EP.257/ Are NSAIDs Causing Your Endo Belly?
Many of us with endo have what we call ‘endo belly’, that swollen, distended abdomen. For some of us, endo belly can be constant, or it can come with a flare up and may also be accompanied by IBS issues like gas, nausea, diarrhoea or constipation.
Whilst you’ve heard me say over and over again that the endo belly is likely caused by gut issues like low stomach acid and digestive enzymes, microbiome imbalances and SIBO (as well of course, inflammation from endo itself), there’s also another culprit I don’t talk about a lot, and that’s NSAIDS.
As some of you may know, I recently punctured a lung and broke three ribs, and for the first few days, I took ibuprofen. However, I ended up quickly stopping because the side effects were just unbearable. I was already dealing with a distended abdomen and gut distress due to the lung puncture, but the ibuprofen took this to the next level. I felt so sick that I couldn’t sleep, I was constantly gassy and every time I ate it was as if I had food poisoning, and to top it off, my already distended stomach expanded even more so, to the point where it looked like I had a different torso, a different body. I additionally puffed up and started retaining water within hours of taking ibuprofen. Now, clearly, this was very heavily influenced by the fact that a lung puncture can cause all of these issues (except for the water retention, that’s a known and recognised side effect of ibuprofen), and I had air pockets escape from my lungs into my abdomen, but I could clearly see a dramatic difference in my symptoms when I was on and off the ibuprofen – and I was shocked. I don’t take NSAIDS anymore, if I ever need a pharmaceutical painkiller, which is rare, I tend to take one paracetamol, so to see the side effects of ibuprofen was quite a contrast to what I’m used to.
And of course, many of us with endo are using over the counter NSAIDS, sometimes daily, to cope with the pain, and for others, they have prescription NSAIDS, which come with even more gut related side effects.
Now, this isn’t just an observation I’ve personally made. These gut related symptoms are common and are known side effects of NSAIDS, and in fact, NSAIDS, when taken consistently and for long periods of time, can quite significantly injure the gut. In the short term, you can end up with symptoms like a big, bloated belly and nausea, but in the long term, you could end up with damage to the lining of the stomach and small intestines, which can lead to issues like nutrient deficiencies.
Now, don’t panic, because I know lots of you need pain relief. The first step is to identify whether the NSAIDS are causing you any of your endo belly problems. If it’s possible, try a few days off NSAIDS, if you need pain medication, try paracetamol or even a supplement shown to be just as effective as NSAIDS, such as ginger root powder (just make sure you take the right dose, head to last week’s episode for that), or talk to your doctor about alternatives, and then, after a few days, observe if you feel any better. If you do feel better, it’s of course up to you whether you decide the endo belly side effects are worth it for the pain relief, or whether actually, you feel so much better endo belly wise that you want to seek alternatives and move off NSAIDS.
You might not be able to achieve this overnight, but it’s possible. I’ve helped so many clients and students move off NSAIDS and pain relief in general through lifestyle, diet, pain relief tools and good supplementation.
Whilst there are more slow and gradual changes to be made, that can bring long term relief, such as pelvic floor physio, adhesion work and good anti-inflammatory nutrition to a name a few, there are a few short-term tweaks you can add to take your pain levels down and give you some other strategies for managing pain, whilst you wean off NSAIDS. Ginger and curcumin have been shown to be just as effective as NSAIDS like mefenamic acid and ibuprofen, and quercetin has been shown to block the same inflammatory pathways as NSAIDS. Lavender essential oil demonstrated similar pain relieving effects as opioid tramadol and there are now countless tools for menstrual pain relief such as TENS machines, the Jovi patch, infrared belts and Be You patches. And whilst these won’t bring instantaneous relief, a meta-analysis found that acupuncture lowered inflammation and pain levels in people with endo, and clinically, we see regular castor oil packs help with pain levels too.
