Endo Belly: What Is It and Why Does It Happen?—A Narrative Review

Abstract

Endometriosis is a chronic inflammatory disease where endometrial-like lesions settle outside the uterus, resulting in extensive inflammatory reactions. It is a complex disease that presents with a range of symptoms, with pain and infertility being the most common. Along with severe dysmenorrhea, cyclic and acyclic lower abdominal pain, cyclic dysuria and dyschezia, dyspareunia, and infertility, there are also nonspecific complaints that can cause confusion and make endometriosis the chameleon among gynecological diseases. These symptoms include unspecific intestinal complaints, cyclic diarrhea, but also constipation, nausea, vomiting, and stomach complaints. It appears that in addition to general bowel symptoms, there are also specific symptoms related to endometriosis such as cyclic bloating of the abdomen, known as endo belly. During the second half of the menstrual cycle leading up to menstruation, the abdomen becomes increasingly bloated causing discomfort and pain due to elevated sensitivity of the intestinal wall. Patients with endometriosis exhibit a reduced stretch pain threshold of the intestinal wall. Here, we review the endo belly, for the first time, pathophysiology and the influence of other diseases (such as irritable bowel syndrome—IBS), microbiome, hormonal levels, inflammation, and diet on the presentation of this condition.

Low Diet Quality and Nutritional Knowledge in Women with Endometriosis: A Pilot Study

“…However, while some studies have noted observations supporting the importance of dietary interventions, only a small fraction have provided evidence-based dietary recommendations [ 33 ]. Given the complexity of the disease, this is not surprising [ 34 ]. The general recommendation is to consume a diet high in fiber, with an emphasis on fruits and vegetables, while minimizing the intake of sugar and animal products [ 35 ].…”