At least 1/3 of patients with endometriosis fit the diagnostics for IBS; since endometriosis may have similar symptoms, particularly if there is bowel involvement. Commonly these patients are actually misdiagnosed as having IBS, and sent away to deal with this issue, rather than getting to the bottom of their chronic pelvic pain and bowel disturbances. A low FODMAP diet can help reduce endometriosis symptoms related to digestive upset, resulting in reduced bloating and endo pain.
So what is FODMAP
Any foods containing fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. They are short chain carbohydrates that are poorly broken down in the upper digestive tract, leading to malabsorption in the small intestine. This causes fermentation resulting in water being drawn into the area, and generates gas/bloating and pain. Since endo is situated mainly in the peritoneal cavity, this increased pressure and inflammation can then further add to pain caused by endometrial lesions.
Addressing the microbiome of the gut either via the small or large intestine (including addressing SIBO) can reduce or eliminate FODMAP symptoms, however doing an elimination of high FODMAP foods can really help to reduce pain and distention in many cases while the gut is being repaired. This is typically done as a short-term solution
Foods to avoid include:
Artichoke
Asparagus
Beetroot
Garlic
Leek (white part)
Onion
Spring onion
Mushrooms
Cauliflower
Snow peas
Chicory
Mangoes
Figs
Prunes
Watermelon
Dried fruit
Blackberries
Nashi pears/pears
Peaches
Custard apples
Nectarines
Plums
Apples
Cherries
Lychees
Apricots
Fruit juice
Honey
Tinned fruit
High fructose corn syrup
Sweeteners such as manitol, sorbitol, xylitol
Grain and cereal foods including wheat and rye
Legumes and pulses
All dairy products
Cashews
Pistachios
Long list…I know! BUT…there are plenty of foods you can still eat.
Foods to Eat Include:
Vegetables
Alfalfa, lettuce, olives, bamboo shoots, green beans, bean sprouts, bok choy, parsnip, potato, capsicum, pumpkin, carrot, celery, silverbeet, chives, choy sum, corn, spinach, spring onions (avoid white part), cucumber, eggplant, zucchini, sweet potato, tomato.
Fruits
Banana, blueberries, mandarins, limes, oranges, paw paw, passionfruit, grapefruit, pineapple, grapes, raspberries, kiwifruit, strawberries, honeydew.
Breads/Cereals/Grains
Gluten free/spelt based breads/pastas/muesli, Corn and rice based crackers, cereals and noodles, cornflour, oats and oat bran (Just make sure these are Non-GMO and organic where possible)
Milk products
Hard cheese, rice milk, lactose and fruit free yoghurt (lactose containing yoghurt in small amounts – 2 tbs)
Download the Monash University: Low FODMAP diet app. It can be a helpful way to track symptoms, download shopping lists and work out which foods to eat while the gut is restored.
Sometimes it’s easier to work with a nutritionist to assess other ways to support you gut health while it heals from FODMAP intolerances. If I can support you further, please feel free to reach out.
Bec xx
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