The Gut-Endometriosis Connection: Understanding Bloating, Digestion & Inflammatio

If you live with endometriosis, bloating is probably a symptom you know all too well. 

The type that makes you look 6 months pregnant when you aren’t. 

That uncomfortable, heavy, sometimes painful swelling in your belly isn’t just a nuisance.. it can also indicate deeper issues in your gut health that are affecting inflammation, digestion, nutrient absorption, and even hormone balance. 

The truth is, endometriosis isn’t just a “period problem.” It’s a full-body condition, and your gut plays a massive role in how severe your symptoms feel day to day. 70-80% of our immune system is IN our gut and this plays a role in how we feel. Understanding this connection is key to finding real relief.

The Role of the Gut in Endometriosis

Your gut and hormones are intimately connected. Poor gut health can worsen systemic inflammation, make it harder for your body to absorb essential nutrients, and disrupt estrogen metabolism — all of which can amplify endometriosis symptoms.

We have a little chunk of our gut microbiome that is designated to metabolizing estrogen. If this is off, this can make it harder for us endo babes to get our estrogen levels under control. Yes, we know endo makes its own estrogen. But your gut (and liver) have to be able to properly break it down and eliminate it from your body to balance hormones/ improve period/ PMS symptoms.

Think of your gut as the foundation for your body’s ability to manage inflammation and pain with endo. The nutrients from the anti-inflammatory food we eat can directly improve pain. And bacteria and pathogens that aren’t supposed to be there can wreak havoc on gut inflammation, and therefore systemic inflammation as well.

Common Gut Issues in Endometriosis

• SIBO (Small Intestinal Bacterial Overgrowth): This overgrowth of bacteria in the small intestine can cause bloating, constipation, diarrhea, and unpredictable digestion. This can also lead to deficiencies in fat soluble vitamins like A, D, E + K. Surgery, scar tissue/adhesions, endo on the bowels, OR low stomach acid can trigger SIBO.
  
  

• Low Stomach Acid: Without enough stomach acid, your body struggles to break down protein and absorb nutrients, which can worsen fatigue, bloating, and pain. Stomach acid is key for adequate digestive enzyme release and bile flow/ absorption of healthy fats.
  
  

• H. Pylori: This infection is notorious for driving inflammation with endo because it increases lipopolysaccharides (LPS) in the gut that acts as a toxin and can lead to leaky gut and worsen endo symptoms. It can also reduce stomach acid, lead to nutrient deficiencies, and has been linked with fertility challenges
  
  

• Dysbiosis: An imbalance of gut bacteria can trigger histamine flares, immune responses, and inflammation.. all of which can exacerbate endometriosis symptoms.
  
  

How Gut Dysfunction Worsens Symptoms

When your gut isn’t functioning optimally, you may notice:

• Persistent bloating, even after excision surgery in addition to other GI symptoms like constipation, diarrhea, etc.
  
  
• Increased period pain, PMS or PMDD symptoms
  
  
• Fatigue that doesn’t seem to improve
  
  
• Food sensitivities or reactions
  
  

• Hormone imbalances, including estrogen dominance, low progesterone or a sluggish thyroid

All of these symptoms are connected — and most women with endometriosis aren’t told that supporting their gut could make all of these issues either go away or at least drastically improve.

Functional Lab Testing: Digging Deeper

To get clarity on what’s really happening in your gut, functional lab testing can be a game-changer.

• GI Map Stool Test: Offers a detailed look at your gut microbiome, identifies dysbiosis, pathogenic bacteria,  parasites, absorption status, immune functioning, etc that can explain the bloat and inflammation.
  
  

• HTMA (Hair Tissue Mineral Analysis): Measures minerals and heavy metals in your body, giving insight into nutrient deficiencies, adrenal stress, digestion and how your body is handling detoxification.. all factors that influence inflammation, gut health, and hormone balance which affect endometriosis symptoms.
  
  

These tests help uncover the root causes behind your bloating and other endometriosis symptoms, instead of just treating the surface-level discomfort.

Supporting Gut Health

Once you know what’s going on in your gut and with your mineral levels, you can support it through:

• Personalized gut protocols (KEY) to restore balance
  
  
• Digestive enzymes or hydrochloric acid support if needed for proper nutrient absorption
  
  
• Nutrition focused on anti-inflammatory and nutrient-dense foods like leafy greens, cruciferous vegetables, colorful fruits, healthy fats, and high-quality proteins
  
  

• Lifestyle support like stress management, movement, and proper sleep to keep your gut and hormones in check
  
  

Gut health isn’t optional for women with endometriosis. it’s a cornerstone of symptom management. And it’s not talked about enough.

Addressing digestion, nutrient absorption, and gut balance can dramatically improve bloating, inflammation, hormone function, and the pain you experience day to day or with each cycle.

Taking a proactive approach now, even before surgery or alongside other treatments, gives your body the foundation it needs to heal, function optimally, and finally feel better.

If you’d like extra support with nutrition, gut health, minerals, and want to have someone who’s walked the walk create a custom plan for you and guide you every single step of the way so you never feel alone, I’d love to help!

DM me on IG at radiatewithrita  OR book a discovery call using the link below.