What is endo belly? How to manage the severe bloating endometriosis can cause
- Endo belly is the severe bloating that endometriosis causes and can last for hours, days, or weeks.
- Make diet changes, use hormonal treatment, and treat any other gastrointestinal issues to manage endo belly.
- There is no cure for endometriosis, but managing the condition can alleviate the symptoms.
Endometriosis bloat, also called endo belly, describes the uncomfortable bloating that's associated with endometriosis - an incurable, inflammatory condition that affects one in 10 reproductive-aged individuals worldwide.
"It may not be a true medical term, but those who have endometriosis are all too familiar with the term endo belly, which is painful bloating and swelling of the abdomen," says Sherry Ross, MD, and author of "She-ology: The Definitive Guide to Women's Intimate Health. Period."
Unlike the typical bloating that an individual may experience during menstruation, endo belly can last a few hours, days, or even weeks which can take a toll on your mental, emotional, and physical health.
Here are the causes, symptoms, and potential prevention methods and pain management options for endo belly.
What causes endo belly?
Endometriosis is a chronic condition in which tissue that's similar to the tissue that normally grows in your uterus grows outside of it.
Each month, this tissue breaks down and bleeds - just like the lining of the uterus does. Because this tissue doesn't have a way to escape or leave the body, it gets trapped resulting in inflammation and the formation of scar tissue.
The Center for Endometriosis reports bloating as a "widely recognized … major symptom" in individuals with endometriosis. In fact, according to the Australian and New Zealand Journal of Obstetrics and Gynecology, 83% of individuals with endometriosis experience bloating as a symptom.
Other common symptoms of endometriosis:
- Heavy or painful periods
- Pain with intercourse
- Spotting or irregular periods
- Pain with bowel movements and/or urination
- Infertility
According to Heather Jeffcoat, DPT, and owner of Femina Physical Therapy, endo belly most likely occurs from endometriosis-related inflammation, causing a "belly that can be flat in the morning and look a few months pregnant by the evening."
Endo belly can happen at any time, for a variety of reasons. Some examples of triggers that may cause endometriosis-related bloating include:
- A gluten or lactose intolerance
- Intolerance to certain food chemicals, such as histamine and the A1 protein
- Hormonal changes
- Taking antidepressants
- Stress
"Many endometriosis patients also have gut issues, typically associated with small intestine bacterial overgrowth (SIBO)," says Jeffcoat.
What does endo belly look like?
Endometriosis is an individualized condition, so each person's experience is going to be different, both symptom-wise and in severity.
"For some women, endo belly looks like a pregnancy in the third trimester," says Ross. "Others may look like they are in the second trimester of pregnancy. Every woman has a different presentation and belly protrusion."
Endo belly before and after:
"Endo belly typically ignites my body dysmorphia to a staggering degree," says Danielle Payton, a woman with endometriosis and the co-founder of kuddose, an online digital fitness and wellness platform. "While I know the endo belly will eventually subside and the pain will subside ... I'm mentally triggered. It's a constant battle with my body and my mental wellbeing."
How to treat and prevent endo belly
Endometriosis should be examined on a case-by-case basis when it comes to pain management and treatment.
That said, you can reduce your endo belly symptoms by successfully managing your endometriosis (via excision surgery, dietary changes, and/or hormonal treatment) and treating any underlying gastrointestinal conditions, such as SIBO or irritable bowel syndrome (IBS).
"Endo belly generally waxes and wanes with flare-ups of endometriosis, so conditions such as SIBO etc. must also be treated in order to eliminate these symptoms," says Laurence Orbuch, MD, endometriosis specialist, and director of GYN Laparoscopic/Robotic Associates LA.
Other things that may help to prevent or reduce the symptoms of an endo belly flare-up include:
- Avoiding inflammatory foods and beverages, including red meat, processed foods, dairy, gluten, alcohol, and caffeine
- Eating more fiber to prevent constipation
- Drinking peppermint tea or ginger tea to relieve digestive issues or pain
- Wear comfortable, loose-fitting clothes
"Many women find relief from hot water bottles or heating pads to the abdominal area, but I find the most relief from a small ice pack in several layers of towels," says endometriosis advocate Brittany Ferri, an occupational therapist and founder of Simplicity of Health. "It gives a gentle cooling feeling to the pressure there."
Insider's takeaway
In addition to severe bloating, endo belly may also cause mental or emotional stress - this is especially true for individuals who are struggling with endometriosis-related infertility. "Looking pregnant" while you're desperately trying to conceive is yet another one of endometriosis' cruel jokes.
Finding a way to successfully manage your endometriosis and any other underlying conditions you may have is the best way to prevent or reduce the symptoms of endo belly. If you're suffering from unusually long-lasting abdominal bloating, be sure to contact your doctor as endometriosis isn't the only condition that can cause a swollen belly.
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