
With many overlapping symptoms, endometriosis is frequently misdiagnosed as Irritable Bowel Syndrome (IBS). While it is possible to live with both of these conditions, it’s often difficult to know if endometriosis is the sole cause of gastrointestinal symptoms or if there are other factors at play. For some people, their bowel symptoms vastly improve or disappear altogether after excision surgery. For others, they continue to have bowel symptoms even after excision. This can leave patients feeling frustrated and unsure of what to do next. The following discusses the symptoms of IBS, how to get diagnosed, and how to manage your symptoms.
For a note on the use of language in the cited source(s): The Endometriosis Network Canada highlights that many people live with the conditions discussed in this post, however, inclusivity may not be reflected in the verbiage of the resource(s).

Symptoms and types of IBS
Cramping, abdominal pain, bloating, gas, diarrhea, constipation, and nausea are all common IBS symptoms. Symptoms can depend on the type of IBS an individual lives with.
There are three types of IBS:
- IBS-D is when the bowel contracts too quickly, resulting in diarrhea.
- IBS-C is when the bowel contracts too slowly resulting in constipation.
- IBS-M is a mixture of diarrhea and constipation, sometimes even within the same bowel movement.
Triggers
Stress, diet and hormonal changes are all factors that can trigger an IBS flare up.
While stressful life events like writing an exam or going through a breakup may be more obvious causes of flare ups, positive experiences of excitement can also contribute. Reducing your stress with activities such as yoga and meditation or working with a therapist can help reduce the severity or frequency of flare ups.
Diet, which will be discussed further below, can either ease or worsen symptoms. While this can vary from person to person, common IBS food triggers are fried, spicy or fatty foods, caffeine, and artificial sweeteners like aspartame. Eating smaller meals more frequently can also help prevent flare ups.
Hormonal changes can affect people even without IBS. This is because the hormone that causes the uterus to contract during a period doesn’t stay localized to the uterus and can cause the intestines to contract as well. However, evidence shows that this presents more commonly in people with IBS. One study found that 50% of people assigned female at birth living with IBS reported flare ups during their period.
If these symptoms and triggers sound familiar, know there are doctors and healthcare providers out there who can help you find the root cause of your symptoms.
Diagnosis
IBS is typically diagnosed by a gastroenterologist, a doctor specializing in conditions affecting the digestive system. While there are no tests designed specifically to diagnose IBS, gastroenterologists will investigate red flags such as blood in the stool or anemia as are indicators of IBD (inflammatory bowel disease) or celiac disease. Blood tests, stool samples and a colonoscopy or endoscopy can help rule out these conditions.
Depending on your symptoms and the doctor you are working with, you may also be tested for small intestinal bacterial overgrowth (SIBO). SIBO occurs when there’s an overgrowth of bacteria in the small intestine. This can cause symptoms similar to IBS and endometriosis.
SIBO is often misdiagnosed or underdiagnosed because of its tendency to present differently in each person.
If you’re experiencing bowel symptoms that aren’t responding to excision or other treatments, speaking to your doctor about SIBO can be a good next step to take.
Once IBD, celiac disease, and SIBO have been ruled out, the only way to know if the gastrointestinal symptoms are related to endometriosis or IBS is to have surgery with an excision specialist. It’s important to keep in mind that adenomyosis can also cause bowel symptoms so it is possible to continue to experience these symptoms even after excision.
Irritable Bowel Syndrome (IBS) vs Inflammatory Bowel Disease (IBD)
While IBS and IBD may share many of the same symptoms, they are very different conditions. IBD is an umbrella term for Crohn’s and ulcerative colitis. These conditions typically worsen without treatment and can cause serious complications. While IBS can be debilitating, it is not a progressive disease, meaning it does not worsen or cause damage overtime if left untreated.
It is possible to have both endometriosis and IBD so it’s best not to ignore symptoms and assume it’s one or the other. While speaking to doctors about bowel problems can be awkward or uncomfortable, it’s important to take care of yourself and receive the care you require.

Low FODMAP Diet
One of the most commonly recommended diets to help manage IBS is the low FODMAP diet developed by Monash University. FODMAP stands for fermentable oligo-saccharides, di-saccharides, mono-saccharides and polyols. These are names of particular sugars in food that are not completely absorbed or digested by the intestines. As these sugars reach the large intestine, they begin to ferment causing an excess of gas. This gas can be quite painful for some people living with IBS as their intestines are more sensitive.
It’s important to note that the low FODMAP diet is highly restrictive and not meant to be a long term solution.
Over a 2-6 week period, high FODMAP foods like onions are swapped out for low FODMAP foods like chives. Once symptoms have improved, those high FODMAP foods are then slowly reintroduced to see which ones cause a flare up. For some, this can be an overwhelming process. Working with a dietician can help ensure you’re getting a balanced diet and create a plan for reintroducing foods. If you are unable to find relief with the low FODMAP diet, a dietician may also have suggestions for other diet modifications.
If you’re not able to see a dietician, keeping a food journal can help you identify which foods are worsening your IBS symptoms. Track your reactions to certain foods by writing down what you’ve eaten, what symptoms you’re experiencing, and watch for any patterns that emerge. There are plenty of free food journal templates online like this one from HealthLink BC that can help you keep your information organized.

Medications and supplements
Your gastroenterologist will be the best person to speak to about potential medications or supplements to try. The Canadian Society of Intestinal Research has informative charts on their website that go over which medications are typically prescribed for each IBS symptom. They can be found here, near the bottom of the page.
A dietician can also provide helpful advice on supplements that may help ease your IBS symptoms.
These might include probiotics, peppermint capsules and fibre. However, it’s important to remember that what works for one person, may not work for another, especially among different types of IBS.
If you’re struggling with IBS symptoms and aren’t sure what your next steps should be or just need some support, join The Endometriosis Network Canada’s private Facebook support group. There you’ll discover thousands of people who know exactly what you’re going through. You may also find recommendations for gastroenterologists or dieticians in your area.
The content of this post does not provide or replace medical advice. It is important to follow up with your doctor with any healthcare concerns you may have and to work with medical professionals to develop treatment plans that are right for you.