Endometriosis vs. IBS - How Can You Determine The Difference (& What To Do About It)

Crap! Literally. And the pain. The gas. The bloating.

Have you ever found yourself running to the bathroom just as you were about to sit down for coffee with a friend? How about during a date? Or while in the carpool line?

You’re not alone.

This was me. I had severe bloating and pain with my Stage 4 Endo.

Life like this can be debilitating, draining, and downright embarrassing. It can also be confusing.

Is this IBS, or could it be caused by endometriosis?

You don’t have to spend countless hours searching for the answers yourself. I have spent years researching all things related to endometriosis pain and symptoms, and I’m excited to share my research with you.

In this guide, I’m going to share with you the differences between endometriosis and IBS, how they are related, and how to find the right diagnosis and treatment plan for you.

What is Endometriosis?

Pain. That’s the easy definition. You can probably relate to this as many women can. 

Scientifically, endometriosis is a painful condition where tissue grows outside your uterus. It is usually found on your ovaries, fallopian tubes, and pelvis, but it can spread further.

Basically, tissue thickens, breaks down, and bleeds with each period cycle.

This is where the pelvic pain comes from, along with other symptoms like:

  • Pain during sex
  • Pain during pelvic exams
  • Pain in lower back and down legs
  • Pain during bowel movements or urination

Do you see a common word there? Pain

It can also cause infertility, bloating, cramping, heavy bleeding, and more…

How is Endometriosis Diagnosed?

If you have signs and symptoms that you think could be endometriosis, it might be time to see your medical professional. 

Tell your doctor everything. Describe the pain, when it occurs, where it occurs, and the severity (if it increases at certain times).

An actual, confirmed diagnosis can only be done with laparoscopic surgery.

However, these are exams and tests that your doctor might perform:

  • Pelvic exam (usually standard)
  • Ultrasound
  • CT Scan
  • MRI
  • Colonoscopy

Can a Colonoscopy Detect Endometriosis?

Yes, and no. 

If you are having any bowel symptoms with your endo, your doctor might order a colonoscopy for you. 


A colonoscopy is usually not successful at finding bowel endometriosis, but it can rule out other possible disorders or can help to explain certain symptoms.

This is why it is very important that you are open and honest with your doctor. Tell your doctor if you are having any bowel issues.

Does Endometriosis Affect Bowel Movements?

A scholarly article published by the Obstetrical and Gynecological Survey revealed:

“Although some women with bowel endometriosis may remain asymptomatic, the majority of them develop a variety of disease-related complaints.”

Endometriosis can affect the bowels in two ways:

  • Superficial bowel endometriosis (surface of the bowel)
  • Deep bowel endometriosis (penetrates the bowel wall)

Can Endometriosis Cause Bowel Pain?


Endometriosis can and does cause bowel pain.

For those who suffer from bowel endometriosis, the pain can be debilitating. 

Endo in the bowels can cause pain upon opening the bowels and/or deep pelvic pain during intercourse.

It can even cause rectal bleeding for some sufferers.

What is IBS?

IBS (Irritable Bowel Syndrome) affects your large intestine. It is believed to be caused by muscles in the intestine, and/or nerves. IBS affects up to 10-15% of adults.

If you suffer from IBS, intestinal discomfort rules your life and often leads to missing important social events and obligations:

  • Work
  • School
  • Gym
  • Dinner
  • Family 

Your life is often put on hold.

For those who suffer from IBS, they can often also suffer from depression and other emotional stress.

How is IBS Detected?

Unfortunately, there aren’t any tests that can confirm IBS.

However, there are common symptoms that your doctor can look at to determine if you have IBS.

According to the National Institute for Health and Care Excellence, there are certain questions that you want to make sure that your doctor is asking:

  • Have there been any changes in your bowel habits (diarrhea or constipation)?
  • Do you have any pain or discomfort in your abdomen?
  • Do you have a bloating feeling?

If you answer yes to any of these questions, your doctor might look into assessing you for IBS.

According to NICE, you also need to have 2 of the following symptoms to get a positive diagnosis:

  • A change in how you pass stools (needing to strain, feeling a sense of 'urgency' or feeling that you haven't completely emptied your bowel)
  • Bloating, tension or hardness in your abdomen
  • A feeling that your symptoms are worse after eating
  • Passing of mucus from the rectum.

How is IBS Treated?

You have been given a positive IBS diagnosis from your doctor? What’s next?

Treatment is never a “one size fits all” deal. 

There are common treatments that are often recommended:

  • Medication (there are several options)
  • Life-style change (diet and reducing stress)
  • Probiotics and antibiotics (for gut bacteria)
  • Counseling
  • Alternative medicine (Chinese medicine, acupuncture, etc)

JAMA Internal Medicine has published a study of alternative therapies and concluded that:

“Dietary factors play an important role in symptom generation for many patients with IBS. True food allergy is extremely uncommon, while food intolerance is quite common.”

At Chiavaye we do not claim to be doctors. Before you choose these treatment options, we highly recommend that you visit your doctor.

Endometriosis Misdiagnosed as IBS

Endo causes abdominal symptoms. 

IBS causes abdominal symptoms. 

So...Which is it? Is it both?

