10 Root Causes of Bladder Pain with Endometriosis This EndoLife

1.    Endometriosis on the bladder - If you have endo lesions on the bladder or infiltrating the bladder, these will be causing scar tissue, inflammation and irritation to the surrounding area, especially during menstruation when this tissue begins to shed. This inflammation causes pain as the body attempts to alert us of a threat (endo), but as our immune system is unable to ‘clean up’ the endo, the body continues to inflame the area and continues to send pain signals.
2.    Chronic inflammation - Inflammation can spread from one area in the pelvis to another over time, especially if the immune system is unable to clean up whatever is causing the threat. If endo is causing inflammation elsewhere in the pelvis and has done for some time, the inflammation and pain can spread as the nerves and surrounding tissue begin to get involved in the ‘alarm’ process.
Inflammation can also come from an inflammatory diet such as a diet rich in trans fats, sugar, processed foods and meat, and alcohol. It can also come from chronic low-lying infections, like an undiagnosed or treatment resistant UTI. Additionally, it can stem from blood sugar dysregulation.
Finally, it can also come from your gut. 70%-80% of your immune system lives in and around the gut and if you have a problem like undetected allergies, SIBO, etc., these can lead to leaky gut. Leaky gut occurs when the tight junctions in between the cells of your gut wall begin to open up and allow small food particles and bacteria to pass through. Your immune system and blood stream are sitting just on the other side of your gut wall, and so the immune system attacks these new ‘invaders’ creating an inflammatory reaction, which spreads throughout the body via the blood stream. The toxins release from SIBO and bad bacteria in the gut, can also leak through the leaky gut wall and into the pelvic cavity, creating localised inflammation.
3.    Small intestine bacterial overgrowth - Interstitial cystitis or at least IC symptoms have long been associated with SIBO, especially hydrogen sulphide type SIBO. This will most likely be in part due to the inflammation caused by SIBO, the toxins previously mentioned entering the pelvic cavity and histamine intolerance, which is often caused as a result of SIBO. 
However, research has also recently found that some of the key bacteria behind hydrogen sulphide type SIBO are also the same bacteria responsible for chronic UTIS, including Citrobacter, klebsiella, proteus and e-coli. This means that certain UTI treatments may also be effective for H2S SIBO and is currently being explored!
4.    Pelvic Floor Dysfunction - Your pelvic floor is like a complex bowl of nerves and muscles, which holds the bladder, vagina/uterus and colon. These nerves and muscles help to control bladder function and sensitivity.
Chronic pain, straining, tensing and pushing can cause the muscles to tighten and lock and the nerves to become hypersensitive This can cause sensitivity, pain and bladder dysfunction over time. 
5.    Histamines and oxalate sensitivity - Oxalates are a natural compound found in food. If we’re consuming too many oxalates or our body has trouble breaking them down, we may end up with crystal like particles in our bladder, which can of course cause irritation. 
Histamines can also be a problem. Research has shown that some patients with IC have higher levels of mast cells (the cells that release histamines) and histamines in the bladder, and we also know that endometriosis lesions contain higher levels of mast cells too. Additionally, we may have trouble breaking down and clearing histamines if our gut is compromised. We may also be making more histamines if we have excess oestrogen as oestrogen triggers the production of histamines, and a condition called Mast Cell Activation Syndrome also causes mast cells to be over-sensitive and produce too much histamine as well. 
Having too much histamine in our body can