top of page

IBS + Endo - What's the connection?

To start off, let’s all get in step with the lingo: IBS is for Irritable Bowel Syndrome and ENDO is for Endometriosis. Cool?

Now, if IBS and ENDO were on Facebook, their relationship status would certainly read “It’s Complicated!”. IBS and ENDO are two very different conditions that typically present with similar symptoms and are often misdiagnosed as the other. And as if that is not complicated enough, it is possible to suffer from both conditions at the same time ( yup you heard right!). While IBS sufferers are both men and women, women are typically twice as likely to have IBS than men. ENDO on the other hand is a female-only condition ( related to the uterus), and women with ENDO are 2.5 times more likely to have IBS.

Now before I confuse you any further, let’s first get to the basics of these two conditions. What exactly is IBS and what exactly is ENDO?.


As the name suggests, IBS is basically a situation when your bowel is irritated! It is a condition that affects specifically your large intestine ( colon). It is an inflammatory condition where your large intestine is slightly inflamed and as a result, you present symptoms like:

  • Cramping

  • Abdominal pain

  • Bloating

  • Gas

  • Diarrhea, and/or constipation

  • The feeling that you haven’t finished a bowel movement

  • Whitish mucus in your stool

Often these symptoms are relived by pooping or passing gas.

IBS is not life-threatening and is caused by a complex interplay of many factors like chronic inflammation, SIBO, food intolerances, allergies/sensitivities, digestive infections, and stress.

Interestingly about 50% of women with IBS report that their symptoms worsen during menstruation.


In the simplest of terms, endometriosis is also an inflammatory condition that is estrogen dependant.

In more complex terns, Endometriosis is when endometrial tissue grows in areas outside the uterus like the ovaries, colon, or other parts of the pelvic cavity. This displaced endometrial tissue behaves like the rest of the endometrium ( uterus lining) by responding to the cyclic hormonal signals. So when the endometrium is being shed during menstruation, these tissues also slough off except that they have nowhere to go! So over time, the tissues build up to form masses and lesions that can significantly affect organ function and fertility status. These masses can grow around the large intestine leading to IBS-type symptoms that are especially severe around menstruation.

In Chinese medicine, endometriosis is considered a blood stagnation. This simply means that blood is not flowing all around the body as well as it should. In this case, this poor flow of blood causes the growth of abdominal lumps.

Common symptoms of endometriosis include:

  • Painful menstruation

  • Pain during or after sex

  • Chronic pelvic pain

  • Heavy or irregular menstruation

  • Uterine bleeding in between periods

  • Pelvic bloating (from endometriotic cysts or an enlarged womb)

  • Subfertility

  • Urinary-related symptoms during menstruation (such as painful urination and bloody urination).

Endometriosis around the large intestine may also result in the following digestive symptoms:

  • Pain during bowel movements

  • Difficulty having a bowel movement

  • At times, the severe abdominal pain resulting from endometriosis may be accompanied by nausea, diarrhea, and/or vomiting


Typically, when a woman presents to her GP with abdominal pain, cramping, bloating, and digestive issues, the GP is likely to diagnose IBS when it could well and truly be ENDO affecting her large intestine. This adds to one of the reasons why it can take women up to 7 years to get a correct endometriosis diagnosis. Not to mention that ENDO can only be truly diagnosed by surgical laparoscopy which involves removing a portion of potentially abnormal tissue and testing it in a lab for the presence of uterine tissue.

A simple way to differentiate the two is that if you find your IBS symptoms worsen around the time of your period, but are milder or non-existent the rest of your cycle. It could possibly be ENDO. In this case, the endometrial tissues that have grown near your large intestine respond to hormones during menstruation causing the abdominal pain, cramping, and changes in bowel movements that are common in IBS.

To make it easier for patients to get the right diagnosis, some research was done to compare the most common symptoms of IBS and ENDO respectively. This research found that:

IBS Patients Are More Likely to Report...

  • Bowel habit changes, i.e. constipation, and/or diarrhea

  • Colicky pain

  • Abdominal Distension

  • Nausea

  • Upper abdominal pain

  • Pain worsened by food and/or stress

While Endometriosis Patients Are More Likely to Report...

  • Bleeding between periods

  • Increased pain during the premenstrual phase of the menstrual cycle

  • Tenderness within the vagina


In case you happen to be teeter-tottering between the two and wondering what the real issue could be, begin by taking time to observe whether your symptoms are more severe around your period or whether they run all through your cycle. The relationship between IBS and ENDO may be complicated but thankfully, it is possible to get the correct diagnosis and with the help of Chinese medicine significantly improve your health and quality of life!.


bottom of page