How to Deflate Endo Belly

In this episode, we're diving into the world of endometriosis and the dreaded "endo belly."

If you're not familiar, endo is when the uterine lining decides to go on a field trip outside the uterus, causing pain, scarring, and bloating that makes you question your clothing choices.

We'll explore the reasons behind the endo belly, including inflammation, hormonal fluctuations, gut microbiome shenanigans, stress, sluggish guts, increased sensitivity, and diaphragm hijinks.

But fear not my endo friends, I've got a list of 7 strategies in this episode to combat the belly, ranging from food tweaks to lifestyle changes. And if you're up for it, grab your handy resource with even more tips to move past your phantom pregnancy days. So let's say goodbye to bloating and hello to feeling more you.

Check out Oh Goodness! Nutrition's website and Instagram for more nutrition and hormone hacks.

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🥰 10 Ways to Feel Wildly More Supported on Your Fertility Journey

👌🏼25 Simple Things to Curb Your Cravings with PCOS

💃 Beat Your Endo Belly


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Oh Goodness! Nutrition is an evidence-based dietitian practice. However, given the general nature of the content presented on this podcast, it can not replace individualised medical advice. Get yo'self a professional (psst, lik...

Transcript

[00:00:00] Hey you, welcome to this episode of the I'm Thinking of Having a Baby podcast. Hosted by yours truly, prenatal dietitian and nutritionist Hannah Eriksen. When you know food makes such a difference to someone's life - whether it's helping them balance their wonky hormones, reduce their pelvic pain or help them prepare for, conceive and carry another life, you want the whole world to know. 

[00:00:27] This podcast is exactly that. It's a source of the latest nutritional know-how so that you can have clarity, assurance and confidence that you're doing everything to get your dream family. Whether that's in the one-year or five-year plan. 

[00:00:41] Today's episode is for all the endo warriors out there who live with the chronic pain of endometriosis. 

[00:00:48] Just in case there's someone listening who doesn't know what endo is, it's where the tissue of the uterine lining, the endometrium, the bits that get bled out during your period. When this grows [00:01:00] outside your uterus, like around your large intestines, your bladder, your fallopian tubes. And just like with your menstrual cycle, these misplaced tissues thicken in the same way, but they also cause scarring, adhesions and ridiculous amounts of pain. 

[00:01:16] And it's not normal for periods to be really painful. But women with this condition live with the pain, not just during their period, but also during ovulation and sometimes the whole length of their cycle with maybe just a couple of days of feeling good. The pain has been described by some of my clients is being stabbed repeatedly with a knife. Yikes. 

[00:01:37] And many struggle with IBS as a result, some with bladder problems and some have pain with intercourse. Among lots of other symptoms. When it comes to treating endometriosis, the research shows us that the best plan of action comes from a multidisciplinary team. For example, having a gynecologist, a chronic pain psychologist, a pelvic health physiotherapist, [00:02:00] and a dietician familiar with hormone health and fertility on your team is more effective at reducing pain long-term than simply medication or surgery as is often the case. 

[00:02:11] As you probably guessed, I help clients have less pelvic pain by avoiding food that exacerbates it. And by having more of the food and nutrients we know that actually can reduce pelvic pain. Today though we're covering a topic that endo warriors put up with on a daily basis. The endo belly. Significant abdominal distention or bloating, is one of the key symptoms linked to endometriosis, and some researchers include it as an important feature to determine one's likely need to be investigated, and surgery to diagnose if they do in fact have endo. 

[00:02:45] Imagine not being able to button up your clothes on a regular basis or being asked by strangers when you're expecting. Bloating among the endo community is a major player in affecting quality of life. It can be painful, frustrating, and awkward. And so, [00:03:00] knowing what causes it, and most importantly, if there's anything that can be done to deal with it is what we're here to cover today. 

[00:03:08] What causes endo belly. I'm going to start with some bad news. 

[00:03:12] It's not one thing it's actually caused by a bunch of different factors. So addressing one of these might not actually reduce your bloating significantly on its own. But attacking things in a multi-pronged approach is likely to help. Because there are seven main drivers of endo belly. 

[00:03:30] The first one is inflammation. I've actually just done an episode on inflammation. So I won't take the time here to get into too much detail. Definitely grab a listen when you can. The key thing is that endometrial tissue, the stuff that gets growing where it shouldn't, is inflammatory. It causes your body to fight an immune response, which draws fluid and gas to the site, a la bloating. 

[00:03:54] The second is hormonal fluctuations. So endo is driven by a relative [00:04:00] high level of estrogen, higher than ideal levels of estrogen in the follicular phase of your menstrual cycle - so that's the beginning two-ish weeks - causes fluid retention and it slows down the movement of your gut. 

[00:04:13] You may also notice bloating in the days before your period. The drop in progesterone around that time can also cause bloating. So the key thing here is that it's the relative amounts of estrogen and progesterone, and their fluctuations across the menstrual cycle that influence bloating. 

[00:04:31] The third thing that can cause endo belly is changes in the gut microbiome. So believe it or not the composition of gut bugs living in your large intestine controls how much estrogen you have in your body. Estrogen travels throughout your body in a joined or conjugated form. Certain gut bugs have the ability to break this joint, releasing free estrogen into the bloodstream. And if you have too many of these gut bugs, then you have too much estrogen. And this is known [00:05:00] to be a driver of endometriosis. And therefore bloating. 

