Gut feeling: understanding the endometriosis-digestive link to enhance patient care and symptom control

Abstract

Purpose of review: Endometriosis is a chronic inflammatory condition that frequently presents with gastrointestinal (GI) symptoms that overlap with disorders such as irritable bowel syndrome, inflammatory bowel disease, and gastroparesis, leading to diagnostic delays. Recent research highlights the intricate relationship between endometriosis and gut health, including the role of microbiota, hormonal influences, and immune dysregulation. This review explored these mechanisms and their clinical implications for enhancing diagnosis and management strategies.

Recent findings: Recent studies have suggested that hormonal fluctuations, prostaglandin dysregulation, and gut microbiota alterations contribute to GI symptoms in endometriosis. The microbiota-gut-brain axis has been implicated in disease progression, with dysbiosis influencing systemic inflammation and estrogen metabolism. Additionally, endometriotic lesions directly infiltrating the bowel can mimic GI disorders. Multidisciplinary care models, including gastroenterologists and gynecologists, are increasingly being recognized as essential for accurate diagnosis and care. Emerging therapies such as microbiome-targeted interventions, dietary modifications, and novel biomarkers offer promising avenues for improving patient outcomes.

Summary: Recognizing the gut-endometriosis connection is crucial for reducing diagnostic delays and optimizing treatment strategies. Future research should focus on refining noninvasive diagnostic tools, exploring microbiome-based therapies, and enhancing interdisciplinary collaboration to improve patient care.

Keywords: endometriosis; gastrointestinal symptoms; inflammatory bowel disease; irritable bowel syndrome; microbiota–gut–brain axis.