Is It Endometriosis or IBS?

If you have pain in your pelvic area, it may be difficult to know what’s causing your discomfort. Maybe you feel nauseous or constipated or have diarrhea. You may have mild to severe cramping during your period. Or perhaps you have pain during intercourse or during a bowel movement. These symptoms can range from inconvenient to incapacitating, and the causes can vary as well.

Endometriosis is commonly misdiagnosed

Endometriosis shares many symptoms of IBS and is commonly misdiagnosed as a result. Like IBS, endometriosis can cause abdominal pain and cramping, and changes in the appearance and frequency of bowel movements. Having a better understanding of the main differences between endometriosis and IBS can help you determine whether you’ve received the right diagnosis.

As you know endometriosis is very common. It affects 10 percent of women. It includes painful periods, pelvic pain, painful intercourse, bladder symptoms, backache, bowel symptoms. Bowel symptoms are very, very common. It can cause the patient diarrhea, intestinal cramping, and painful bowel movements. As well it may include bloating and nausea.

But sometimes endometriosis can do much more damage in your body. And like we all know it’s pretty hard to convince the doctors that all of your symptoms are real and you don’t need another appointment with a gastroenterologist.

Many women assume that the symptoms they experience with endometriosis are directly related to their periods, which is partly why endometriosis sometimes goes undetected. Also, the tissue growths from endometriosis can develop next to the large intestine, leading to inflammation, and contribute to problems with bowel movements. As a result, some physicians diagnose endometriosis incorrectly as IBS.

Common symptoms of endometriosis include:

  • Strong abdominal pain and cramping, especially during your period
  • Pain during or after sexual intercourse
  • Bladder difficulties
  • Infertility
  • Pain during bowel movements
  • Constipation
  • Diarrhea
  • Nausea and/or vomiting
  • Irregular bleeding between periods
  • Vaginal tenderness

Endometriosis is a tricky condition because its symptoms are similar to other conditions, and some women may not realize that their “bad periods” are not normal, but symptoms of a more serious condition.

But if you have Endometriosis and IBS symptoms, that doesn’t mean that you have for sure endometriosis on the bowel.

endometriosis abdominal pain

Some women with endometriosis have constipation, others have diarrhea. Often it is menstrual but sometimes it could be throughout the cycle. Or sometimes it can be alternating with constipation and diarrhea. Most of the women with endometriosis have intestinal cramping and painful bowel movements. What the average gynecologist is going to do when they come across these symptoms they are not going to focus on the fact that you have pelvic pain. They are going to focus on the fact that you have these GI symptoms and that is not my thing so they are going to send you to a gastroenterologist. Or if you have any bladder symptoms they are going to send you to the urologist. Unfortunately, that helps to delay the diagnosis, and often patients will be sent to a gastroenterologist not only one time but maybe two, three, four or five times to get different opinions.

Irritable bowel syndrome has many different names. It is also spastic colon, irritable colon or spastic colitis.

IBS: About one in six people have IBS. Women are twice as likely to have it compared to men. Patients who have IBS and endometriosis have a lot of their symptoms occur at the same time.
Most of them start having these symptoms early on in their teens or early 20s, which is really the same time that women with endometriosis start having their symptoms as well. Over 80 percent of women with endometriosis have painful periods as their initial symptom and so, you know, again they are dismissed for a number of years saying, “Oh that’s just normal, kind of deal with it” but ultimately they end up developing more symptoms, which finally end up being diagnosed.

When to suspect an invasive endometriosis of the bowel?

Painful bowel movements

The number one thing is painful bowel movements. When women are having painful bowel movements that is really the herald that it is probably either adhesions involving the bowel, where the bowel has been kinked and has to go through a narrowing; or there is actually an invasive disease which is causing a narrowing as well.

Another common symptom is alternating constipation and diarrhea. Patients will have a hard time having a bowel movement for several days or even weeks. Intestinal cramping and bloating are also very common.

Blood in the stool

A lot of people say they have blood in their stool. Most of the time that can be because of constipation and hemorrhoids (which they may not see because they are internal). The number one thing is to check the colour of the blood. If it is bright red blood it is usually associated with hemorrhoids, but if it’s old, dark brown blood (or if it is very mucousy), that would suggest invasive disease of the bowel. In that case, it’s better to do a rectovaginal exam. The doctor is examining the patient deeply into the higher part of the vagina on the back wall, they may feel a mass which is also suggestive of endometriosis involving the bowel.

What if they found endometriosis on the bowel?

Are they going to treat it?

Most of the gynecologists would say no. And that’s pretty normal. The doctors are always worried that if they use a form of energy to destroy the endometriosis they can injure the back, so they are not going to even touch it. And that’s not because they never treated or seen invasive bowel endometriosis. Some of the doctors are not sure what to do if they found an obliterated cul-de-sac or invasive endometriosis, because they are worried about getting into the bowel and what would they do if they did that. Obliterated cul-de-sac is where the bowel is stuck to the back of the uterus, which is probably found in around 20 to 30 percent of patients. Fortunately, it can be treated well and all the anatomy restored to normal in an expert’s hands.

high carbohydrate foods

Help your body with some food

If you have endometriosis and IBS you can help your body with a diet.

Foods to eat that may provide symptom relief (home remedies and others) for some people:

  • Dietary fiber supplements
  • Water
  • Low-fat foods
  • High-carbohydrate foods (such as whole-wheat pasta, brown rice, and wholegrain bread)
  • Probiotics (containing Lactobacillus acidophilus a and Bifidobacterium) and prebiotics

Some people report kefir or Aloe Vera juice helps symptoms. Talk to a doctor about these home remedies.

Foods to avoid or limit if you have IBS

  • Dairy products, including milk and cheese (Lactose intolerance symptoms can be similar to IBS symptoms.)
  • Specific vegetables that increase gas (such as cauliflower, broccoli, cabbage, Brussels sprouts) and legumes (such as beans)
  • Fatty or fried foods
  • Alcohol, caffeine, or soda
  • Foods high in sugars
  • Artificial sweeteners
  • Chewing gum
  • Nuts

Endometriosis symptoms can vary and be unique to each of us. But one thing I’ve noticed is that many of us, including myself, deal with IBS symptoms, often daily. This can not only interfere with our daily activities but can also cause embarrassment when eating out and being social. It can be exhausting not knowing what’s triggering these symptoms, and, eventually, these complications can take a toll on your confidence and mental health. If your intestines suffer like mine, so you have a big problem with your endometriosis meal plan.

Written by Lora Rizova. Find more of her blog content here:




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