[00:05:04] Stress is the next factor at play. Chronic stress. Think of that low grade anxiety we can kind of put up with, but it's always there. If you have a stressful job or ongoing life circumstances which create a lot of stress, our cortisol hormone is released from our adrenal glands. Cortisol slows down our guts movements, which causes more gas and fluid to accumulate in our abdomen. 

[00:05:28] Now not directly related to bloating, but as a side note, higher levels of cortisol also increases our sensitivity to pain. So for those with endo who have bloating, you might also experience greater levels of pain as related to your stress. 

[00:05:44] Fifth, the slow moving gut is something I've already mentioned, which happens when our hormones are in flux. To break it down a slow moving gut means that the muscles in your intestines aren't working together as a team, they're a bit all over the show. So food doesn't make its way down the pipes [00:06:00] in a fashion that's ideal. Moving more slowly creates more pressure on the abdomen, more gas and fluid buildup, as well as constipation. And again, another side note constipation also increases the amount of pain women with endometriosis feel.

[00:06:16] The sixth factor causing endo belly is increased gut sensitivity. Remember how having endometriosis is linked with having more estrogen in your body. This extra estrogen talks to estrogen receptors in your gut. And these tell your brain to amplify the feeling of being bloated. So not only are you bloated, but you feel it in greater intensity. 

[00:06:42] And finally the belly can also be mechanical, caused by an inappropriate movement of your diaphragm. Your diaphragm is a muscle that sits underneath your lungs. When you breathe in, normally your belly sticks out a bit as the abdomen relaxes to fill with air. But what can happen- and those with chronic [00:07:00] gut pain in an effort to reduce pain, the brain subconsciously contracts the diaphragm and relaxes the belly, which leads to a bloated looking tum. 

[00:07:10] Cool, cool now you know the reasons why endo belly is such a feature of endometriosis. Let's talk about how you can combat it. I have a list of seven things here. I'm just vibing the number seven today. 

[00:07:22] There are more things you can try than just these, in fact, I have a little resource for you with 12 things that you can give a go. Once you finish this episode, you can go ahead and download it and let me know which ones you tried and what difference they made. 

[00:07:36] The first thing we can try is food because I am a dietitian and we're going to start there. 

[00:07:41] I'm going to give you a couple of foods to avoid. First up artificial sweeteners. These not only reduce the diversity of your gut bugs and therefore make way for more estrogen to be freed, but they also make your belly produce more gas, which gets trapped, making bloating worse. 

[00:07:58] Secondly, I'd avoid [00:08:00] smoothies and fruit juices choosing the whole food instead. 

[00:08:04] Smoothies can have a bit of a health halo attached to them. So this recommendation might come as a surprise to some. In general, having the odd smoothie is okay for most people. However, they can also increase the amount of gas produced. And since we're trying to reduce bloating choosing the whole food, like an apple over apple juice is a simple step in the right direction. 

[00:08:25] Fermented food is awesome. If you love a good kombucha or kefir, kimchi or 'kraut, that's fine, but this can also cause more gas to be produced. So if you are experiencing bloating, I would halve your intake for a couple of weeks to see if anything changes for the better. And then continue having smaller portions. Of course not so relevant if you're not currently eating fermented products. 

[00:08:48] A couple of lifestyle changes can also really help reduce bloating. I've got four here. 

[00:08:53] Chew your food. Look, it sounds silly, but we often forget. I say to my clients, chew until your [00:09:00] food is liquid and try putting down your utensils every now and then. Practice this. It doesn't happen overnight. 

[00:09:08] The second thing, get moving. A gentle walk or stretch can move food and gas through. Walking can also help reduce fluid buildup. 30 minutes per day is awesome. But three, 10 minute sessions is even better. 

[00:09:23] Next, you could try peppermint oil, if you haven't already. Peppermint oil has been shown to relax your gut muscles, which can help to get rid of gas. Peppermint oil has been shown to work best in capsules. So if you want try 180 to 225 milligrams of peppermint oil up to three times per day, 30 minutes before meals on an empty stomach. 

[00:09:48] Diaphragmatic breathing is the final thing, it can help train your diaphragm to relax so that your tummy doesn't stick out. There are videos of how to breathe like this all over the internet. So [00:10:00] have a Google. Aim for five minutes a day and over time, you'll be a lot more aware when it's happening subconsciously. 

[00:10:07] Like I said, there are more strategies known to help reduce bloating, if you wanted to give them a go also. The download is in the show notes. As always start with the easiest things and get them under your belt before moving onto the next. 

[00:10:20] While endo belly is complicated, there are some simple strategies that can help. Knowing that things like inflammation, stress, and excess estrogen impact it you're in a much better position to make tracks and make your Phantom pregnancy days a thing of the past. 

[00:10:37] For more nutrition and hormone hacks visit Oh Goodness! Nutrition's website ognutrition.co.nz and our instagram page at ohgoodness_nutrition. See you next sesh for how to reduce endo pain naturally. Already counting down!