Decoding Digestive Issues
Similar symptoms can make it tough to tell what’s wrong.
Gut disorders can be confounding. Are you sprinting to the bathroom because of something you ate, or is stress upsetting your stomach? Was that pain in your abdomen a gas bubble, or could you have an ulcer?
The first thing to keep in mind is that many digestive issues share the same initial symptoms. When there’s a problem in your gut, you’re likely to have one or more of the following:
- Excessive gas
- Bloating
- Constipation
- Diarrhea
- Nausea and vomiting
- Belly pain
- Incontinence
- Bleeding
- Trouble swallowing
The second thing to know is that your experience of these symptoms may be unique. Research has found that a surprising number of factors impact how vulnerable you are to digestive issues and how intensely you’re affected by them.
You may be more or less susceptible to — and impacted by — gut dysfunction, depending on your:
- Genetics
- Personality traits
- Mental health
- Cultural background
- Ability to manage stress
- Other health conditions
When talking to medical professionals about digestive issues, report your symptoms with confidence. If your concerns are dismissed or you’re treated as if you’re “overreacting,” you may benefit from seeing a gastroenterologist (GI), who will better understand the complexity of these conditions.
The Nitty Gritty Details
To help get an accurate diagnosis, be clear about the shape, consistency, and color of your stool, as well as how frequently you go. If you’re reluctant to paint a detailed picture of your poop, consider giving its consistency a number, based on the Bristol Stool Scale:
Bristol Stool Scale
Type 1: Separate hard lumps, like nuts (hard to pass)
Type 2: Sausage-shaped, but lumpy
Type 3: Like a sausage, but with cracks on its surface
Type 4: Like a sausage or snake — smooth and soft
Type 5: Soft blobs with clear-cut edges (passed easily)
Type 6: Fluffy pieces with ragged edges, a mushy stool
Type 7: Watery, not solid pieces — entirely liquid
Check for unusual coloring (that isn’t related to colorful foods like beets or blueberries), and report that, too.
- Stool that’s very light brown or gray may indicate a blockage between the liver and gut.
- Stool that’s black or red may contain blood.
Changes in color and consistency may or may not signal a problem, but clue in your doctor to help them make an informed assessment.
Treating Tummy Troubles
Helpful tips for common digestive issues.
The digestive issues highlighted below happen so often that they can seem like no big deal. And if tummy troubles are short-lived and due to an obvious cause (diarrhea after eating bad seafood or constipation after a long day of travel), they may easily resolve with rest and plenty of water.
But if these conditions persist, are unexplained, or accompany worrisome symptoms like abdominal pain or bloody stool, it’s best to see your primary care provider (PCP) as soon as possible, since they can sometimes be linked to a more serious condition.
Constipation
What it is: Bowel movements are difficult and infrequent — one common criteria is fewer than 3 bowel movements per week.
Possible causes: Too little fiber (from vegetables, fruits, or whole grains) and/or water, certain medications, traveling, or other shifts in routine. In rare cases, a serious bowel blockage may be to blame.
Treatment options: Some of the safest treatments are bulk-forming laxatives (for example, Citrucel™ and Metamucil™) and osmotic laxatives (for example GlycoLax™ and MiraLax™), which draw water into stool and help it move through the digestive tract. (People with kidney problems should avoid osmotic laxatives that contain magnesium and phosphate.)
Prevention tips:
- Drink plenty of water.
- Eat naturally high-fiber produce and whole grains.
- Engage in light activity after meals.
- Go to the bathroom when you need to instead of “holding it.”
- Make a daily trip the bathroom 15-45 minutes after breakfast.
- Prop your feet up on a stepstool and lean forward on the toilet for easier elimination.
Diarrhea
What it is: Having 3 or more loose, watery bowel movements in a day.
Possible causes: Viral or bacterial infections, food allergies and intolerances, artificial sweeteners, caffeine, certain medications.
Treatment: Drink water and broth to replace lost fluids and sodium. Over-the-counter anti-diarrheal medications can provide some relief. That said, they should be avoided if you have a fever or bloody diarrhea.
See your PCP if diarrhea lasts longer than 2 days and/or stool contains blood or pus, you have a fever, severe abdominal pain, or signs of dehydration — dark-colored urine, dry skin, fatigue, dizziness.
Prevention tips:
- Take care to eat food that’s safely prepared and stored.
- Limit drinks and foods that contain caffeine or artificial sweeteners.
- Ask your PCP or pharmacist if medications you use may cause diarrhea.
- Take antibiotics only when necessary and prescribed by your PCP.