A medical article from Obstet Gynaecol in Australia concluded that:

“When a woman presents with chronic abdominal and/or pelvic symptoms, defining the cause – endometriosis, IBS or both – can be challenging.”

Why is that?

“This dilemma may in part contribute to the average delay of between 6 and 11 years before an eventual diagnosis of endometriosis is made.”

1 in 6 do have IBS, and women are two times more likely than men to have it. When a woman has IBS symptoms, that is typically where the doctor will begin. The other systems are often filed under “menstrual symptoms.”

Endometriosis and IBS Symptoms

I get it, though. Endo and IBS can share many of the same symptoms:

  • Abdominal cramping
  • Bloating
  • Diarrhea
  • Nausea 
  • Pain with bowel movements
  • Difficulty having a bowel movement

Fun times, right?

Difference Between IBS and Endometriosis

So, if endo is often misdiagnosed as IBS, what are the differences between the two? 

Both cause severe pain.

The major difference lies in where the pain is coming from.

Your endometriosis pain is coming from your uterus and the tissue that is growing on the outside of it, and then shedding. This becomes scar tissue and can be incredibly painful. 

Your IBS pain is coming from the bowel.

Differences in Effective Treatments for Endo vs IBS

Endometriosis can be greatly helped with hormone therapy (such as birth
control pills, injections). Having your ovaries and uterus removed is the only way to completely rid your body of endometriosis and to prevent it from returning.

IBS would not be helped with hormone therapy. The above treatments are normally used. Mental health treatment is also known to help improve the patient’s quality of life. At least 50% of IBS sufferers also suffer from depression or anxiety.

IBS or Endometriosis

OK, so now we have the run-down on what each condition is, how they are diagnosed, what we do to help the symptoms, and the major differences. 

Is your head spinning? It’s OK. Let’s recap:

  • IBS and Endo= 2 different things that can look like the same thing
  • See your doctor for a diagnosis, and be open and honest. 
  • Make sure that your doctor asks good questions, and doesn’t ignore any of your symptoms.
  • Endo is often misdiagnosed as IBS. But now you know the difference, so you can help to work with your doctor to determine the diagnosis and treatment plan. Go, team!

Remember these differences between Endo and IBS:

  • Endo- tissue outside the uterus, hormone-related, might need laparoscopy procedure, usually worse around and during a period
  • IBS- affects bowels specifically, isn’t affected by menstrual cycle, and pain usually is affected by meals and/or bowel movements

What is Bowel Endometriosis?

I touched on this a little bit above, but it’s important for you to know what bowel endometriosis is. 

It is incredibly common to misdiagnose for IBS or other conditions. 

If you have bowel endometriosis, the tissue that grows outside the uterus now finds its way to the bowel. Thankfully, this isn’t common, but it can affect some women.

How is Bowel Endometriosis Diagnosed?

What will your doctor do if you’re suspected to have bowel endo?

It is important to rule out other issues that can mimic bowel endo.

Doctors usually begin with an ultrasound.

Then, the most common way to rule out and/or diagnose is to perform a laparoscopy and a proctoscopy (a camera is placed in the rectum). 

Depending on your symptoms, a CT scan might also be ordered.

How is Bowel Endometriosis Linked to Vaginal Endometriosis?

Bowel endometriosis is sometimes caused by having rectovaginal endometriosis which affects both the vaginal area and the rectum.

Vaginal endometriosis is considered a deep infiltrating endo that not only goes deep into the vagina, the area between the vagina and rectum but also into the rectum.

This is the most painful kind of endometriosis because of where it lies.

How to Treat Bowel Endometriosis

If you get a bowel endometriosis diagnosis, there are several treatment options.

Surgery and medication are the main treatment choices by doctors. 

Other treatments can help as well:

  • Diet change
  • Lifestyle change
  • Hormone therapies

Treatment for Endometriosis and IBS Symptoms

Pain sucks! We can agree on that. Whether the pain is from endo, or from IBS, there is hope.

Diet change. Lifestyle change. Medication. Both conventional and natural treatments can help with symptoms.

The point is -- you’re not alone. I’ve been where you are. I have treated my own endo.

At Chiavaye we do not claim to be doctors. Before you choose these treatment options, we highly recommend that you visit your doctor.

Conventional Treatment for Endometriosis and IBS Symptoms

Most medical doctors are going to give you treatment options that are considered more conventional. These conventional methods are often:

  • Medication for symptoms
  • Surgery 
  • Hormonal therapy for endo

Naturopathic Remedies for Endometriosis and IBS Symptoms

There is hope beyond the conventional methods. 

Endometriosis can even be reversed naturally

The naturopathic method dives into underlying causes that most medical doctors never get to.

The Institute for Natural Medicine  states:

“Treatment for endometriosis begins by stimulation of the body’s innate ability to heal through restoring healthy inflammatory response, balancing hormones, and aiding the liver’s ability to break down environmental toxins and naturally occurring estrogens.”

This can be helped with:

  • Nutrition
  • Botanical medicine
  • Supplements
  • Acupuncture
  • Personal moisturizer 

An all-natural personal moisturizer, like Chiavaye, can help to relieve the

painful vaginal dryness that so many of us suffer with. 

Do you remember that other annoying side effect of pain during sex?

A personal moisturizer can help with that too.

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