Irritable bowel syndrome (IBS) and endometriosis are both chronic conditions that can cause similar symptoms like abdominal pain, bloating, and cramping. Despite the similar symptoms, however, endometriosis and IBS are different conditions, with different causes, that require different treatments.
Since both conditions are difficult to diagnose, their similar symptoms often mean that IBS is misdiagnosed instead of endometriosis.
This article discusses the symptoms, causes, similarities, and differences of endometriosis and IBS and the treatment options for both.
What Is Irritable Bowel Syndrome?
IBS is a chronic intestinal disorder that affects 14-24% of women in the US. Although it is a chronic condition, meaning it persists or recurs over a long period of time, not all patients experience severe symptoms.
The most common symptoms include abdominal pain, bloating, cramping, diarrhea, constipation, and changes in bowel behavior. Upper abdominal pain, discomfort after eating, increased gas, nausea, and mucus in stools are also common with IBS.
What Is Endometriosis?
Endometriosis occurs when tissue similar to the endometrium (the inner lining of the uterus) grows outside the uterus. Although most commonly found on the ovaries and fallopian tubes, endometrial-like tissue can also grow on the bladder, bowel, intestines, and rectum.
Because endometrial-like tissue responds to hormone changes like the endometrium, women with endometriosis commonly experience increased pelvic pain, bloating, and cramping before menstruation, as well as heavy menstrual bleeding, and spotting between periods. When the growth of endometrial-like tissue affects the bladder and bowel, symptoms can also include diarrhea, constipation, and frequent urination.
Statistics show that endometriosis affects approximately 11% of women aged between 14 and 44, but the percentage is thought to be far higher due to underreporting of symptoms and difficulties in diagnosing.
What Causes IBS?
The exact cause of IBS is unknown; however, research indicates that several factors play a role. These include stress, oversensitive nerves in the intestines, food passing through the digestive tract either too quickly or too slowly due to muscle contractions in the intestines, or an infection from an intestinal virus or bacteria. Scientists also suspect that IBS could be passed down through family genetics.
What Causes Endometriosis?
Similar to IBS, the cause of endometriosis is also unknown. Although several theories exist, the most widely accepted suggestion is that endometriosis is genetically passed down through female members of a family. This essentially means that endometrial-like cells outside the uterus could form during fetal development, only becoming susceptible to hormone fluctuations once menstruation starts.
Since endometriosis is asymptomatic for some and mild for others, many women don’t realize that they have endometriosis until getting pregnant proves difficult.
Symptoms Common to IBS and Endometriosis
Abdominal pain, bloating, cramping, diarrhea, and constipation are symptoms that are common to both endometriosis and IBS. Given that the cause of both conditions is unknown and both are notoriously difficult to diagnose, these common symptoms often lead to a misdiagnosis of IBS instead of endometriosis.
For this reason, it’s helpful to understand the unique symptoms of both conditions and be knowledgeable enough to mention them during consultations with your healthcare practitioner. Endometriosis and IBS are chronic conditions that require long-term management, so it is imperative that the correct diagnosis and treatment are prescribed to alleviate symptoms.
What Triggers IBS?
Food and stress appear to be triggers for IBS. That said, IBS is not believed to be caused by food allergies or stress. However, certain foods and high-stress levels are thought to increase the severity of symptoms. Foods known to trigger IBS symptoms include beans, cabbage, coffee, chocolate, carbonated drinks, citrus fruits, milk, and wheat products.
What Triggers Endometriosis Flare-ups?
Endometriosis flare-ups are essentially driven by estrogen. In the same way that the endometrium (inner lining of the uterus) reacts to hormone fluctuations during the menstrual cycle, so too does any endometrial-like tissue growing outside the uterus.
This means that it swells during estrogen surges around the time of ovulation, breaks down before menstruation when estrogen and progesterone levels decline, and bleeds during menstruation.
IBS and Endometriosis: Are they Linked?
Although evidence suggests that there is a symbiotic relationship between IBS and endometriosis, one is not known to cause the other. Research does show, however, that IBS appears to be more common in women with endometriosis, and gynecological conditions also seem to be more prevalent in women who have IBS.
