
- Dysmenorrhea (painful durations not absolutely relieved by meds)
- Painful intercourse
- Unexplained infertility
“These would assist level a affected person within the path of a major gynecologic difficulty,” she provides.
Tips on how to handle gut-related endometriosis signs
Not everybody with endometriosis can have intestine points. In reality, 20 to 25 % of individuals with endometriosis are asymptomatic—often known as silent endometriosis, in line with a 2010 evaluation within the Journal of Assisted Replica and Genetics.
That mentioned, in case 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 in your endometriosis. Here is what the specialists advocate:
Maintain a meals diary
This may occasionally really feel tedious if you’re coping with excessive ache, however belief me, realizing which meals trigger your intestine signs to flare up may be extraordinarily worthwhile.
“Sadly, there isn’t any particular weight-reduction plan to advocate to endometriosis sufferers; we now have to appreciate that everybody’s intestine microbiome, genetics, and atmosphere is exclusive,” says Dr. Chu. “I’d urge folks to start out a meals diary to grasp their private signs.”
Dr. Chu additionally recommends making an attempt 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 attainable to have endometriosis and a separate GI dysfunction on the identical time. In reality, folks with endometriosis are at a 3 times greater threat of growing concurrent GI circumstances like IBS, says Dr. Pham.
That will help you distinguish between a GI difficulty and endometriosis, it could be useful to see a gastroenterologist—particularly in case your intestine points occur repeatedly and intervene together with your each 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 crew of health-care professionals
The most effective issues you are able to do for your self is to assemble a crew of docs who can present complete care and assist. My crew 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 crew could look totally different, although, and will embrace primary-care docs, OB/GYNs, gastros, and even registered dietitians.
“It is necessary to get a crew on board who’s there to handle your issues,” says Dr. Shane. “That always begins with specialists with whom you’re feeling comfy speaking all of your signs, and who’re conversant in endometriosis.”
From there, your crew can assist sort out 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. 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 attainable.
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 crew 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 at last, if you have not been formally recognized with endometriosis however assume you’ve gotten it, discuss 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 physician who focuses on endometriosis to debate your issues.
The underside line
Endometriosis can positively trigger GI points, and people could typically be the primary warning signal (aside from painful durations) that one thing could also be off. As a result of endometriosis remains to be a largely misunderstood (and underdiagnosed) situation, it is necessary you encompass your self with the suitable sort of assist—together with a crew of medical professionals that may deal with all totally different points of the illness.
In different phrases, do not simply go to an OB/GYN; they’re typically not educated within the complexities of this situation. Discover an endometriosis specialist, in case 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 in 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:
