From Bloating to Reflux: Resolving Gastrointestinal Symptoms

Treating Gastrointestinal Symptoms Can be Straightforward

If you have been experiencing gastrointestinal symptoms (GI symptoms) like bloating, constipation, diarrhea, or stomach pain, you know how confusing and overwhelming it can be to figure out exactly where your symptoms are coming from and how to resolve them. 

Depending on symptoms, a Google search might make it look like you could have dozens of different possible digestive diseases, which can be overwhelming. 

In this article, we will try to simplify things for you by providing an overview of common GI symptoms, some common causes, and interventions that can help, even if you do not know the exact cause of your symptoms right away. 

gastrointestinal symptoms: woman with a stomachache sitting on a couch

Gastrointestinal Symptoms at a Glance

  • GI symptoms can include abdominal pain, diarrhea, bloating, weight loss (or gain), heartburn, constipation, or intestinal cramping. 
  • There are also non-digestive symptoms of digestive illness such as brain fog, fatigue, and joint pain.
  • While drastic changes in gastrointestinal symptoms should be checked by a gastroenterologist or other healthcare practitioner, many chronic digestive symptoms can be resolved with a holistic approach to gut healing.
  • It is not always necessary to know exactly what is causing your GI symptoms in order to start resolving symptoms with an anti-inflammatory diet, probiotics, and herbal antimicrobials if needed. 

We are going to approach this topic in two ways. First, by looking at the most common symptoms one by one, and then by looking at some of the most common reasons for multiple GI symptoms. Each section will include possible causes and the most effective treatment options. 

At the end of the article we will review the three steps to supporting gut healing and resolving GI symptoms even if you do not have a diagnosis yet. 

Common Gastrointestinal Symptoms and Their Treatments

Some of the most common GI symptoms are constipation, diarrhea, abdominal bloating, reflux, abdominal pain, and nausea. We will review these symptoms below and look at some of the most effective treatments for them.

If you have been experiencing just one symptom, it can be helpful to look at what some of the common causes are and effective treatments. 

First let’s look at a quick overview of six of the most common GI symptoms:

1. Constipation 

Constipation is a lack of or reduction in bowel movements, or pain or difficulty pooping, with no obvious cause [1 Trusted SourcePubMedGo to source]. You may also experience severe lower abdominal pain with constipation.

What causes constipation? Constipation can be caused by functional (due to abnormal functioning of the digestive tract) or non-functional (not caused by abnormal functioning) issues. For example, a functional issue would be if the muscles in your colon do not squeeze and relax like they should, so this slows the colon down causing constipation. A non-functional issue could be constipation due to food sensitivities. 

Helpful treatments for constipation:

2. Diarrhea

This is loose or watery stools. It can be acute (happening for two weeks or less) or chronic (happening for longer than four weeks.) 

What causes diarrhea? It can be caused by viral infection or noninfectious conditions [9 Trusted SourcePubMedGo to source]. Acute diarrhea is usually caused by viral infection, such as Norovirus, which causes one-fifth of all infectious diarrhea worldwide [9 Trusted SourcePubMedGo to source]. 

Chronic diarrhea, on the other hand, may be caused by malabsorption, inflammatory bowel disease (Crohn’s or ulcerative colitis) [9 Trusted SourcePubMedGo to source], leaky gut [10 Trusted SourcePubMedGo to source, 11 Trusted SourcePubMedGo to source], food sensitivities/intolerances [9 Trusted SourcePubMedGo to source, 12 Trusted SourcePubMedGo to source], small intestinal bacterial overgrowth (SIBO) [13 Trusted SourcePubMedGo to source, 14 Trusted SourcePubMedGo to source], bacterial infection H. pylori, or side effects from medications [9 Trusted SourcePubMedGo to source].

Helpful treatments for diarrhea:

  • Probiotics. A meta-analysis of 82 randomized control trials found that probiotics work to reduce antibiotic-associated diarrhea [15 Trusted SourcePubMedGo to source].
  • L-glutamine. L-glutamine supplements normalize gut wall integrity in patients with leaky gut and diarrhea-predominant IBS [16 Trusted SourcePubMedGo to source].
  • Low-FODMAP diet. A 2021 Romanian guidelines for non pharmacological treatment of IBS recommend trying a low FODMAP diet to improve abdominal pain, bloating, and/or diarrhea for a minimum of four weeks [17 Trusted SourcePubMedGo to source]. 

3. Abdominal bloating

This happens when gas accumulates in the intestines, causing a bloating sensation and/or when the abdomen expands. It tends to be uncomfortable and can produce gas [18 Trusted SourcePubMedGo to source]. 

What causes abdominal bloating? Causes are varied and usually associated [19 Trusted SourcePubMedGo to source] with a larger digestive disease or issue such as SIBO, IBS or IBD related to food sensitivities.

Helpful treatments for abdominal bloating:

gastrointestinal symptoms: woman with an illustration of the stomach, touching her throat

4. Heartburn and Reflux Symptoms

Reflux happens when contents of the stomach, including stomach acid, flow back up into the esophagus and sometimes the throat. Reflux symptoms typically include heartburn and may also include sore throat, coughing, or difficulty swallowing. 

