This EndoLife podcast

What's a Healthy/'Normal' Gut vs. What's Endo Belly?

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This week’s episode is a snippet from my upcoming course, The Endo Belly Course. I realised when creating this lesson, that this information is info everyone should know, not just my students! So today’s episode is all about what’s a ‘normal’ and healthy gut vs. what is the endo belly?

So first up, I wanted to actually talk about what the endo belly is.

The ‘endo belly’ is not actually a medical term, but instead is a name the community has coined in reference to the severe bloating we often experience. So, there isn’t technically a set definition, but it is generally thought to be severe bloating/swelling that tends to be attributed to endometriosis and is sometimes accompanied by pain. Some experts, articles and endo patients also include gut problems within this term too, but not always.

My definition, from my training and from seeing so many clients with these symptoms is that the endo belly is exaggerated/severe bloating, often accompanied by gut symptoms, pain or discomfort - but it is not always caused by endometriosis directly.

So here are some of the common symptoms I see in my clients and that I tend to think of as fitting under the term ‘the endo belly’:

  • Flares up with stress/food/pain/cycle - but not always, this might just be a daily thing for you.

  • Normally comes with IBS issues like diarrhea, constipation, abdominal pain, gas. These might not be flares, but more so just your daily bowel habits and gut issues. So, for example, you may tend to always lean towards constipation or loose stools, or you may have a lot of gas on a daily basis.

  • It’s often debilitating -  so it may disturb social life, diet, work, or confidence. You might worry about eating out because you’re scared of a flare up, you might have to eat a restricted diet to control symptoms, you might have to sometimes take sick days, or you just struggle at work with your symptoms. It’s not as simple as just feeling a bit bloated after lunch.

  • Normally a dramatic increase in abdominal size - endo patients often report looking pregnant, requiring different sized clothing, having swelling that’s so bad they’re in pain. 

 And finally, I just want to note - some sources discuss the endo belly swelling being lower down in the abdomen and that IBS issues are higher up, but I think the problem with this is that it’s not true for everyone and it might mean you dismiss any other possible causes because you think “Oh it’s low down, it’s just my endo”. I’ve seen lots of people with SIBO and endo, whose bloating is from their diaphragm all the way down or starts from their belly button and goes down to their pubic bone, so I really wouldn’t pay a huge amount of attention to where the bloating is, unless of course you’re just getting a tiny bit of bloat or a bump on say one side near your ovaries, which might indicate a cyst, for example.

So, something I really think is important to discuss is what is normal vs. what is endo belly, because I don’t want us to be trying to reach for an unattainable vision of a healthy gut.

So here are some signs of the endo belly/something more is going on with your gut…

  • Bloating and gut problems get worse and worse as day goes on. You get more uncomfortable, maybe your pain increases and by your last meal your stomach has swollen to triple its normal size.

  • Symptoms can only be controlled through restriction - a ‘normal’ diet can’t be achieved, and you find yourself skipping meals or having to restrict to avoid flare ups.

  • Often can no longer fit into clothes or need to change to be comfortable when your belly swells up because it’s become so distended. In short, the bloating is severe and significant.

  • May be accompanied by other health problems and nutrient deficiencies like achy joints, fatigue, low B12 or low iron. These are signs of inflammation and malabsorption of nutrients.

  • You might get constipated before period. From a functional medicine point of view, which is what my training is based on, you should have at least one daily bowel movement, and this is actually really important for hormonal health, because old oestrogen is excreted through waste and that needs to occur daily. However, in contrast, dieticians and conventional doctors tend to take a different stance and say whatever is normal for you, is normal or at least three times a week. In terms of my training with Dr Allison Siebecker, Dr Jessica Drummond, etc. we would consider that as constipation, basically anything that is not once a day, is leaning towards a form of constipation. It might be considered normal, but we wouldn’t class it as optimal for health.

  • Diarrhea on period which causes abdominal discomfort, eating problems (maybe you have to avoid food or eat a restricted diet), affects daily life (you might not be able to have a normal workday because you’re stuck in the toilet), sicks days, etc.

  • Often affects daily life/confidence because you’ve been asked so many times whether you’re pregnant, you get comments or you just feel fed up with not being able to wear the clothes you’d like. Additionally, your gut symptoms are affecting your daily life, so for example, I had a client who would get several bouts of loose stools every morning, to the point where she would sometimes be late for dropping her child off to nursery. Another client wouldn’t be able to finish meals without needing to dash to the toilet.

  • Wake up bloated already or with gut problems/sleep is disturbed due to discomfort. So, I had one client who had a distended belly all the time, and it was so bad she actually got to the point where it was too painful to sit or stand up, she had to lay down all the time. Another client wouldn’t be able to sleep because by the evening, her belly was so bloated she couldn’t get comfortable, and she’d be in agony from all the gas inside her.

 

So, in contrast, I wanted to talk about what is normal for a healthy gut, and some of this might surprise you -

  •  Feel satisfied after eating, not overly full or like food isn’t going down. Of course, if it’s Christmas or Ramadan you might be feasting on more food than you normally would, so of course sometimes you’re going to feel full to bursting, but generally, you should feel like you’re able to digest your food and like it’s going down. It’s not just sitting there for hours afterwards.

  • May be a bit bloated or gassy after meals (esp. high fibre. or large meals), but the bloating should subside a few hours later and it’s not accompanied by GI distress. This is because our good gut bugs actually eat our food and ferment it, as part of the digestion process. We actually need this to happen to get all of our nutrients. But a result of this process is the creation of gas from the bacteria, and so naturally we will get a bit of expansion after a meal and of course, we’re putting food into our stomach, you wouldn’t expect to fill an empty bag with food shopping and for it not to expand or look bigger. So, there will be some extension of your abdomen after meals, but it shouldn’t be painful, be accompanied by GI distress, be severe or worsen as the day goes on. It should naturally go down and not affect your life or comfort. Additionally, so you know, according to the NHS, a normal amount of passing gas is about 5 to 15 times a day.

  • You should wake up with a relatively flatter stomach in contrast to after meals. This is because your digestion has been working overnight. Now note I don’t say your stomach should be flat in the morning, it will be flatter in contrast to after meals, because you haven’t eaten in something like 10 or 12 hours.

  • And to follow on from that, a normal healthy gut doesn’t mean your stomach is flat all the time. Your stomach shouldn’t be flat all the time, it should naturally expand a bit with food!

  • Bloating tends to increase towards period and in luteal phase, but it shouldn’t be severe/painful/debilitating. This is because progesterone and oestrogen affect water retention, and so bloating and swelling can increase towards your period when progesterone is at its highest. Now if your hormones are imbalanced, this will be worse, so supporting your hormones (which this course will help with) should minimise the effects, but they won’t eradicate them entirely. Additionally, those inflammatory chemicals, prostaglandins, naturally begin building in the uterus from ovulation to your period, and as we know, inflammation creates swelling, so there may be some level of normal swelling during this time, but again, it shouldn’t be severe. If it is, this may be an indicator that your inflammation levels are too high, which is likely to be the case anyway, given that the endometriosis lesions release prostaglandins. Lastly, progesterone relaxes muscles, including the muscles of the intestines, so as a result, digestion slows down, meaning things become a bit sluggish and we get a bit more of a build-up of gas and waste, leading to a bit of bloating - again, it shouldn’t be severe.

  • Bowels might feel a bit sluggish towards period but shouldn’t have full-blown constipation or if you do have any, it should at least short lived, so a day or so, for example. Or maybe your stools are a little harder or more cracked than normal.

  • In contrast, it’s normal to have bowel movements that are looser during your period. This is because those prostaglandin E2 causes the muscles to contract, and as your uterus is right next to your colon, this can create contractions in the colon, resulting in a bowel movement and looser stools. If your inflammation levels are high, you may get full blown diarrhea, and that’s when we’ll want to reduce those levels. Ideally, a normal scenario is maybe more bowel movements which are a bit looser on your period, but they shouldn’t be causing you pain or affecting your day-to-day life during this time.

  • Bloating after meals doesn’t require a new dress size!

Image from Integrative Women’s Health Institute

To show you what a healthy stool looks like, here is the Bristol Stool Chart. This is a diagnostic tool used to determine the health of stools, especially in IBS populations. In terms of functional medicine training, at IWHI we aim for a 4, so your stools should be snake like, smooth, easy to pass with a banana-like consistency. You should be having one to three bowel movements a day, one is the minimum because for optimal health and hormonal health, we want to removing waste on a daily basis, including old oestrogen, to prevent hormonal imbalances. 

Now, dieticians and conventional medicine will likely say to aim for somewhere between a 3-5. In terms of my training, we see 3 as beginning to lean towards constipation and 5 beginning to lean towards diarrhea. This is something that we focus on heavily with SIBO, a lot of people think that they don’t have constipation, or they don’t have diarrhea - but these bowel movements actually exist on a spectrum. Stools that are like pellets, hard and round, or difficult to pass, is a form of constipation. In my training, anything before 4 is a form of constipation and above 4 is a form of diarrhea or loose stools. They don’t show pudding like stools here, but I would consider that as form of diarrhea. However, opinions will vary as I have mentioned, so be guided by what feels best for you.

The caveat here is that if you are vegan and eat a lot of plants (not processed vegan food), you may have softer stools, nearer to a 5, so I wouldn’t worry too much about that. The other thing I would say is don’t chase perfection, which I’ve been guilty of. When my IBS was the most managed it’s ever been (at the time of recording it’s not, because I’ve had a SIBO relapse), my stools were about a 5 but I was very caught up on getting them to a 4! So, if your endo belly dramatically improves, if you get an all clear for gut conditions, etc. but sometimes your stools are a little either side of type 4, this is probably not something to worry about. It might just be that you ate a little more or a little less fibre that week, or maybe that’s just your normal. If you’re concerned about it, certainly see a gut health practitioner, but I just wouldn’t obsess about it that’s the only issue left and there are no other signs that something is up with your gut. 

Just to finish off this section, I want to hammer this home. A super flat stomach does not equal a happy gut - in fact, it sort of suggests that the gut microbiome is under fed or non-existent, because for them to thrive, they need to eat food and as a result, that creates gas.

So, we’re not aiming for washboard abs all the time, we’re aiming for gut health that doesn’t affect your daily life, cause you pain or physical/mental/emotional distress.

Listen and subscribe on your favourite player or listen directly/download MP3 here or just listen below!

Let's get social! Come say hello on Instagram or sign up to my newsletter.

Sign up to the wait list for my course, Live and Thrive with Endo here.

My cookbook This EndoLife, It Starts with Breakfast is out now! Get 28 anti-inflammatory, hormone friendly recipes for living and thriving with endometriosis. Order your copy here.

If you feel like you need more support with managing endometriosis, you can join Your EndoLife Coaching Programme. A 1-to-1 three month health and life coaching programme to help you thrive with endometriosis. To find out more about the programme and to discuss whether it could be right for you, email me at [email protected] or visit my website.

This episode is sponsored by The Pod Farm. Learn all about how to start your own podcast with the complete course from The Pod Farm. Aimed at beginners, this course takes a simple and straightforward approach to planning, equipment buying, setting up, recording, editing and hosting your own podcast. With hours of audio and video materials, and downloadable guides and useful links, this multimedia approach aims to have something for every kind of learner. From now until April 15, newsletter subscribers get 20% off the course price. Visit www.thepodfarm.com to enroll or find out more

This episode is sponsored by BeYou. Soothe period cramps the natural way with these 100% natural and discreet menthol and eucalyptus oil stick on patches and CBD range. Click here to find out more and to shop: https://beyouonline.co.uk

Show Notes

https://www.siboinfo.com/symptoms.html

https://www.endofound.org/endo-belly

https://drseckin.com/endo-belly/

https://www.nhs.uk/conditions/irritable-bowel-syndrome-ibs/symptoms/

https://www.nhs.uk/live-well/eat-well/remedies-for-bloating-and-wind/

https://nutritionstripped.com/is-bloating-normal/

https://www.nhs.uk/conditions/flatulence/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2849969/?fbclid=IwAR3kn0CVHyH4aZsIJ0hPq8__O7k4WfM_rk7EWKSLWj4RmQlVZsnCbnEu4Yg#R7

https://joe.bioscientifica.com/view/journals/joe/89/2/joe_89_2_011.xm

https://nicolejardim.com/howyourperiodaffectsdigestivetract/

https://pubmed.ncbi.nlm.nih.gov/16992446/

 

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Soothe period cramps the natural way with these 100% natural and discreet menthol and eucalyptus oil stick on patches and CBD range. Click here to find out more and to shop: https://beyouonline.co.uk This episode is sponsored by Semaine. Try their supplement for period pain and daily supplement for hormonal balance and PMS prevention with code ENDOLIFE to get 20% off your first order. Show Notes Charcoal https://pubmed.ncbi.nlm.nih.gov/3717809/ https://pubmed.ncbi.nlm.nih.gov/3521259/ https://pubmed.ncbi.nlm.nih.gov/7015846/ https://pubmed.ncbi.nlm.nih.gov/3717809/ https://pubmed.ncbi.nlm.nih.gov/7949514/ https://pubmed.ncbi.nlm.nih.gov/12516788 https://www.siboinfo.com/uploads/5/4/8/4/5484269/sibo_symptomatic_relief_suggestions_jan_2020.pdf   Ginger https://pubmed.ncbi.nlm.nih.gov/10442508/ https://pubmed.ncbi.nlm.nih.gov/16865831/ https://pubmed.ncbi.nlm.nih.gov/24390893/ https://pubmed.ncbi.nlm.nih.gov/17545109/ https://www.europeanreview.org/article/10145 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3958926/ https://pubmed.ncbi.nlm.nih.gov/18403946/ https://pubmed.ncbi.nlm.nih.gov/25912592/ https://pubmed.ncbi.nlm.nih.gov/23612703/ https://pubmed.ncbi.nlm.nih.gov/30423929/ https://www.siboinfo.com/uploads/5/4/8/4/5484269/sibo_symptomatic_relief_suggestions_jan_2020.pdf   Peppermint https://bmccomplementmedtherapies.biomedcentral.com/articles/10.1186/s12906-018-2409-0 https://pubmed.ncbi.nlm.nih.gov/11207510/ https://pubmed.ncbi.nlm.nih.gov/24100754/ https://pubmed.ncbi.nlm.nih.gov/26319955/ https://www.siboinfo.com/uploads/5/4/8/4/5484269/sibo_symptomatic_relief_suggestions_jan_2020.pdf   Magnesium https://www.siboinfo.com/uploads/5/4/8/4/5484269/sibo_symptomatic_relief_suggestions_jan_2020.pdf   PHGG https://pubmed.ncbi.nlm.nih.gov/25843197/ http://ecite.utas.edu.au/121479 https://pubmed.ncbi.nlm.nih.gov/16413751 https://pubmed.ncbi.nlm.nih.gov/25519526/ https://www.siboinfo.com/uploads/5/4/8/4/5484269/sibo_symptomatic_relief_suggestions_jan_2020.pdf
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    SIFO, Yeast Disorders and Endometriosis with Dr. Ami Kapadia

