Gut Health and Endometriosis

It is now widely accepted that endometriosis is a whole body inflammatory disease.  Pain is the main symptom, but other symptoms can include bladder or bowel problems, abdominal bloating, headaches, fatigue, bleeding between periods and infertility. 

Last week I did an instagram live with a wonderful endometriosis group.  I regularly teach masterclasses on various topics and how they factor into endometriosis to this group. This time we chatted about all things gut health and microbiome. 

We started with the basics: what is the microbiome?  It is the collective DNA of bacteria, viruses, fungi that live inside and ON the body.   The gut microbiome is the sum of the good and the bad in the gut, your intestinal tract!

What factors affect the gut microbiome?  Over the last decade we have refined these factors but the biggest ones are mostly things out of our control.  Vaginal births (vs c-section), breastfed babies (vs formula), and an abundance of green space (vs city life) all improve our microbiome diversity.   One of the biggest factors in our control is actually vegetable diversity (vs processed foods) ! The more vegetable diversity, the better the microbiome!

So without doing testing how do you know if you have a good gut or dysbiosis?  If you have specific symptoms like the following chances are your gut is not happy:

• constipation/diarrhea, heartburn, food sensitivities
• eczema
• depression (95% of your serontonin is made in the gut!)
• autoimmune conditions

We will circle back to this and continue to talk about how to improve your gut health but let’s also discuss estrogen metabolism since we are talking about endometriosis.

The estrobolome is a collection of bacteria in the gut that is focused on metabolizing estrogen.  The estrobolome makes beta - glucoronidase, an enzyme which deconjugates estrogen into active forms.  Dysbiosis decreases this enzyme activity so you need a healthy gut microbiome to have a healthy estrobolome.  If digestion is poor then over time estrogen or hormonal balance will be affected.

Women with endometriosis have higher amounts of dysbiosis overall as well as bacterial overgrowth in the estrobolome, leading to higher estrogen levels that stimulate endometrial growth.

Women with endometriosis also have much higher rates of IBS, suggesting an important connection between endometriosis and a disrupted microbiome.

Remember endometriosis is a whole body inflammatory disease. Gut health is usually just one piece in this complex puzzle.

WHAT CAN WE DO? 

• avoid ultra processed foods - starves the good
• avoid sugar - feeds the bad
• reduce alcohol as is damages the microbiome
• eat variety of vegetables and healthy starches- DIVERSITY
• identify food sensitivities as they cause inflammation
• manage stress
• exercise
• good restorative sleep
• ensure good stomach acid
• avoid meds like antibiotics, PPIs, and BCP
• prebiotic foods: garlic, onions, leeks, flax, artichokes, chia, chicory
• probiotic foods: fermented foods like kefir, sauerkraut, kimchi AND supplements

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