Endo belly: Diet to lose it without losing your mind

Swollen stomach Endo belly -- more than just cosmetic issue (Image: Sandhya Raghavan)

Dealing with the bloat is every woman’s problem before a big day. It ruins the fit of your dress and makes you look puffy. But women who have endometriosis deal with it on a semi-regular basis. The dreaded endo belly is more than just a cosmetic problem that ruins your look on a crucial day. It’s a cruel joke.

Back in 2019, a co-worker and a friend splayed her fingers across my tummy and asked me with an anxious look in her eyes; “Are you preggers?”

I couldn’t blame her. For days, I had been hiding my distended stomach with loose tops. But I let my guard down one time and wore a fitting shirt. In retrospect, bad idea.

On the same day, my neighbour walked up to me, quickly darted her eyes left and right, and asked me the same question.

Mother Nature sure a sick sense of humour. Infertility is one of the complications of endometriosis. Despite which, women with endo are often posed with pregnancy questions thanks to our swollen bellies.

What is endo belly?

Endo belly is a rather endearing term for something very egregious. It’s a painful condition that causes bloating or swelling in the abdominal area of women who have endometriosis. Endo belly becomes more prominent on days preceding periods.

According to Healthline, there are four main causes of endo belly.

  • Inflammation in the abdomen caused by a buildup of endometrial tissues
  • Cysts on ovaries that can cause bloating
  • Small intestinal bacterial overgrowth or SIBO, seen in women who have endometriosis
  • Associated gastrointestinal issues like indigestion, constipation and gas

What does endo belly feel like?

The bloating or swelling makes the lower abdomen jut out, giving an early-pregnancy-like appearance. The stomach is hard to touch and can cause pain and discomfort.


The bloating can stay for days or even weeks. In some cases, it can disappear in a few hours.

Symptoms of endo belly may vary, but most women vouch for the pain and embarrassment it can cause.

Luckily, there are quite a few things you can do to tackle this annoying and discomforting endometriosis symptom. You’ve guessed it. It has to do with food.

Why I think undereating is an underappreciated health tip

Endo belly diet

Since the symptoms have a gastrointestinal connection, changing the diet will be a good place to start.

Generally, acids in your stomach stave off SIBO. Low gastric pH is an effective antibacterial agent since it kills bacteria and slows down their growth. Migrating motor complex, a mechanism by which the stomach muscles get rid of undigested food, also prevents bacteria from sticking around too long. Certain health conditions, like endo, can affect these functions.

FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols. It defines poorly-absorbed, short-chain carbohydrates that can cause fluid and gas accumulation, leading to bloating, tummy ache and distention.

Foods that contain lactose, fructose in excess of glucose, fructans, galacto-oligosaccharides, and polyols (sorbitol, mannitol, xylitol, and maltitol) are high FODMAP.

These foods are badly absorbed in the body and cause all-round havoc in your stomach. To counter this, try a low FODMAP diet.

Avoid foods that are high in fructose like apple, mango, peach, pear watermelon, honey, large servings of dried fruit and fruit juice.

Cut down on lactose foods like yoghurt, milk, cheese and butter entirely. Vegetables: artichoke, asparagus, beetroot, broccoli, Brussels sprout, cabbage, fennel, garlic, leek, okra, onion, pea, shallot, etc. are high in Oligosaccharides. Avoid them entirely.

Cereals like rye and wheat cereals, when eaten in large amounts, can aggravate endo belly. So eat them in moderation. Baked bean, chickpea, lentil, red kidney bean can also worsen gastrointestinal issues like gas. Best to avoid them.

Ideally, give up on processed foods. Check for sweeteners that end in “-ol”( isomalt, maltitol, mannitol, sorbitol, xylitol) and avoid them completely.

What to eat instead

Foods that figure in the low FODMAP range include fruits like banana, blueberry, cantaloupe, carambola, durian, grape, grapefruit, honeydew melon, kiwi, lemon, lime, orange, passion fruit, pawpaw, raspberry, strawberry and tangelo.

Use dairy substitutes like oat milk, almond milk or rice milk.

Make veggies like bamboo shoots, bok choy, capsicum, carrot, celery, chives, choko, choy sum, corn, eggplant, green bean, lettuce, parsnip, pumpkin, silverbeet, spring onion (only the green part) a part of your daily diet.

Going gluten-free has helped some women with the endo belly.

Drink anti-inflammatory endometriosis teas to relax your immune system and to ease the inflammation. Brew them by using peppermint, chamomile, green tea, turmeric, ginger, lavender or ashwagandha.