As a longtime endometriosis sufferer diagnosed years after seeking answers to my debilitating symptoms (menstrual cramps, pelvic pain, fatigue, nausea and shooting pain in my legs), neither I nor any of my doctors suspected a correlation between my frustrating stomach bloat and endometriosis pain.
Coincidentally, endometriosis bloat is the only visible symptom of this chronic illness. We can use makeup to mask our fatigue and a smile to hide excruciating pain, but a bloated abdomen demands to be seen unless you move north for the summer or opt to make muumuus a permanent fixture of your wardrobe (neither of which we recommend as real solutions, btw). And bloating has a knack for affecting intimacy in new relationships when your early morning “normal stomach” suddenly looks as though you’re carrying a bowling ball under your pajamas.
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For me, endo bloat is extremely painful — stretching my skin to its limit — and oftentimes embarrassing. It requires close monitoring, exercise and making serious dietary changes. Even though I know my food triggers, it can be hard to turn down peanut butter M&Ms at the movie theater or Red-Vines to get through a deadline. When that happens, the last thing I want to wear is clothing that clings too closely to my midsection — because this otherwise silent health condition is responsible for making me look like I’m with child (a common refrain from endo sufferers).
I wish I had known years ago that there are preventative measures I can take to reduce endo bloat. Finding real solutions in online communities has been a game-changer for me. Not only can I adjust my daily gut health routine in real time based on suggestions from fellow endo warriors, but I finally see myself reflected in their endo bloat selfies on social media.
We spoke with six other people with endometriosis about how endo bloat affects their lives, what they do to manage the pain and their go-to sources to reduce a flare up. Sharing information has changed the way I live with my own endometriosis and has empowered me with tools to manage this lifelong disease. Based on their recommendations, I’m anxiously awaiting an online package with some goodies to try out the next time bloating tries to get the best of me.
Essential oils and an anti-inflammatory diet
“Before I was diagnosed with endo last February, I would experience endo bloat without knowing exactly what it was. The bloat usually lasts no more than two hours, but it’s crazy how in the morning I can have a flat stomach and by evening I look six months pregnant. The swelling isn’t up high like when you’re full from eating too much; it’s low like a pregnant belly. Most of the time, it’s just uncomfortable but when it’s painful, it’s painful!
“I use essential peppermint and digize oils and stay away from mushrooms and garlic when I’m eating. I also use heat packs and ibuprofen when I really need it.” — Liz D., 27
Activated charcoal and ginger tea
“I have yet to pinpoint what causes my flares. It varies — some days it’s my food choices, while others it’s my alcohol consumption, physical activity or even stress. Some of my flare-ups are mild, while others have affected my ability to walk so much that I need crutches.
“Some days I can manage. Other days I lay out on the floor in pain and a cold sweat — dizzy, nauseated and experiencing numbness in my limbs. Endo has exacerbated my anxiety and depression, but I do my best to push through with the help of antidepressants and therapy. Education and connecting with other endo warriors has been the best medicine. Endo used to be a flaw. Now it’s my badge of honor. To manage, I take activated charcoal supplements to absorb gases in the belly, soak in hot baths using Epsom salt and use heating pads (both electrical and disposable). I also drink ginger tea and increase water intake, but avoid dairy, fried foods, sweets and foods high in sodium. I have yet to find a miracle method to treat my flares and bloating — I just manage. I keep notes on my diet and symptoms to discuss with my doctors during appointments. I also see a pain management doctor every two to three months and found that to be very beneficial since I don’t want to become reliant on pain medications.” — Kai BP, 34
Epsom salt baths and essential oils
“During the first three days of a cycle, I can’t move and am in so much pain, in addition to having a super heavy flow. My symptoms happen during the peak of ovulation and the first two to three days of my period. Twice a month, it’s a struggle to help my children — ages four and two-and-a-half — with their daily needs.
“I managed bloat over the years in several different ways and learned a lot about my body and what causes me more pain. I try my hardest to stick to an anti-inflammatory diet, but mainly cutting out gluten was a lifesaver for me. I eat a lot of inflammation-reducing foods during that time instead of giving into the chocolate or junk food cravings. A good heating pad is a must, as are warm Epsom salt baths with essential oils. When the pain is the worst, I use several essential oils on my lower belly and back with a hot compress over the oils. I’ve learned so much about gut health — why it’s so important what you put in and on your body — because my daughter was diagnosed with an autoimmune disease.