- Drink filtered or bottled water when traveling abroad.
Acid Reflux & GERD
What it is: Acidic stomach contents back up into your esophagus. This can cause a burning feeling in your throat, chest, or upper abdomen (aka “heartburn”). If this happens more than twice a week or if you’ve been taking over-the-counter antacids for two weeks or more with no relief, you may have gastroesophageal reflux disease (GERD), and you should see your PCP.
Possible causes: Medication side effects, smoking, and/or excess pressure on the abdomen from being overweight can cause the sphincter (muscular opening) between the stomach and esophagus to weaken or relax.
Treatment: Occasional acid reflux can be treated with over-the-counter antacids and medications that inhibit stomach acid production. If you have GERD, your PCP can help you choose the best treatment based on suspected causes.
Prevention Tips:
- Eat moderately-sized meals.
- Avoid foods and drinks that make symptoms worse.
- Avoid lying on your back after eating.
- Elevate the head of your bed.
- Avoid smoking.
Hemorrhoids
What it is: Veins that line the lower rectum or anal opening become swollen.
Possible causes: Straining during bowel movements, chronic diarrhea, being overweight, standing or sitting for long periods.
Treatment options: You may be able to relieve swelling and discomfort with ice packs or by sitting in a warm bath. Over-the-counter hemorrhoid creams and suppositories can also help. In some cases, hemorrhoids may have to be removed.
Prevention tips: The steps to prevent constipation and diarrhea (see above) will also help prevent hemorrhoids.
Digestive Disorders
These more serious conditions belong on your radar.
Sometimes digestive symptoms like diarrhea, constipation, or acid reflux are related to more complex conditions, like the ones below. If you suspect you might have any of these issues, schedule a visit with your primary care provider (PCP), and ask if you could benefit from seeing a gastroenterologist.
Irritable Bowel Syndrome (IBS)
IBS is a testament to the intricate connections between the digestive and nervous systems. If you have this condition, the muscles of your colon will contract more often than normal, often in relation to stress. This can lead to overly frequent bowel movements or equally disruptive “false alarms,” and it can also be associated with painful cramps and bloating.
IBS can be challenging to manage but often improves through changes to your diet (for example, eating frequent small meals and avoiding foods that worsen IBS) and by taking steps to reduce and cope with stress. Your PCP or specialist may also recommend medication.
Celiac Disease
If you have celiac disease, your immune system reacts to gluten (found naturally in wheat, rye, and barley) by attacking the lining of your small intestine, which can inhibit nutrient absorption.
You may not have any symptoms, but if you do they can include diarrhea, constipation, fatigue, or abdominal pain and bloating. If untreated, lack of nutrition absorption can contribute to osteoporosis, anemia, and cancer. Celiac disease can sometimes appear as a severe skin rash called dermatitis herpetiformis.
Switching to a gluten-free diet — though by no means easy — will prevent the immune reaction.
Diverticular Disease
When the lining of the large intestine becomes weak (which can happen naturally as you age), the pressure of hard stools may cause small areas to bulge out to form pockets or “diverticula.”
At least half of all people have diverticula by the time they reach 80 years old. Diverticular disease is diagnosed when diverticula become associated with abdominal pain, bloating, fever, or diarrhea, usually due to inflammation or infection.
You may be prescribed antibiotics to fight infection as well as dietary changes (increased fiber and water) to help prevent constipation. In some cases, sections of the large intestine may need to be removed.
Colorectal Cancer
Tissue growths or “polyps” that grow in the lining of the colon or rectum can sometimes become cancerous. If you’re over 50, ask your PCP if you’re due for a colonoscopy (an internal screening to detect polyps).
Polyps found during screening can be easily removed before they can become cancerous. If a polyp does become cancerous, treatment depends on the extent to which cancer has spread.
Inflammatory Bowel Disease (IBD)
IBD includes Crohn’s disease (extensive inflammation of the digestive tract), ulcerative colitis (inflammation of the large intestine), esophagitis (inflammation of the esophagus), and other digestive conditions characterized mainly by inflammation.
With IBD, you may have symptoms including diarrhea, fever, fatigue, abdominal pain and cramping, bloody stool, reduced appetite, and unintended weight loss. These symptoms often come and go as inflammation fluctuates, making IBD an especially frustrating condition to manage and live with. The causes of IBD are still unknown, but they are thought to be immune-related.
Treatment is highly individualized, depending on the level of inflammation and where it occurs, but often involves lifestyle changes (diet and exercise) plus medication to reduce inflammation, suppress auto-immune response, or fight infection. Surgery is sometimes recommended.