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 I used to be simply 10 years outdated, and I used to be so scared I might accomplished one thing flawed that I hid my stained underwear in my closet.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 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 obtained worse. I might spend days doubled over in ache, fleeing to a heat tub once I may for aid. 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: Each 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 regarded pregnant.
Even after telling my medical doctors that my mother had endometriosis (I might watched her undergo the identical actual 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 (also called bladder ache syndrome). Up till that time, all I might ever heard from medical doctors was “nothing’s flawed 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 keeping 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 situations like irritable bowel syndrome (IBS), Crohn’s illness, or appendicitis. However in the event you’re an individual with a uterus, endometriosis must be thought of as a possible trigger. (Although it typically is not—no marvel, then, that it takes seven years on common to get a correct prognosis, with 6 in 10 circumstances of endometriosis going undiagnosed, per a Could 2023 assessment in Cureus.)
“Endometriosis may very well be the main 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 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 main 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 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 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 aid.
Finally, in the event you’ve been identified with endometriosis (or are nonetheless ready for a prognosis) 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 approach get applicable remedy for endometriosis-related intestine points (and for the situation generally).
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 (almost certainly) bedridden and nonetheless looking for solutions.
Advocating for your self and listening to what’s actually happening 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 stomach swelling, is a typical symptom of endometriosis. It will probably final for hours, days, or weeks, trigger discomfort and ache, and might even make you look pregnant or severely swollen. Docs 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 Well being.
Increased-than-usual ranges of the hormone-like substance prostaglandins (which is typical for folks with endo) can even 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 may have bodily and psychological well being results, like low shallowness and physique picture points, in keeping 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 components like stress.
Folks with endometriosis could have fixed stomach ache or pelvic ache, which frequently worsens throughout menstruation, per UCLA Well being. This implies endometriosis may 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? Once 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 principally imagine it is because of my interstitial cystitis meds.
“The factor with girls’s anatomy is that every 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 could have decrease stomach 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 affect intestine motility, i.e., how typically you “go.” In consequence, folks with endometriosis could have extreme constipation or diarrhea alongside ache, bloating, and nausea, she provides.
Diarrhea
Endometriosis can even 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 might get extraordinarily painful diarrhea.
As soon as once more, that is doubtless because of 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 increased in these with endometriosis, as they typically produce increased ranges of prostaglandins, says Dr. Pham.
Principally, the uterine contractions felt throughout your interval (because of prostaglandins) can have an effect on your close by intestine, particularly when you 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. In the event you’re throwing up (or always 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 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 (because of hormone modifications, per Nemours TeensHealth), nausea and vomiting with endometriosis are normally because of ache, per the Endometriosis Basis of America.
How one can 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 doubtless linked to endo.
Dr. Chu says you also needs to examine whether or not you could 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 main gynecologic challenge,” she provides.
How one can handle gut-related endometriosis signs
Not everybody with endometriosis may have intestine points. Actually, 20 to 25 % of individuals with endometriosis are asymptomatic—also called silent endometriosis, in keeping with a 2010 assessment within the Journal of Assisted Copy 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 in your endometriosis. This is what the specialists advocate:
Maintain a meals diary
This may occasionally really feel tedious whenever you’re coping with excessive ache, however belief me, understanding which meals trigger your intestine signs to flare up may be extraordinarily useful.
“Sadly, there isn’t any particular eating regimen to advocate to endometriosis sufferers; now we have to comprehend that everybody’s intestine microbiome, genetics, and atmosphere is exclusive,” says Dr. Chu. “I might urge folks 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 issues
Seems, it is attainable to have endometriosis and a separate GI dysfunction on the similar time. Actually, folks with endometriosis are at a thrice increased threat of growing concurrent GI situations like IBS, says Dr. Pham.
That can assist you distinguish between a GI challenge and endometriosis, it might be useful to see a gastroenterologist—particularly in case your intestine points occur recurrently and intervene together with your every day life. They will 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
Top-of-the-line issues you are able to do for your self is to assemble a crew of medical doctors who can present complete care and help. My crew 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 crew could look totally different, although, and will embrace primary-care docs, OB/GYNs, gastros, and even registered dietitians.
“It is essential to get a crew on board who’s there to deal with 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 crew may 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. 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 outdoors 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 significantly 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 identified with endometriosis however assume you could have it, discuss to your physician. If they do not hear or take you significantly, 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 typically be the primary warning signal (other than 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 proper kind of help—together with a crew of medical professionals that may tackle all totally different elements 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 the event you can.
And bear in mind: For many individuals, myself included, it takes a number of years to get an official prognosis. Do not be afraid to face up for your self alongside the way in which, and to proceed to advocate in your care.
If you wish to discover a specialist however aren’t positive the place to begin, listed here are some free on-line sources that may assist:
