Is It Endometriosis or IBS?

Symptoms of the two conditions can often overlap

In This Article

Many women find that their IBS symptoms worsen around the time of their period. When this happens, it is not too much of a stretch to wonder if perhaps the problem has to do with the reproductive organs and not the bowel.

Endometriosis is a gynecological disorder that, like IBS, can result in symptoms of abdominal pain and cramping. This overview of endometriosis and its possible overlap with IBS can help you to determine if you have been diagnosed accurately.

Overview

Endometriosis is a condition in which the endometrial tissue lining the inside of a woman's uterus grows in parts of the body outside the uterus. Because this tissue is outside of the uterus, it cannot be expelled out through the vagina during a woman's period. This tissue may become inflamed and/or result in adhesions and cysts. To make matters worse, this tissue will be stimulated to grow by the same hormones that encourage the lining of the uterus to build up each month.

When endometriosis is present, tissue growths are most commonly found in the lower abdomen and the pelvic area. Growths may be seen on the outside of the uterus, the ovaries, the bladder, the rectum, and the large intestine.

Symptoms

For some women, endometriosis may be present without any symptoms. Others may see the pain from the condition as a normal part of getting one's period.

The main symptoms of endometriosis include:

  • Strong abdominal pain and cramping, particularly during one's period (dysmenorrhea), but maybe present throughout the cycle
  • Pain experienced during or after sexual intercourse (dyspareunia)
  • For some women, infertility
  • Bladder difficulties

Digestive Symptoms

Relevant to our present discussion of the relationship of endometriosis to IBS, endometriosis 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

Commonalities

Women who have endometriosis are at higher risk of receiving a diagnosis of IBS. Interestingly, this higher risk occurs both before and after the endometriosis is identified. This suggests that IBS is not merely a misdiagnosis of endometriosis.

Why the overlap between endometriosis and IBS? In many cases, the misplaced endometrial tissue is located alongside the large intestine. Inflammation associated with this tissue may contribute to bowel problems.

Differences

Although both disorders result in abdominal pain and cramping, there appear to be some important differences between the two health disorders. One research study did a head-to-head comparison of the two conditions, plus included pelvic inflammatory disorder in the mix.

The researchers found that IBS patients were more likely to report the following symptoms as compared to endometriosis patients, and vice versa for endometriosis patients as compared to IBS patients.

IBS Patients Are More Likely to Report...

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

  • Colicky pain

  • Distension

  • Nausea

  • Upper abdominal pain

  • Pain worsened by food and/or stress

Endometriosis Patients Are More Likely to Report...

  • Bleeding between periods

  • Increased pain during the premenstrual phase of the menstrual cycle

  • Tenderness within the vagina

Diagnosis

If your IBS worsens during the time around your menstrual period, it is understandable that you may be concerned that you have been misdiagnosed. If this is the case, it is essential that you speak with your gynecologist. Studies have found that there is often quite a long delay between the onset of endometriosis symptoms and a diagnosis. Part of the problem is that endometriosis can only be definitively diagnosed through laparoscopy.

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Article Sources

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  2. Farquhar C. Endometriosis. BMJ (Clinical research ed.). 2007; 334(7587):249-53. doi:10.1136/bmj.39073.736829.BE

  3. Seaman H, Ballard K, Wright J, de Vries C. Endometriosis and its coexistence with irritable bowel syndrome and pelvic inflammatory disease: findings from a national case-control study-Part 2. BJOG. 2008; 115(11):1392-1396. doi:10.1111/j.1471-0528.2008.01879.x

  4. Lea R, Bancroft K, Whorwell PJ. Irritable bowel syndrome, chronic pelvic inflammatory disease and endometriosis. European Journal of Gastroenterology & Hepatology. 2004; 16(12):1269-1272. doi:10.1097/00042737-200412000-00006

  5. Agarwal SK, Chapron C, Giudice LC, et al. Clinical diagnosis of endometriosis: a call to action. American Journal of Obstetrics and Gynecology. 2019; 220(4):354.e1-354.e12. doi:10.1016/j.ajog.2018.12.039

Additional Reading

  • Fact sheet: Endometriosis. PubMed Health.

  • Ballard, K., Seaman, H., De Vries, C. & Wright, J. Can symptomatology help in the diagnosis of endometriosis? Findings from a national case–control study—Part 1. BJOG: An International Journal of Obstetrics & Gynaecology 2008 115:1382-1391. DOI: 10.1111/j.1471-0528.2008.01878.x.