These are just some examples, and of course, we ideally want to lead with healthy diet and lifestyle changes first, but in the meantime, these tools can help.
I appreciate that some of you can’t even think of moving off pharmaceutical medication right now, so if you are concerned about your NSAID use, have a conversation with your doctor to see if there are any alternatives you could try in the meantime – and of course, if your NSAIDs are prescribed, chat with your doctor first before coming off them. I will say that LDN may be a good option, and I’ve linked to that in the show notes.
Finally, if you’re curious about some of the tools and supplements I’ve mentioned and how to use them, I do have a free pain relief handout that I made last year, which I’ve linked to in the show notes. I’ve also linked to two episodes on supplements, and if you really want to dive deeper, I have a Natural Pain Relief Tool Kit masterclass, which is £30.
Okay, I hope for some of you, this episode may have revealed one of the key causes of your endo belly issues and this is the start of getting some relief from that!
Show Notes
NSAIDS
https://www.nhs.uk/medicines/ibuprofen-for-adults/side-effects-of-ibuprofen/
https://www.nhs.uk/conditions/nsaids/
https://www.health.harvard.edu/blog/are-you-taking-too-much-anti-inflammatory-medication-2018040213540
https://onlinelibrary.wiley.com/doi/abs/10.1111/j.0954-6820.1982.tb03171.x
https://bpspubs.onlinelibrary.wiley.com/doi/10.1111/bcp.14752#:~:text=NSAID%2Dinduced%20peripheral%20oedema%20has,Indeed%2C%20NSAIDs%20inhibit%20RAAS.&text=Disruption%20of%20renal%20homeostasis%20induced,PGs)%20is%20the%20primary%20mechanism.
Supplement episodes
https://www.theendobellycoach.com/podcast/supplements-shown-to-target-endometriosis
https://www.theendobellycoach.com/podcast/supplements-for-period-pain-menstrual-symptoms
Acupunture
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5659600/
https://pubmed.ncbi.nlm.nih.gov/29944729/
Castor oil packs
https://nicolejardim.com/castor-oil/
Quercetin
https://pubmed.ncbi.nlm.nih.gov/19462895/
https://www.hindawi.com/journals/ecam/2014/781684/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4808895/
https://pubmed.ncbi.nlm.nih.gov/19297429/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6273625/
https://avivaromm.com/remedies-seasonal-allergies/
Curcumin
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4533742/
https://www.karger.com/Article/FullText/491886
https://www.sciencedirect.com/science/article/abs/pii/S0753332217346838?via%3Dihub
https://www.sciencedirect.com/science/article/pii/S1756464615000092
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5407015/
https://pubmed.ncbi.nlm.nih.gov/24672232/
https://pubmed.ncbi.nlm.nih.gov/25277322/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3476912/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7694612/
Ginger
https://pubmed.ncbi.nlm.nih.gov/23865123/
https://pubmed.ncbi.nlm.nih.gov/26177393/
https://onlinelibrary.wiley.com/doi/10.1002/ptr.6730
Lavender
https://pubmed.ncbi.nlm.nih.gov/26247152/
Free pain relief tool kit
https://mailchi.mp/thisendolife.com/natural-pain-relief-took-kit-for-endometriosis
Need more help or want to learn how to work with me?
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This episode is sponsored by Semaine. Semaine is a plant-based supplement for reducing period pain and inflammation, that you take for 7 days of your cycle, during your period. Semaine is made up of 9 super-powered plant extracts and minerals that are all vegan and sourced for maximum quality and bioavailability and selected based on the latest clinical research. If you want to try Semaine, they are currently offering 15% off your first order and they deliver worldwide! Head to: www.semainehealth.com
This episode is sponsored by BeYou Cramp Relief Patches. Soothe period cramps the natural way with these 100% natural and discreet menthol and eucalyptus oil stick on patches. Click here to find out more and to shop: https://beyouonline.co.uk/pages/how-it-works
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