    1:18:54

    I first came across Dr. Ami Kapadia’s work through some presentations she held for an online SIBO conference. Her lectures focused on small intestine fungal overgrowth, yeast disorders and mould - and what I heard resonated with not only my story, but so many of my clients’ stories. And I’m not alone. Dr. Jessica Drummond often speaks on the connection she sees between chronic pelvic pain and yeast problems, and yeast/SIFO are prevalent issues within the SIBO community. In fact, left untreated, they can really hinder SIBO progress. The trouble is, they’re not easy to diagnose and the symptoms are often identical to SIBO, and at least a quarter of SIBO patients, if not more, also have SIFO. So, given that research is currently estimating that up to 80% of endometriosis patients also have SIBO, I wanted to invite Dr. Ami onto the show to discuss how to identify and treat years disorders both alongside SIBO and alone. Dr Ami. Kapadia is a family medicine and integrative medicine physician, with a special interest in yeast and fungal disorders. She is the creator of practitioner course A Minimalist's Approach to SIFO And Mold Related Illness and patient course An Integrative Approach to SIFO: Small Intestinal Fungal Overgrowth And Related Conditions. In this episode we discuss: What are fungal/yeast related disorders and how do they affect the body. The connection between yeast/fungal disorders, endometriosis and SIBO. The signs and symptoms of fungal/yeast related disorders and how to test for them. Dr. Ami’s unique treatment approach and her specific anti-fungal protocols. Dietary considerations (it’s not what you think!) and what to do if you find food restriction triggering. How to work with Dr. Ami. This episode was fascinating and I completely geeked out (you' can probably tell!), I hope you enjoy it just as much as I did! Let's get social! Come say hello on Instagram or sign up to my newsletter. Sign up to the wait list for my course, Live and Thrive with Endo here. My cookbook This EndoLife, It Starts with Breakfast is out now! Get 28 anti-inflammatory, hormone friendly recipes for living and thriving with endometriosis. Order your copy here. If you feel like you need more support with managing endometriosis, you can join Your EndoLife Coaching Programme. A 1-to-1 three month health and life coaching programme to help you thrive with endometriosis. To find out more about the programme and to discuss whether it could be right for you, email me at [email protected] or visit my website. This episode is sponsored by The Pod Farm. Learn all about how to start your own podcast with the complete course from The Pod Farm. Aimed at beginners, this course takes a simple and straightforward approach to planning, equipment buying, setting up, recording, editing and hosting your own podcast. With hours of audio and video materials, and downloadable guides and useful links, this multimedia approach aims to have something for every kind of learner. From now until April 15, newsletter subscribers get 20% off the course price. Visit www.thepodfarm.com to enroll or find out more This episode is sponsored by BeYou. Soothe period cramps the natural way with these 100% natural and discreet menthol and eucalyptus oil stick on patches and CBD range. Click here to find out more and to shop: https://beyouonline.co.uk This episode is sponsored by Semaine. Try their supplement for period pain and daily supplement for hormonal balance and PMS prevention with code ENDOLIFE to get 20% off your first order. Show Notes Website: www.amikapadia.com Teachable course for practitioners: https://drkapadia.teachable.com/p/a-minimalist-s-approach-to-mold-related-illness-and-small-intestinal-fungal-overgrowth-sifo Teachable course for patients: https://drkapadia.teachable.com/p/sifo-in-integrative-course-for-patient-education
  • This EndoLife podcast

    Endo and Relationships Part Two: Family and Friends

    43:58

    This episode is an IG Live I hopped on to answer your questions in endometriosis and navigating relationships with family and friends. In this Q&A I answer: How to have fun with friends again? Feels like endo always gets in the way. How to handle family not understanding how endo affects my life? How to explain it to those who don’t get how impactful it is? What to say or do when a friend questions if you’re really in pain when you say you can’t go out? Also, a few of the resources I mentioned in the live: Endometriosis UK Endometriosis NewsEndometriosis News @vickiewilliams_ Let's get social! Come say hello on Instagram or sign up to my newsletter. Sign up to the wait list for my course, Live and Thrive with Endo here. My cookbook This EndoLife, It Starts with Breakfast is out now! Get 28 anti-inflammatory, hormone friendly recipes for living and thriving with endometriosis. Order your copy here. If you feel like you need more support with managing endometriosis, you can join Your EndoLife Coaching Programme. A 1-to-1 three month health and life coaching programme to help you thrive with endometriosis. To find out more about the programme and to discuss whether it could be right for you, email me at [email protected] or visit my website. This episode is sponsored by The Pod Farm. Learn all about how to start your own podcast with the complete course from The Pod Farm. Aimed at beginners, this course takes a simple and straightforward approach to planning, equipment buying, setting up, recording, editing and hosting your own podcast. With hours of audio and video materials, and downloadable guides and useful links, this multimedia approach aims to have something for every kind of learner. From now until April 15, newsletter subscribers get 20% off the course price. Visit www.thepodfarm.com to enroll or find out more This episode is sponsored by BeYou. Soothe period cramps the natural way with these 100% natural and discreet menthol and eucalyptus oil stick on patches and CBD range. Click here to find out more and to shop: https://beyouonline.co.uk
  • This EndoLife podcast

    How I Became an Endo Health Coach

    50:19

    This episode is another live Q&A from Instagram. I had a number of you ask me about the training I did to became an endo health coach and what training is generally required, so I decided to answer some of those questions live on Instagram. In this Q&A I talk about - What motivated me to become an endo health coach. The work experience I had to prepare me to coach. The certifications I took to qualify as a women’s health coach. The certifications I took to qualify in endometriosis specifically. The certifications I then went onto take for SIBO. My business model (what working with clients looks like on a week to week basis). My plans for the future (naturopathic doctor)! My struggles with perfectionism and workaholism during my training and start-up period. Let's get social! Come say hello on Instagram or sign up to my newsletter. Sign up to the wait list for my course, Live and Thrive with Endo here. My cookbook This EndoLife, It Starts with Breakfast is out now! Get 28 anti-inflammatory, hormone friendly recipes for living and thriving with endometriosis. Order your copy here. If you feel like you need more support with managing endometriosis, you can join Your EndoLife Coaching Programme. A 1-to-1 three month health and life coaching programme to help you thrive with endometriosis. To find out more about the programme and to discuss whether it could be right for you, email me at [email protected] or visit my website. This episode is sponsored by The Pod Farm. Learn all about how to start your own podcast with the complete course from The Pod Farm. Aimed at beginners, this course takes a simple and straightforward approach to planning, equipment buying, setting up, recording, editing and hosting your own podcast. With hours of audio and video materials, and downloadable guides and useful links, this multimedia approach aims to have something for every kind of learner. From now until April 15, newsletter subscribers get 20% off the course price. Visit www.thepodfarm.com to enroll or find out more This episode is sponsored by BeYou. Soothe period cramps the natural way with these 100% natural and discreet menthol and eucalyptus oil stick on patches and CBD range. Click here to find out more and to shop: https://beyouonline.co.uk
  • This EndoLife podcast

    Endometriosis and Ehlers-Danlos Syndrome - Is There a Connection?