Despite the connection, however, more evidence is required before a definitive conclusion is reached.
How to Treat IBS
Treating IBS largely depends on how severe a patient’s symptoms are. Some people with IBS can relieve their symptoms by eliminating trigger foods from their diet, drinking plenty of water, and reducing stress with sufficient sleep, exercise, yoga, and meditation.
For those with severe IBS, medication for constipation or diarrhea might be prescribed. When stress worsens IBS symptoms or IBS symptoms result in depression, counseling, therapy, and/or antidepressants might be suggested.
If you suspect you have IBS, start by scheduling a consultation with a dietician or nutritionist to learn to identify and eliminate trigger foods from your diet. It’s also a good idea to ask if probiotics, prebiotics, or peppermint oil could ease your symptoms. Although research is limited, all three have been suggested as holistic approaches for treating IBS.
How to Treat Endometriosis
Mild endometriosis is typically managed with pain medication and hormonal birth control to regulate hormones and prevent both menstruation and the growth of endometrial-like tissue. When symptoms are more severe, gonadotropin-releasing hormone (GnRH) agonists and antagonists are sometimes prescribed to prevent the production of estrogen and ovulation.
Laparoscopic surgery to remove endometrial-like tissue or a hysterectomy to remove both the uterus and the ovaries are also performed to alleviate the symptoms of severe endometriosis.
Endometriosis is a chronic condition that persists or recurs until menopause when estrogen levels naturally drop. Due to the side effects of hormone therapy and surgical procedures, many women prefer to manage their symptoms with holistic treatment options like pelvic physical therapy, yoga, acupuncture, conscious breathing, and warm baths.
Although each can contribute to alleviating symptoms, pelvic physical therapy is considered the most effective complementary treatment for managing pelvic pain and dyspareunia experienced with endometriosis. Pelvic physical therapists also teach endometriosis patients how to relieve symptoms at home with pelvic wand massage and vaginal dilator therapy.
Pelvic wands are mindfully shaped to relax deep pelvic trigger points, massage endometrial scar tissue, and relieve tight pelvic floor muscles. Vaginal dilator therapy, which is regularly used to treat dyspareunia, gently relaxes tight vaginal muscles that have spasmed due to ongoing pain or discomfort during penetration.
The regular use of both these medical tools not only helps to relieve the symptoms of endometriosis but also helps women to enjoy pain-free intercourse that can often lead to getting pregnant naturally.
Of the pelvic wands and vaginal dilators currently sold in the US, Intimate Rose is the only FDA-approved manufacturer. Made from smooth and safe medical-grade silicone that feels comfortable inside the body, their products are recommended by both gynecologists and pelvic health specialists for treating several pelvic conditions.
Even though IBS and endometriosis can result in some similar symptoms, they are separate conditions, stemming from different organs, and are treated in different ways. Due to the unknown causes of both, endometriosis and IBS can be difficult to diagnose and one is sometimes erroneously diagnosed instead of the other.
Because endometriosis and IBS are chronic conditions that often require lifelong management, it is vital to understand the differences between symptoms before beginning medical or holistic treatment for either.
American College of Gastroenterology – Irritable Bowel Syndrome (IBS) - https://gi.org/topics/irritable-bowel-syndrome/
American College of Gynaecologists & Obstetricians - https://www.acog.org/womens-health/faqs/endometriosis
Cleveland Clinic – The Uterus - https://my.clevelandclinic.org/health/body/22467-uterus
National Institute of Diabetes and Digestive and Kidney Diseases - https://www.niddk.nih.gov/health-information/digestive-diseases/irritable-bowel-syndrome/all-content
International Foundation for Gastrointestinal Disorders – IBS in Women - https://aboutibs.org/what-is-ibs/ibs-in-women/
National Centre for Complementary and Integrative Health - Irritable Bowel Syndrome: What You Need To Know - https://www.nccih.nih.gov/health/irritable-bowel-syndrome-what-you-need-to-know