Endo Belly: Definition, Causes, Symptoms & Treatment

By Dr. Kenosha Gleaton, OBGYN

What is Endo Belly?

Endometriosis is a chronic inflammatory gynecologic condition that's characterized by uterine tissue, also referred to as implants, growing outside of the uterus. [1] These implants can be found in or around the ovaries, fallopian tubes, gastrointestinal (GI) tract, and elsewhere. “Endo belly” refers to a common symptom experienced by many people with endometriosis. Endo belly is not an official medical term, but has been used by various providers and patients to describe specific GI symptoms caused by endometriosis. [2-3] 

Causes of Endo Belly

Endo belly is a side effect of endometriosis. More specifically, endo belly is a buildup of inflammation and gas inside the abdomen. [3] When endometrial implants become inflamed and bleed, nearby organs and tissues can also be impacted. Depending on where the implants grow, endometriosis can irritate or block the intestines, which results in gastrointestinal discomfort. [1] The short answer is that endometriosis causes internal inflammation, which can lead to GI discomfort, aka endo belly. [1,3] 

Symptoms of Endo Belly

So what does endo belly actually feel or look like? There are both physical and mental effects of endometriosis and endo belly. Depending on the stage of endometriosis, endo belly symptoms can be severe or mild.

Learn about what endometriosis feels like in our blog.

Physical Symptoms of Endo Belly

Endo belly can be described as gastrointestinal-related pain or discomfort. The most common symptoms include [1,3,4]:

• Abdominal bloating or tenderness
• Constipation
• Diarrhea
• Nausea
• Painful bowel movements

Aside from these GI symptoms, endometriosis patients also report experiencing [1,4]: 

• Painful sex
• Painful urination
• Period pain
• Heavy and abnormal bleeding
• Pelvic pain or back pain
• Fatigue
• Infertility (Learn more about endometriosis and its effect on fertility and pregnancy) 

Emotional and Mental Impact of Endo Belly

Endometriosis is a chronic condition, meaning it is persistent and recurring, and currently incurable. This can cause an emotional or mental impact on some people. Some psychological symptoms tied to endometriosis or endo belly include [5]:

• Depression
• Anxiety
• Stress
• Poor quality of life

If you are currently experiencing any difficult symptoms related to physical or mental health, be sure to speak to a healthcare provider about your treatment options. 

Diagnosing Endo Belly

It can be difficult to determine the cause of gastrointestinal symptoms, especially because the symptoms of endo belly closely mimic many other GI conditions, including celiac disease, Crohn's disease, irritable bowel syndrome (IBS), and others. [1,3] Endo belly isn’t an official medical term or diagnosis, but a healthcare provider may be able to determine that your GI pain and discomfort are being caused by endometriosis, rather than another underlying condition. If your GI symptoms seem to be cyclical and in line with your menstrual cycle, you may be experiencing endo belly. [3] If you have symptoms that tend to flare up randomly or after eating certain foods, you may be dealing with a specific GI condition. Talking to a healthcare provider directly is your best option for identifying the cause of your symptoms.

When to Consult a Doctor

You should always consult a healthcare provider if you are concerned or have questions about your health. A professional will be able to help you determine the root of your GI pain and discomfort. In order to determine the cause of your symptoms, your healthcare provider will take a look at your family history, health condition history, and may screen you for other endometriosis symptoms if you haven’t already been diagnosed. Some tests or exploratory surgeries can help healthcare providers determine if you have endometriosis and where the implants are located. [1,4] 

Some people may actually be experiencing both endo belly and a GI condition. Depending on the cause, your provider can discuss what treatment options may be beneficial to reduce your symptoms. 

Treatment Options for Endo Belly

At this time there is no cure for endometriosis, however, there are ways to manage and treat endometriosis pain and symptoms, including endo belly. [1,4] 

Over-the-counter Medications and Prescription Hormonal Medications

Various medications and prescriptions may be helpful in reducing GI pain and other endometriosis symptoms. Endometriosis is an estrogen-dependent condition, meaning it relies on the presence of estrogen to grow, and estrogen tends to aggravate the inflammation and symptoms related to endometriosis. [1] 

In order to target the inflammation causing GI discomfort and the hormone levels responsible for aggravating this inflammation, first-line pharmacological therapies include non-steroidal anti-inflammatory drugs (NSAIDs), progestins, or combined hormonal contraceptives. [1] These medications can help alleviate inflammation and keep hormone levels balanced.  In some cases, hormonal contraceptives can be used to prevent menstruation from occurring, which may reduce endometriosis flare-ups. Gonadotropin-releasing hormone (GnRH) antagonists and gas pills, such as simethicone may also be used to block estrogen production or relieve gas buildup. 

