Women With Endometriosis Find Relief from GI Symptoms on Low FODMAP Diet

A dietary strategy originally developed to manage irritable bowel syndrome (IBS) has been shown to relieve gastrointestinal symptoms in women with endometriosis, according to new research from Monash University.

In a randomised controlled crossover trial, 60% of participants who followed a low FODMAP diet reported clinically meaningful reductions in symptoms such as abdominal pain and bloating. In contrast, just 26% of participants experienced similar improvements on a control diet based on Australian dietary guidelines.

The study, published in Alimentary Pharmacology and Therapeutics, also found that participants on the low FODMAP diet had a 40% lower overall gastrointestinal symptom severity score compared to those on the control diet.

Targeting symptoms overlooked in current guidelines

Gastrointestinal symptoms are commonly reported by women with endometriosis but are often unaddressed in clinical guidelines for the condition. These symptoms, which include bloating, abdominal pain and altered bowel habits, can resemble those of IBS. Despite this overlap, evidence supporting specific dietary interventions for women with endometriosis has been limited.

“Gastrointestinal symptoms associated with endometriosis are largely ignored in clinical guidelines. Most endometriosis guidelines fail to mention gastrointestinal symptoms and none offer advice about identification or management. Nor do IBS guidelines mention screening for endometriosis.”

 Dr. Rebecca Burgell.

The study enrolled 35 women aged over 18 with laparoscopically confirmed endometriosis and self-reported gastrointestinal symptoms. Participants initially consumed their regular diet for 1 week before being randomised to follow either a low FODMAP diet or a control diet for 28 days. Both diets were matched in terms of energy, macronutrient and fibre content, and only differed in their levels of fermentable carbohydrates.

After a four-week washout period, participants switched to the alternate diet. Gastrointestinal symptoms, stool consistency and quality of life measures were assessed at the end of each intervention period.

Clinically meaningful improvements observed

The majority of women following the low FODMAP diet reported improvements in abdominal discomfort and bloating, as well as normalisation of stool form. These outcomes suggest that reducing FODMAP intake may be a useful strategy to manage bowel-related symptoms in this population.

The low FODMAP diet was first developed by Monash University researchers in the mid-2000s and is widely used in IBS management. The team behind the diet launched a mobile app in 2012 and a cookbook in 2023 to support people implementing the approach at home.

This latest study provides new evidence supporting the use of the diet in a broader clinical context, specifically for people with endometriosis and gut-related symptoms.

Reference: Varney JE, So D, Gibson PR, et al. Clinical trial: Effect of a 28-day low FODMAP diet on gastrointestinal symptoms associated with endometriosis (Endofod)—a randomised, controlled crossover feeding study. Aliment Pharmacol Ther. 2025;61(12):1889-1903. doi: 10.1111/apt.70161

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