Written by: Alyssa Chavez

When you hear about endometriosis, you likely think of it as a “reproductive issue.” 

In basic terms, endometriosis is where tissue similar to the endometrial lining of your uterus grows outside of your uterus, often in places like your ovaries, bowels, bladder, and elsewhere in your pelvic region and beyond. 

Endometriosis comes with symptoms like period pain, pain with intercourse, pain with ovulation, and can also be linked to infertility on many occasions.

But at the end of the day, endometriosis is so much more. Endo is a full-body disease. That means we need to stop focusing on the reproductive organs alone and start zooming out and looking at the bigger picture. That starts with your gut!

Why look to your gut?

Your gut may not be the first thing that comes to mind when you think of endometriosis, but it is a huge piece of the puzzle. Let’s take a look at why it matters.

One of the major symptoms that women with endometriosis experience is pain. Pain is a symptom of inflammation. Inflammation is a sign that your immune system is at work.

Picture this: you get a paper cut on your finger. The very first thing that you notice is pain at the site of the injury, followed by some redness and possibly puffiness. That is your immune system at work to clear out anything it considers “foreign.”

Let’s make some connections

If you have endometriosis, you likely experience pain on some level. You might be in a lot of pain during your period, ovulation, or intercourse, or you might have a more chronic form of pain. 

Either way, if we want to get to the bottom of that pain, we need to take a look at where that inflammation is coming from. 

This is where your gut comes in. Did you know that 70-80% of your immune system lives in your gut?

So, if we have pain, telling us there is inflammation, which is telling us your immune system is at work, wouldn’t it make sense to look to the place where 70-80% of your immune system lives?

But what if my pain isn’t in my gut?

This is a fair question! This is where we go back to the concept that endometriosis is a full-body disease.

With a chronic illness like endometriosis, what we are really looking at is chronic inflammation due to the immune system chronically being triggered.

The thing is, nothing in your body works independently. Each system impacts the next. So, inflammation in your gut can absolutely contribute to inflammation in your uterus.

If you want to get to the root of that, your gut is an incredibly important place to begin.

Why is there inflammation in my gut?

There are several reasons inflammation can be present in your gut and getting to the bottom of that puzzle can have huge impacts on the healing process!

One way that the immune system in your gut and gut inflammation can pop up is from food sensitivities. 

Ever heard the term “leaky gut?” Basically, this means that the lining of your gut is damaged and is allowing large food particles to come into contact with your bloodstream, causing your immune system to react. 

When this is happening all the time, multiple food sensitivities can develop and chronic inflammation can be at play.

Another source of this inflammation is dysbiosis in your gut. This means that the microbiome is out of balance, so there is an overgrowth of the “bad gut bugs” which your immune system doesn’t love either.

Oftentimes these pieces go hand in hand. Leaky gut and food sensitivities can develop right alongside dysbiosis. This winning combo can lead straight back to that chronic inflammation. 

Wearing down the troops

Here’s the thing: your immune system only has so many resources available at any given time.

Think of it like an army. If all of the troops from the army are, for example, sent off to North Korea, then there aren’t a lot of resources available to put out a fire in Iraq. 

Your immune system is much the same. 

If a lot is going on in your gut and your immune system is always at work there, there won’t be a lot of resources at hand to, say, clean up those endometriosis lesions developing in your abdomen. 

Of course, we don’t yet know everything there is to know about endometriosis and how it develops, but one theory out there is that most people actually have those endometrial-like cells outside of their uterus at one point or another. 

It’s just that most people’s immune systems come around and clean it up before it becomes a problem.

When your immune system is busy doing other jobs, now we have a problem!

So what do we do?

An excellent place to start is by bringing everything in your gut back into balance and calming down your overall inflammation.

That can look like pinpointing your unique food sensitivities and working with a trained professional to bring your microbiome back into balance. 

It’s a lot more than just “killing off those bad gut bugs.” 

It’s about figuring out why your microbiome is out of balance in the first place, supporting the “good gut bugs,” and supporting your digestive and immune systems to function optimally.

There is a lot to think about there, but hopefully, this empowers you to know that there is something you can do!

What can I start with today?

I always love to send people away with some actionable steps you can start with right away, so here you go!

1. Support your digestive health by sitting down and eating meals slowly and calmly and chewing your food thoroughly. This will help to ensure that your food is properly broken down before it reaches your intestines!

2. Eat the rainbow! (and no, I don’t mean Skittles). Eat a wide variety of fruits and vegetables, which are high in fiber and polyphenols to help feed those good gut bugs. Put all the colors in your shopping cart each week! Red, blue, yellow, orange, green, purple, you name it!

3. Stay hydrated and move your body. Drinking water (aim for around half your body weight in ounces each day–so if you weigh 140lbs, your goal is 70oz/day) and movement are essential for digestion. Grab a water bottle and head out for a walk!

Endo is a full-body disease

Endo is, as we talked about before, a full-body disease. That means that while supporting your gut health is a wonderful place to start, it also is not an end-all-be-all solution.

Take time to tune in to your body, get to know your symptoms and what they are telling you, and remember that true healing is a journey and a process, not a one-stop shop.

Keep putting one foot in front of the other and taking small steps towards better health each and every day.

You’ve got this, my friend!

If you want to learn how to ditch the endo belly, get to the bottom of your digestive distress, and kick your pain and fatigue to the curb, check out Alyssa on The Endo Belly Girl Podcast!

About the author: Alyssa Chavez is a functional nutritionist specializing in supporting women with endometriosis to finally get to the root of their symptoms. She is also the host of The Endo Belly Girl Podcast, which you can find wherever you listen to podcasts. You can connect with her on Instagram @endobellygirl or on her website.

References:

Ahn, Soo Hyun; Monsanto, Stephany P.; Miller, Caragh; Singh, Sukbhir S.; Thomas, Richard; Tayade, Chandrakant. (2015). Pathophysiology and Immune Dysfunction in Endometriosis. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4515278/

Omoigui, Sota. (2007). The Biochemical Origin of Pain: The origin of all Pain is Inflammation and the Inflammatory Response. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2771434/#:~:text=Irrespective%20of%20the%20characteristic%20of,inflammation%20and%20the%20inflammatory%20response.

National Institute of Health National Library of Medicine. (2018). What is an inflammation? Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK279298/

Pahwa, Roma; Goyal, Amandeep; Jialal, Ishwarlal. (2022). Chronic Inflammation. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK493173/