Estrogen causing digestive problems after gastric surgery?

Are you having digestive problems after gastric surgery? Estrogen could be the culprit. You see, certain levels of estrogen can cause digestive problems. And fluctuating levels of estrogen are very common after gastric surgery.

Not to mention, the average age for bariatric surgery is 40-45 year old females. Ironically, the same age that peri-menopause can start for many females. The season of life where fluctuating estrogen and progesterone levels begin.

More specifically, when it comes to digestive problems this would include

Constipation
Diarrhea
Abdominal pain
Bloating
Gas

So let’s dig into estrogen and its connection to digestive problems after gastric surgery.

Important estrogen facts

First off, estrogen is a group of hormones that play an important role in the normal sexual and reproductive development in women. They are also sex hormones. In fact, the woman’s ovaries make most estrogen hormones, although the adrenal glands and fat cells also make small amounts of estrogen too.

In addition to regulating the menstrual cycle, estrogen affects the reproductive & urinary tract, heart & blood vessels, bones, breasts, skin, hair, mucous membranes, pelvic muscles and the brain. But studies also show there is a connection between ovarian hormones(estrogen and progesterone) and digestive problems around the time of menses and early menopause.

Estrogen and digestive problems

This has been recognized for quite some time. As in this study from 1998 found that “Peri and postmenopausal women have a high prevalence of altered bowel function and IBS-like gastrointestinal complaints that should be carefully assessed.”

A study published in 2012 “Do fluctuations in ovarian hormones affect gastrointestinal symptoms in women with irritable bowel syndrome”. They found the increase in digestive problems around the time of menses and early menopause occurs at times of declining or low ovarian hormones, suggesting that estrogen and progesterone withdrawal may contribute either directly or indirectly.

Then by 2013 “Estrogen rather than progesterone cause constipation in both female and male mice”. Although an animal study may not be 100% equivalent to humans, it’s controlled information.

Now, fast forward a few years. And a 2020 study found that postmenopausal females with IBS experience more severe digestive problems than premenopausal women with IBS. In fact, they concluded that the modulatory effect of female sex hormones on brain-gut interactions which affect visceral perception and GI function likely contributes to these findings. Lastly, study published in 2019 found that estrogen can affect GI motility and sensitivity. But what do we know about after bariatric surgery?

Estrogen after gastric surgery

A study published in 2017 ”Effect of bariatric surgery on sexual function and sex hormone levels in obese patients: A meta-analysis”. They report the levels of estrogen were significantly decreased in female bariatric surgery patients. But let’s be honest, there are so many moving pieces with a woman’s body. And just because bariatric surgery may “lower” estrogen levels doesn’t mean it’s actually low. So let’s discuss how to improve digestive problems to support a healthy estrogen metabolism.

Improve digestive problems to support a healthy estrogen metabolism

Let’s face it, estrogen levels are all very individual. In fact, your genetics, detoxification, methylation, alcohol consumption, environmental toxins and nutrient deficiencies can influence your estrogen level. But there are things you can do to improve digestive problems that can also support a healthy estrogen metabolism.

These include..

Optimize your gut health
Focus on diet quality

Optimize gut health to improve estrogen metabolism & digestive problems

At no surprise, gut imbalances are directly correlated to digestive problems AND estrogen metabolism. You see, as explained in this study. The gut microbiota regulate estrogen through the secretion of beta-glucuronidase. An enzyme that deconjugates estrogens into their active forms. To further clarify, your liver packages up estrogen during phase 2 detoxification. Then phase 3 detoxification excretes it. This is by binding to bile and going out in your poop, as well as through your urine from your kidneys. As well as through sweat from your skin.

But, high levels of fecal beta-glucuronidase can indicate unfavorable metabolic changes in the colon. It may indicate dysbiosis and interference with phase 2 detoxification. This typically indicates problems with detoxifying estrogen. Not to mention, high levels of beta-glucuronidase is associated with an increased cancer risk.

This is where measuring beta-glucuronidase in a stool test can be helpful to identify elevated levels. So the best thing you can do is correct dysbiosis. To clarify, having gut dysbiosis can show up as constipation, diarrhea, abdominal pain, bloating and gas. Aka…digestive problems.

The cool thing is you can work on restoring gut imbalances while focusing on improving diet quality.

Why diet quality matters for digestive problems and estrogen

You see, diet quality matters when it comes to digestive problems and estrogen. But, it can be a little tricky and require working with a provider like myself who can help you restore gut balance too. Technically, if you have gut dysbiosis you may struggle to tolerate the appropriate foods that can support healthy estrogen metabolism. To further explain, to support healthy estrogen metabolism you NEED FIBER!! But guess what increases digestive problems?

You guessed it…Fiber!. You see, fiber from flaxseeds, whole grains, beans, and seeds bind unconjugated estrogens in the digestive tract. Additionally, fiber will favorably influence intestinal bacterial balance reducing beta-glucuronidase activity. Not to mention, taking probiotics with prebiotics combined with adequate fiber inhibit beta-glucuronidase.

Furthermore, there are additional foods that can improve estrogen metabolism AND optimize short-chain fatty acid production improving gut health.

These include…

Cruciferous vegetables(broccoli, cauliflower, Brussels sprouts, kale, etc)
Broccoli sprouts
Turmeric
Green tea
Rosemary

You see cruciferous vegetables have a compound indole-3-carbinol(I3C) that when in presence of adequate stomach acid converts the I3C to Di-indole-methane(DIM). DIM removes estrogen from circulation. So when an individual is experiencing elevated estrogen levels DIM can be helpful. However, it will likely take between 3-4 cups of these vegetables daily to help maintain this. Additionally, if your estrogen level is low you might want to consider broccoli sprouts instead.

Broccoli sprouts contain the compound sulforaphane. This is great to use if your estrogen levels are normal or low. And removing estrogen from circulation isn’t warranted. The good news is, even if you have digestive issues you can still meet your fiber needs while restoring gut imbalances. This is where following a Low FODMAP diet for a period of time can be helpful. You can learn more about FODMAPs in this post, as well as this one. This is why it’s so important to work with a provider who can address estrogen and digestive problems together.

Conclusion

As you can see, digestive problems can be influenced by estrogen. Understanding that estrogen impacts GI motility can be helpful as you navigate through your digestive problems. Even though genetics, detoxification and methylation make estrogen levels very individual. Focusing on optimizing your gut health and diet quality can support healthy estrogen metabolism and correct your digestive problems.