If you have endometriosis or have been reading more about endo, you may have heard the term “endo belly.”
This painful condition is more than just bloating or swelling, and it’s not your imagination or emotions playing tricks on you.
Let’s take a closer look at what it is and how to manage the symptoms.
What is “Endo Belly?”
Endo Belly is a severe and sudden bloating of the abdomen caused by inflammation, GI distress, and pelvic floor dysfunction commonly associated with endometriosis.
The bloating commonly stems from the lower abdomen and can be so severe that the individual can look several months pregnant. During a flare, the abdomen is hard and rigid, and the swelling and inflammation can wreak havoc on the digestive system and pelvic muscles, organs, and bones.
The most common symptoms of endo belly include:
Severe abdominal bloating and distension
Lower back pain
GI upset (nausea, diarrhea, gas, etc.)
Pelvic inflammation and pain
What Causes Endo Belly Flares?
Endo belly typically worsens in a cyclical pattern, peaking around menstruation.
Approaching and during menstruation, estrogen and progesterone drop to their lowest levels which triggers the release of prostaglandins - inflammatory chemicals that force muscles in your body to contract.
These are what help the uterus shed its lining each month, forcing the uterine muscles to contract and squeeze.
The prostaglandins also cause blood vessels to contract, reducing oxygen flow and increasing cramping. These inflammatory chemicals also attack the digestive system, triggering fluid secretion which cause swelling, but also causing extra sensitivity of nerve endings in the pelvis and intestines.
This means that even the smallest bit of bloating, gas, or muscle aches, are amplified.
Endometriosis itself relies on estrogen to grow. During the late luteal phase (the time right before your period), estrogen drops releasing prostaglandins, the excess prostaglandins stimulate estrogen production in the pelvis, causing estrogen levels to rise and endometriosis lesions to swell.
This never-ending loop of hormones can result in endo belly flares.
How Long Does Endo Belly Last?
Flares are typically cyclical, peaking around the time of your period.
Usually, the onset is very sudden and comes along with an endo flare (a temporary worsening of symptoms).
However, because the loop of hormones can keep perpetuating symptoms, endo belly flares can greatly vary in duration - sometimes only lasting a few hours, but sometimes for weeks at a time.
What Affects How Long Endo Belly Lasts?
Chronic inflammation plays a key role on duration length of endo belly.
People with endometriosis are more likely to suffer from co-occurring disorders, including Irritable Bowel Syndrome (IBS), Small Intestinal Bacterial Overgrowth (SIBO), Ulcerative Colitis (UC), adenomyosis, and many autoimmune diseases.
All of these disorders cause elevated inflammatory markers and can join the hormone loop of endometriosis: rising levels of prostaglandins, rising levels of estrogen, rising inflammation.
Pelvic adhesions and scar tissue can also affect how long endo belly lasts. Inflammation of these lesions and tissues can physically slow intestinal movement down by narrowing the intestines and blood vessels.
Managing Endo Belly Day to Day
Our top two choices for managing endometriosis and endo belly flares are excision surgery with a surgeon who specializes in endometriosis, and pelvic floor physical therapy.
Excision surgery cuts out endometriosis lesions, which will greatly reduce overall pelvic inflammation.
Pelvic floor physical therapy, particularly with a provider trained and specialized in endometriosis, will help regulate your nervous system, mobilize scar tissue and adhesions, increase blood flow and oxygen to pelvic organs and tissues, and relieve muscular and joint pain with manual hands-on therapy.
Lowering overall inflammation should help ease the discomfort of endo belly flares. You can eat a low-inflammatory diet, prioritizing foods with natural anti-inflammatory properties like leafy greens and berries. You can avoid certain inflammatory triggers in your diet like alcohol and caffeine or ultra processed foods.
Hormonal birth control methods can help avoid the rise and fall of hormones. Oral birth control pills can be taken continuously to keep hormones at an even level and help prevent hormone-related flares. IUDs or GnRH antagonists can also be helpful at lowering estrogen and therefore endometriosis inflammation.
Oral NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen targets inflammation specifically and can help relieve some of the discomfort of a flare.
When to Talk to Your Provider
If you are regularly experiencing endo belly flares, particularly if they last longer than a few hours or if they cause disruptions in your daily life, you should consult with your provider.
You should absolutely consult with the doctor managing your endometriosis (find a list of specialists we recommend here) before beginning any new medications or drastic dietary changes to confirm your safety.
Where to Find Pelvic Floor PT for Endometriosis in Thousand Oaks
If you are tired of suffering through the endless loop of pain, inflammation, and flares, it’s time to make a plan.
At Cappuccino Physical Therapy, our doctors are constantly expanding their knowledge-base to provide the best treatment available to manage pelvic disorders like endometriosis.
Quality, specialized care can make all the difference when dealing with chronic conditions and endometriosis is chronic, cyclical, and can be debilitating.
Our team knows first-hand how endometriosis and endo belly can affect your quality of life and we are here to help you feel like yourself again.
Next on your reading list:
How is Endometriosis Treated? A Pelvic Floor PT’s Approach
Endometriosis and Pelvic Inflammatory Disease (PID): What You Need to Know
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