Send us a text with a question or thought on this episode ( We cannot replay from this link)

What if your “IBS” isn’t just a gut problem—but part of a larger endometriosis story that involves nerves, immune triggers, and the way your body processes pain? We sit down with a neurogastroenterologist, Dr. Zachary Spiritos and  colorectal surgeon, Dr. Vincent Obias, to connect the dots between bowel endometriosis, mast cell activation, dysautonomia, and the stubborn symptoms that linger after surgery. No platitudes here—just clear explanations, candid timelines, and practical strategies that help you make sense of complex, overlapping conditions.

We explore how deep infiltrating endometriosis can change rectal compliance and bowel habits, why post-op bloating and urgency often follow colorectal procedures, and when those symptoms should improve. From the GI side, we challenge the “IBS” catch-all by listening for patterns—cyclical pain, flushing, migraines, brain fog, POTS—that point to mast cell activation or brain–gut dysregulation. You’ll hear how perioperative planning for MCAS (H1/H2 blockers, steroid rescue, anesthesia choices, fluids for POTS) reduces flares, and why excision by experienced teams beats ablation for long-term outcomes.

We also get real about the gray areas: normal tests with abnormal lives, “invisible” inflammation, and how hypermobility can complicate recovery. Expect concrete ideas—targeted imaging and ultrasound for bowel nodules, timelines for healing, SIBO and adhesions as culprits, pelvic floor retraining, sleep as a pain modulator, and GI-focused CBT or hypnosis to calm anticipatory anxiety. The big takeaway: better results come from better teams. When surgery, neuro-GI care, anesthesia planning, and pelvic rehab align, the gut, the nerves, and the person finally get on the same page.

If this conversation helped you see your symptoms in a new light, follow the show, share with a friend who needs answers, and leave a review with your top question for a future episode. Your story might guide our next deep dive.

Support the show

Website endobattery.com

Send us a text with a question or thought on this episode ( We cannot replay from this link)

We challenge the myth that teens are “too young” for endometriosis and show how to spot red flags that go far beyond “normal cramps.” Dr. Megan Wasson shares clear signs, family dynamics that normalize pain, and steps to get answers sooner.

• redefining normal: pain as more than an inconvenience
• family patterns that normalize severe period pain
• the pediatrician pitfall: quick dismissal without probing
• functional impact: missed school, sports, and social life
• pain outside bleeding days as a key clue
• GI symptoms that flare around menses
• practical steps: symptom tracking and focused questions
• when to escalate: specialists, imaging, and tailored care

Do you have more questions? Keep them coming. Send them in, and I'll bring you the expert answers. You can send them in by using the link in the top of the description of this podcast episode or by emailing [email protected] or visiting the Endobattery.com contact page

Support the show

Website endobattery.com

Send us a text with a question or thought on this episode ( We cannot replay from this link)

We explore the hard edges of parenting with endometriosis—pregnancy losses, grief, guilt, and the small wins that keep us going—and how those experiences drove us into advocacy that meets medicine where it starts: in classrooms. Along the way we talk kids’ questions, self‑grace, and building real community support.

• balancing parenting with chronic pain and fatigue
• pregnancy, miscarriage, and fear of recurrence
• children witnessing pain and asking about risk
• guilt, comparison, and redefining “good mom”
• individualized disease, individualized care
• post‑op healing, pacing, and self‑grace
• teaching kids to self‑advocate with doctors
• educating medical students to spot endo earlier
• outdated research vs evidence‑based care
• community support through Endofriend and campus outreach
• many paths to advocacy, from letters to events

Reach out if you have questions—I do get back to you

Support the show

Website endobattery.com

Send us a text with a question or thought on this episode ( We cannot replay from this link)

We trace Nikki’s 28-year path from a painful first period to an excision surgery that finally connected endometriosis, PCOS, and adenomyosis, and we talk about pregnancy losses, pelvic floor pain, and the power of community. We share practical tools that shorten the time from symptoms to care and turn experience into advocacy.

• early menarche, fainting episodes, heavy bleeding dismissed
• overlap of endometriosis, PCOS, and adenomyosis symptoms
• ablation versus excision and why technique matters
• recurrent miscarriage and weak explanations from clinicians
• gestational diabetes, metabolic health, and PCOS links
• postpartum return of pain and daily function challenges
• finding a specialist, surgical findings beyond reproductive organs
• pelvic floor physical therapy and nervous system retraining
• living well after hysterectomy with ovaries retained
• building community and educating medical students

Support the show

Website endobattery.com

Send us a text with a question or thought on this episode ( We cannot replay from this link)

Dr. Jeff Arrington explains why insurance is a major barrier for endometriosis specialists and patients seeking care. The healthcare payment system fundamentally fails to recognize the difference between quick, superficial treatments and proper excision surgery that actually removes the disease.

• Insurance payment systems are based on Relative Value Units (RVUs) set by Medicare
• The RVU system has three components: work involved, malpractice risk, and geographic location
• A superficial 15-minute ablation receives the same insurance payment as a 3-hour expert excision
• The system creates no financial incentive for surgeons to perform proper, thorough excision
• Complex work around sensitive structures like ureters and bowel is not recognized by insurance
• Skilled specialists often can't afford to accept insurance due to this payment inequality

Send your questions by using the link in the description, emailing [email protected], or visiting the Indobattery.com contact page.

Support the show

Website endobattery.com

Send us a text with a question or thought on this episode ( We cannot replay from this link)

Professor Horace Ramon shares groundbreaking insights on how surgery for colorectal endometriosis significantly improves fertility outcomes, even for patients who've experienced multiple failed IVF attempts. His research reveals that removing endometriotic lesions throughout the pelvis gives patients a better chance at natural conception by addressing multiple fertility barriers.

