Endo Belly

Let’s Talk About Endo Belly

Endo belly is a term used to describe the uncomfortable, often painful, swelling and severe bloating that’s associated with endometriosis. Many women with Endo Belly will look like they are pregnant, when in fact they are not.

All too often, Endo Belly is misdiagnosed as being something that it isn’t, and this is something we see with endometriosis in general. Too often women and missed and dismissed and misdiagnosed by those who do not have experience with endometriosis and those who are not really an endometriosis expert.

For this article I thought it was important to focus on the topic of Endo belly, as it is rarely talked about, but it’s often a very distressing symptom.

What is endometriosis?

Endometriosis is a condition in which tissue that’s similar to the lining inside the uterus, called the endometrium, is found outside the uterus where it doesn’t belong. Endometriosis is really just normal tissue, growing in abnormal areas, but it can cause debilitating symptoms and affect the life of suffers in many ways. (see -The Facts about Period Pain and Endometriosis)

Endometriosis is more than just period pain

Endometriosis is often only talked about in terms of period pain and we need to start talking about all the other associated symptoms such as Endo Belly. Many women with endometriosis suffer extreme gastrointestinal symptoms, severe bloating, abdominal pain, pain on bowel movement, pelvic and rectal pressure feeling, IBS like symptoms, nausea, vomiting, UTI like symptoms, mood swings, anxiety, depression, and a whole range of symptoms that affect their daily life. Endometriosis is more than just period pain and we need to start getting this information out there.

The interesting fact is that a significant portion of women with endometriosis are asymptomatic and do not have any symptoms at all. Many of these women are diagnosed by accident, or may not even be diagnosed at all. Even then it often takes up to 10 years, or more, for many women to be diagnosed and so many are missed and dismissed along the way. The only way to definitely diagnose endometriosis is via surgical intervention, and usually by a laparoscopy.

Endo belly is often missed and dismissed

Every day I see pictures of women with swollen belly’s posted in social media as many are just trying to get an answer to the swollen belly and other associated gastrointestinal symptoms that they experience often, or even daily. I also see many of them then misdiagnosed and given wrong advice, when as an expert in endometriosis, it is plain to see that these poor women are suffering an endometriosis flare and that they have endo belly.

So often women are misdiagnosed as having the following:

  1. Irritable Bowel Syndrome (IBS)
  2. Gluten intolerance/ and or Coeliac disease
  3. SIBO (Small Intestine Bacteria Overgrowth)
  4. Food intolerances
  5. PMS (premenstrual syndrome)
  6. Pregnancy

While some women may in fact have some of these issues in conjunction with endometriosis, or some of these conditions may be exacerbating their symptoms, the real cause of their swollen belly is endometriosis. If this is overlooked, which is often the case,  and their symptoms are never addressed properly and they will continue to have flares not matter what they do. Women with endometriosis could have the best diet in the world and still have endo belly and flare, if the endometriosis implants are not properly excised and regrowth of microscopic endometriotic implants suppressed from growing again. It is all about having a proper multimodality treatment and management approach when it comes to endometriosis and why it is important to see an endometriosis expert.

Women with Endometriosis need to see an Endometriosis Expert

The problem for many women with endometriosis is that they are not seeing a healthcare practitioner who has the appropriate post graduate training in women’s health medicine, and who is not an expert in endometriosis. Many are also taking advice of people in social media groups too, which also leads to wrong diagnosis, or misdiagnosis. It is a big issue and why so many women suffer for years, all because of the wrong advice, seeing the wrong person and not being managed properly by an endometriosis expert.

What are the main symptoms of Endo Belly?

The main symptom of endo belly is severe bloating, and swelling of the abdomen. This may also be associated with severe pain. Some women with endo belly may even need to be admitted into hospital to control their endometriosis flare and pain.

