IBS & Endometriosis: Often co-exist, often misdiagnosed
Endometriosis and IBS often go hand in hand due to similar symptoms of abdominal pain, digestive issues and chronic inflammation. The 2 conditions often co-exist or end up misdiagnosed leading to mis-management and delays in diagnosis (1).
The problem is that endometrial lesions can occur on the digestive tract – causing digestive problems. Likewise – digestive issues can contribute to, and worsen endometriosis as outlined on the image on the right.
Why is this?
Researchers have yet to find the cause of Endo, however more and more evidence is pointing us to immune dysfunction. Immune cells play a roll in development, growth and invasion of endometrial cells. They also secrete inflammatory cytokines that further affect the endometriosis growth (2). So where do these immune cells come from you ask? Well, we know that at least 70% of our immune system is found within our GUT!!!! (3)
Too many of the wrong kind of bacteria (gram negative bacteria) produce something called ‘LPS’ toxins which cause inflammation (4).
This imbalance of bacteria combined with inflammation causes ‘intestinal permeability’ – meaning it becomes permeable allowing these toxins to pass through into the blood stream causing inflammation throughout the body and activates our immune system.
There is now debate amongst researchers that it may even be autoimmune driven and is definitely associated with an increased risk of AI disease (5). LPS toxins have been associated with both IBS, and Endometriosis and Adenomyosis. Studies have shown antibiotics have reduced size of lesions, but we can’t depend on these long term (4).
What's the Solution??
When I am working with people with Endometriosis (and Adenomyosis) I always start with the GUT. I start people on a gut healing program while supporting hormones with simple strategies. This is the approach I take...
Reduce inflammation
Heal intestinal lining
Supporting increase levels of healthy bacteria
Reduce gram negative bacteria to reduce LPS toxin production
Modulate’ the immune system
Hormones – There are so many things we can do to support our hormone production with specific nutrients or diet variations to improve hormone production which I do alongside our gut program. But this is for another post.
Meanwhile, why not book a free strategy call to chat about what's going on for you and what we can do to help.
References:
Chiaffarino, F., Cipriani, S., Ricci, E. et al. Endometriosis and irritable bowel syndrome: a systematic review and meta-analysis. Arch Gynecol Obstet 303, 17–25 (2021). https://doi.org/10.1007/s00404-020-05797-8
Abramiuk M, Grywalska E, Małkowska P, Sierawska O, Hrynkiewicz R, Niedźwiedzka-Rystwej P. The Role of the Immune System in the Development of Endometriosis. Cells. 2022; 11(13):2028. https://doi.org/10.3390/cells11132028
Wiertsema SP, van Bergenhenegouwen J, Garssen J, Knippels LMJ. The Interplay between the Gut Microbiome and the Immune System in the Context of Infectious Diseases throughout Life and the Role of Nutrition in Optimizing Treatment Strategies. Nutrients. 2021 Mar 9;13(3):886. doi: 10.3390/nu13030886. PMID: 33803407; PMCID: PMC8001875.
Shigesi N, Kvaskoff M, Kirtley S, Feng Q, Fang H, Knight JC, Missmer SA, Rahmioglu N, Zondervan KT, Becker CM. The association between endometriosis and autoimmune diseases: a systematic review and meta-analysis. Hum Reprod Update. 2019 Jul 1;25(4):486-503. doi: 10.1093/humupd/dmz014. PMID: 31260048; PMCID: PMC6601386.