The term “endo belly” describes the painful and often severe abdominal bloating associated with endometriosis. This severe bloating is likely due to inflammation, growths, or other digestive issues resulting from endometriosis.
However, it can take 4–11 years to receive the correct diagnosis, and as many as 6 in 10 cases of endometriosis may remain undiagnosed.
Because the symptoms of endo belly are similar to those of gastrointestinal disorders such as irritable bowel syndrome (IBS), a doctor may overlook or misdiagnose endometriosis.
Along with heavy menstrual periods, pain, and infertility, endometriosis can cause symptoms such as:
This article looks at the causes and symptoms of endo belly, some treatment and management options, and some other conditions that cause abdominal bloating.
This bloating is often painful and firm to the touch. In fact, some people may describe their endo belly as looking like a pregnant belly.
Endometriosis takes its name from the endometrium, which is the tissue that forms the inner lining of the uterus. With endometriosis, a similar type of tissue also grows outside the uterus.
For example, this other tissue may grow on the outer surface of the uterus, the fallopian tubes, or the ovaries. Although the tissue typically resides in the reproductive system, it can also spread to the bowels, bladder, or lining of the abdominal cavity.
Inside the uterus, this tissue normally builds up and sheds each month during the menstrual period. The endometrial-like tissue also builds up and sheds, but it does not have a way to exit the body. This can cause people with endometriosis to experience gastrointestinal symptoms.
Endometriosis can cause abdominal bloating for a number of reasons, including the fact that:
- The endometrial-like tissue can build up and cause the abdomen to become inflamed.
- If the endometrial-like tissue covers or enters the ovaries, it can trap blood and give rise to ovarian cysts.
- Endometriosis can lead to digestive issues such as gas and constipation.
Abdominal bloating is the most common symptom of endo belly.
Bloating happens when the lower abdomen swells with gas or air. When this happens, the abdomen looks bigger than usual and might feel tight or swollen.
Endo belly often happens before or during a menstrual period and can last anywhere from a few hours to a few weeks.
Endo belly is a visible symptom of endometriosis and often comes with other, less visible symptoms.
These may include:
Treating endo belly typically means treating endometriosis. Treatment options can vary from simple over-the-counter (OTC) pain medications to invasive surgeries.
The right treatment option for an individual will depend on factors such as their age, pain severity, and pregnancy plans.
Options may include:
Pain relief medications
Depending on the level of pain a person experiences, a doctor may suggest an OTC pain medication, such as a nonsteroidal anti-inflammatory drug, or prescribe a stronger type of pain medication.
Hormonal medications may supplement or stop other hormones, which can help slow the growth of the endometrial-like tissue and may stop new scar tissue and adhesions from developing.
Some options include:
- Birth control pills: These may help regulate monthly hormonal changes.
- Progesterone and progestin: These hormones come in the form of a pill, injection, or intrauterine device. They may prevent endometrial-like tissue from growing, reduce the size of existing lesions, or stop monthly periods altogether.
- Gonadotropin-releasing hormone (GnRH) antagonist: This medication can help stop hormone production, tissue growth, and menstruation. GnRH antagonists send the body into a menopausal state. In 2018, the
Food and Drug Administration (FDA)approved elagolix (Orilissa) for treating endometriosis pain. The FDA based its approval on the results of two clinical trials involving 1,686 women with moderate-to-severe endometriosis pain.
- Androgens: Medications such as danazol (Danocrine) can stop hormone production related to menstrual cycles. People taking this drug may have few or no periods, but danazol is not a form of birth control.
Laparoscopy is minimally invasive, and a surgeon will carry it out to remove the endometriosis patches.
Hysterectomy is a procedure wherein a surgeon removes the uterus. They may also remove the ovaries to increase the chance of getting rid of every endometriosis patch.
Surgeons tend to reserve hysterectomy for people with untreatable endometriosis pain and those who do not plan to become pregnant.
When exploring at-home remedies for endo belly, it is important to consider the symptoms themselves. They may include inflammation and bloating, gas pains and cramps, constipation, and diarrhea.
The following self-care tips may help alleviate endo belly symptoms:
- Consider an anti-inflammatory diet: Foods such as fruits and vegetables, lean proteins, and healthy fats can help ease inflammation. Avoid inflammatory items, such as red meat, dairy, caffeine, and alcohol.
- Choose foods high in fiber: Eating high fiber foods such as apples, carrots, oats, almonds, and sweet potatoes can help prevent constipation.
- Try certain herbs and spices: Ginger and mint are common remedies for nausea. Also, cinnamon and cloves may help reduce gas, cramps, and bloating.
Following a low FODMAP diet may help alleviate some gastrointestinal distress in the short term. FODMAP stands for fermentable oligo-, di-, monosaccharides, and polyols.
One 2017 meta-analysis suggests that following a low FODMAP diet long term may have physiological consequences on the intestinal microbiome, metabolism, and nutritional status. However, more research is necessary to see if it can help benefit endo belly.
A person can also ask a registered dietitian for help with adjusting their diet for relief from endo belly symptoms.
Even when someone has a diagnosis of endometriosis, several other conditions can cause abdominal bloating.
- premenstrual syndrome
- ovarian cysts
- food intolerance
- celiac disease
- ulcerative colitis
- Crohn’s disease
In other cases, trapped gas may cause a bloated belly. Sometimes, just eating certain foods — such as beans, cabbage, and dairy products — can cause a buildup of gas.
It is important for people to undergo regular checkups and report any symptoms and changes in their menstrual periods.
If a person has not previously received an endometriosis diagnosis from a doctor but they often experience cramps, lower back pain, and pelvic pain, they should discuss this with a doctor.
If a person with endometriosis experiences gastrointestinal distress alongside abdominal bloating, they should contact a doctor. They will be able to determine if the bloating relates to endometriosis or another cause and suggest appropriate treatment.
The following organizations may provide help with more information about endo belly:
Endo belly refers to endometriosis-related abdominal bloating. Although the symptoms of endometriosis typically affect the reproductive system, in some cases, the condition can also affect the abdomen and cause gastrointestinal distress.
People may be able to manage the symptoms of endo belly by making certain dietary changes and taking medications. Some people may require more invasive options, such as surgery, to alleviate endometriosis symptoms such as endo belly.
It is important to remember that endometriosis is difficult to diagnose and that other conditions can also cause abdominal bloating.
A person should contact a doctor for a proper diagnosis and treatment plan.