How do I know I have a digestive problem?

Signs and Symptoms of a Digestive Problem

I'm going to assume you're reading this because you either think or know you have a digestive problem. If this is in fact the case I want to start off by saying, I'm sorry because I know first hand how much it sucks to have undiagnosed digestive symptoms.

Let’s start by identifying some common symptoms:

1. Acid reflux or heartburn

2. Trouble swallowing, feeling like there is a lump in your throat, or like your throat is tight

3. Dyspepsia (pain in the upper portion of your abdomen, through your chest and even your back)

4. Nausea and vomiting

5. Burping

6. Bloating or distention

7. Constipation (bowel movements (BMs) that happen infrequently, cause straining, or feeling like the BM was not complete)

8. Diarrhea

There are also some signs beyond typical textbook symptoms that can bring just as much chaos to your life:

1. Feeling like everything you eat causes symptoms

2. Anxiety over deciding what to eat

3. Avoiding eating whole food groups, skipping meals, or going an entire day without eating due to fear of symptoms

You could be experiencing 1 or all of these symptoms plus more depending on what’s causing them. Beyond common symptoms, there are some red flags that generally warrant a trip to see your doctor:

1. Bright blood in your stool, or black stool

2. Family history of inflammatory bowel disease or colorectal cancer

3. Symptoms frequently occuring at night

4. Symptoms first starting after the age of 50

5. Unexplained weight loss

What Causes Digestion Problems?

This is a big and complicated question. There are a lot of different factors that can cause a digestive problem. First, it depends on what the problem is. The cause is easier to uncover when we have a diagnosis, usually. So, do you have a disease, disorder, intolerance, or something else. Second, there are a few main categories of causes that can all factor into a digestive problem:

1. Genetics

2. Food Intolerance (lactose, fructans/fructose, gluten, etc.)

3. Lifestyle (diet, movement, sleep, and stress)

4. Mental health (trauma, anxiety, depression, eating disorder)

5. Medication

6. Infection (past and present)

7. Other diagnosed disease

What really makes this question complicated is that the root cause of a digestive problem is highly individual. This means that what may cause your digestive problem can be vastly different compared to someone else who has similar symptoms. The best way to uncover the cause of your digestive issues, regardless of what they are, is to work with the right healthcare provider or team of healthcare providers. This would likely include your main provider (physician, nurse practitioner, etc.), and possibly a dietitian, therapist or counselor, specialist physician (gastroenterologist for example), and wellness practitioners.

Now not everyone will need a team of providers, but involving some kind of healthcare provider who is willing to support you is going to greatly increase your chances of figuring out what is going on, why, and what to do about it.

If after reading this you’re now thinking, “I’ve already seen X amount of healthcare providers/wellness practitioners and no one can tell me what the %*$@ is wrong with me”, I get it. Not only have I been in your shoes but I see clients all the time who tell me that they have spent the last 1-10 years trying to understand their symptoms and triggers. Unfortunately, digestive issues can be extremely complicated and take time and a lot of determination to get a handle on, which is why I’m here writing this blog.

Here are a few causes of gastrointestinal conditions or digestive symptoms that you may not have considered:

1. Mental Illness

Although I have mentioned mental illness already in this blog, it is important to discuss in further detail because it is such a common cause for FGIDs and IBD that many people don’t consider. Anxiety, depression, and eating disorders are all common causes of both gastrointestinal conditions and undiagnosed symptoms.

2. Traumatic Events

I have had a lot of clients who’s digestive symptoms started right after they experienced a traumatic event or a period of excessive stress. This may be an accident, loss of a family member, abusive relationship, sudden and traumatic illness or experience in the hospital, and many other situations.

3. Previous Infection(s)

If you experienced some kind of gastrointestinal infection or have a history of them, this could be the cause of your digestive symptoms, especially if you have been diagnosed with a functional gastrointestinal disorder like IBS.

4. Genetics

If you have lots of family members who also experience digestive symptoms or have a diagnosed gastrointestinal condition there is a good chance that your genetics play a big part in the cause of your symptoms.

Figuring out the root cause of your symptoms or condition is difficult but important as it can indicate what kind of treatment will be the most beneficial to you long-term.

Different Diseases of the Gastrointestinal (GI) Tract

Now that we are currently overwhelmed by the amount of potential causes there are for your digestive issues, let's move on to some common diseases of the GI tract.

1. Gastroesophageal Reflux Disease (GERD)

GERD is defined by chronic heartburn and regurgitation of stomach contents that causes damage to the lining of the esophagus. Lifestyle changes are often the first line treatment for GERD including weight loss. I personally do not support medical or alternative wellness providers recommending or “prescribing” weight loss as there are always alternative forms of treatment available. Regardless of the preferred treatment, if GERD is left untreated it can cause serious complications including increasing the risk for esophageal cancer. The goal for treatment is symptom relief and reducing the risk for complications.

2. Inflammatory Bowel Disease (IBD)

IBD is a chronic disease that causes episodic inflammation of the GI tract. The two main forms of IBD are Crohn’s disease and ulcerative colitis. Although we do not know specifically what causes IBD, it is likely that environmental and dietary factors are the main culprits. The goal for treating IBD is to increase the remission length, or the time between flare-ups.