  • Endo Belly can be worse during, or right before your period, but flares can happen at any time in the cycle and by triggered by multiple factors.
  • Endo Belly is when the abdomen fills with air or gas, making it looks larger. It may also feel tight, or hard to the touch through the bloating of the belly. As mentioned previously many women with endo belly can in fact look like they are pregnant.
  • Endo belly can cause discomfort, pain, and pressure in your abdomen and refer into a woman’s back and pelvis. Endo belly can cause the stomach to swell for hours, days, or even weeks on end if not managed properly.
  • Endo belly is just one gastrointestinal symptoms of endometriosis. As previously mentioned, many women who experience endo belly often have other gastrointestinal symptoms, such as gas pain, nausea, constipation, diarrhoea, vomiting and pain on bowel movement. Some women even get severe bleeding from the bowel as well.

What causes Endo Belly?

Endo Belly is caused by inflammation in the intestines, caused by endometriosis, and build-up of dysbiotic bacteria that cause gas and the swelling of the intestines and abdomen. These dysbiotic bacteria also add to further inflammation in the gut/microbiome and why they need to be cleared and replaced with good strain specific probiotic bacteria. There is now good research to show the role of the microbiome with inflammation, weight gain and even mood disorders. This is why I recommend women with endometriosis and endo belly should be doing a proper microbiome restore, to address the dysbiotic bacteria and also increase the growth and colonisation of the good bacteria.

What Things Can Trigger an Endo Belly Flare?

Inflammatory based refined foods and foods that cause gas in the gastrointestinal tract and intestines lead to bloating and abdominal pain. Foods and drinks that are known to exacerbate endometriosis, cause gas and inflammation, and cause endo belly are the following:

  1. Legumes (beans, chickpeas, lentils etc)
  2. Refined Grains (such as wheat, cereals, pasta, oats etc)
  3. Some vegetable (such as cabbage and Brussel sprouts)
  4. Products containing yeast (bread, beer, vegemite etc)
  5. Soft drinks and sodas
  6. Some fruits
  7. Alcohol
  8. Some forms of dairy

To help and assist endo belly as part of a multimodality approach it also usually require looking at a woman’s diet and making dietary changes. Fad diets have been shown to be of little benefit to women with endometriosis. Women with endometriosis and endo benefit from and individualised, low inflammatory based diet with lot of whole foods and cutting out pro-inflammatory refined foods. I recommend the PACE diet (Primal, Ancestral, Clean-Eating Diet) to all my patients with endometriosis, as they comment that it the most helpful in assisting their symptoms and overall health.

What can help Endo Belly

Endometriosis and endo belly need to be properly managed by an endometriosis expert and via a multimodality approach. This can involve surgical interventions, hormones, pain medications, complementary medicines, diet and lifestyle changes, counselling, pelvic floor therapy, exercise, meditation and mindfulness. All treatments and management of endometriosis and endo belly require an individualised care approach as women with endometriosis all have similar, but differing symptoms. Again, for proper care management an endometriosis expert with experience with endometriosis should be consulted to help you and assist you properly.

Final word

Endo belly refers to the painful abdominal bloating that’s associated with endometriosis.

Women can manage the symptoms of endo belly with a multimodality treatments mentioned above alongside dietary and lifestyle changes. It is important that endo belly is managed proper, by management of endometriosis, the underlying condition and underlying. This needs to be done by seeing an endometriosis expert, and working in with them to assist you manage endometriosis properly.

If you have abdominal bloating that’s painful, frequent, or lasts longer than a few days, be sure to see your healthcare specialist and see about getting a referral to an endometriosis expert, or women’s health specialist.

It’s also important to keep in mind that other conditions can cause a bloated or swollen belly. Your healthcare practitioner will be able to properly diagnose the cause and prescribe the right type of treatment plan. Please do not google your symptoms or take the advice of friends on social media. That can be dangerous and even be fatal if a serious health issues is missed.

If you do need help with endo belly and the associated symptoms of endometriosis, then please give my friendly staff a call and find out how I can assist you.


Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-The Endometriosis Experts

-The Experts Program

Posted in Uncategorized.

Leave a Reply

Your email address will not be published. Required fields are marked *