    13:48

    Okay today I want to now talk about something a little more unusual, and that’s Ehlers-Danlos syndrome and its possible connection to endometriosis.  Ehlers-Danlos Syndrome is a group of 13 conditions which all affect connective tissue (collagen) in the body. Most are rare, but one type called hypermobility EDS is common.  Because the intestines are made from soft tissue, EDS affects digestion and often causes IBS symptoms. It is a major risk factor for developing SIBO, because it slows down motility. If you have EDS and SIBO, you will be chronic - but you can still live well! And we’ll get to that in the bonus lesson with Dr Allison Siebecker.  And just to hammer this point home about the connection between EDS and IBS, one study of 228 IBS patients found 48% also had EDS. Now the reason why I want to bring EDS to your attention is because I am seeing it more and more in my clients with both endometriosis and SIBO. Despite these statistics, to my knowledge, most experts do not consider EDS and endometriosis to be significantly connected. At present, it is thought that most of the period pain and menstrual problems of those with EDS is not caused by endometriosis, but EDS itself.  However, I have spoken to multiple health care practitioners who do see a connection and see the two conditions together in patients, and because EDS can cause gut problems and SIBO, I think it’s worth raising here.   So, here’s an overview of what we know so far…  Current estimation is 6-23% of patients with EDS also have endometriosis. More research is being done into the connection at present. 32-77% of those with EDS have vulvodynia and or pain with sex. 33-75% have heavy menstrual bleeding.  73-93% have painful periods. And here are some of the main symptoms of EDS, though there are many and they are often far reaching. You do` not have to have them all to have EDS: ·Joint pain/full body pain Hypermobility (can be very subtle) Stretchy skin Soft, velvety skin Bruise easily Dislocations of joints Chronic fatigue Dental crowding  And I wanted to include some signs or clues of EDS as well… Unusual symptoms that seem random, so people with EDS often feel like they have lots of symptoms and never really feel well. Family has hypermobility - again, this can be very subtle. They might have no idea. Tight muscles and stiffness - because your joints are unstable, the muscles overcompensate and are often stiff and tight to try and create some stability in the body. Allergies - and this is because MCAS is now being identified as a co-condition of EDS. MCAS is when the mast cells which release histamine are overly sensitive and easily triggered, resulting in a higher amount of histamine being released on a daily basis. Mast Cell Activation Syndrome still isn’t widely acknowledged by conventional medicine, but many functional and naturopathic doctors are leading the way with this. MCAS is now showing up in the research as being a likely co-condition of EDS, as part of a trio with another condition call PoTS, which stands for Postural Tachycardia syndrome. Low blood pressure and/or dizziness - because EDS often comes with something called dysautonomia Racing heart or palpitations - due to a type of dysautonomia which I mentioned earlier, called PoTs IBS - because of how EDS affects the gut So, following on from that, I just wanted to provide a bit more education around dysautonomia in case you have the signs.  Dysautonomia is a group of conditions that affect the autonomic nervous system, which control involuntary functions of the body.  Postural Tachycardia syndrome or PoTs is one of these conditions and is part of a trio of EDS-MCAS-PoTs I mentioned earlier, and it affects blood flow and blood pressure in the body, so that too little blood is getting to the heart and the heart rate increases when going from sitting/lying down to standing. Some of the symptoms of dysautonomia are…  Blood sugar dysregulation Low blood pressure/fainting Chest pain/breathing issues/palpitations/racing heart Gut problems and bladder problems Dizziness/balance difficulties/vertigo Struggle to regulate temperature  I’ll take you through some ways to get tested in the next lesson. Now I know this might sound scary, but if you do get a diagnosis, you can manage these symptoms long-term, and your quality of life will dramatically improve! And just because I found this personally quite helpful, because there’s a lot of symptoms floating around with this, EDS specialist Dr Alena Guggenehim sees loose joints, joint pain and dysautonomia as the main signs/symptoms of hEDS. Diagnosis for EDS is best done through a rheumatologist, but reportedly this is more frequently being performed by GPs these days. If you can’t get a referral on the NHS (if you’re based in the UK), then I think the best route would be to buy health insurance and get referred to an EDS specialist. I think that would be safest, because not all GPs are fully versed in diagnosing EDS. For hypermobility EDS, diagnosis is based on a physical test called Beighton score, which looks at the range of mobility in your joints, as well as issues like teeth overcrowding. Family and patient history should also be taken into account, and signs of co-conditions, like allergies and dizziness. It’s worth noting here that you can still have hEDS if you don’t score highly on the Beighton score. There is a link to it in the slides, but it does have some confusing terminology and is not to be used as a tool for diagnosis without a doctor. Genetic testing will also be carried out to rule out the rarer forms of EDS. PoTs is tested for by testing heart rate and blood pressure when going from sitting to standing and lying down (on a tilted table) to upright. You’ll need to speak to your GP to get a referral. If you test positive for EDS and you have signs of dysautonmia, even if it’s just fatigue, it’s worth looking into this.  Other tests may be run to look for other types of dysautonomia   Listen and subscribe on your favourite player or listen directly/download MP3 here or just listen below! Let's get social! Come say hello on Instagram or sign up to my newsletter. Sign up to the wait list for my course, Live and Thrive with Endo here. My cookbook This EndoLife, It Starts with Breakfast is out now! Get 28 anti-inflammatory, hormone friendly recipes for living and thriving with endometriosis. Order your copy here. If you feel like you need more support with managing endometriosis, you can join Your EndoLife Coaching Programme. A 1-to-1 three month health and life coaching programme to help you thrive with endometriosis. To find out more about the programme and to discuss whether it could be right for you, email me at [email protected] or visit my website. This episode is sponsored by The Pod Farm. Learn all about how to start your own podcast with the complete course from The Pod Farm. Aimed at beginners, this course takes a simple and straightforward approach to planning, equipment buying, setting up, recording, editing and hosting your own podcast. With hours of audio and video materials, and downloadable guides and useful links, this multimedia approach aims to have something for every kind of learner. From now until April 15, newsletter subscribers get 20% off the course price. Visit www.thepodfarm.com to enroll or find out more This episode is sponsored by BeYou. Soothe period cramps the natural way with these 100% natural and discreet menthol and eucalyptus oil stick on patches and CBD range. Click here to find out more and to shop: https://beyouonline.co.uk Show Notes Stats references https://www.rcgp.org.uk/clinical-and-research/resources/toolkits/ehlers-danlos-syndromes-toolkit.aspx https://www.siboinfo.com/associated-diseases.html https://pubmed.ncbi.nlm.nih.gov/29687534/ https://www.ehlers-danlos.com/pdf/2018-annual-conference/N-Blagowidow-2018Baltimore-OB-GYN-and-EDS-HSD-S.pdf Symptoms https://www.nhs.uk/conditions/ehlers-danlos-syndromes/ https://www.rcgp.org.uk/clinical-and-research/resources/toolkits/ehlers-danlos-syndromes-toolkit.aspx https://ehlers-danlos.com/wp-content/uploads/hEDS-Dx-Criteria-checklist-1.pdf https://www.rcgp.org.uk/clinical-and-research/resources/toolkits/ehlers-danlos-syndromes-toolkit.aspx Dysautonomia https://pubmed.ncbi.nlm.nih.gov/31267471/ https://drbeckycampbell.com/mast-cell-activation-syndrome-postural-orthostatic-tachycardia-syndrome-and-ehlers-danlos-syndrome-what-is-the-connection/ https://www.nhs.uk/conditions/postural-tachycardia-syndrome/ https://my.clevelandclinic.org/health/diseases/6004-dysautonomia https://join.sibosos.com/page/94124 Testing references https://www.nhs.uk/conditions/ehlers-danlos-syndromes/ https://ehlers-danlos.com/wp-content/uploads/hEDS-Dx-Criteria-checklist-1.pdf https://www.rcgp.org.uk/clinical-and-research/resources/toolkits/ehlers-danlos-syndromes-toolkit.aspx https://www.nhs.uk/conditions/postural-tachycardia-syndrome/
  • This EndoLife podcast

