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Endo Belly: What It Is, Symptoms, Causes, Treatment

by Tamer Seckin, MD | Posted on January 11, 2021

What is Endo Belly?

Endo belly is a term that describes the extremely uncomfortable and severe bloating symptom specifically related to endometriosis that is often dismissed, misdiagnosed, and disguised as IBS by primary practitioners and GI doctors due to similarities in symptoms.

Endometriosis is a disease where the cells that are normally inside the uterus, making up the inner lining (the endometrium), lie outside their normal location and thus can grow on the external lining of other organs in the abdomen and pelvis, primarily female reproductive organs and can spread or attach to other organs such as the intestines. These lesions can only be identified with laparoscopic surgery, whereas IBS or IBD is mostly “internal” diseases affecting the inside of the intestine. Endometriosis can be easily forgotten, dismissed, and the diagnosis delayed if initial workup with gastrointestinal endoscopy and colonoscopy point to another diagnosis, especially if the patient mainly has GI symptoms. During the Virtual Patient Conference for The Endometriosis Foundation of America in October of 2020, Dr. Seckin stated, “IBS is BS when it’s Endometriosis and is the main culprit in a misdiagnosis that causes years of delay”.

By definition, Endometriosis is endometrium-like tissue outside of the uterine cavity or as Dr. Seckin uniquely defines it, “a stem cell-orchestrated, estrogen-dependent fibrosis and inflammation in reaction to endometrial-like tissue”.

Endobelly: a stem cell-orchestrated, estrogen-dependent fibrosis and inflammation in reaction to endometrial-like tissue


Tissues that grow outside of the uterus due to endometriosis, as they are hormonally responsive, attempt to replicate the menstrual process of shedding the lining of the uterus. However, there is no exit for the tissue—this causes inflammation, swelling, and irritation, which over time can form scar tissue. Endometriosis can also cause increased water retention resulting in weight gain accompanying the bloat one may feel. As a result, the inflamed tissue can cause scarring and link together furthering irritation and discomfort.


With endo belly, women experience a constant feeling of pressure, gut irritation, and tightness in the lower abdominal region varying in length of time prior to menstruation. There is a notable distinction between IBS and endo belly physically as the belly chronically swells, primarily in the lower abdominal region, similar to a three-month pregnant belly that is tense to the touch. The gastrointestinal tract can be affected by irritation and inflammation with symptoms of gas pain or cramps, nausea, constipation, and diarrhea.

Endobelly: a stem cell-orchestrated, estrogen-dependent fibrosis and inflammation in reaction to endometrial-like tissue

Home remedies:

Health is directly linked to food and endometriosis is no exception. There is no cure for endometriosis but there are certain foods that can aid in reducing and managing symptoms such as endo belly and drastically improving overall health. Changes in diet include:

  • Drinking ginger and peppermint tea to help with nausea and to provide antioxidants to reduce pelvic irritation
  • Avoiding caffeine as it can agitate the digestive tract, especially with endo belly
  • Following a Low FODMAP diet to monitor symptoms and work out which foods work best for you
  • Avoid red meat as it has added hormones that can cause an imbalance 
  • High fiber intake to help lower absorbed estrogen from the diet

Heat pads with timers can help ease endometriosis flare-ups and endo belly pain by relaxing muscles. It is recommended that heating pads are used with caution and not to excess as they can cause burns and skin irritation if used for too long at a high setting or with direct skin contact.

When should you see a doctor:

Early-onset symptoms of endometriosis:

  • Debilitating camps
  • Heavy and long periods
  • Painful intercourse (during or after)
  • Nausea/Vomiting
  • Painful bowel movements and urinary disorders
  • Infertility

To start, review symptoms with a primary practitioner or trusted medical professional as they can refer you to a specialist and assist in the process. Dr. Seckin goes into grave detail about the importance of setting high standards when seeking an endometriosis specialist in his book, “The Doctor Will See You Now”. Gynecologists that perform the endometriosis surgery are not necessarily specialists and this commonly results in laparoscopy where the procedure consists of direct burning of lesions with lasers or energy as opposed to removing the lesion entirely with deep excision using traditional surgical equipment that can have a lasting relief and is less likely to create adhesions during the healing process.


Surgical and Medical

Treatment alternatives: Birth control pills (low estrogen) suppresses symptoms and maintains balance in hormones to stabilize and disable endometriosis growth or spread, nutritional therapy cutting inflammatory foods will eliminate or improve gut symptoms, acupuncture stimulates targeted muscles, nerves, and tissues to ease endo pain, over-the-counter pain medication and at the last resort, painkillers that can provide instant relief of pain but can cause gastric upset.

The gold standard: Treating the underlying condition with deep-excision surgery.

Other bloated belly causes:

  • Crohn's Disease
  • Ulcerative Colitis
  • Food allergies or intolerance
  • Ovarian Cysts
  • Irritable Bowel Syndrome (IBS)/Irritable Bowel Disease (IBD)
  • Pregnancy

Seek medical attention if you have a high fever, vomiting, bloody stools, or rapid weight loss.

Painful bowel symptoms for endometriosis patients:

Often painful bowel movements can be problematic for endometriosis patients during or just before menstruation. Irregularities include:

  • Constipation
  • Diarrhea
  • Intestinal cramping when having a movement
  • Rectal pain or bleeding
  • Nausea/vomiting

Treating adhesions from scar tissues on organs can help reduce complications to the bowel and endo belly bloating. Adhesiolysis (cutting away scar tissue) surgery needs to be carefully determined with medical professionals for treatment as there is a risk of recurrence.

Ready for a Consultation?

Our endometriosis specialists are dedicated to providing patients with expert care. Whether you have been diagnosed or are looking to find a doctor, they are ready to help.

Our office is located on 872 Fifth Avenue New York, NY 10065.
You may call us at (646) 960-3080 or have your case reviewed by clicking here.


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