Dr. Mark Noar explores the surprising connection between endometriosis and chronic digestive issues like reflux, bloating, and constipation. He explains how endometriosis disrupts gut motility and mimics conditions like GERD and IBS. Highlighting the groundbreaking Endosure test, Dr. Noar offers hope through early, non-invasive diagnosis that can finally explain mysterious reflux symptoms in women.
Understanding Endometriosis and Tier One Diagnostics
Josef Kreitmayer
Hello and welcome to another session of the Reflux Summit. Today I’m joined by Dr. Mark Noar. We’re doing a series of short segments, and this first one is about endometriosis—an often misunderstood condition that also affects gut health. Before we dive into the diagnostic instrument Dr. Noar developed, let me introduce him.
Dr. Mark Noar
Thanks, Josef. It’s a pleasure to be with you again.
Josef Kreitmayer
Dr. Mark Noar is a gastroenterologist and inventor, best known for his work with the minimally invasive Strata procedure for GERD and LPR. He’s also a pioneer in reflux care and now in the diagnosis of endometriosis, having developed the first tier one diagnostic test for the condition. Mark, can you explain what a tier one test is?
Dr. Mark Noar
A tier one diagnostic is a test that’s simple, fast, affordable, and easy to access. Without these tests, doctors often treat empirically, which leads to confusion about what’s actually being treated.
For example, if someone has multiple symptoms and improves after treatment, you still don’t know what caused the improvement.
Endometriosis never had a tier one test—until now. That’s why it’s been so misunderstood and mistreated for decades.
What Are Endometriosis and Adenomyosis?
Josef Kreitmayer
Can you explain what endometriosis is—and also adenomyosis?
Dr. Mark Noar
The most common symptoms are painful periods, heavy bleeding, and pain during ovulation. What’s less known is that 96% of people with endometriosis also have bowel symptoms.
These include reflux, bloating, fullness, constipation, diarrhea, pain with bowel movements, and even bleeding during urination.
Endometriosis occurs when the endometrial lining of the uterus implants outside the uterus—on the bowel, bladder, or other organs.
Adenomyosis is when this tissue grows into the muscle wall of the uterus. Both conditions can severely disrupt gut function and mimic GI disorders.
Diagnostic Methods and the Challenge of Superficial Disease
Josef Kreitmayer
Your test is non-invasive. That’s a major shift, right?
Dr. Mark Noar
Exactly. Surgery is no longer the first line, but imaging like ultrasound and MRI often miss superficial disease—the most common form.
Endometriosis is classified as superficial, ovarian, or deep infiltrating. Superficial disease can exist anywhere—even in the lungs or brain—and is extremely difficult to detect with imaging.
The Endosure test detects superficial disease, which makes it a breakthrough.
Progression and the “Rule of 30s”
Josef Kreitmayer
Does endometriosis progress over time?
Dr. Mark Noar
It can. We often describe it with the “rule of 30s.”
About 30% resolve spontaneously.
About 30% progress.
About 30% stay the same.You can’t predict which group someone falls into. Symptoms don’t always match disease severity, which makes diagnosis even harder.
Causes and Immunologic Mechanisms
Josef Kreitmayer
What causes endometriosis?
Dr. Mark Noar
The main theory is retrograde menstruation, where menstrual blood flows backward into the pelvis.
Some people are also born with misplaced cells due to fetal hormone exposure. These cells may remain dormant until triggered by inflammation.
Immune dysfunction plays a huge role. Endometriosis cells express CD47 receptors, which tell the immune system, “Don’t attack me.”
As a result, these cells survive, implant, and create chronic inflammation.
Pacemaker Cells, Gut Contractions, and the Endosure Test
Josef Kreitmayer
You mentioned gut contractions are part of the diagnosis?
Dr. Mark Noar
Yes. The gut is regulated by pacemaker cells called ICCs. These same cells exist in the uterus and fallopian tubes.
Endometriosis produces two prostaglandins:
– F2 alpha, which causes painful, spastic contractions
– PGE2, which supports normal movementThe imbalance creates a chaotic contraction pattern that’s easy to detect.
Our device measures contraction frequencies that are unique to endometriosis, allowing us to detect presence, severity, and progression.
Visual Data, Genetic Patterns, and Device Features
Dr. Mark Noar
We compared contraction patterns in women with and without endometriosis and found dramatic differences.
Even more fascinating—the contraction “fingerprints” appear genetic. Mothers and daughters often share identical patterns.
The device is simple to use:
– Fast for 6–8 hours
– Drink water until full
– Relax for 30 minutes
– Press a buttonResults are immediate.
Early Onset, Impact, and Cost to Society
Josef Kreitmayer
When does endometriosis usually begin?
Dr. Mark Noar
Typically within one to two years after menstruation begins.
The economic impact is massive—$26 billion annually in medical costs in the U.S. and $55 billion in lost productivity.
Diagnosis currently takes an average of 8.6 years.
Our test reduces that to 30 minutes.
Symptoms and Gut Involvement
Josef Kreitmayer
Many patients present with gut symptoms first, right?
Dr. Mark Noar
Exactly. Very few present with textbook gynecologic symptoms.
Most present with bloating, cramping, reflux, and post-meal discomfort.
Many are misdiagnosed with IBS or IBD.
With this test, we can redirect patients to the correct specialist immediately.
Is Endometriosis a Modern Disease?
Josef Kreitmayer
Is this a modern disease, like reflux?
Dr. Mark Noar
No. It’s been documented for over 600 years.
Historically, women were dismissed as hysterical. Even today, many are told their pain is normal.
That narrative must change.
Effects on Digestion and Reflux
Josef Kreitmayer
How does endometriosis affect digestion?
Dr. Mark Noar
It causes small bowel stasis, slowing motility.
This leads to SIBO, microbiome disruption, and increased reflux risk.
It’s one reason women experience gut issues more frequently than men.
A New Era in Diagnosis and Accessibility
Josef Kreitmayer
Is the device available globally?
Dr. Mark Noar
It’s available in Canada, Mexico, the UK, Israel, and the Middle East.
The EU and Australia are next, followed by the U.S.
The vision is home testing—like a pregnancy test—with cloud-based results patients can bring to their doctors.
That would completely change access and equity.
Ongoing Treatment and Monitoring
Josef Kreitmayer
Is treatment ongoing?
Dr. Mark Noar
It depends. Pregnancy, hormones, or medication can suppress the disease.
The breakthrough is monitoring. You can test before treatment, during treatment, and afterward to see what’s working.
Final Thoughts and Call to Action
Josef Kreitmayer
Any final message?
Dr. Mark Noar
Yes. This test empowers women.
In 30 minutes, you can know whether you have endometriosis.
Don’t let anyone tell you the pain is normal or all in your head.
Ask for the test. Share the information. This can change lives.
Josef Kreitmayer
Thank you so much, Mark. Below this video, you’ll find more information and resources. Stay tuned for future sessions.
Dr. Mark Noar
Thank you very much.
