Ask the Doc: Celiac, endometriosis and PCOS
Posted on February 17th, 2009 by alison
Q. I have had polycystic ovarian syndrome (PCOS) for several years and luckily, though various fertility treatments, was able to conceive and give birth to two beautiful boys (ages 5 and 2). Since my youngest was born via C-section, I had been having abdominal pain, cramping, intermittent diarrhea, etc. I had never had gastro problems before this. Last month, I had a laparoscopy that found endometriosis/adenomiosis/ovarian cysts, all of which were cauterized. I continued to be extremely fatigued, losing weight, diarrhea, etc., so on a whim I had a blood test for celiac that was suggested months earlier by my gastro. Of course, it was positive. I am just coming to grips with all this right now. I am unable to work because I am in the bathroom half the day, on my heating pad for the continued back pain from the laparoscopy, and always exhausted. My family is going on the gluten-free diet to see if that helps me feel better and I am going to have my allergist check me for other food allergies and for a Candida albicans yeast allergy (the allergist found earlier last year that I had virtually no immunity to any strep infection strains and after a pneumonia vaccine shot, the numbers improved - I had been having 8-10 sinus infections a year, flu/bronchitis twice in the past 3 years, and various other weird infections requiring multiple rounds of antibiotics).
My question is - are all of these (PCOS, endometriosis, celiac) related? Are there good resources on these diseases if they are or people who actually have all 3? I feel like every few months I find out something new about myself, so I feel like I flit from problem to problem instead of addressing a larger cause.
A. Endometriosis is a completely independent condition, but PCOS and celiac are related. Treatment of the endometriosis should be explored with your gynecologist. The gluten-free diet should help with the other problems, but remember that celiac disease is an inherited condition, so you’ve had this all your life, only to be unmasked by the C-sections. Thus, it will be several months before you’ll see a major benefit of the diet.
Q. Can endometriosis be made worse by celiac disease?
A. There is no doubt that untreated celiac disease can lead to an excessive sensitization of the enteric nerves, and thus augment any pain that might arise from endometriosis. Endometrial implants on the outer surface of the gut are surrounded by connective tissue-as a way of encasing these abnormal tissues. That process can also involve the intestinal muscles and nerves, and, when activated by the immune cells in the celiac patient, the painful sensation is enhanced. I see this also in IBS and IBD and coexisting endometriosis. When I control the inflammation with gut anti-inflammatory drugs, the pain improves. Other than that, these are two independent phenomena that often interact, and one should not consider celiac disease as a cause or effect of endometriosis.
Health and happiness,
Dr. Aron
Have a question for the doc?
Dr. Aron,
I read your earlier post, and was wondering if their is a link between single abdominal or ovarian cysts and gluten-intolerance?
And also can food poisoning and/or excessive use of anti-biotics (with their effects on intestines) also cause or exacerbate gluten-intolerance?
Thanks in advance!
Tami
I’ve been diagnosed with endometriosis as well, had laparoscopy last November, but they couldn’t get it all as it is likely it is in my uterus as well. I’m tired a lot, feel poorly, have spasms in my uterus and back. I also noticed a direct link with pain and diet for me. I’m a big meat eater and love beef. However, the more beef I eat, the worse I feel. That is, until I switched to organic, hormone-free beef. I did some reading online and learned that xenoestrogen is injected into a lot of the beef readily available (most grocery stores and most restaurants as well). Thank goodness to have a Trader Joe’s nearby. For the past month, I’ve only eaten organic beef and the pain as well as the spasms have lessened for me. Just thought I’d share in case there are any other beef lovers out there who are also having this problem.
I recently found that eliminating gluten from my diet has made a HUGE improvement in my health. For all of my adult life I suffered from joint and back pain, fatigue, terrible cramps and PMS, dandruff, pelvic pain, abnormal monthly bleeding, insomnia, frequent diarrhea and anxiety. Since undergoing a bunch of tests,my doctor found three polyps in my uterus which accounted for the abnormal bleeding and them from online research, I tried eliminating gluten and within three days the vast majority of my symptoms went away. My PMS and pelvic pain are 90% better. I think that there must me a lot of unexplained symptoms that could be helped with diet and that the majority of Doctors don’t receive adequate training in nutrition. My aunt is an MD and a nutritionist and has been much more helpful than my local doctors. Once I realized how much better I feel, I really don’t feel like I’m missing out too much from avoiding gluten.
A pilot study is showing that there is potentially a link between Celiac and endometriosis. See here:
http://www.ncbi.nlm.nih.gov/pubmed/19400413