One of the most frustrating challenges that our clients with endometriosis face is how to relieve the chronic bloating known as “Endo Belly.”
Over the years, my practice has seen thousands of women struggling with this, and we have developed an integrative protocol for relieving the bloat for good.
What is “Endo Belly”?
Before we get into the steps to relieving Endo Belly, let’s talk about what it really is. Endo Belly is the symptom of underlying dysbiosis of the small intestine and/or the colon, usually both. Dysbiosis is when the microbial community living in our intestines gets out of balance, with the beneficial bacteria being overrun by “bad” bacteria, fungi, and other microbes.
In fact, in the small intestine, the community of microbes should be quite small. When too many microbes (even some of the good guys) proliferate, bloating happens. Quite literally, the microbes in the intestines ferment the food that you eat and release gasses. It’s exactly the same thing that happens when you brew beer or kombucha.
When this happens in the small intestine, it’s called Small Intestinal Bacterial Overgrowth and/or Small Intestinal Fungal Overgrowth (SIBO or SIFO.) Associated with the microbial imbalances is inflammation, increased intestinal permeability, and stress on the immune system. (Did you know that about 80% of the immune system is in and around the digestive system?)
What is The Drummond Endo Belly/ SIBO Protocol?
Because this microbial dysbiosis is so common among our clients with endometriosis and pelvic pain, we have developed a protocol over the years to address it. We consider SIBO (or similar bacterial overgrowths or imbalances) through a wide, integrative lens to support long term healing.
One thing to keep in mind is that for people with endometriosis, the endometriosis lesions, related adhesions, inflammation, or surgeries can change the anatomy and/or motility of the intestines. When this is the case, consider that the dysbiosis will be managed over time, instead of being fully eradicated.
How to Relieve Endo Belly Step-by-Step?
Step 1: Support parasympathetic dominance while eating.
Step 2: Continuous improvement of heart rate variability (HRV), a measure of stress resilience.
Step 3: A perspective of delicious, pleasurable nourishment.
Step 4: Finish eating for the day by 7-8pm.
Step 5: Consider the impact of surgery/ endometriosis/ adhesions/ inflammation on the anatomy and motility of the intestines?
Step 6: Visceral physical therapy/ supplement motility support
Step 7: Follow a personalized anti-inflammatory food plan.
Step 8: Chew each bite of food 40 times.
Step 9: Utilize targeted supplementation, including digestive enzymes, betaine HCL as needed, and cycling anti-microbial herbs (such as Biocidin, FC Cidal & Dysbiocide, and/or Candibactin AR & BR for at least 3 months.
Step 10: Utilize a binder such as GI Detox.
Step 11: Utilize personalized supplementation and nutrition to build up a robust, healthy colon microbiome using prebiotic fibers (such as onions, garlic, green banana, burdock root, green tea, FOS, psyllium, artichoke, and asparagus) and targeted probiotics.
Why do we focus so much on the nervous system to relieve digestive bloating?
You’ll notice in the protocol above that there’s a lot of attention to calming the nervous system, and optimizing stress resilience. In our practice, we track improvements in this using fitness tracking technology. We use many tools available for calming the nervous system to enable better digestion because after all, you can’t “rest and digest” if you’re living in “fight or flight.” You can start today to improve your digestion by eating more mindfully, chewing 20-40 times per bite of food, adding short sessions of mindfulness or breathwork through the day, and eating with more pleasure. While it’s important to a nutrient dense anti-inflammatory diet, how you eat is as important as what you eat.
How do we determine the right nutrition and supplement plan for each client?
We test and refine over at least 4-6 months. Optimizing the digestive microbiome in a world filled with stress, poor sleep, and processed foods is a challenge. Committing to the process for at least 4-6 months, and often longer, is key to taming Endo Belly. During that time, we consider functional digestive testing (such as stool testing and organic acids testing), genetics and epigenetics, and your body’s symptom response to dietary recommendations. Often, your body will feel better with a committed focus to healing foods. Then, when you test foods that can cause more bloat your body will tell us if you’re resilient enough to eat them yet, or not. The most common foods that contribute to Endo Belly are gluten, dairy, sugar, and alcohol. Sometimes raw vegetables, fruit, other grains, soy, eggs, and beans can also be contributors. But, in most cases, eventually – with proper supplementation, sleep, and stress balance – most people can tolerate all of the healthiest foods on this list.