"Endo belly" is the nickname people use for the dramatic swelling that often comes with endometriosis. Your abdomen (belly) may stretch from under your ribs down to your pelvis, leaving your whole midsection tight and painful. Some people say it makes them look six months pregnant.
"I think anybody who has endometriosis knows this term, and those who treat a lot of endometriosis know it," says Hugh Taylor, MD, an endometriosis expert and chair of obstetrics and gynecology at Yale Medicine. "But your general gynecologist probably doesn’t."
Endo belly often flares with the menstrual cycle, yet many doctors often miss it as a symptom of endometriosis. This gap in awareness can delay diagnosis and treatment for years.
"The whole-body effects of endometriosis is not just about the pelvic pain. It’s a systemic disease that affects so many other organ systems," Taylor says. "But that’s not the conventional thinking in medicine today. It needs to change, but we're making very slow progress."
What Causes Endo Belly?
Endometriosis is a long-term inflammatory condition. It happens when tissue similar to the uterine lining grows outside the uterus. It’s known for painful periods, ongoing pelvic pain, painful sex, and trouble getting pregnant.
Gut symptoms are also common. Studies show people with endometriosis are more likely than those without it to report bloating, constipation, diarrhea, and belly pain with visible swelling. These issues often get worse in the two weeks before a period, though some people have them all month.
Science still hasn’t pinned down the exact cause of endo belly.
"The answer is that we don’t really know, as there has been so little research into this phenomenon in people with endometriosis," says Jane Varney, PhD, a senior research dietitian with Monash University and Alfred Health in Melbourne, Australia, who studies digestive symptoms in endometriosis and irritable bowel syndrome (IBS).
Experts say several things may team up to cause it, such as:
Inflammation. Endometriosis sparks "tremendous inflammation," Taylor says. These cells can spread through your abdominal space and irritate your intestines and other organs, particularly around the time of your period.
Visceral hypersensitivity. The gut wall is extra sensitive to normal stretching. "This can make people feel bloated even when the abdomen isn’t visibly distended," Varney says.
Central sensitization. Endometriosis can lower your pain threshold. Signals that wouldn’t register as pain in someone else, like normal amounts of food or gas, can hurt a lot and trigger more swelling.
Scar tissue. Adhesions from endometriosis may pull on or kink the intestines, making it harder for food and gas to pass.
Abnormal muscle response. Your muscles may get their signals crossed. When this happens, the diaphragm may push down while the belly wall relaxes. Called abdominophrenic dyssynergia, this process forces the belly outward. It’s more common in people with heightened nerve sensitivity.
Hormonal changes. In the second half of the menstrual cycle, hormones shift and naturally slow digestion. That alone can cause more constipation and bloating in many people. In people with endometriosis, that slowdown can be made worse by inflammation and sensitivity.
Pelvic floor problems. Chronic pain and inflammation can disrupt the muscles that help you pass stool and gas. They may be too tight or not work together the way they should.
Changes in gut bacteria. Some research suggests people with endometriosis may have higher or lower levels of certain gut bacteria. This might affect digestion, gas production, inflammation, and how you sense pain.
What other conditions can cause endo belly-like symptoms?
Painful bloating and distension aren’t unique to endometriosis. Other conditions that can mimic or overlap with it include:
- Irritable bowel syndrome (IBS)
- Small intestinal bacterial overgrowth (SIBO)
- Gastroparesis
- Celiac disease
- Crohn’s disease
- Ulcerative colitis
- Food sensitivities or malabsorption
- GI or gynecologic cancers
Many of these conditions have specific tests. Your doctor can go over which ones might be right for you.
What Does an Endo Belly Feel Like?
An endo belly usually feels hard and tight, not soft like body fat. And it often comes with painful pressure.
You may have intense bloating or distension, which are related but not the same. Bloating is the sensation of pressure or fullness, even if your belly doesn’t stick out. Distension is when your belly visibly gets bigger.
Few researchers have studied abdominal distension in endometriosis. But studies in people with IBS have shown that waist size can increase by as much as 12 cm (4.7 inches) in some people, "and that distension is at its worst right before your period starts," Varney says.
Endo belly may also come with:
- Widespread belly pain or tenderness
- Skin sensitivity
- Nausea, heartburn, or throwing up
- Diarrhea and constipation
- Excess gas that doesn’t fully ease pressure when you pass it
- Early fullness or trouble finishing meals
- Trouble taking deep breaths
Many people say they feel unhappy or uneasy about how their body looks and feels during a flare. The mix of pain, pressure, and visible change is part of what makes endo belly so hard to live with.
