What you need to know about endo belly

Here we’ll explain what causes endo belly and share some advice on how to manage it naturally!
Adam Hamdi
Written by

Coni Longden-Jefferson



If you have endometriosis, pain around your period is not the only symptom you have to deal with. Endo belly is a term used to describe the painful abdominal bloating that 96% of endo warriors face regularly. This bloating not only causes serious physical discomfort, but it can also have a huge impact on your mental well-being. 

Here we’ll explain what causes endo belly and share some advice on how to manage it naturally!   


What is endo belly?

Endo belly is a symptom of endometriosis. Many people with endo will be familiar with the swollen, bloated feeling they often have across the abdominal and pelvic area. For some people, it happens around the middle of the cycle, close to ovulation but usually, it’s worse in the lead-up to your period. It might last for a few hours, or it could go on for much longer. 

If you have ever felt so full after a meal that you have to lie down in a certain position to feel comfortable - you can start to imagine what endo belly feels like. Combine that with the pain of general endo inflammation or lesions and it’s easy to see why so many people find endo belly hard to cope with. 

It can also have an impact on your mental health. Having a hard, swollen belly can make it hard to find clothes that feel comfortable or that you feel confident in. In some cases, it can be so extreme that you look pregnant - which can be particularly triggering for those endometriosis patients who are also struggling with fertility. 


Why does Endo belly happen?




Endometriosis is a condition characterised by ongoing (chronic) inflammation (not just painful periods as many people would have you think!). Inflammation occurs when the body is trying to fight off infection or a threat. If you think about when you hurt your hand or foot, it will become inflamed and swollen. Well, imagine that is happening to organs inside your body all the time. Endometriosis can impact not only your reproductive system but your digestive system too. When these organs become inflamed and swollen it can contribute to endo belly.


Gut dysbiosis

In our gut, there is a delicate balance of good and bacteria  - otherwise known as the microbiome. These bacteria do lots of different jobs from supporting our immune system to keeping our hormones in check. When this balance is disrupted, this can lead to gut dysbiosis which can cause bloating, gassiness, constipation and diarrhoea. Many things can lead to gut dysbiosis but research has indicated that people with endometriosis are more susceptible to developing it. 


A certain type of gut dysbiosis known as SIBO (small intestinal bacterial overgrowth) is also pretty common among people with endo. In a healthy gut, most bacteria are located in the large intenstine, whereas for people with SIBO, there is more in the small intestine. 


Poor digestive health


When you combine inflammation with imbalances in the gut, it’s probably not surprising that many people with endometriosis regularly suffer from digestive issues that can trigger bloating - and also why it’s often misdiagnosed as IBS.

Common digestive health issues associated with endometriosis include: 


  • Constipation 
  • Diarrhoea 
  • Irregular bowel movements
  • Acid reflux 
  • Trapped wind  


Digestive health issues can also occur if the endometriosis itself is growing on an organ involved in the digestive system, like the bowel. In some extreme cases endo warriors with bowel endo may have to have part of their bowel removed. This may cause them to require a colostomy bag and a stoma, permanently or for an extended period of time before it can be reversed. 


How can I manage my endo belly?


If you are living with endometriosis, there are many ways that you can help to improve your digestion and reduce the risk of endo belly. 



Identify trigger foods

Starting a food journal is one of the best pieces of advice we would give to anyone struggling with endo belly. Everyone is unique and whilst there are certain food groups you may want to avoid generally (we’ve listed some below!) the truth is that your digestive upset could be triggered by anything. Keep a note of what you’re eating and when certain endo belly symptoms flair up and this can help you adapt the way you eat.  



Look for natural anti inflammatories

We know that endo can cause chronic inflammation, so following an anti-inflammatory diet could help with many of its symptoms. Studies have also shown that an anti-inflammatory diet can also help to keep your gut happy. Try to eat a rainbow of colourful fruits and vegetables and include herbs and spices like turmeric and ginger which are all known for their anti-inflammatory properties. Omega-3-rich oily fish like salmon are also an important part of an anti-inflammatory diet. 



Follow a low FODMAP diet

Research indicates that eating a low FODMAP diet—which avoids foods that are hard to digest—could also help with symptoms of endo belly This is because high FODMAP foods like milks, cheese and beans can make you more gassy - which can lead to painful trapped wind and bloating.

Relieve Muscle Tension


When our muscles are inflamed they can become very tight, which is painful in itself. Muscle tension also doesn’t allow for things to flow in the body the way they are supposed to - whether that’s blood flowing around your uterus, or your digestive system working efficiently. 


Relieving muscle tension can not only relieve pain and trapped wind, but relaxing your GI tract can also help to reduce the risk of digestive health issues. Light exercise is great for relieving muscle tension, and you can also try to include more magnesium in your diet.  Magnesium helps to relax muscles and has also been linked to reduced water retention.