3. Functional Gastrointestinal Disorders (FGIDs)

FGID is an umbrella term for 33 different (adult) disorders of the GI tract, including IBS. Although FGIDs are chronic conditions they aren’t considered diseases as they can’t be identified using traditional diagnostic tests and have no discernible pathology (development). What we do know is that they are generally caused due to alterations in the gut-brain axis. Treatment goals for FGIDs normally revolve around symptom relief.

4. Peptic Ulcer Disease (PUD)

PUD is defined by open wounds (ulcers) that are most commonly found on the lining of the stomach or first segment of the small intestine (the duodenum). The ulcers form due to the thinning of the protective outer layer of the upper GI tract and/or decrease in other physiological defenses. This leaves the tissue below the protective coating bare and susceptible to stomach acid and digestive enzymes. There are several common causes for PUD: stress, H. pylori infection, chronic or excessive use of NSAIDs (ibuprofen, naproxen, etc.), smoking, and alcohol intake to name a few. The goal for treatment is to relieve symptoms, heal and prevent future ulcers, and reduce risk for complications.

5. Celiac Disease

Celiac disease is characterized by inflammation of the small intestine due to gluten intake. As the inflammation increases the intestines are no longer able to absorb essential nutrients leading to further issues and potentially serious complications. The cause of Celiac disease isn’t well understood but it is clear that there is a genetic component. Although Celiac disease is not curable, there is an extremely effective treatment, a gluten-free diet.

6. Diverticular Disease

Diverticular disease is the recurring infection or inflammation of diverticula. Diverticula are small pockets that form most commonly in the large intestine around middle age. Although the presence of diverticula are common and normal, these pouches becoming infected are not and can in some cases require surgery. It is possible to help prevent diverticular disease through lifestyle change, but once established the goal for treatment is to reduce the chances of infection.

Although many of these diseases/disorders are common in the western world, there are other possible digestive issues. Even though food intolerances or sensitivities are not as medically serious as the diseases discussed above, they can still greatly reduce your quality of life. And, even if you’ve had every diagnostic test under the sun and have been told there is no sign of disease you still deserve help from medical or alternative wellness providers and relief from your symptoms.

Do I need to “clean out” my Digestive System?

If you are interested in digestive health, it’s likely you’ve seen ads, blogs, social media posts, etc. concerning some sort of method to “clean out”, “renew”, “restart”, “detox”, or “cleanse” your digestive tract. The methods vary from diet plans, recipes, supplements, invasive procedures, or teas and they generally state that cleaning out your colon and starting fresh is the quickest fix for your digestive symptoms and to improve your gut health along with a myriad of other benefits. But is it a good idea?

Here’s the issue with detoxes and cleanses, both commercially made or homemade ones, there is no scientific evidence that shows they have a benefit to our health. Homemade detoxes or cleanses that contain ingredients common to most households are at least more likely to be safe (but that’s not a guarantee) but you need to be careful when buying products meant to detoxify or act as a cleanse. The main reason these products are so popular is not because they work but due to the fact that they make those who are selling them a lot of money.

Despite the fact that there is no scientific evidence to show that they provide a health benefit, there is evidence to show that they may cause harm. Depending on the product, recipe, diet plan, or procedure there are a variety of potential risks:

1. Malnutrition

2. Irritation of the esophagus or stomach

3. Digestive distress (giving yourself explosive diarrhea is generally not a benefit to your digestive health)

4. Intestinal perforation

5. Liver damage

It’s important to think critically when deciding on whether to do any kind of detox or cleanse, ask yourself:

1. Why do I really want to do this?

2. Are the symptoms they describe, that are supposedly caused by these toxins, specific or could they apply to literally anyone (poor complexion, fatigue, bloating, etc.)?

3. Do they provide sources or evidence for what they are claiming (customer testimonials don’t count as evidence)?

4. Is the monetary cost and potential risks really worth the possible benefits?

Fixing Poor Digestion

There is a lot you can do in order to improve your digestion. What may work for you will depend on a few things: what the problem is (disease, disorder, intolerance, etc.), your symptoms, the root cause, what treatments you’ve already tried, your history with dieting or an eating disorder, if you’re open to alternative treatments, and your budget. All of these things that I’ve listed matter when you are considering what treatment path to go down.

Some options for treatment include:

1. Dietary changes (avoiding trigger foods, elimination diet, changing amount or type of dietary fibre, including functional foods, etc.)

2. Joyful movement (moving your body, or exercise, in a way that you truly enjoy)

3. Improving your relationship with food and your body

4. Seeking treatment for mental illness

5. Hypnotherapy

6. Herbal treatment

7. Medication or supplements

8. Acupuncture

9. Yoga or breathing techniques

10. Surgery

11. Abdominal message

12. Managing stress

13. Improving sleep

Regardless of what treatment(s) you may pursue, I suggest seeking out the proper healthcare provider or wellness practitioner who can support you with individualized treatment and advice. This means not just finding someone who is technically qualified but who supports your goals and autonomy.