Do you experience regular digestive upset like bloating, gas, abdominal pain, irregular bowel movements, etc? While some of these symptoms will occur after eating certain foods for many individuals, consistent problems with a variety of foods may indicate a gastrointestinal disorder. Recognizing the difference between these conditions is crucial to getting the right diagnosis, treatment, and nutrition therapy.
It’s vital to find the root cause(s) for poor digestion and nutrient absorption to begin healing your gut and to rule out any diseases. This blog will briefly discuss common gastrointestinal (GI) symptoms and disorders to provide a greater understanding of digestive health.
I will also share my personal story about how I determined what my gut health issues were and how I manage digestive upset now with nutrition.
Causes of Digestive Upset & Common Gastrointestinal Disorders
Please note that this is not a comprehensive list of GI disorders, but some of the most common ones which share similar symptoms. I am not a doctor and this article is not intended as medical advice. If you suspect you have a GI disorder, contact your doctor and you may need a referral to a gastroenterologist. Don’t hesitate to advocate for yourself or seek out another doctor if they brush off your symptoms or concerns. For most of these diseases, you will want to work with a registered dietitian after diagnosis to ensure safe and proper treatment and management.
Celiac Disease
Celiac disease is an autoimmune disease that occurs in people who are genetically predisposed. It is estimated to affect 1 in 100 people worldwide, but only about 30% are properly diagnosed. Consuming gluten, which is found in wheat, barley, rye, and malt leads to damage of the villi in the small intestine. This can impact digestive enzyme production, nutrient absorption, and ability to tolerate certain foods. Symptoms of celiac disease include bloating, abdominal pain, diarrhea, nausea, fatigue, constipation, gas, weight loss, and/or lactose intolerance. Celiac disease can cause malabsorption of nutrients such as iron, B12, iodine, vitamin D and calcium. There is no cure for celiac disease. The only treatment for celiac disease is lifelong restriction of gluten-containing foods and avoidance of gluten cross-contamination. To learn more about it, how it is diagnosed, and dietary tips, check out my video on celiac disease.
Non-Celiac Gluten Sensitivity
Non-celiac gluten sensitivity (NCGS), also known as non-celiac wheat sensitivity or gluten intolerance, is similar to celiac disease, but without damage to the intestines. This is also different from a wheat allergy. NCGS is not an actual diagnosed disease at this time, and is often self-diagnosed. There are no biological markers or tests for gluten sensitivity/intolerance as there are in celiac disease. It is estimated that about 6% of the population may have non-celiac wheat sensitivity. However, there is still debate if gluten is the culprit or other components of wheat including high levels of fructans and amylase-trypsin inhibitors. This may also depend on the individual and which component they are sensitive to. Symptoms of digestive upset are similar to celiac disease when gluten is consumed. Digestive upset management is the same as celiac disease as well – complete restriction of gluten-containing foods if gluten is determined to be the problem.The best way to determine if you have NCGS is to rule out other diseases like those listed in this blog, and by working with a registered dietitian who specializes in gut health/GI disorders.
Irritable Bowel Syndrome
Irritable bowel syndrome (IBS) is a general term for a group of co-occurring symptoms related to changes in bowel habits with diarrhea, constipation, or a mix of both. It is estimated that 10-15% of the population may have IBS. The exact causes are unknown, but stress, anxiety, the nervous system, inflammation, food poisoning, and/or changes in the gut microbiome can play a role in the development of IBS. Symptoms include regular diarrhea or constipation, abdominal pain/cramping, bloating and/or gas relieved by bowel movements, accompanied by changes in the frequency or appearance of stools. There are no biological markers, damage to intestines, or gold standard for diagnosis. The intestines are often hypersensitive in individuals with IBS, and therefore a low-FODMAP diet (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) is a typical approach to managing symptoms. These carbohydrates are rapidly fermented in the gut, which contribute to gas, bloating and diarrhea. Other management techniques include increasing/decreasing fiber, use of laxatives, and adding low-to-moderate intensity exercise. A low-FODMAP diet should be done under the guidance of a registered dietitian due to its restrictive nature and systematic process.
Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) is a general term for two conditions that are characterized by areas of inflammation in the GI tract – Crohn’s disease and Ulcerative Colitis. It is estimated that 3 million adults in the United States are diagnosed with IBD. Ulcerative colitis affects the colon, while Crohn’s can occur at any point along the GI tract from the esophagus to the colon. Both Crohn’s and Colitis can be diagnosed by biological markers of inflammation and damage. Symptoms include bloody stools, diarrhea, weight loss, abdominal pain, and fatigue. IBD can cause malabsorption of nutrients such as fat, protein, iron, B12, vitamin A, D, K, calcium, zinc, and more. IBD tends to have periods of flare-ups and remission, and diet must be managed accordingly to reduce symptoms and discomfort. While medication is often the primary form of treatment by doctors, it is ideal to work with your doctor and a registered dietitian to manage this condition.
Small Intestinal Bacterial Overgrowth (SIBO)
SIBO is a condition when excessive numbers of bacteria move into the small intestine, causing uncomfortable GI symptoms and digestive upset. It is often caused by food poisoning or may be co-occurring with IBS, Sjogren’s syndrome, autoimmune conditions, antibiotics, endometriosis and more. Symptoms include bloating, belching, excessive gas, cramping/pain, diarrhea and/or brain “fog”. SIBO is diagnosed with a breath test and the typical treatment is a round of antibiotics. A low-FODMAP diet may be used for symptom relief.
Diverticulosis/Diverticulitis
Diverticulosis is when small pouches develop in your intestines. Diverticulitis is when these pouches become inflamed. It is estimated that about 50% of people over the age of 60 have diverticulosis. Exact cause is unknown, but it is associated with inadequate fiber intake. Inflammation, obesity, smoking, changes in the gut microbiome, and lack of exercise may play a role in development. Symptoms include abdominal pain, constipation, fever, nausea, vomiting, and changes in bowel habits. Increased fiber and fluids may help after a flare-up.
How to Know if You Have a GI Disease
One of the challenges with some of these GI diseases is that overlapping conditions can occur and digestive upset symptoms are similar, making diagnosis and management difficult. For instance, Celiac, IBD, and SIBO often present with IBS, or IBS may begin after the other diseases are in remission. Luckily, many of these can be well managed with a proper diet, though a doctor may prescribe pharmaceutical drugs if needed.
If you suspect you have a GI disorder, a doctor/gastroenterologist may start by ordering tests as well as biopsies if needed to rule out certain conditions like inflammatory bowel disease, Celiac disease, or colon cancer.
It is important to consult with a Registered Dietitian for proper nutrition therapy to manage and reduce symptoms to avoid malnutrition, nutrient deficiencies and other complications.
By understanding the differences between these diseases, individuals can take control of their health and work towards managing their symptoms through proper diagnosis, treatment, and nutrition therapy.
Note for Women: digestive upset will often become worse prior to your period or during your period. It is helpful to journal your symptoms to better understand causes and how the time of the month affects you.
My Digestive Upset & Gut Healing Story
I had digestive upset for years, such as bloating, abdominal pain/cramps, gas. I assumed it was normal for most of those years. When I got married, I became more aware of their severity when my issues no longer affected only myself. Before becoming a Registered Dietitian and fully understanding these issues, I tried to manage them with random digestive enzymes, probiotics, digestive bitters, essential oils, herbs, ginger, etc. These all helped temporarily but didn’t fix the underlying problem.
I learned about the 4 R’s of gut health and used this protocol to find my food triggers, which included gluten, eggs, lactose, and a few other foods like cashews. I also worked on healing my gut, and my symptoms pretty much disappeared. This entire process/protocol can be found in my Gut Health Guide. This process was instrumental in finding my root cause, but it was not the end for me. There were still some foods that bothered me, mostly healthy foods like certain fruits, vegetables and beans, and the connection was that they were all high in FODMAPs.
Very long story short, this led me down the path to a research deep-dive into irritable bowel syndrome (IBS) and was certified in IBS Management by the GI Institute. IBS is managed with a 3-step low-FODMAP diet process, as well as Celiac disease, which my father has. Due to issues with Celiac testing, I may never know with 100% accuracy that I don’t have it, but my lengthy process led me to the conclusion that I have a non-celiac gluten sensitivity. Since this is managed exactly like Celiac, an exact diagnosis isn’t necessarily critical.
Now that I know my food triggers and how much of certain foods I can eat without problems, I rarely have GI upset! And if I do, I can almost always pinpoint what caused it. I essentially manage my gut health as though I have Celiac disease and IBS and feel like a new person!
Get Help Managing your Digestive Upset
If you need help managing your gut health and digestive discomforts, please contact me for a free consult for nutrition coaching & support!
