Trial Evaluating Nutritional Fiber in Digestive Symptoms of Endometriosis

Inclusion Criteria

• Confirmed diagnosis of endometriosis (by imaging, laparoscopy, or physician clinical assessment).
• Enriched gastrointestinal phenotype: self-reported gastrointestinal symptoms on at least 3 days per week for the preceding 3 months, including at least one of bloating, constipation, or abdominal discomfort
• Predominantly Bristol Stool Scale Type 1-3 (constipation-predominant), or self-reported bloating as a dominant symptom.
• Stable hormonal status: either no hormonal therapy, or stable hormonal therapy (combined oral contraceptive, progestin, or GnRH analogue) for at least 3 months with no planned change during the study.
• Estimated habitual dietary fiber intake below 25 g/day based
• Willingness to share menstrual cycle data.
• Willing to maintain stable diet, physical activity, and medication regimens throughout the study.
• Able to provide electronic informed consent and to comply with stool and vaginal self-sampling procedures.
• Ownership and consistent use of a home body-weight scale for the duration of the study, to support the standardized at-home morning weighing protocol.

Exclusion Criteria

• Inflammatory bowel disease (Crohn's disease, ulcerative colitis), celiac disease, or other organic gastrointestinal disease.
• Severe irritable bowel syndrome (IBS) requiring active pharmacological management. Mild-to-moderate overlap is permitted as part of the enrichment strategy.
• Antibiotic use within 8 weeks prior to baseline or anticipated during the study.
• Probiotic, prebiotic, or fiber supplement use within 4 weeks prior to baseline (washout required).
• Major gastrointestinal surgery, excluding appendectomy or cholecystectomy more than 6 months prior, and excluding surgical intervention for endometriosis.
• Current pregnancy, breastfeeding, or plans to conceive during the study.
• Severe constipation requiring regular prescription laxatives.
• Significant renal, hepatic, cardiac, or endocrine disease.
• Active malignancy.
• Known allergy or intolerance to any LOAM fiber component.
• Significant dietary change or weight-loss intervention within the preceding 3 months.
• Use of medications known to significantly alter gut motility or the microbiome (for example, recent metformin initiation, regular opioid use, or chronic proton-pump inhibitor use), per investigator judgment.
• Any surgical intervention for endometriosis (including laparoscopy, laparotomy, or endometrioma excision) within the 6 months prior to screening, as post-surgical physiological changes may confound symptom and biomarker assessments.