Endo belly vs. regular bloating vs. irritable bowel syndrome
Regular bloating usually comes after eating or drinking too much and settles within hours. IBS can cause unpredictable gas and discomfort. While symptoms from both can be like those of endo belly, the main difference is timing.
"If symptoms come around the same point in your menstrual cycle every month – you can track them with a calendar or app – it's more likely endometriosis than a primary bowel problem," Taylor says.
How Do I Get Rid of Endo Belly?
There isn’t a quick fix. The swelling comes from problems linked to inflammation, gut sensitivity, and the endometriosis itself.
"There are foods you can eat that will make it better – softer foods with the right amount of fiber and not a lot of sugar – but you're not fixing it by changing your diet," Taylor says. "That may take the edge off, but you've really got to treat the underlying cause."
Your care team may suggest one or more of the following approaches to manage endometriosis:
Anti-inflammatory medicines. Over-the-counter or prescription nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen (Advil) or celecoxib (Celebrex), can ease pain and inflammation. But they don't treat the disease.
Hormonal therapies. Birth control pills, hormonal intrauterine devices (IUDs), progestins, and gonadotropin-releasing hormone (GnRH) drugs can suppress periods and may reduce inflammation. These may calm some endo belly flares, but they don’t always work for everyone.
Surgery. Laparoscopy remains the only way to diagnose endometriosis for certain and remove visible lesions or scar tissue. Surgery may be most helpful if you have adhesions that pull on your organs, an ovarian endometrioma, infertility, or ongoing pain that doesn’t go away with medicine.
Pelvic floor therapy. Endometriosis can throw off how your pelvic muscles work. A physical therapist can teach relaxation and coordination techniques. This may ease general pelvic pain and help bowel movements and gas pass easier.
Nutrition counseling. A dietitian can help you identify foods that ease or worsen symptoms. They can guide you through anti-inflammatory or low-FODMAP eating plans. This can reduce bloating while ensuring you still meet your nutrient needs.
Stress management. Stress can heighten gut sensitivity and make bloating feel worse. Relaxation strategies, like mindfulness, yoga, or deep breathing, may calm the nervous system and ease digestive discomfort. Cognitive behavioral therapy (CBT) may also help with pain and mood.
What Are Home Remedies for Endo Belly?
Endo belly usually gets better on its own in a few days or weeks. But if you're in an active flare, here are some things you can do to feel better:
Adjust your diet. If you're really bloated, don't go for a salad or high-fiber meals. Try small portions of bland foods until your symptoms ease. Think BRAT diet: bananas, rice, applesauce, and toast.
Try over-the-counter relief. Digestive aids like simethicone (Gas-X) or bismuth subsalicylate (Pepto Bismol) may reduce gas and nausea. Water pills (diuretics) may help flush excess fluid.
Diaphragmatic breathing. This belly breathing technique helps retrain how your diaphragm and abdominal wall work together. For some people, it may ease pressure and bloating during a flare. It's simple to learn, and many doctors, physical therapists, and psychologists can teach it.
Use gentle movement and heat. Avoid high-impact exercises like running or jumping. Try walking, light yoga, or meditating with a heating pad. This may help ease tension and keep your bowels moving.
Soften your stool. It has been shown that two kiwis per day can help ease belly pain and constipation. This may ease bloating without added bulk. If that doesn’t help, ask your doctor if taking an osmotic laxative (MiraLAX) around your period might be worth trying.
What about supplements?
Rachelle LaCroix Mallik, RD, LDN, is a Chicago-based dietitian who specializes in reproductive health and nutrition. She doesn’t routinely recommend dietary supplements to manage endo belly. She says there’s not enough research to prove they work well for everyone with endometriosis pain or symptoms.
"That said, in practice I review what clients are already taking and discuss individual options – because context matters," she says. "For instance, ginger may help reduce period pain for some people, and vitamin and mineral supplements may be important if dietary needs aren’t being met via food."
What Is the Best Diet for Endo Belly?
There’s no magic menu for endometriosis. But food does matter. Not because you caused the condition by eating the "wrong" thing, but because certain choices can ease inflammation and soothe (or stoke) a sensitive gut.
Most experts suggest leaning toward foods that fight inflammation, like:
- High-fiber plant foods (fruits, vegetables, beans, whole grains)
- Omega-3 fats (salmon, walnuts, flaxseed, chia seeds)
- Unsaturated fats (olive oil, avocado, nuts, seeds)
And limiting foods that may fuel inflammation, like:
- Red and processed meats
- Saturated fats (especially from animal sources)
- Ultra-processed snacks and packaged foods
- Added sugars
Some people with endometriosis say they feel better when they cut back on specific things like:
- Caffeine
- Alcohol
- Dairy
- Gluten
What does science say about the best diet for endometriosis?