    Endo Q&A: Healing Painful Sex

    40:11

    This episode is from a mini IG Live answering your questions about painful sex with endo (which turned out not to be mini, more like 40 mins). Here’s the three most common questions I answered: Is there anything that will make sex with endo eventually not painful/how do I fix it? I’ve tried everything but still get pain, is surgery the next option? How to navigate painful sex without killing the mood? In this IG Live I talk about inflammation, adhesions, having a hypertonic pelvic floor, pain science and share lots of tools, resources and books to help you on your way to having less pain (hopefully pain free) sex. I really hope you find this useful! Let's get social! Come say hello on Instagram or sign up to my newsletter. Sign up to the wait list for my course, Live and Thrive with Endo here. My cookbook This EndoLife, It Starts with Breakfast is out now! Get 28 anti-inflammatory, hormone friendly recipes for living and thriving with endometriosis. Order your copy here. If you feel like you need more support with managing endometriosis, you can join Your EndoLife Coaching Programme. A 1-to-1 three month health and life coaching programme to help you thrive with endometriosis. To find out more about the programme and to discuss whether it could be right for you, email me at [email protected] or visit my website. This episode is sponsored by The Pod Farm. Learn all about how to start your own podcast with the complete course from The Pod Farm. Aimed at beginners, this course takes a simple and straightforward approach to planning, equipment buying, setting up, recording, editing and hosting your own podcast. With hours of audio and video materials, and downloadable guides and useful links, this multimedia approach aims to have something for every kind of learner. From now until April 15, newsletter subscribers get 20% off the course price. Visit www.thepodfarm.com to enroll or find out more This episode is sponsored by BeYou. Soothe period cramps the natural way with these 100% natural and discreet menthol and eucalyptus oil stick on patches and CBD range. Click here to find out more and to shop: https://beyouonline.co.uk
  • This EndoLife podcast

    What's a Healthy/'Normal' Gut vs. What's Endo Belly?

