Endometriosis and IBS

How They Overlap and How to Manage Both

Both endometriosis and Irritable Bowel Syndrome (IBS) can significantly affect health, mood and quality of life, and they overlap far more than most people realise. This guide walks through both conditions, where they intersect, and practical strategies for managing them.

Understanding endometriosis

Endometriosis is a chronic condition affecting around 1 in 7 women and people assigned female at birth in Australia (AIHW, 2025).. It occurs when tissue similar to the uterine lining grows outside the uterus, often affecting the ovaries, fallopian tubes and pelvic lining. Endometriosis isn’t just a reproductive condition. It can be found in and around other major organs too.

Symptoms vary widely and can include chronic pelvic pain, heavy menstrual bleeding, fatigue and nausea, alongside gastrointestinal symptoms like diarrhoea, constipation, bloating, and bowel or bladder pain. Because of this symptom overlap, endometriosis is often misdiagnosed as IBS. There’s currently no cure, and the exact cause isn’t fully understood, though genetic, hormonal and immune factors are all thought to play a role.

Understanding IBS

IBS is complex, and its exact cause remains unclear, but contributing factors can include how your gut nerves function, changes in gut motility, heightened sensitivity to certain foods or stress, shifts in gut bacteria, and mild inflammation in the digestive system. Genetics and environment can play a role too.

Diagnosis typically involves your medical history, a physical check, and tests to rule out other gut conditions, which might include blood or stool tests, imaging like a colonoscopy, or breath tests for bacterial overgrowth or lactose intolerance.

Management is usually tailored to the individual and may include dietary changes such as a low FODMAP approach to reduce fermentable carbohydrates that trigger symptoms, medication for specific symptoms like pain or bloating, and lifestyle strategies like stress reduction, regular movement and good sleep hygiene.

Where endometriosis and IBS overlap

Research shows a genuine overlap between the two conditions. Those living with endometriosis are around twice as likely to also be diagnosed with IBS compared to those without it. This is likely due to shared symptoms like diarrhoea, constipation, nausea, bloating and abdominal pain. Possible mechanisms include gut hypersensitivity common to both conditions, endometriosis growing in or around the bowel causing inflammation and irritation, and elevated oestrogen and prostaglandins amplifying gastrointestinal symptoms.

A holistic approach to managing both

Managing endometriosis and IBS well usually comes down to diet, movement and stress management working together.

Diet. Include omega-3 rich foods like oily fish and flaxseed, and antioxidant-rich foods such as extra virgin olive oil, berries and turmeric to help manage inflammation. Add plenty of fibre from fruit and vegetables, and probiotic-rich foods like yoghurt and kefir to support digestion and reduce IBS flare-ups. Be cautious with common triggers like gluten, dairy, alcohol and highly processed, high-saturated-fat foods, but please talk to your dietitian before removing entire food groups, unnecessary restriction can worsen symptoms or create nutrient gaps rather than solve the problem.

Movement. Gentle, regular activity like yoga, pilates or light aerobic exercise can help manage pain and support digestion. If exercise tends to flare your symptoms, a pelvic floor physiotherapist or an exercise physiologist experienced in endometriosis can build a program that works with your body rather than against it. Movement also supports stress reduction, which benefits both conditions.

Stress management. Mindfulness, meditation, or cognitive behavioural therapy (CBT) can meaningfully ease symptoms by supporting the physiological processes shared by both conditions.

Building your care team

A multidisciplinary approach usually works best for endometriosis and IBS. Your team might include your GP, a specialist, a dietitian, a pelvic floor physiotherapist, a psychologist, and an exercise physiologist. Come to appointments with specific questions ready, around diet, treatment options, or anything else on your mind, and don’t hold back on discussing the emotional side of living with these conditions alongside the physical.

Where to from here

Understanding and managing endometriosis and IBS together can genuinely improve your quality of life. With the right strategies and the right support team, a balanced, fulfilling life is absolutely possible alongside these conditions.

Blog written in collaboration with Rachel Gearon, Fertility and Endometriosis Dietitian and co-founder of Hera Nutrition, and Annabel Johnston, Gut Health Dietitian and founder of Nutrition for Living.

References

• How common is endometriosis? Australian Institute of Health and Welfare (AIHW). 2025.
• Chiaffarino F, Cipriani S, Ricci E, et al. Endometriosis and irritable bowel syndrome: a systematic review and meta-analysis. Archives of Gynecology and Obstetrics. 2021.
• Barnard ND, Holtz DN, Schmidt N, et al. Nutrition in the prevention and treatment of endometriosis: a review. Frontiers in Nutrition. 2023.