The Role of Surgery in Treating Endo Belly

Some people opt for surgical treatment to reduce endometriosis symptoms and improve their quality of life. There are a few different options for surgery, but most healthcare providers will perform endometriosis laparoscopy in order to remove implants. [1,3,4] Laparoscopy is a minimally invasive procedure that involves inserting a camera and other tools through a small incision in the abdomen. Once inside the body, the healthcare provider is able to see where the endometrial tissue has grown and can remove the lesions. In some cases, surgery may include completely removing the uterus or other organs and tissues. [1,3]

Natural Remedies for Treating Endo Belly

There is data to support the use of various dietary changes, supplements, and other methods for endometriosis self care. Dietary changes have been helpful for many people facing GI discomfort. [3] Cutting out foods that are inflammatory and emphasizing an anti-inflammatory diet may help with some of the endometriosis bloating, nausea, and other endo belly symptoms. [3] Some examples of anti-inflammatory foods include fiber, omega-3 fatty acids, probiotics, avocados, berries, plant oils, etc. [3,6] The FODMAP diet is also commonly recommended for some with digestive problems. Speak to a healthcare provider about your diet and potential changes you can make to relieve symptoms. 

Ginger has also been found to be a helpful food or supplement for treating various gastrointestinal disorders. Research shows that ginger improves gastric emptying, reduces cramping, severe bloating, nausea, and fights off inflammation. [7] 

You should always consult a healthcare professional before attempting any professional or such as treatments, changing your diet, or making changes to your supplement routine. 

Natalist's Role in Supporting Women and People with Endo Belly

Endometriosis can cause pain, infertility, and uncomfortable gastrointestinal problems. Whether or not you’re attempting to conceive anytime soon, Natalist has products that can support your reproductive health. Shop anti-inflammatory supplements such as CoQ10 and Omega DHA, or try out products like Fiber, ginger gummies, and Magnesium Plus to find what works best for you. As a reminder, you should always consult a healthcare provider before trying any new supplements or attempting to manage a condition on your own. 

Dr. Kenosha Gleaton is board-certified in gynecology and obstetrics and is the Medical Advisor of Natalist. She received her MD from MUSC and completed her residency at Carolinas Medical Center in Charlotte, NC.

Dr. Gleaton is passionate about women, youth, and mentoring. She is a Scrubs Camp instructor, a program to increase student entry in healthcare, and serves as a Compassion International adoptive parent. She is also a member of the American College of Obstetrics & Gynecology, the American Association of Gynecologic Laparoscopists, and the American Association of Professional Women.  

References:

1. Tsamantioti ES, Mahdy H. Endometriosis. [Updated 2023 Jan 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK567777/
2. Akers, A. Mariz, F. What to know about endo belly. Medical News Today. April 28 2021. URL. 
3. Endo Belly: What It Is and How To Get Rid of It. Cleveland Clinic. January 4 2023. URL. 
4. Endometriosis. World Health Organization. March 24 2023. URL. 
5. Laganà AS, La Rosa VL, Rapisarda AMC, et al. Anxiety and depression in patients with endometriosis: impact and management challenges. Int J Womens Health. 2017;9:323-330. Published 2017 May 16. doi:10.2147/IJWH.S119729
6. Cristofori F, Dargenio VN, Dargenio C, Miniello VL, Barone M, Francavilla R. Anti-Inflammatory and Immunomodulatory Effects of Probiotics in Gut Inflammation: A Door to the Body. Front Immunol. 2021;12:578386. Published 2021 Feb 26. doi:10.3389/fimmu.2021.578386
7. Nikkhah Bodagh M, Maleki I, Hekmatdoost A. Ginger in gastrointestinal disorders: A systematic review of clinical trials. Food Sci Nutr. 2018;7(1):96-108. Published 2018 Nov 5. doi:10.1002/fsn3.807