    21:56

    This week’s episode is a snippet from my upcoming course, The Endo Belly Course. I realised when creating this lesson, that this information is info everyone should know, not just my students! So today’s episode is all about what’s a ‘normal’ and healthy gut vs. what is the endo belly? So first up, I wanted to actually talk about what the endo belly is. The ‘endo belly’ is not actually a medical term, but instead is a name the community has coined in reference to the severe bloating we often experience. So, there isn’t technically a set definition, but it is generally thought to be severe bloating/swelling that tends to be attributed to endometriosis and is sometimes accompanied by pain. Some experts, articles and endo patients also include gut problems within this term too, but not always. My definition, from my training and from seeing so many clients with these symptoms is that the endo belly is exaggerated/severe bloating, often accompanied by gut symptoms, pain or discomfort - but it is not always caused by endometriosis directly. So here are some of the common symptoms I see in my clients and that I tend to think of as fitting under the term ‘the endo belly’: Flares up with stress/food/pain/cycle - but not always, this might just be a daily thing for you. Normally comes with IBS issues like diarrhea, constipation, abdominal pain, gas. These might not be flares, but more so just your daily bowel habits and gut issues. So, for example, you may tend to always lean towards constipation or loose stools, or you may have a lot of gas on a daily basis. It’s often debilitating -  so it may disturb social life, diet, work, or confidence. You might worry about eating out because you’re scared of a flare up, you might have to eat a restricted diet to control symptoms, you might have to sometimes take sick days, or you just struggle at work with your symptoms. It’s not as simple as just feeling a bit bloated after lunch. Normally a dramatic increase in abdominal size - endo patients often report looking pregnant, requiring different sized clothing, having swelling that’s so bad they’re in pain.   And finally, I just want to note - some sources discuss the endo belly swelling being lower down in the abdomen and that IBS issues are higher up, but I think the problem with this is that it’s not true for everyone and it might mean you dismiss any other possible causes because you think “Oh it’s low down, it’s just my endo”. I’ve seen lots of people with SIBO and endo, whose bloating is from their diaphragm all the way down or starts from their belly button and goes down to their pubic bone, so I really wouldn’t pay a huge amount of attention to where the bloating is, unless of course you’re just getting a tiny bit of bloat or a bump on say one side near your ovaries, which might indicate a cyst, for example. So, something I really think is important to discuss is what is normal vs. what is endo belly, because I don’t want us to be trying to reach for an unattainable vision of a healthy gut. So here are some signs of the endo belly/something more is going on with your gut… Bloating and gut problems get worse and worse as day goes on. You get more uncomfortable, maybe your pain increases and by your last meal your stomach has swollen to triple its normal size. Symptoms can only be controlled through restriction - a ‘normal’ diet can’t be achieved, and you find yourself skipping meals or having to restrict to avoid flare ups. Often can no longer fit into clothes or need to change to be comfortable when your belly swells up because it’s become so distended. In short, the bloating is severe and significant. May be accompanied by other health problems and nutrient deficiencies like achy joints, fatigue, low B12 or low iron. These are signs of inflammation and malabsorption of nutrients. You might get constipated before period. From a functional medicine point of view, which is what my training is based on, you should have at least one daily bowel movement, and this is actually really important for hormonal health, because old oestrogen is excreted through waste and that needs to occur daily. However, in contrast, dieticians and conventional doctors tend to take a different stance and say whatever is normal for you, is normal or at least three times a week. In terms of my training with Dr Allison Siebecker, Dr Jessica Drummond, etc. we would consider that as constipation, basically anything that is not once a day, is leaning towards a form of constipation. It might be considered normal, but we wouldn’t class it as optimal for health. Diarrhea on period which causes abdominal discomfort, eating problems (maybe you have to avoid food or eat a restricted diet), affects daily life (you might not be able to have a normal workday because you’re stuck in the toilet), sicks days, etc. Often affects daily life/confidence because you’ve been asked so many times whether you’re pregnant, you get comments or you just feel fed up with not being able to wear the clothes you’d like. Additionally, your gut symptoms are affecting your daily life, so for example, I had a client who would get several bouts of loose stools every morning, to the point where she would sometimes be late for dropping her child off to nursery. Another client wouldn’t be able to finish meals without needing to dash to the toilet. Wake up bloated already or with gut problems/sleep is disturbed due to discomfort. So, I had one client who had a distended belly all the time, and it was so bad she actually got to the point where it was too painful to sit or stand up, she had to lay down all the time. Another client wouldn’t be able to sleep because by the evening, her belly was so bloated she couldn’t get comfortable, and she’d be in agony from all the gas inside her.   So, in contrast, I wanted to talk about what is normal for a healthy gut, and some of this might surprise you -  Feel satisfied after eating, not overly full or like food isn’t going down. Of course, if it’s Christmas or Ramadan you might be feasting on more food than you normally would, so of course sometimes you’re going to feel full to bursting, but generally, you should feel like you’re able to digest your food and like it’s going down. It’s not just sitting there for hours afterwards. May be a bit bloated or gassy after meals (esp. high fibre. or large meals), but the bloating should subside a few hours later and it’s not accompanied by GI distress. This is because our good gut bugs actually eat our food and ferment it, as part of the digestion process. We actually need this to happen to get all of our nutrients. But a result of this process is the creation of gas from the bacteria, and so naturally we will get a bit of expansion after a meal and of course, we’re putting food into our stomach, you wouldn’t expect to fill an empty bag with food shopping and for it not to expand or look bigger. So, there will be some extension of your abdomen after meals, but it shouldn’t be painful, be accompanied by GI distress, be severe or worsen as the day goes on. It should naturally go down and not affect your life or comfort. Additionally, so you know, according to the NHS, a normal amount of passing gas is about 5 to 15 times a day. You should wake up with a relatively flatter stomach in contrast to after meals. This is because your digestion has been working overnight. Now note I don’t say your stomach should be flat in the morning, it will be flatter in contrast to after meals, because you haven’t eaten in something like 10 or 12 hours. And to follow on from that, a normal healthy gut doesn’t mean your stomach is flat all the time. Your stomach shouldn’t be flat all the time, it should naturally expand a bit with food! Bloating tends to increase towards period and in luteal phase, but it shouldn’t be severe/painful/debilitating. This is because progesterone and oestrogen affect water retention, and so bloating and swelling can increase towards your period when progesterone is at its highest. Now if your hormones are imbalanced, this will be worse, so supporting your hormones (which this course will help with) should minimise the effects, but they won’t eradicate them entirely. Additionally, those inflammatory chemicals, prostaglandins, naturally begin building in the uterus from ovulation to your period, and as we know, inflammation creates swelling, so there may be some level of normal swelling during this time, but again, it shouldn’t be severe. If it is, this may be an indicator that your inflammation levels are too high, which is likely to be the case anyway, given that the endometriosis lesions release prostaglandins. Lastly, progesterone relaxes muscles, including the muscles of the intestines, so as a result, digestion slows down, meaning things become a bit sluggish and we get a bit more of a build-up of gas and waste, leading to a bit of bloating - again, it shouldn’t be severe. Bowels might feel a bit sluggish towards period but shouldn’t have full-blown constipation or if you do have any, it should at least short lived, so a day or so, for example. Or maybe your stools are a little harder or more cracked than normal. In contrast, it’s normal to have bowel movements that are looser during your period. This is because those prostaglandin E2 causes the muscles to contract, and as your uterus is right next to your colon, this can create contractions in the colon, resulting in a bowel movement and looser stools. If your inflammation levels are high, you may get full blown diarrhea, and that’s when we’ll want to reduce those levels. Ideally, a normal scenario is maybe more bowel movements which are a bit looser on your period, but they shouldn’t be causing you pain or affecting your day-to-day life during this time. Bloating after meals doesn’t require a new dress size! Image from Integrative Women’s Health Institute To show you what a healthy stool looks like, here is the Bristol Stool Chart. This is a diagnostic tool used to determine the health of stools, especially in IBS populations. In terms of functional medicine training, at IWHI we aim for a 4, so your stools should be snake like, smooth, easy to pass with a banana-like consistency. You should be having one to three bowel movements a day, one is the minimum because for optimal health and hormonal health, we want to removing waste on a daily basis, including old oestrogen, to prevent hormonal imbalances.  Now, dieticians and conventional medicine will likely say to aim for somewhere between a 3-5. In terms of my training, we see 3 as beginning to lean towards constipation and 5 beginning to lean towards diarrhea. This is something that we focus on heavily with SIBO, a lot of people think that they don’t have constipation, or they don’t have diarrhea - but these bowel movements actually exist on a spectrum. Stools that are like pellets, hard and round, or difficult to pass, is a form of constipation. In my training, anything before 4 is a form of constipation and above 4 is a form of diarrhea or loose stools. They don’t show pudding like stools here, but I would consider that as form of diarrhea. However, opinions will vary as I have mentioned, so be guided by what feels best for you. The caveat here is that if you are vegan and eat a lot of plants (not processed vegan food), you may have softer stools, nearer to a 5, so I wouldn’t worry too much about that. The other thing I would say is don’t chase perfection, which I’ve been guilty of. When my IBS was the most managed it’s ever been (at the time of recording it’s not, because I’ve had a SIBO relapse), my stools were about a 5 but I was very caught up on getting them to a 4! So, if your endo belly dramatically improves, if you get an all clear for gut conditions, etc. but sometimes your stools are a little either side of type 4, this is probably not something to worry about. It might just be that you ate a little more or a little less fibre that week, or maybe that’s just your normal. If you’re concerned about it, certainly see a gut health practitioner, but I just wouldn’t obsess about it that’s the only issue left and there are no other signs that something is up with your gut.  Just to finish off this section, I want to hammer this home. A super flat stomach does not equal a happy gut - in fact, it sort of suggests that the gut microbiome is under fed or non-existent, because for them to thrive, they need to eat food and as a result, that creates gas. So, we’re not aiming for washboard abs all the time, we’re aiming for gut health that doesn’t affect your daily life, cause you pain or physical/mental/emotional distress. Listen and subscribe on your favourite player or listen directly/download MP3 here or just listen below! Let's get social! Come say hello on Instagram or sign up to my newsletter. Sign up to the wait list for my course, Live and Thrive with Endo here. My cookbook This EndoLife, It Starts with Breakfast is out now! Get 28 anti-inflammatory, hormone friendly recipes for living and thriving with endometriosis. Order your copy here. If you feel like you need more support with managing endometriosis, you can join Your EndoLife Coaching Programme. A 1-to-1 three month health and life coaching programme to help you thrive with endometriosis. To find out more about the programme and to discuss whether it could be right for you, email me at [email protected] or visit my website. This episode is sponsored by The Pod Farm. Learn all about how to start your own podcast with the complete course from The Pod Farm. Aimed at beginners, this course takes a simple and straightforward approach to planning, equipment buying, setting up, recording, editing and hosting your own podcast. With hours of audio and video materials, and downloadable guides and useful links, this multimedia approach aims to have something for every kind of learner. From now until April 15, newsletter subscribers get 20% off the course price. Visit www.thepodfarm.com to enroll or find out more This episode is sponsored by BeYou. Soothe period cramps the natural way with these 100% natural and discreet menthol and eucalyptus oil stick on patches and CBD range. Click here to find out more and to shop: https://beyouonline.co.uk Show Notes https://www.siboinfo.com/symptoms.html https://www.endofound.org/endo-belly https://drseckin.com/endo-belly/ https://www.nhs.uk/conditions/irritable-bowel-syndrome-ibs/symptoms/ https://www.nhs.uk/live-well/eat-well/remedies-for-bloating-and-wind/ https://nutritionstripped.com/is-bloating-normal/ https://www.nhs.uk/conditions/flatulence/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2849969/?fbclid=IwAR3kn0CVHyH4aZsIJ0hPq8__O7k4WfM_rk7EWKSLWj4RmQlVZsnCbnEu4Yg#R7 https://joe.bioscientifica.com/view/journals/joe/89/2/joe_89_2_011.xm https://nicolejardim.com/howyourperiodaffectsdigestivetract/ https://pubmed.ncbi.nlm.nih.gov/16992446/  
  • This EndoLife podcast