• Endometriosis acts "like smoke" that impairs fertility at every level - affecting egg quality, sperm mobility, and creating inflammatory conditions
• Cleaning the pelvis through surgery gives patients additional opportunities for natural conception
• Deep dyspareunia (painful intercourse) from rectovaginal nodules often reduces sexual frequency, especially during ovulation
• Pain reduction after surgery may indirectly improve conception rates by enabling more frequent intercourse during fertile windows
• The connection between inflammation and fertility explains why removing disease improves the body's reproductive function

Do you have more questions? Send them in by using the link in the description of this podcast episode, emailing [email protected], or visiting the endobattery.com contact page.

Support the show

Website endobattery.com

Send us a text with a question or thought on this episode ( We cannot replay from this link)

Dr. Naomi Whittaker shares critical distinctions between diffuse and focal adenomyosis and their impact on fertility. She highlights how adenomyosis is often over-diagnosed on ultrasound while explaining that diffuse adenomyosis rarely affects fertility, though focal adenomyomas require surgical intervention by fertility-friendly specialists.

• Diffuse adenomyosis is more common in women who have had children and typically doesn't impact fertility
• Adenomyosis is frequently over-diagnosed on ultrasound as technology improves
• Finding adenomyosis on imaging doesn't necessarily mean it's clinically significant 
• Focal adenomyosis (adenomyomas) can cause infertility but are surgically treatable
• Surgeon choice is critical for fertility preservation
• Concerning cases exist where fallopian tubes were removed without patient consent
• Important to choose fertility-friendly surgeons who handle tissue delicately

Send your questions by using the link in the top of the description of this podcast episode, by emailing [email protected], or by visiting the endobattery.com contact page.

Support the show

Website endobattery.com

Send us a text with a question or thought on this episode ( We cannot replay from this link)

Dr. Melissa McHale, a gynecologic surgeon specializing in minimally invasive endometriosis surgery, shares expert guidance on finding qualified surgeons for endometriosis treatment. She provides practical strategies for evaluating surgeon credentials, training backgrounds, and professional connections to ensure patients receive care from true specialists capable of performing complete excision surgery.

• Research where potential surgeons received their training and who specifically taught them endometriosis surgery techniques
• Ask direct questions about when endometriosis became their focus and how they developed their surgical skills
• Consider that most fellowship-trained gynecologists in the US aren't adequately trained in complete endometriosis excision
• Evaluate the surgeon's professional network—those who regularly associate with other endometriosis specialists likely stay current with best practices
• Look at both patient reviews and professional reputation among other physicians
• If you wouldn't trust their mentor to operate on you, question whether you should trust them

Have questions about finding the right endometriosis specialist? Send them in through the link in the episode description, email [email protected], or visit the endobattery.com contact page.

Support the show

Website endobattery.com

Send us a text with a question or thought on this episode ( We cannot replay from this link)

Dr. Canio Martinelli, OBGYN specialist and head of clinical programs at Sbarro Health Research Organization, discusses groundbreaking research on AI applications in medicine and surgical decision-making to improve patient outcomes.

• Research shows AI systems like ChatGPT perform comparably to resident physicians in diagnostic accuracy
• Human doctors and AI make different types of errors, suggesting they could complement each other
• AI maintains consistent performance under time pressure while human performance declines
• The "gray area dilemma" in surgery refers to critical decisions surgeons make based on incomplete information
• PULSAR study aims to decode surgical decision-making by analyzing billions of data points
• True personalized medicine must consider what "functionality" means to each individual patient
• Future AI systems could help surgeons tailor procedures to each patient's specific anatomy and goals
• Communication remains challenging when explaining complex medical concepts and statistics to patients

Use promo code ENDOBATTERY for an exclusive 20% discount at Strong Coffee Company and help support these expert conversations at EndoBattery.

Support the show

Website endobattery.com

Send us a text with a question or thought on this episode ( We cannot replay from this link)

Dr. Ramiro Cabrera explains how surgical mapping revolutionizes endometriosis treatment by allowing surgeons to visualize deep infiltrating disease before operating. This European-originated technique enables personalized surgical planning and proper specialist involvement, replacing outdated diagnostic approaches with comprehensive pre-surgical imaging.

• Endometriosis has three types: peritoneal (superficial), deep infiltrating, and ovarian endometriomas
• Only endometriomas are easily visible on standard ultrasound, while deep disease requires specialized imaging
• Surgical mapping uses special protocols including rectal gel, vaginal gel, and bowel preparation
• Expert radiologists need 5-10 years of experience to accurately detect deep endometriosis
• Modern ENZIAN classification provides detailed disease location instead of simple staging
• Mapping shows precisely which organs are affected and to what extent
• Pre-surgical knowledge allows assembly of the right surgical team (urologists, colorectal surgeons, etc.)
• Even the best surgeons cannot see through tissue without proper mapping
• No surgeon should perform diagnostic laparoscopy without first completing imaging mapping

Send your questions by using the link in the description, emailing [email protected], or visiting the endobattery.com contact page.

Be Prepared for anything with Prep Starts Now. Use code ENDOBATTERY and get 15% off
https://prepstartsnow.com/discount/ENDOBATTERY

For Sleek Comfort that's still Stylish, oh and did I mention Ecofriendly? Use Code ENDOBATTERY for an amazing 20% off your order on wearplayground.com

https://wearplayground.com/discount/ENDOBATTERY

Support the show

Website endobattery.com