“So, even though I’ve dealt with endometriosis for years, I’d say in the last three to four years is when I really started educating myself to get relief without taking so many pain killers. I started asking my OB-GYN more questions and switched doctors when I felt like they weren’t listening to me. I began to do research and finding companies that I trusted. Turmeric (I add it to my smoothies) and cinnamon (I add the essential oil to teas, lattes and diffuse it) are good ways I’ve found to reduce inflammation. As long as I don’t eat gluten or foods high in sugar, the bloat and pain is manageable.” — Ashley W., 27
Coffee with collagen powder
“For me, [endo bloat] is not always painful, but always incredibly uncomfortable. Because there is no cure for endometriosis, diet and exercise is the only way I can help manage my endo symptoms and endo belly. My main triggers for endo belly are gluten, dairy, caffeine and alcohol but I try to eliminate inflammatory foods from my diet including gluten, dairy, soy, refined sugar, processed foods, caffeine and alcohol. My flares typically last about two to three days. I swear by my Great Lakes Hydrolysate Collagen powder — it goes in my decaf coffee every morning.
“Even though all I want to do is lay down with a heating pad, staying up and being as active as possible helps. I’ve had endo for 22 years — you learn how to continue your daily life with the pain and discomfort, which is why we call ourselves warriors! Wearing loose fitting clothes is a must during these days.” — Sarah D., 37
Castor oil and yoga
“Bloat was my biggest symptom before I put my endo in a remission of sorts that I’m in now. I would need different sized pants in the morning and night, with one being two sizes larger for the afternoon and evening. On some days, I could gain up to 15 pounds in a single day. My stomach would be rock hard and distended after every dinner, and I was chronically constipated (I’d go every four days or so). When I began work with a nutritional therapy practitioner, she helped me discover that I had a gut pathogen very common with endo called small intestinal bacterial overgrowth (SIBO), an overgrowth of bacteria in the small intestine. This affects many people with endo due to a slower migrating motor complex function, pain medication, birth control use and a diet high in refined carbs, which I turned to when I was often too tired and uncomfortable to cook healthy, balanced meals. After working with her, I healed my SIBO and I don’t get endo belly anymore unless I eat foods that trigger it. This also healed my constipation issue.
“These days, I don’t have flare-ups very often, but when I do it’s because of a food trigger, lack of quality sleep or stress. They last anywhere from two to three days and include fatigue, leg pain, pelvic pain, bloat and joint pain. I may have to cancel social engagements or extracurricular activities. I try to respect my body’s needs and eat balanced, nutrient-dense meals, stay properly hydrated, stretch and do as much yoga as my body allows. I also use castor oil packs to help fight inflammation, take Epsom salt baths to help my achy muscles, prioritize lots of quality sleep and take activated charcoal between meals to help absorb any residual irritant in the gut.” — Kristy D., 30
Magnesium and melatonin supplements
“Bloating effects me immensely. Drinking and eating milk, gluten or anything unhealthy will puff it right up. I rarely wear jeans because of how uncomfortable it can be. To manage the pain, I’ve been prescribed a few different things. I do yoga and use Deep Blue Rub for my belly. My must-haves for bloating are magnesium and melatonin. Both help wondrously!” — Isabelle D., 22
Comfy clothes for the win
“I go through cycles of battling endo bloat every month; I feel like I’ve tried everything imaginable to manage my symptoms. Typically when I experience extreme bloat, I have my period and already am in a lot of pain. On these days when I have to go to work, I have found that wearing accommodating clothes helps a lot. I mainly wear high waisted pants that don’t put pressure on my lower abdomen, loose-fitting dresses or loose skirts that I feel confident in. Anything with a waistband above my lower abdomen helps significantly, especially when I’m sitting at a desk all day. I’ve also found that I struggle with [my] confidence during these cycles of bloat because my body looks vastly different than I’m used to. Wearing clothes that don’t highlight my bloat helps both with the pain and my confidence that week. In addition to wearing the right clothes, I also try to take multiple walks a day to alleviate the bloat. Getting up and moving does wonders for me sometimes!
“Greasy foods, coffee, sugar and alcohol amplify my symptoms dramatically, so I avoid these at all costs when I’m approaching my period. I’ve found that taking preventative measures helps reduce the amount of bloat I experience in the first place. Trigger foods vary from person to person, so foods that irritate my endo may be different than yours.” — Jordan H., 26
Red wine and exercise
“Endo bloat is a symptom I’ve dealt with since age 12. I’d always wondered why my belly was shaped like I had a beer gut and how it would only get worse when I ate. Fast forward ten years, and I now know the dreaded bloat all too well. Despite trying different diets, yoga, oils, etc., I’ve only found relief in bizarre ways.
“Red wine has been my best relief. A maximum of two glasses of red wine at night helps me wake up to my ‘normal’ (for me) sized stomach. Although it’s a plus that I love wine, it truly does seem to help the flatness of my stomach. The second thing that has helped my bloat is exercise! I’m not talking hardcore cardio and weight lifting — I mean simply adding some extra steps into my day. Taking the stairs instead of elevators at work has made all the difference. Letting all the gases in my stomach move around makes for less bloat as well.” — Shelby P., 26
Interviews have been edited for clarity and length. While online groups and social media communities can be life-changing, they are not a substitute for seeing a trained medical doctor about your endometriosis or symptoms. It is best to discuss any and all treatment options with your medical provider before making any changes to your personal treatment plan.
A version of this article was previously published in October 2019.
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