    Endo Belly Q&A and The Endo Belly Course

    28:06

    This episode is a quick IG Live to answer your questions about endo belly and The Endo Belly Course! If you missed the live and you still have questions, please feel free to just DM me or drop me an email. Doors close on The Endo Belly Course at 10pm tonight and won’t reopen until next fall (2022). We already have a lovely group of 50 and I would love to welcome you if you feel this could help you. In this live, I answer... What to eat to prep for a coeliac disease test. Whether you can do The Endo Belly Course when taking NSAIDs (because they can damage the gut). Whether you can do the course when on hormonal birth control (again, hormonal birth control affects the gut). If the course is suitable for those just out of surgery or about to have surgery. If you need a SIBO diagnosis to do the course (no!). How long you have to complete the modules and action steps. How The Endo Belly Course differs from Live and Thrive with Endo and my one-to-one coaching. Please feel free to post any other questions in the comments! I hope this quick live is helpful and if you’re getting tested for coeliac disease, please let me know! We can test together!  Let's get social! Come say hello on Instagram or sign up to my newsletter. Sign up to the wait list for my course, Live and Thrive with Endo here. My cookbook This EndoLife, It Starts with Breakfast is out now! Get 28 anti-inflammatory, hormone friendly recipes for living and thriving with endometriosis. Order your copy here. If you feel like you need more support with managing endometriosis, you can join Your EndoLife Coaching Programme. A 1-to-1 three month health and life coaching programme to help you thrive with endometriosis. To find out more about the programme and to discuss whether it could be right for you, email me at [email protected] or visit my website. This episode is sponsored by The Pod Farm. Learn all about how to start your own podcast with the complete course from The Pod Farm. Aimed at beginners, this course takes a simple and straightforward approach to planning, equipment buying, setting up, recording, editing and hosting your own podcast. With hours of audio and video materials, and downloadable guides and useful links, this multimedia approach aims to have something for every kind of learner. From now until April 15, newsletter subscribers get 20% off the course price. Visit www.thepodfarm.com to enroll or find out more This episode is sponsored by BeYou. Soothe period cramps the natural way with these 100% natural and discreet menthol and eucalyptus oil stick on patches and CBD range. Click here to find out more and to shop: https://beyouonline.co.uk
  • This EndoLife podcast

    Endo Belly? A Plea to get Tested for Coeliac Disease - and Six Surprising Symptoms

