Supporting Endometriosis Through Gut Health: A Nutritional Therapy Guide
Jayne Higgins explores the emerging science connecting the gut microbiome to endometriosis. Turning the latest science into something practical and helpful because for those living with this condition, actionable support matters. Knowledge without direction can feel like yet another dead end, and in this blog she offers more than that.
The research is clear that gut dysbiosis - an imbalance in the gut microbiome - is consistently found in women with endometriosis. This dysbiosis disrupts the estrobolome, the community of gut bacteria responsible for metabolising and regulating oestrogen, which can drive elevated circulating oestrogen levels and fuel the growth of endometriotic lesions. Gut imbalance also promotes chronic inflammation and compromises the body's own anti-inflammatory defences. In short: what happens in the gut does not stay in the gut.
These are not abstract findings. They point directly to areas where targeted nutritional support can make a genuine difference.
What You Can Do Right Now: Nutritional Therapy for Gut Health and Endometriosis
What I share here comes from both professional training and lived proximity to this condition. I have spent years alongside someone navigating it without adequate support, and that experience has profoundly informed the way I approach this work with clients. These are not abstract recommendations drawn from textbooks — they reflect what I have come to understand, through science and through life, about how the body can be genuinely supported.
These approaches do not replace your medical care - please see the disclaimer below - but they can make a meaningful difference to how you feel day to day.
1. Adopt an Anti-Inflammatory Dietary Foundation
Chronic inflammation is central to endometriosis. An anti-inflammatory diet provides the building blocks for a calmer internal environment. Focus on:
- Omega-3 rich foods: oily fish (salmon, mackerel, sardines), walnuts, flaxseeds, hemp seeds
- Colourful vegetables and fruits: particularly leafy greens, berries, broccoli, and beetroot — all rich in antioxidants and polyphenols
- Olive oil as your primary cooking fat
- Reduced red meat and processed foods, which promote inflammation and may worsen gut dysbiosis
2. Support Your Estrobolome with Fibre and Fermented Foods
A fibre-rich diet feeds the beneficial bacteria responsible for healthy oestrogen metabolism. Aim for a wide variety of plant-based fibre sources — vegetables, legumes, wholegrains, fruits, nuts, and seeds. Diversity is key: try to eat 30 different plant foods per week as a practical target.
Fermented foods introduce beneficial bacteria and support microbiome diversity. Include small, regular portions of live yoghurt (unsweetened), kefir, sauerkraut, kimchi, and miso in your diet.
3. Consider Targeted Probiotic and Prebiotic Support
Research points to specific bacterial deficits in endometriosis. A qualified nutritional therapist can help you identify appropriate probiotic strains and prebiotic fibres (such as inulin and fructooligosaccharides) that may help to address your individual microbiome imbalances. Supplementation should always be tailored rather than generic.
4. Identify and Reduce Dietary Triggers
Certain foods consistently worsen gut dysbiosis and systemic inflammation:
- Ultra-processed foods and refined sugars, which feed pathogenic bacteria and promote LPS production
- Alcohol, which is both pro-inflammatory and disruptive to the gut lining
- Gluten and dairy, which some women with endometriosis find exacerbate their symptoms — an elimination and reintroduction protocol, guided by a practitioner, can help identify individual sensitivities
- Excessive caffeine, which may worsen oestrogen metabolism and disrupt sleep
5. Prioritise Gut Lining Integrity
A compromised gut lining allows bacterial endotoxins — including LPS from Gram-negative bacteria — to enter the bloodstream and trigger systemic inflammation. Nutrients that support gut lining integrity include L-glutamine, zinc, vitamin D, and omega-3 fatty acids. These are best taken within a personalised, practitioner-supervised plan.
You Deserve Support — and You Are Not Alone
If you have spent years being told your pain is normal, being dismissed by the very people who should have helped you, or managing a complex condition largely on your own - please know that your experience is valid, your pain is real, and you deserve so much better.
I know something of what it means to sit beside a person you love and feel helpless. To watch years pass without answers. To witness the toll that dismissal, trial-and-error prescribing, and the absence of a clear plan takes - not just on the body, but on a person's sense of themselves. That experience did at times leave me feeling totally helpless. But it drove me to understand this condition as deeply as I can, and to offer the kind of support I wish had been available sooner.
The research emerging around gut health and endometriosis is not a cure, and I want to be clear about that. But it does open genuinely meaningful avenues for support - and it reinforces what nutritional therapists have long understood: that food, the gut, hormones, and inflammation are deeply, inseparably connected.
At Jayne Higgins Nutrition, I work with women navigating exactly this kind of complex, chronic condition. This is not simply a specialism I have chosen - it is work I feel compelled to do. If you would like to explore a personalised nutritional therapy plan as part of your broader management of endometriosis, I would be glad to work with you. You can find out more about working with me [on the services page].
Disclaimer: Nutritional therapy is a complementary approach and is not a replacement for medical diagnosis, treatment, or the care of your GP, gynaecologist, or other healthcare professionals. If you are experiencing symptoms of endometriosis, please seek medical advice. The information in this article is intended for educational purposes only and does not constitute medical advice.
