6: Why Bloating Isn’t Always Gut Problem: Pelvic Venous Congestion in Women

Team Gut Girls Hosts - Dr. Christina Carew, ND, Dr. Dominque Vanier, ND and Dr. Whitney Baxter, ND discuss how chronic bloating, heaviness, pressure, constipation, and pelvic pain may be caused by pelvic venous disorders (pelvic venous congestion/insufficiency) rather than the gut, and note it is under-diagnosed, often mislabeled as IBS, and is the second leading cause of pelvic pain lasting over six months after endometriosis, with frequent comorbidity. They explain how pelvic congestion creates blood pooling and pressure (“traffic jam”) that can worsen with standing/sitting, end of day, menstruation, ovulation, pregnancy, and sex, and may include urinary urgency without infection, painful bladder fullness, hemorrhoids, visible pelvic/leg veins, swelling (often left-sided), fatigue, and relief when lying down or with compression. Risk factors mentioned include pregnancy, ages 25–40, hypermobility, POTS/orthostatic intolerance, and possible increases post-COVID/vaccination. Diagnosis may involve ultrasound, pelvic MRI, venography, and referral to interventional radiology; treatment can include stenting or trial injections.