Endometriosis, IBS and the low FODMAP diet

There is considerable overlap between the symptoms of endometriosis and Irritable Bowel Syndrome (IBS), two of the leading causes of chronic pelvic pain in women. Research has found that approximately one-third of women with endometriosis meet the diagnostic criteria for IBS, with one study finding that 79% of women with IBS actually had endometriosis when examined via laparoscopy.

So what does this mean for women with endometriosis, IBS or both? And what role does the low FODMAP diet play?

What is endometriosis? 

Endometriosis has only recently begun to get the attention it deserves by the medical community and the public. The condition, which affects one in 10 women, occurs when cells similar to those that line the uterus, grow outside of it. This usually impacts the ovaries, fallopian tubes, ligaments in the pelvis and large intestine, bladder, vagina and, in rare cases, the lungs. Symptoms can be debilitating and greatly affect your daily life.

Symptoms of endometriosis include:

• Severe period pain
• Heavy periods
• Pain during sex
• Fatigue
• Abdominal pain
• Pain going to the toilet
• Lower back and pelvic pain
• Bloating
• Mood changes
• Changes in bowel habits (constipation and diarrhoea)
• Infertility

What is IBS?

IBS is a functional gastrointestinal disorder characterised by symptoms such as:

• Cramping
• Abdominal pain
• Bloating
• Gas
• Diarrhoea or constipation, or both.

Further complicating this chronic condition is that there is currently no known cause or cure. But don’t be disheartened, determining your IBS triggers can help manage the condition for the long term and improve your quality of life.

What can the low FODMAP diet do?

It’s clear that there’s plenty of overlap between symptoms of endometriosis and IBS, including bloating, altered bowel habits, abdominal pain and reduced quality of life. A critical factor in both IBS and Endometriosis is visceral hypersensitivity, a term used to describe the experience of pain within the inner organs (viscera) at a level that is more intense than normal. This pain is thought to be caused by too much water and gas in the large bowel. How does the water and gas get in there?

1. High FODMAP foods are eaten (e.g. wheat, rye, mango, milk, honey) and travel down to the small intestine.
2. Some FODMAPs are not digested properly
3. They keep going down to the large bowel (where they technically shouldn’t go) drawing water with them along the way.  The bacteria there gobble them up producing methane, hydrogen and carbon. These are the gases which cause bloating and pain to the sensitive intestine.

So, in following the low FODMAP diet we can find out which foods are causing the issues and limit them. Research has found that a low FODMAP diet can help with endometriosis and IBS management.

Important points

The low FODMAP diet is different for EVERYONE depending on what they are sensitive to. It is not supposed to be really restrictive and requires the guidance of a FODMAP trained dietitian. The good thing is we have some great ones here at The FODMAP Challenge as well as an online course you can do from home.

The overlap in endo and IBS is also an example of why you shouldn’t self-diagnose! If you suspect you have either condition, speak to a doctor before making dietary changes to ensure an underlying issue isn’t left untreated.

Need help with the low FODMAP diet? Our FREE dietitian developed program will guide you through it, step-by-step. Includes a low FODMAP food guide. Sign up now.

If you are experiencing gut symptoms and have not been recommended a low FODMAP diet by a health professional, get started with the manage your gut symptoms program.

Reviewed by the healthylife Advisory Board March 2022