Sources and further reading:
- Pérez-Prieto et al., BMC Medicine (2024) — Gut microbiome signatures in endometriosis
- Wang et al. (2025) — Firmicutes/Bacteroidetes ratio in endometriosis
- Hearn-Yeates et al., Reproduction & Fertility (2024) — Gut-brain axis and endometriosis
- Huang et al. (2021) — Ruminococcus as a diagnostic biomarker
- Frontiers in Cellular and Infection Microbiology (2025) — Fusobacterium, LPS and immune microenvironment
Endometriosis and the Gut: What the Latest Research Tells Us
If you have endometriosis, you already know what it feels like. You know the kind of pain that does not respond to paracetamol and a hot water bottle. You know the cancelled plans, the days lost to bed, the invasive tests that come back "normal", hours in A&E unable to stand to be given morphine and sent home and the calls to the GP where your concerns are minimised or dismissed and often not even allocated appointments by the triage system. Emma Barnett described it as "bone-grinding agony." That language matters. It names an experience that too many women have been told is simply part of being female.
I watched this happen first-hand. Years of being told it was period pain. Antibiotics issued as a precaution rather than with purpose. The suggestion, implicit and sometimes explicit, that the pain was being exaggerated. What I observed across those years was not unusual, as the data we are now seeing makes painfully clear.
What is SIBO?
Small Intestinal Bacterial Overgrowth (SIBO) happens when too many bacteria build up in the small intestine, leading to uncomfortable gut symptoms and, in some cases, nutrient deficiencies.
I work with clients to help them understand what is driving their symptoms, calm inflammation, and make practical changes so you can eat with more confidence again.
What is SIBO?
SIBO is essentially an overgrowth of bacteria in the small intestine, where normally only relatively low numbers of microbes should be present. This overgrowth can interfere with digestion and absorption, leading to gas production, irritation of the gut lining, and problems with how you process fats, carbohydrates, and some vitamins.
• The excess bacteria ferment carbohydrates, producing hydrogen and/or methane gas, which drives bloating, pain, and changes in bowel habits.
• Over time, SIBO can contribute to malabsorption of nutrients such as vitamin B12, fat-soluble vitamins (A, D, E, K), and minerals like calcium.
Common SIBO symptoms
SIBO symptoms can overlap with IBS and other digestive issues, which is one reason it often goes undiagnosed for a long time.
Typical digestive symptoms include:
• Bloating and visible abdominal distension, often worsening after eating
• Excess gas, belching, and flatulence
• Abdominal discomfort or cramping
• Diarrhoea, constipation, or alternating between the both at differing times
• A feeling of fullness very quickly or discomfort after eating small amounts
Possible whole-body symptoms include:
• Unintentional weight loss or difficulty maintaining weight.
• Fatigue, weakness, and “brain fog” linked to nutrient deficiencies.
• Signs of low B12 or vitamin D over time, such as tingling, low mood, or bone health issues.
What causes SIBO?
SIBO is usually the result of something affecting how food and bacteria move through the small intestine or how well the gut’s natural defences are working.
Key contributors can include:
• Sluggish gut motility (slow movement of food), which might be linked to diabetes, connective tissue conditions, hypothyroidism, or nerve issues.
• Structural changes in the gut, such as adhesions, diverticula, strictures, or previous abdominal surgery that creates “pockets” or slows transit of food.
• Reduced stomach acid or bile flow, which would normally help keep bacterial numbers in check.
• Long-term use of certain medications, such as some acid-suppressing drugs, which can alter the gut environment.
• Co-existing conditions like coeliac disease, Crohn’s disease, or scleroderma that change how the small intestine functions.
How SIBO is usually diagnosed
Diagnosis is typically done by a gastroenterologist or specialist, and a nutritional therapist will often work alongside this medical process.
Common approaches include:
• Breath testing (usually lactulose or glucose) to measure hydrogen and methane gases produced by bacteria in the small intestine.
• In more complex cases, small bowel aspirate and culture, or investigative endoscopy, to directly sample small intestinal contents.
• Blood tests for nutrient levels (like B12, iron, and vitamin D) and markers of malabsorption if symptoms suggest deficiencies.
What to expect from working with me
Working with me when you have a SIBO diagnosis is not just about “what to eat” but about understanding your underlying triggers, supporting medical treatment, and helping you rebuild a more resilient gut over time.
The process:
• Firstly, I take a detailed health and symptom history: looking at your digestion, energy, previous diagnoses, medications, stress levels, and diet to identify patterns and possible root causes.
• I support you with access to testing if necessary and explain any results you already have that may be complicated and confusing: I help you understand breath test options, timing, preparation, and how test results might link to your symptoms (while diagnosis itself remains medical).
• I make a phased nutrition plan for you: starting with a plan to reduce symptoms (often adjusting fermentable carbohydrates, meal timing, and texture), then gradually re-expanding your diet to avoid long-term unnecessary restriction.
• Gut motility and digestion support: using food timing, fibre types, hydration, and sometimes carefully selected supplements (where appropriate) to support stomach acid, bile flow, and the migrating motor complex.
• Nutrient repletion: identifying where SIBO may have led to low B12, iron, or fat-soluble vitamins and using food-first strategies, with supplements if needed, to rebuild levels safely.
• Longer-term relapse prevention: gradually I will help you to broaden your diet, to support gut microbiome balance in the large intestine, and I will also work with you on lifestyle factors such as stress, sleep, and gentle movement, which all influence gut motility.
For many people, the most valuable parts of this process are having a clear plan, feeling understood, and no longer guessing which foods are “safe” day to day. I can help you move from constant firefighting of symptoms to a more stable, flexible way of eating that supports both your gut and overall health.