"As surgeons and doctors, we want to remove lesions. But people's pain persists more often than we like to report," says Amira Quevedo, an obstetrician-gynaecologist who runs endometriosis clinical trials at the University of Florida in Gainesville.
The persistence of pain after the original stimuli have subsided or been removed is a key feature of many kinds of chronic pain. In some whole-body pain conditions, such as fibromyalgia, there is no clear cause.
At least in the case of endometriosis, that relief is often found in switching diets. The foods people eat can rapidly alter the vast collection of microbes that reside in the intestine, in turn releasing chemicals that either drive or dampen pain.
Observations that people with chronic pain have different mixes of microbes in their gut from other individuals have also given rise to the idea that manipulating this gut microbiome - through diet or other means - might help.
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