Endometriosis and the gut - what's the connection?
Endometriosis is estimated to affect one in ten women of reproductive age, meaning 176 million women worldwide. Studies have shown that it takes between three to eleven years from the onset of endometriosis symptoms for those women to receive a final diagnosis. The procedure necessary for diagnosis is both invasive and expensive as performing a laparoscopy is currently the only way to accurately find out if endometriosis is the cause of chronic pelvic and period pain.
We now know endometriosis is not caused by one single factor, it is in fact a multifactorial condition where genetics, inflammation, environmental factors (such as toxins), and autoimmunity can all play a role. Most recently, a study raised a hypothesis that bacterial contamination may also play a role in the development of the disease, let me explain!
The study found that menstrual blood of women with endometriosis was highly contaminated with a bacteria called E. coli. E.Coli is a known resident in our large intestine and releases toxins that promote inflammation via overstimulation of the immune system. Now I know what you are thinking, how can a bacteria that lives in our gut be involved in this mechanism?! The study suggests that it can translocate through the gut barrier to the pelvic cavity.
Keeping our gut barrier strong and healthy is possibly one of the most effective ways to minimise the cross-talk between gut bacteria toxins and the immune system. You may already have heard that 70% of our immune cells reside in the gut, which makes sense as the GI tract is our first point of contact with the external world bringing all sorts of microbes and toxins with each mouthful of food.
Top tips to keep the gut barrier strong
Thanks to the emerging interest in gut health, we now know that food and lifestyle play a significant role in keeping our gut barrier strong. Luckily, looking after it is much easier than it sounds! Here are my top tips that can be easily incorporated into your routine.
Eat a plant-oriented, anti-inflammatory diet: Plant-derived components called polyphenols have proven beneficial effects on the gut barrier so feasting on all types of plant foods such as fruits, vegetables, legumes, whole grains, nuts and seeds is an easy way to strengthen it.
Watch out for vitamin deficiencies: deficiencies of vitamin D, vitamin A and zinc have been found to compromise the gut barrier with an increased risk to infection and inflammation - make sure you are getting those nutrients in by eating oily fish and sun-exposed mushrooms - rich in vitamin D, sweet potatoes, carrots and butternut squash - rich in betacarotene, the precursor of vitamin A, as well as cashews, chickpeas, almonds and oysters for a good dose of zinc.
Limit your intake of environmental toxins: that includes alcohol, cigarettes, medications and ingredients found in ultra-processed foods that contain gut barrier disruptors such as emulsifiers and additives - for example carrageenan, polysorbate, carboxymethyl cellulose, citric acid esters.
Reduce stress levels: stress is a lifestyle factor that has been linked to the deterioration of the gut barrier via gut-brain axis interactions, and is a well-known risk factor for onset and reactivation of chronic disorders such as endometriosis.