Chronic pelvic pain is a difficult condition for many and needs to be investigated and managed on time. The main conditions responsible for such symptoms are irritable bowel syndrome (IBS) and endometriosis. Both the conditions are closely associated and require accurate diagnosis and treatment.
What is endometriosis, and what are the symptoms?
Endometriosis is a gynecological problem related to the growth of endometrial tissue outside the uterus. This tissue growth can be observed from the lower abdomen and pelvic area. The excess tissue leads to inflammation and problems with bowel movements.
Common symptoms show pain during periods, unexplained pelvic pain, pain during intercourse, and abdominal discomfort. Endometriosis can affect several aspects of the patient's life, including physical and mental health, social relationships, and overall well being. Infertility is also seen more frequently among patients who have endometriosis, than in the general population.
Like endometriosis, which is predominantly found in women, irritable bowel syndrome is another digestive tract disorder. As a consequence, both endometriosis and IBS may appear to coexist. Women with endometriosis have a higher risk of IBS than women who don’t have endometriosis. The severity of symptoms differs from person to person, and symptoms often overlap with Irritable Bowel Syndrome (IBS).
What is IBS, and what are related symptoms?
Irritable bowel syndrome (IBS) is a gastrointestinal disorder associated with bowel movement, dysfunction. The condition is also known as chronic intestinal inflammation that has significant effects on gut-flora. IBS affects around 10-12% of the global population. The symptoms are:
- Constipation or both
Disordered bowel habits are also observed in many patients. The severity of symptoms of IBS and unsatisfactory treatments may affect the quality of life and the additional economic burden too.
What are the causes of IBS and endometriosis?
Although the pathophysiology of both endometriosis and IBS is incompletely understood, fermentable carbohydrates are known as a key potential cause of symptoms. IBS is caused by increased sensitivity of bowel, infection, trauma, or genetic factors.
The bowel is a part of the digestive system, and bowel movement is responsible for passing the food through the digestive system. The endometriosis condition is caused by the formation of tissue growth next to the large intestine and contributes to abnormal bowel movement. Endometriosis is confined to women, while IBS is observed in both men and women but more commonly in women.
Differences between endometriosis and IBS
Endometriosis and IBS common symptoms: As the symptoms of two conditions overlap, it is possible that only one condition is diagnosed and the other is overlooked. Women suffering from both conditions may indicate signs of the predominant illness but require treatment for both for a successful outcome.
Abdominal pain being a common symptom, the difference in symptoms of endometriosis and IBS is as follows:
For endometriosis, pain is largely associated with periods, i.e., your symptoms worsen around your periods, while IBS symptoms are related to abdominal bloating or diarrhea.
Most importantly, patients with IBS report additional symptoms such as nausea, constipation, colicky pain, etc. Having a good medical history will help diagnose the two conditions. Also, good communication between gynecologists and gastroenterologists will facilitate accurate diagnosis.
How are endometriosis and IBS diagnosed?
The symptoms of both endometriosis and IBS seem common and difficult to distinguish. Thus, there is no clear diagnosis in many cases, creating a clinical dilemma, and reducing the treatment options for the patient. IBS is difficult to diagnose, as it is a functional gastrointestinal disorder.
During your first visit to a general physician, your doctor will inquire about your symptoms and accordingly run a few IBS and endometriosis tests, and refer you to the specialist.
The specialist will take a detailed history of the patient’s medical health and perform certain tests to confirm the diagnosis. This may include examination of vagina to identify the presence of vaginal endometriosis, or in some cases, a rectal examination may also be performed. Ultrasound imaging tests, such as MRI, may be performed as well.
Another form of diagnosis is the laparoscopic approach. A laparoscope is inserted through the vagina to confirm the finding and get a clear picture of the inside of the pelvic region.
What are the endometriosis and IBS treatment options?
Treatment of endometriosis and IBS has been through medical management, wherein the traditional therapies include pain medications, hormonal treatment, and surgical interventions to reduce the endometriosis and IBS symptoms.
Hormones also play a role in IBS, and thus it can be managed with hormonal therapy. Many patients have been benefited from the hormonal treatment, and symptoms can be managed for many years under the specialist's guidance. This includes the use of oral progestins, contraceptive pills, total hormonal suppression with GnRH agonists, or combinations of these.
many professionals perform laparoscopic surgery for resection of severe endometriosis. The planning of surgery is done by identifying the size and location of the lesions, followed by careful removal of lesions. Apart from a few surgical risks associated, the procedure is safe and effective for most patients. Women with significant fertility issues are often benefited from this laparoscopic intervention.
The surgeons may recommend a colonoscopy based on the symptoms and diagnosis.
Complementary therapies such as naturopathy, herbal medications also work for many patients and minimize the symptoms.
Management of lifestyle factors, especially nutritional management, is often recommended as the first line of action. Diet has a huge impact on the symptoms of endometriosis and IBS
Let us learn more about endometriosis and IBS diet plans.
Patients who have adopted an individually-adapted diet such as a gluten-free diet have experienced an improvement in painful symptoms, physical function, and overall health experience. These dietary changes also positively impact the social and mental well being of a patient.
Irritable bowel syndrome IBS high fiber diet:
Another dietary pattern is the low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (known as FODMAP) diet known to reduce gastrointestinal symptoms to a larger extent. Experts recommend probiotic supplements to the FODMAP diet plan for improvement in abdominal pain intensity and frequency. Alterations in the gut microbiome have also been suggested through microbiota-based therapies.
Patients also share that the dietary changes led to increased energy levels and a better understanding of how they could affect their overall wellbeing. Healthcare professionals play a major role in filling the knowledge gap about necessary dietary changes and lifestyle changes to alleviate symptoms and improve the well-being of the patient.
This diet intervention can be quite challenging to follow and choose. It is essential to get the guidance of a qualified professional who can suggest a suitable diet format that is practical. The excellent collaboration of physicians‐ nutritionists can help achieve a successful outcome for patients.
When to see doctor
The symptoms of endometriosis and IBS have a considerable effect on multiple facets of a patient’s life. The severity of symptoms depends upon the stage of IBS and endometriosis, and it can be an extremely painful experience for the patients. Women who have endometriosis in the pelvis or bowel that may be affecting their fertility are required to consult the specialist for further treatment.
Can endometriosis and IBS be cured?
Endometriosis and IBS are chronic diseases with no known cure but can be managed under the guidance of a specialist. Patients are recommended to use conventional and complementary therapies to reduce the symptoms.
Many studies indicate that diet can influence the symptoms of endometriosis. The primary interventional therapy is related to a diet based on fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP). Such a low FODMAP diet appears effective in women with IBS symptoms and endometriosis.
People with endometriosis and IBS suffer from many bowel related problems, and women often suffer from infertility issues. Even though there is no specific cure, it is comforting to know that both conditions can be effectively managed with various treatment options.Finding the right doctor is a good place to start who can offer you a tailored plan as per your condition.