EP.358/ The Low FODMAP Diet and Endometriosis: What the Research Shows

Podcast

11 Aug

Last week I talked about the low FODMAP diet for lowering histamine levels and helping to improve MCAS or histamine intolerance symptoms, but today I want to talk about the low FODMAP diet specifically for endometriosis and what the research shows so far.

And just like in our last episode on the topic, those who aren’t familiar, let’s do a basic overview of the low FOMDAP diet. The low FODMAP diet is a therapeutic diet prescribed to those with IBS and/or SIBO, which reduces for a period of 2-6 weeks, foods high in fermentable carbohydrates. Fermentable carbohydrates, like inulin, which is found in garlic and onions, help feed our good gut microbiome, which is known as the process of fermentation. This process creates gas, and this triggers in some sensitive individuals, IBS-symptoms or SIBO flares. Once the restriction phase is over, each FODMAP group (as there are different types) are reintroduced to test tolerance, and from there, people are able to create a personalised nutrition plan that is unique to their individual FODMAP tolerances.

So, what does the research say?

The most recent study was published in May 2025, and this study compared 28 days (so a month) of the low FODMAP diet versus a control diet, in endo participants who also had gastrointestinal symptoms.

There were 35 participants and they were each randomly assigned to the low FODMAP diet, which allows for less than 5g of FODMAPS a day, or a control diet which limited FODMAPS to 20g a day.

60% of those on the low FODMAP diet saw improvements, in contrast to 26% in the control group. Those who saw improvements reported an increase in quality of life and a reduction in bloating (a.k.a endo belly), abdominal pain and improvements in stool form. Additionally, those in the low FODMAP group scored better on the Endometriosis Health Profile Questionnaire, which is an official scale for measuring how much endometriosis is impacting on one’s life.

Now, that’s not the only study to show improvements with endo.

A prospective cohort study published in April 2025 also studied the low FODMAP diet in 47 endo participants. This study followed the patients through both the restriction phase, which is 4 weeks, and then the reintroduction phase, which varied for each participant but was at least 10 weeks.

The amazing outcomes of this study were that the symptom improvements were not just based around the gut. 65% reported a reduction in chronic pelvic pain and using the same scale as the other study, there were also significant improvements reported in sex, work, emotional wellbeing, self-image, and feelings of control and powerlessness.

In terms of gastrointestinal symptoms, constipation significantly improved and 53% reported a decrease in bloating.

Now, it’s worth noting that as I shared in my last episode, the low FODMAP diet can be challenging because it involves measuring and weighing so much. As a result, there was a high drop out rate, with thirteen not starting the diet, and ten stopping during the trial, meaning only 24 actually continued with and completed the diet, so something to realistically think about there.

Now, our final study is older, but not old - from 2017.

In 58 women both with IBS and endo, 72% experienced a 50% or higher improvement in bowel related symptoms. What’s really interesting here is that they also included women with IBS but no endo in the study, and only 49% in that group experienced the same level of improvement, so the low FODMAP diet was actually more beneficial to those with endo and IBS, than IBS alone.

So, if this sounds of interest to you, as I shared last week, the low FODMAP diet was designed to be prescribed by a doctor or dietician, and it’s best performed with the support of a low FODMAP trained professional, as it can be challenging.

If you’re interested in trying the low FODMAP diet, share these studies with your doctor and ask them to refer you to a dietician, or if you can afford to go private, seek out a low FODMAP specialist. For those in the UK, I’ve linked to a trusted private clinic in the show notes (they don’t know who I am, and I am not affiliated with them in any way).

Okay, that’s it for this week!

Show notes

Low FODMAP diet info

https://www.monashfodmap.com/about-fodmap-and-ibs/

https://pmc.ncbi.nlm.nih.gov/articles/PMC4918736/

Studies referenced

https://pubmed.ncbi.nlm.nih.gov/28303579/

https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-025-03715-1

https://pmc.ncbi.nlm.nih.gov/articles/PMC12107219/

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