Is Low FODMAP Good for Endometriosis?

December 14, 2025 •

3 min read

According to Endometriosis New Zealand, around 72% of endometriosis patients with concurrent IBS symptoms have reported reductions in their abdominal and bowel issues after eliminating high-FODMAP foods. The low FODMAP diet, primarily known for managing irritable bowel syndrome (IBS), has also shown significant promise for those with endometriosis who experience similar gastrointestinal distress.

Quick Summary

This article explores the link between the low FODMAP diet and endometriosis-related gastrointestinal symptoms. It details how FODMAPs can trigger digestive distress, outlines the three phases of the diet, and provides a comparison of high and low FODMAP foods. The text covers research findings and emphasizes the importance of professional guidance for safe implementation.

Key Points

Symptom Relief: A low FODMAP diet can significantly reduce gastrointestinal symptoms like bloating, pain, and altered bowel habits in many endometriosis sufferers, particularly those with IBS-like issues.
Evidence-Based: Multiple studies, including a recent 2025 trial and a 2017 review, provide evidence supporting the effectiveness of the low FODMAP approach for managing endometriosis-related digestive distress.
Structured Phases: The diet consists of three phases—elimination, reintroduction, and personalization—to identify specific food triggers and create a sustainable, less restrictive long-term plan.
Professional Guidance: Due to the diet's restrictive nature, it is crucial to work with a dietitian to prevent nutritional deficiencies and ensure correct implementation for a healthy gut microbiome.
Limited Scope: The low FODMAP diet addresses digestive symptoms but does not treat the underlying cause of endometriosis itself, serving as one component of a comprehensive management plan.
Not for Everyone: While effective for many, it does not work for all individuals, and other dietary or medical interventions may be necessary to achieve symptom relief.

The Connection Between FODMAPs and Endometriosis Symptoms

Many women with endometriosis experience gastrointestinal (GI) symptoms similar to those of irritable bowel syndrome (IBS), including bloating, abdominal pain, constipation, and diarrhea. Hormonal changes and inflammation, especially during the menstrual cycle, can exacerbate these symptoms. The low FODMAP diet can help by targeting fermentable carbohydrates that worsen these digestive issues.

How FODMAPs Affect Endometriosis Sufferers

FODMAPs are short-chain carbohydrates poorly absorbed in the small intestine. In sensitive individuals, this leads to issues explained by the small and large bowel theories:

Small Bowel Theory: Unabsorbed FODMAPs increase water in the small intestine, causing bloating and potentially speeding up bowel transit.
Large Bowel Theory: In the large intestine, gut bacteria ferment FODMAPs, producing gas that leads to bloating, flatulence, and abdominal pain.

Increased gas and water can trigger significant discomfort and pain for those with endometriosis, who may have visceral hypersensitivity (oversensitive gut nerves). Reducing these carbohydrates minimizes intestinal irritants and alleviates gut symptoms.

The Three Phases of the Low FODMAP Diet

The low FODMAP diet is a temporary, structured process to identify food triggers, not a permanent eating plan. It has three phases:

Elimination Phase: For 2 to 6 weeks, high-FODMAP foods are strictly removed. This phase reduces GI symptoms and requires professional supervision for nutritional adequacy.
Reintroduction Phase: High-FODMAP food groups are reintroduced one by one to find which FODMAPs and amounts cause symptoms, as tolerance varies.
Personalized Phase: In this long-term phase, the diet is adjusted to include as many tolerated FODMAPs as possible, avoiding only specific triggers. This helps maintain nutritional diversity and sustainability.

Comparison of High and Low FODMAP Foods

Identifying foods by category is key to following the diet.


Food Category	High FODMAP Examples	Low FODMAP Alternatives
Fruits	Apples, pears, peaches, watermelon, cherries	Grapes, strawberries, oranges, unripe bananas
Vegetables	Onion, garlic, asparagus, mushrooms, cauliflower	Carrots, potatoes, spinach, zucchini, bell peppers
Dairy	Milk, yogurt, ice cream, soft cheese (e.g., ricotta)	Lactose-free milk, hard cheeses (e.g., cheddar, parmesan), almond milk
Grains	Wheat, rye, barley (including most bread and pasta)	Gluten-free bread, oats, rice, quinoa
Legumes	Beans, lentils, chickpeas	Canned chickpeas and lentils (rinsed), small servings of firm tofu
Nuts & Seeds	Cashews, pistachios	Almonds, walnuts, pumpkin seeds, sesame seeds
Sweeteners	High-fructose corn syrup, honey, agave nectar	Maple syrup, table sugar (in moderation)

Scientific Evidence Supporting Low FODMAP for Endometriosis

Research supports the low FODMAP diet for managing endometriosis symptoms, particularly for those with IBS-like issues. A 2025 study in BMC Women's Health showed significant improvements in constipation and quality of life, including pain, for endometriosis patients on the diet. This aligns with a 2017 study where 72% of women with both conditions saw reduced bowel symptoms.

The diet helps manage digestive discomfort but does not treat the cause of endometriosis. It is part of a broader treatment plan that may involve medical and surgical options.

Potential Downsides and Considerations

The low FODMAP diet is restrictive and needs careful planning. Long-term, unsupervised use can lead to nutritional deficiencies and may harm the gut microbiome, as high FODMAP foods are prebiotics. The strict nature can also lead to high dropout rates. Working with a dietitian is strongly advised for correct implementation, duration, and incorporating low FODMAP prebiotics for gut health.

Conclusion

For many with endometriosis experiencing significant GI distress, a low FODMAP diet can be beneficial. It reduces bloating, gas, and abdominal pain by lowering fermentable carbohydrate intake, improving quality of life. However, it is not a cure and is most effective for IBS-like bowel symptoms. Due to its restrictive nature, it must be implemented under healthcare professional guidance. The diet serves as a promising self-management tool within a holistic treatment strategy.

Additional Resources

For more information on endometriosis and the low FODMAP diet, explore the Monash University FODMAP Diet website. Learn more at Monash University FODMAP Diet

Frequently Asked Questions

The low FODMAP diet helps by reducing the intake of fermentable carbohydrates that are poorly absorbed in the gut. This minimizes gas and fluid retention, which can aggravate the sensitive gut nerves common in endometriosis patients and lessen associated digestive symptoms like bloating, pain, and gas.

No, the low FODMAP diet is not a cure for endometriosis. It is a dietary strategy focused on managing and reducing the gastrointestinal symptoms associated with the condition, such as bloating and abdominal pain, but it does not treat the endometrial lesions themselves.

The initial elimination phase typically lasts for 2 to 6 weeks. This short duration is intentional to minimize the risk of nutrient deficiencies and negative impacts on the gut microbiome before the reintroduction phase begins.

While it is possible, it is strongly recommended to work with a dietitian experienced in the low FODMAP diet. A professional can ensure proper nutrition, guide you through the reintroduction phase safely, and help you create a sustainable long-term eating plan.

If you do not experience symptom relief during the elimination phase, the low FODMAP diet may not be the right approach for you. In such cases, a healthcare provider can help explore other therapies and strategies, as not all endometriosis-related symptoms are linked to FODMAPs.

Examples of low FODMAP foods include common items like grapes, oranges, rice, oats, carrots, potatoes, chicken, and lactose-free dairy products. A comprehensive list can be found using the official Monash University FODMAP Diet App.

The low FODMAP diet is not intended to be a permanent, highly restrictive diet. The goal of the reintroduction phase is to determine your individual tolerance levels, allowing you to incorporate as many FODMAPs as you can without triggering symptoms.