Around the world it is estimated that around 1 in 10 women are affected by endometriosis. Now, this doesn’t seem like a lot of people at first glance, but this adds up to being around 190 million women throughout the world.1 Surprisingly, this is actually a very similar number to the amount of people who have diabetes.
It takes on average seven and a half years to get an endo diagnosis, with many women being missed in terms of diagnosis. So, I would say the number of women affected by endometriosis is actually much higher than 1 in 10.
At the moment, the only way to get that diagnosis is to go through a laparoscopic surgery. The thought of having surgery can be quite scary, and you're not alone in feeling this, but can I encourage you to go in with an open mindset. The surgery is an important step in the journey, to understanding your body and health.
As I am sure your doctor or surgeon has explained to you what the laparoscopy involves, let’s just skip to what you can do to prepare yourself for the surgery….
Before the laparoscopy
Often people with Endo say that they will wait to get started on their nutrition journey after their laparoscopy. And a lot of the focus around laparoscopies is placed on what happens after the surgery and how to look after yourself after the procedure happens.
Ideally, we really want to get prepared for surgery with good nutrition before you go in. I mean, if you had a big race coming up, you wouldn’t want to start getting your nutrition in check until after your race. So, why is a surgery any different?
Your body needs time to build up its nutrient stores so that when your laparoscopy is completed so that it has all of the tools it needs to heal quickly and enhance your recovery.
So, what nutrients do we want to focus on? Well, we’ve got a few which are energy, protein, vitamins A, C and D, zinc, iron, calcium, and fibre. Now I know that sounds like a lot but lots of these nutrients overlap.
Energy and protein
Ideally we want to be having at least three balanced main meals every day with one to two smaller mid meals. This makes sure that we are getting enough energy. To make sure we are getting enough protein, we want to make sure that we include a source of protein with each meal. Good sources of protein include foods like chicken, fish, meat, tofu, dairy, beans, lentils or eggs.
Vitamins and minerals
Ensuring that you have enough vitamins and minerals in your diet is essential for healing post-laparoscopy. Vitamins A, C, and D as well as zinc, iron and calcium are essential to help initiate your body’s healing processes and produce collagen.2
Now you’ve probably heard of collagen before, but what does it actually do? Well, it forms and rebuilds tissues in our body and is essential to help heal wounds caused by procedures.
Vitamin A is one of the most essential nutrients for wound healing since it helps control the “inflammatory response” and helps the formation of collagen. We can find it in milk, cheese, eggs, fish, dark green vegetables as well as orange and red fruits and vegetables.
Vitamin C is also involved in the production of collagen and has been found to enhance your immune system, which can help your body to fight off any post op infections. It is mostly found in fruits and vegetables, especially citrus fruits, tomatoes, and leafy vegetables. Some fruit juices have added vitamin C in them, but they usually only have a small amount.
Zinc can be found in foods like red meat, fish, shellfish, milk products, poultry, eggs and pepitas.
Iron can best be found in liver, beef, kangaroo and salmon. Plant iron food sources are less absorbed by the body, but can weetbix, allbran, tofu and legumes.
Calcium can be found in milk, yoghurt and cheese; soy products like milk and tofu; and some tinned fish.
Vitamin D can also be found in eggs, activated mushrooms and some plant fortified milks like soy. However, we get most of our vitamin D from the sun, to get enough we want to try to aim to get around 10 to 30 minutes, most days of the week.
Fibre and fluids
After surgery it is common to experience constipation, so it is important to start making sure you are getting enough water and fibre before you go in. The last thing you want when you’re already sore is to struggle going to the toilet. Ideally aim for at least 2L a day of water and try to include high quality fibre foods including vegetables, fruit, and wholegrains.
After the surgery
Immediately after the surgery you may experience side effects like nausea, vomiting, mild vaginal bleeding, mild pain at the site of the incision, soreness in the abdomen and changes in mood. You always want to take it easy after having surgery but here are a few tips on how you can ease the recovery process:
Sleep: Most likely you are going to be sleeping more than usual for the first week so make sure you have a comfortable place to rest where you have easy access to things like the remote, extra pillows and blankets.
Wear comfy clothes: For a while after your surgery all you might want to do is wear PJ’s and that is perfectly understandable. Most likely you will not want to wear anything with a tight waistband for at least a couple of days so make sure you have a pile of comfy clothes handy.
Stay hydrated: As we talked about before, the last thing you want to deal with after having your surgery is having trouble going to the toilet. We can make this easier on your body by making sure you get enough water and fibre into you before and after the surgery.
Eating a nutritious diet and drinking enough fluids: Continue to include rich sources of protein, vitamins A, C and D, zinc, iron, calcium, and fibre, and make sure you are eating enough. Seeing a women's health dietitian; endometriosis dietitian, can help you tailorise a food plan which includes the foods rich in these nutrients but are the foods you like to eat.
Stay active but give yourself time to rest: While yes you need time to rest, you should also try to get up and move a little bit within 24 hours of your surgery if you are up to it. Simply walking around the house is enough. In no way are you expected to be walking long distances while you’re still healing. Make sure you stay where you are comfortable.
Don’t be discouraged: It is important to remember that everybody’s body is different and heals differently. So, let your body tell you what feels right. If you are tired or in pain, make sure you rest, even if your brain is trying to tell you differently. It is okay to not do much at all for a couple of days while you are healing.
Follow wound care instructions: Make sure you follow any instructions from your doctor as to how to look after your body. Make sure it is kept clean and keep an eye on any signs of infection such as pain or inflammation. I can’t say this enough but please contact your doctor as soon as any complications arise even if they only seem minor.
Be kind to yourself: Healing from a surgery is never an easy process, and it is different for every person.
What else is there?
I think most people go into having a laparoscopy looking for answers whether that be why they are experiencing menstrual pain, pain with intercourse, pain with bowel movements or urination, excessive bleeding, infertility, or a wide range of other symptoms. Most people are also looking for a fix because who wants to experience any of those symptoms.
For some the laparoscopy won’t show a cause of the symptoms that they have probably been experiencing for years. And then they’re left with even more questions.
For those who do get the endo diagnosis, sadly, it doesn’t always fix everything.
Around 75% of people who are diagnosed with endometriosis are likely to need another laparoscopy only two years after their last. This is because the surgery only clears existing endometrial tissue rather than stopping the original growth or production of this tissue.
As I mentioned before we don’t yet know how to cure or stop the development of endometriosis, but we do know that nutrition and lifestyle changes can help with reducing inflammation, balancing hormones, and optimise gut and immune function. This can all help to manage your endo symptoms.
If you would like to learn more about how diet can help to support you with your
endometriosis diagnosis, then download my how do I eat for endometriosis e-book here.
The bottom line
There are so many factors that can contribute to one’s management of endo. Luckily, we are learning more and more about the role of food and nutrition when it comes to diseases like endometriosis.
Your endo nutrition journey starts before you even go in for your laparoscopy, because we need to give your body enough time to build up its nutrient stores to give it all of the tools it needs to help you heal quickly. Make an appointment with us, Nicole Barber Dietetics, to help tailorise your nutrition prior to the surgery, and then beyond.
As always, our team at Nicole Barber Dietetics are always here to help, so please don’t hesitate to reach out with any of this.
This Blog was written by Accredited Practicing Dietitian Makayla Zok.