Is There a Link Between IBD and Endometriosis?

Endometriosis is a chronic condition that affects the female reproductive system. It is thought to affect up to 1 in 10 people of reproductive age who have a uterus.¹

Endometriosis can cause symptoms including:¹

• Severe pelvic pain
• Irregular periods
• Heavy periods
• Infertility

It can also cause digestive symptoms. These can easily be confused for inflammatory bowel disease (IBD) symptoms. They may include:²

• Nausea
• Vomiting
• Diarrhea
• Abdominal pain

Not only do IBD and endometriosis have similar symptoms, but they also can occur together. One study showed that women living with endometriosis may be up to 80 percent more likely than other women to develop IBD.³

What is endometriosis?

Endometrial tissue is what lines the inside of the uterus. It is shed during menstrual periods. Usually, it is limited to the inside of the uterus. But in endometriosis, this tissue can grow outside the uterus.¹

The most common areas for endometrial tissue to grow outside the uterus is on the ovaries, pelvis, and lining of the abdomen. But it can grow anywhere in the body. It can even attach to the lungs or onto the intestines themselves.¹

When outside the uterus, the tissue causes inflammation wherever it is attached. This inflammation can lead to pain. The tissue responds to the same hormones that cause your menstrual cycle. So, women generally have more pain while they are having their period.¹

How is endometriosis diagnosed?

Your ob-gyn may be able to diagnose endometriosis by assessing your symptoms and trying certain medicines. But endometriosis can be officially diagnosed only with laparoscopy. This is a surgery in which your doctor makes a small opening in your abdomen and uses a camera to look inside your pelvis.⁴

The average time it takes to diagnose endometriosis is 7 years. If you are having severe pelvic pain or irregular periods, talk to your doctor.²

What is similar between the two conditions?

The 2 disorders that make up IBD, ulcerative colitis and Crohn's disease, are both autoimmune diseases. Experts do not fully understand what causes endometriosis. But it is thought to have an autoimmune component as well.⁴

Both disorders also involve high levels of inflammation. And they often have similar symptoms such as:^3,4

• Abdominal pain
• Bloating
• Painful bowel movements

It is possible for the endometriosis and IBD symptoms to be confused for each other. This can make it harder and take longer to diagnose the conditions. Doctors must consider both IBD and endometriosis when a person is experiencing chronic pelvic or abdominal pain and symptoms like these.²

How can you tell endometriosis and IBD apart?

Endometrial tissue responds to estrogen. Someone with endometriosis may have pelvic pain when they are not on their period. But endometriosis symptoms are usually the worst during the menstrual cycle. IBD has flares as well, but they are less likely to be related to the menstrual cycle.³

Also, endometriosis will improve with birth control drugs. IBD is not likely to improve with birth control. IBD usually responds well to immune-suppressing drugs like corticosteroids (commonly called steroids). Endometriosis symptoms usually do not change on drugs like these.³

Finally, the best way to diagnose both disorders is with a biopsy. A biopsy is when a doctor takes a small piece of tissue to look at under a microscope in the lab. To diagnose IBD, doctors can take a biopsy during a colonoscopy. To diagnose endometriosis, doctors can take a biopsy during laparoscopy.³

If you have IBD and also irregular periods, trouble getting pregnant, or worse symptoms around your menstrual cycle, talk to your doctor. It may be time to see an endometriosis specialist.³