Uterine fibroids, or leiomyomas, are non-cancerous growths that develop in the muscular wall of the uterus. They are extremely common, affecting an estimated 40% to 80% of women by age 50. While many women remain asymptomatic, others experience issues like heavy menstrual bleeding and pelvic pressure. Fibroids do not directly cause indigestion through chemical means. However, their size and location can lead to physical compression of digestive organs, mimicking or causing symptoms of indigestion.
Understanding Uterine Fibroids
Fibroids are composed of smooth muscle cells and fibrous connective tissue. Their size varies dramatically, from microscopic seedlings to masses that can fill the entire abdominal cavity. The location of the fibroids is a key factor in determining the type and severity of symptoms experienced.
Fibroids are classified based on their position within or on the uterus. Intramural fibroids grow within the uterine wall, submucosal fibroids protrude into the uterine cavity, and subserosal fibroids develop on the outside surface. Subserosal fibroids that grow outward toward the abdominal or pelvic cavity are the most likely to exert pressure on adjacent organs.
The Mechanical Link to Indigestion
The connection between uterine fibroids and indigestion, which encompasses upper gastrointestinal symptoms like heartburn or fullness, is purely mechanical. When fibroids grow very large or numerous, they can displace or compress nearby structures. Because the uterus sits low in the pelvis, only extremely large fibroids extending into the upper abdomen typically affect the stomach or small intestine.
This physical pressure can lead to early satiety, the feeling of being full after eating only a small amount of food. Compression on the stomach reduces its capacity and alters its normal function, contributing to abdominal discomfort interpreted as indigestion. Pressure on the stomach and the lower esophageal sphincter can also contribute to symptoms resembling acid reflux or heartburn.
This mechanical interference, rather than a chemical change, is the primary reason for upper GI tract complaints in individuals with large fibroids. The symptoms are a result of physical crowding and displacement of the digestive organs.
Other Common Gastrointestinal Symptoms
While true indigestion relates to the upper digestive tract, large fibroids more frequently cause lower gastrointestinal symptoms. The uterus is situated close to the colon and rectum, making these organs susceptible to compression. When a fibroid grows toward the back of the pelvis, it can press on the colon or rectum, interfering with stool passage.
This pressure is a common cause of chronic constipation in individuals with large subserosal fibroids. The bulk of the fibroids can also cause abdominal distention and a chronic feeling of bloating or heaviness in the lower abdomen. Fibroids can also indirectly affect bowel habits, as heavy menstrual bleeding often leads to iron supplementation, which can cause constipation.
The pressure symptoms are not limited to the digestive system. Fibroids can also displace the bladder, which sits in front of the uterus. This often leads to frequent urination or the urgent need to urinate, even when the bladder is not full.
When to Consult a Healthcare Provider
Individuals experiencing persistent or worsening digestive symptoms, especially alongside heavy periods or pelvic pressure, should seek medical attention. A healthcare provider can determine if fibroids are the cause and rule out other gastrointestinal conditions. Diagnosis typically begins with a pelvic examination, followed by an ultrasound. The ultrasound provides detailed images of the uterus, allowing the size, number, and location of any fibroids to be assessed.
For fibroids significantly impacting the quality of life, management options are available beyond observation. Medical treatments include hormonal medications to manage heavy bleeding. Minimally invasive procedures, such as Uterine Fibroid Embolization (UFE), cut off the blood supply to the fibroids, causing them to shrink. Surgical options range from a myomectomy, which removes only the fibroids, to a hysterectomy, which removes the entire uterus.