If you’re looking for something more structured, the low-FODMAP diet has the strongest research behind it. FODMAPs are certain types of carbohydrates that can be hard to digest. They may pull water into the intestines and increase gas, leading to painful bloating in people with endometriosis and IBS.
At Monash University, where the low-FODMAP diet was first developed, Varney and a team of researchers found that about 60% of people with endometriosis and gut symptoms had less bloating, pain, and diarrhea after four weeks on a low-FODMAP plan.
"These findings are encouraging and provide the first evidence-based diet therapy for endometriosis," Varney says.
FODMAPs can be found in many foods. Common ones include:
- Wheat- and rye-based breads and cereals
- Fruits such as apples, pears, and mangoes
- Vegetables like onions, garlic, mushrooms, and cauliflower
- Beans, legumes, and lentils
- Dairy products with lactose
- Nuts like cashews and pistachios
Because the low-FODMAP diet is complex and restrictive, experts recommend following it with help from a dietitian.
How Can I Lose Weight With an Endo Belly?
Endo belly isn't about weight gain. People of any body size can get it, and losing weight won't make it go away. The swelling likely comes from a mix of inflammation, fluid shifts, or stool buildup. "But when your abdomen is distended and sticking way out, it feels like weight gain," Taylor says.
Shifts on the scale can also be misleading. "If you weigh yourself the week before or during your period, that number will likely be up," says Khara Simpson, MD, an assistant professor of gynecology and obstetrics at Johns Hopkins Medicine. "Diet and exercise likely won't change that kind of weight gain."
For some people, the challenge goes the other way. On average, people with endometriosis are more likely to have lower weight and less body fat, compared to people without the condition. Endo belly can also make eating uncomfortable, leading to unintentional weight loss.
No matter your size, here are ways to keep nutrition on track:
Track patterns, not just pounds. Notice if weight changes happen cyclically with your period.
Try smaller, frequent meals. Four to six mini meals or snacks may be easier than three big ones.
Choose softer foods. Things like smoothies, blended soups, or cooked vegetables may sit easier.
Add nutrient-dense calories. If you need to gain, boost meals with nut butters, avocado, or olive oil.
Prioritize protein. Protein supports muscle, energy, and recovery. Add protein powder if needed.
Stay hydrated. Water and other fluids help soften stool and keep food moving through your gut.
Cook at home, at least during a flare. Meal prep gives you more control than eating out.
Remember, endo belly is about swelling, not extra fat. The goal isn’t to shrink your body. It’s about finding what helps you feel nourished and comfortable. Ask your doctor for more tips.
When Should I See a Doctor for Abdominal Bloating?
Not all bloating needs a doctor visit. But you should get checked out if your symptoms:
- Are severe, frequent, or cause a lot of pain
- Follow your menstrual cycle
- Keep you from eating normally
- Come with nausea or vomiting
- Happen along with changes in bowel habits
- Last more than a few menstrual cycles
- Interfere with daily activities or quality of life
The sooner you're diagnosed and treated for endometriosis, the better your chances of avoiding problems later. Even when symptoms ease up, regular check-ins with your doctor still matter.
"Please make sure that you’re engaged with a health care provider at least once a year," Simpson says. "It's important to know what your baseline is and when things change."
Takeaways
Endo belly is severe swelling of the abdomen (belly) in people with endometriosis. It's linked to inflammation, gut sensitivity, and digestive changes. Bloating and distension may flare in the weeks before your period or last all month.
There's no cure for endometriosis or endo belly, but treatment can ease symptoms and improve daily life. Options may include diet changes, anti-inflammatory medication, hormone therapy, surgery, or pelvic floor therapy.
Most people need to try a mix of things to feel better. For the best care, you may need to work with a team of health professionals including gynecologists, gastroenterologists, dietitians, and physical therapists.
Endo Belly FAQs:
Is belly swelling always a sign of endometriosis?
No. Not everyone with severe bloating and belly swelling has endometriosis. But if you have signs of endo belly, it’s important to talk to your doctor about what’s going on. The best treatment depends on what’s causing your symptoms.
Is endo belly a sign of uterine cancer?
The most common sign of uterine cancer is abnormal uterine bleeding (AUB), not bloating. But if you have belly swelling that’s painful or doesn’t go away, talk to your doctor. They’ll want to rule out more serious causes.
Is endo belly permanent?
No. While you may feel boated and distended for long stretches, it’s not a permanent change.
Can exercise get rid of endo belly?
It depends. High-impact workouts may worsen pain and swelling. But gentle exercise like walking, yoga, or Pilates may help food move through your gut or ease tension.