    21:47

    Today on the show I am talking about one of the possible root causes of your endo belly – coeliac disease. Now, before you turn this podcast off because you think you don’t react to gluten, I am literally begging you to listen.  I have noticed a trend in my clients to dismiss coeliac disease as a possibility, because they don’t have immediate reactions after gluten. But – here’s the thing, the reactions from gluten are not always obvious and they don’t always happen straight away.  So, if you’re bloated all the time, tired all the time, maybe you have diarrhoea regularly or gas, or constipation, or maybe you don’t have any gut symptoms at all – but you have brain fog, fatigue and achy joints, then it may be down to coeliac disease.  And these symptoms don’t just have to occur after straight after gluten. In fact, according to the Food Allergy Research and Resource Program at the University of Nebraska-Lincoln, coeliac disease is a “delayed hypersensitivity reaction where symptoms develop 48-72 hours after ingestion” of gluten.(1) Now yes, some people with coeliac disease will experience symptoms soon after eating gluten, but for others, it’s a couple of hours or even longer, as demonstrated here. So just because your symptoms do not show up straight after gluten, that doesn’t mean you do not have coeliac disease and in fact, if you tend to eat gluten daily, and you tend to feel unwell daily – maybe you have chronic fatigue, for example - then this could be the result of that delayed reaction, just blurring into the next, because there’s little time between each serving.  Additionally, the NHS states that symptoms can actually be mild and can come and go, so the signs of coeliac disease may be inconsistent(2). Your reactions to gluten do not have to be severe for you to have coeliac disease, for example, my brother was hospitalised with severe abdominal cramping and vomiting when he was diagnosed, whereas my sister literally said she was just “fed up of feeling nauseas”. And here’s why it’s important to get checked.  In the UK, only 30% of people with coeliac disease have been diagnosed(3), and it is estimated that 500,000 people are walking around with undiagnosed coeliac disease.(4)  In America, 83% of people with coeliac disease are undiagnosed.(5) And it’s not rare either. In the UK, 1 in 100 people have coeliac disease (3) and in the USA, 1 in 133 people have coeliac disease.(5) And as you can see from these stats, the majority of them don’t know they have it. And if you have endometriosis, the chances of having coeliac disease is higher. Research has identified a strong  association between endometriosis and coeliac disease. Coeliac disease patients were found to be almost twice as likely to develop endo in research(6) and studies have found that people with endometriosis are significantly more likely to develop coeliac disease.(7) To add to that, coeliac disease is a co-condition of small intestine bacterial overgrowth(8), which is a condition where normal bacteria which should be found in the large intestine, are growing in the small intestine. And SIBO is at present, estimated to affect up to 80% of people with endometriosis(9) and is a root cause of the endo belly, because the signature SIBO symptom is bloating. So, if you have endometriosis and SIBO, this is a really strong indicator that you should get tested. Additionally, in a study of over 200 women with endo, 75% experienced a reduction in symptoms after eliminating gluten for 12 months.(10) That doesn’t mean you have to be as strict as someone with coeliac disease if you don’t have it, as people with coeliac disease have to avoid cross-contamination, so literally they have to have separate food prep areas, chopping boards, etc. But not eating gluten containing foods may make a significant difference to life with endo.  Now, clearly, this isn’t for everyone. For some people in this study, it didn’t help, and we have to be careful when we talk about eliminating foods, as it can be triggering and cause issues with disordered eating, so I am not saying to just go and cut out gluten today. In fact, I actually advise against that – at least until you’ve been tested for coeliac disease! Then if you don’t have it, I advise you work with someone to identify if gluten is a problem for your endo personally or take one of my courses where I teach you how to do that yourself, and as you guys know, The Endo Belly Course is currently open for enrolment now. So now you know the prevalence rates of coeliac disease, I thought I’d take you through some of the signs. Now, gut symptoms are often common symptoms, but  some people don’t have these at all and in fact, they have other symptoms that may be seemingly random or connected to endometriosis, so they dismiss the possibility of it being coeliac disease. So today, I want to take you through some surprising signs of coeliac disease to look out for: 1) Rashes. Number one is rashes and specifically, a rash called dermatitis herpetiformis. My brother developed this, but my sister didn’t, and the rash turned up probably a year or more before his gut issues arrived and it’s actually common for people who have the rash, to not have the gut symptoms (though this isn’t always the case). The rash looks like blisters on the skin, and is itchy, red, and tends to occur on the elbows (which is where my brother had it), knees and glutes. It is only a rash that appears in coeliac disease patients and is caused by gluten, it is not a rash anyone could get and is not caused by herpes, however, it does look like the herpes virus! Of course, if you have a rash like this and you have some of the other symptoms of coeliac disease, it’s worth testing for it, but you can also get a biopsy to confirm whether this is dermatitis herpetiformis.(11) 2) Number two is dental problems. Now this tends to occur if the coeliac disease developed as a child (and just be mindful that coeliac disease can develop at any age!) due to the body being unable to absorb enough nutrients due to the damage in the intestines and from my understand, also as a result of the immune reactions. Dental problems can occur as issues with the enamel and can look like discolouration, patches on the teeth, translucent areas, grooves on the teeth and potentially increased cavities. Additionally, the growth of adult teeth can be delayed too.(12) 3) Number three is mouth ulcers(13), and these would be on the side of the mouth, on the cheeks and tongue, not on the lips – so we’re not talking about cold sores. These won’t occur in everyone, but if they do, they’ll usually be recurring and you may have a few at one time. Again, this is thought to be a result of the nutrient deficiencies and immune response to the gluten.  4) Number four is anaemia, either b12 or iron deficiency induced anaemia or both(14). And this is tricky, because this is also a sign of SIBO!(15) So again, it’s easy to dismiss coeliac disease here. B12 and iron deficiency anaemia will cause symptoms like tiredness, dizziness, shortness of breath, heart palpitations, numbness in the hands and feet, mouth ulcers, brain fog and irritability to name a few.(16,17) I’ve linked to the NHS page for symptoms in the show notes.  You can fairly easily get tested for these through your GP or online testing sites like Thriva in the UK, and I’ve linked to a few of them(18). If your levels are low but not deficient, it’s still worth ruling out coeliac disease, because they have to get low to get deficient and if you’ve only just recently developed coeliac disease, it may take some time for your levels to drop. And on top of that, if you have the presence of gut problems, endo belly or any of the other symptoms I’ve listed, and you have low levels of iron and B12, it’s safer just to rule it out. 5) Number five is infertility or reoccurring miscarriages, and I think this is an important one to raise because we often dismiss fertility problems as a symptom of endometriosis.  Now if coeliac disease is diagnosed and treated (as in, a person sticks to a strictly gluten free diet, which is the only form of treatment there is) then fertility rates return to normal and are equal to someone without coeliac disease. The problem is when it’s left undiagnosed, and in fact, the guidance in the UK is that people who have recurring miscarriages or fertility struggles should be tested. I mean I think they should be tested as soon as the difficulty begins, to save people all that heartache, but I guess it costs the NHS less this way. There are numerous reasons why coeliac disease will affect fertility, from disrupting hormones, causing inflammation in the body, nutrient deficiencies and so on. But the bottom line is, the only way to treat it would be with a diagnosis and an adherence to a gluten free diet.(19)  6) Number six is brain fog(20). Coeliac disease patients often report brain fog and fatigue and research confirming these reports, with MRI scans showing brain changes and damage in people with coeliac disease. This brain fog may be accompanied by memory loss, headaches, and even balance or speech problems.  One small study found a significant improvement in patients with CD and cognitive impairment after a year on a strict gluten free diet(21), so there is definitely hope if this is a symptom you have and you’re diagnosed!  And I thought I’d raise this one because so many of us report brain fog with endometriosis, and whilst there are many root causes behind this (in fact, I have a whole episode on them) often we just dismiss it as something we have to live with. So those are a few symptoms that you may not suspect would be behind coeliac disease – and these can all occur with or without gut problems and the endo belly. Some other signs to look out for include the development of autoimmune conditions like hashimoto's thyroiditis, type 1 diabetes (which my brother developed) and osteoporosis(22). So now let’s move onto testing. To accurately test for coeliac disease, you must be eating gluten daily, at least twice a day, for six weeks(23). This is because the immune system will create antibodies against gluten and that’s what’s being measured. If you’re not eating gluten at all or not regularly, you’ll get a false negative test, even if you have the disease. So, if my brother tested today, he would come up as negative, because he hasn’t eaten gluten for several years.  Once you’ve done the blood test, you’ll then also be sent for a biopsy.  If you’re still not sure whether it’s worth getting tested, I’ve linked to an online assessment in the show notes, which will literally create a letter to take to the doctor, if it advises you to get tested, based on your symptoms.(24)  So that’s it! If you have the endo belly, full stop, I advise you to get tested. And if any of these other symptoms sound familiar, I advise you to get tested too! Left undiagnosed, coeliac disease can cause serious health problems and increase your risk of multiple conditions and chronic diseases(24), and we’ve never lived in a better time to be gluten free, so even though it might be a hassle to get tested, it’ll be worth it in the long run.  I’ve also linked to some gluten free courses and cookbooks in the show notes.(25) Listen and subscribe on your favourite player or listen directly/download MP3 here or just listen below! Let's get social! Come say hello on Instagram or sign up to my newsletter. Sign up to my free workshop: Creating a Roadmap to Endo Belly Healing Sign up to the wait list for my course, Live and Thrive with Endo here. My cookbook This EndoLife, It Starts with Breakfast is out now! Get 28 anti-inflammatory, hormone friendly recipes for living and thriving with endometriosis. Order your copy here. If you feel like you need more support with managing endometriosis, you can join Your EndoLife Coaching Programme. A 1-to-1 three month health and life coaching programme to help you thrive with endometriosis. To find out more about the programme and to discuss whether it could be right for you, email me at [email protected] or visit my website. This episode is sponsored by The Pod Farm. Learn all about how to start your own podcast with the complete course from The Pod Farm. Aimed at beginners, this course takes a simple and straightforward approach to planning, equipment buying, setting up, recording, editing and hosting your own podcast. With hours of audio and video materials, and downloadable guides and useful links, this multimedia approach aims to have something for every kind of learner. From now until April 15, newsletter subscribers get 20% off the course price. Visit www.thepodfarm.com to enroll or find out more This episode is sponsored by BeYou. Soothe period cramps the natural way with these 100% natural and discreet menthol and eucalyptus oil stick on patches and CBD range. Click here to find out more and to shop: https://beyouonline.co.uk  Show Notes 1.      https://farrp.unl.edu/resources/gi-fas/celiac-disease 2.     https://www.nhs.uk/conditions/coeliac-disease/symptoms/ 3.    https://www.coeliac.org.uk/information-and-support/coeliac-disease/coeliac-disease-faqs/ 4.      https://www.coeliac.org.uk/information-and-support/coeliac-disease/about-coeliac-disease/myths-about-coeliac-disease/?&&type=rfst&set=true#cookie-widget 5.      https://www.beyondceliac.org/fast-facts-about-celiac-disease-infographic/ 6.     https://pubmed.ncbi.nlm.nih.gov/21840904/ 7.     https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6601386/ 8.    https://www.siboinfo.com/associated-diseases.html 9.    https://pubmed.ncbi.nlm.nih.gov/9660426/ 10.  https://pubmed.ncbi.nlm.nih.gov/23334113/ 11.    https://celiac.org/about-celiac-disease/related-conditions/dermatitis-herpetiformis/ 12.   https://celiac.org/about-celiac-disease/related-conditions/oral-health/, https://jcda.ca/article/b39 13.  https://www.coeliac.org.uk/information-and-support/coeliac-disease/about-coeliac-disease/what-are-coeliac-disease-symptoms/ 14.   https://www.coeliac.org.uk/information-and-support/coeliac-disease/about-coeliac-disease/what-are-coeliac-disease-symptoms/ 15.   https://www.siboinfo.com/overview1.html 16.  https://www.nhs.uk/conditions/vitamin-b12-or-folate-deficiency-anaemia/symptoms/ 17.   https://www.nhs.uk/conditions/iron-deficiency-anaemia/ 18.  https://thriva.co, https://valahealth.com, https://www.letsgetchecked.com 19.  https://www.coeliac.org.uk/information-and-support/coeliac-disease/conditions-linked-to-coeliac-disease/infertility-and-coeliac-disease/ 20. https://www.coeliac.org.uk/information-and-support/coeliac-disease/conditions-linked-to-coeliac-disease/neurological-conditions/ 21.   https://celiac.org/about-the-foundation/featured-news/2014/07/brainfog/ 22.  https://www.coeliac.org.uk/information-and-support/coeliac-disease/conditions-linked-to-coeliac-disease/ 23.  https://www.coeliac.org.uk/information-and-support/coeliac-disease/getting-diagnosed/#glutenthroughout 24.  https://www.nhs.uk/conditions/coeliac-disease/complications/ 25.  https://www.penguinrandomhouse.com/books/665647/cannelle-et-vanille-bakes-simple-by-aran-goyoaga/, https://www.arangoyoaga.com/on-demand-videos,https://www.learningwithexperts.com/foodanddrink/courses/river-cottage-gluten-free?ref=naomidevlin, https://gluten-free-baking-school.thinkific.com/courses/gluten-free-sourdough-bread, https://gluten-free-baking-school.thinkific.com/courses/enriched-dough, https://gluten-free-baking-school.thinkific.com/courses/everyday-gluten-free, https://gluten-free-baking-school.thinkific.com/courses/bao-noodles-and-dumplings, https://sweetlaurel.com

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