What causes reflux? Possible causes of chronic reflux conditions including gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux (LPR or “silent reflux”) include impaired esophageal motility, IBS or SIBO, or hiatal hernias (in which part of the stomach pushes up into the chest) [24 Trusted SourcePubMedGo to source, 25 Trusted SourcePubMedGo to source].

Helpful treatments for reflux: 

  • Melatonin. Melatonin is a hormone your body produces each night to stimulate sleep, and it may also help to protect the esophagus for people with GERD and heartburn. It may be as effective as proton pump inhibitors (PPI) for treating GERD [26 Trusted SourcePubMedGo to source]. Studies suggest melatonin may be as effective as a PPI for improving GERD [27 Trusted SourcePubMedGo to source, 28 Trusted SourcePubMedGo to source].
  • Probiotics. A recent systematic review of 12 studies found that 79% of the studies reported positive outcomes when GERD was treated with probiotics. These included reduced regurgitation, improvements in reflux, heartburn, indigestion, nausea and gas-related symptoms like burping [29 Trusted SourcePubMedGo to source]. 

5. Abdominal Pain 

This is pain in the stomach region or belly, anywhere between your chest and groin area. You may have generalized pain where you feel it in more than half of your abdomen,

localized pain where you feel it in only one spot. 

What causes abdominal pain? When it is located in one spot, this is often associated with a problem with an organ like the appendix or gallbladder, cramp-like pain often from gas or diarrhea, or colicky pain, which is severe and comes in waves and more often happens with kidney stones and gallstones [30]. More chronic, generalized abdominal pain may be associated with various digestive disorders including IBS, IBD, and SIBO. 

Helpful treatments for abdominal pain:

6. Nausea 

Nausea is when you feel sick to your stomach. It may or may not lead to vomiting. 

What causes nausea? Both nausea and vomiting are defense mechanisms that help us avoid ingesting or digesting toxic substances. They may also be symptoms of a virus. Other chronic causes of nausea may be celiac disease, food sensitivities, or gastritis.  

Helpful treatments for nausea:

  • Intermittent fasting. This is commonly used in cases of nausea and vomiting for any cause. It allows the stomach time to calm and reset and can decrease disease severity. Particularly in IBS, a study with a 10-day fast and five days of re-feeding showed significant improvement in abdominal pain, bloating, diarrhea, nausea, and anxiety [34 Trusted SourcePubMedGo to source, 35 Trusted SourcePubMedGo to source].
  • Probiotics. Probiotics have been shown to help reduce nausea in some cases, including when the nausea is related to GERD [29 Trusted SourcePubMedGo to source].

The table below will help you quickly find the symptom you are most interested in and get the information you need. While the list of causes for any one of these symptoms seems overwhelming, you will notice that there is a lot of overlap where one symptom is found in multiple GI disorders. Many of the treatments for the digestive disorders overlap as well. Because of this overlap, it is not always necessary to know exactly what digestive disorder you have in order to start healing your gut and getting relief of symptoms. 

After the table, we’ll talk about simple ways to start feeling better.  

Symptom Likely Causes Effective Treatments
Constipation Common functional gastrointestinal issues [1 Trusted SourcePubMedGo to source]:
• Stenosis or strictures in the colon or anus that cause narrowing of the passageways.
• Muscular or nerve abnormalities where the nerves that control the stomach and gut or the muscles of the digestive system are not working properly.

Common non-functional gastrointestinal issues:
• Irritable bowel syndrome (IBS) [36 Trusted SourcePubMedGo to source]
• Premenstrual syndrome (PMS) [34 Trusted SourcePubMedGo to source] and menstruation [37 Trusted SourcePubMedGo to source]
• Celiac disease and non-celiac gluten sensitivity [1 Trusted SourcePubMedGo to source, 12 Trusted SourcePubMedGo to source]
• Histamine intolerance [38 Trusted SourcePubMedGo to source]
• Food sensitivities and intolerances (including lactose or casein intolerance) [39 Trusted SourcePubMedGo to source]
• Too little dietary fiber, not enough water, withholding bowel movements [1 Trusted SourcePubMedGo to source]
• Metabolic disorders, such as hypothyroidism and type-2 diabetes [1 Trusted SourcePubMedGo to source]
• Cystic fibrosis, inflammatory bowel disease (IBD), and scleroderma [1 Trusted SourcePubMedGo to source]
Multi-strain probiotics

In people with IBS, probiotics, fiber (for some,) and stress reduction (meditation and cognitive behavioral therapy) can be a powerful combination in healing [40 Trusted SourcePubMedGo to source, 41 Trusted SourcePubMedGo to source, 42 Trusted SourcePubMedGo to source].

Digestive enzymes
Diarrhea • Viral infection, such as Norovirus [9 Trusted SourcePubMedGo to source]
• Bacterial infection, such as Helicobacter pylori [9 Trusted SourcePubMedGo to source]
• IBS (diarrhea or mixed types) [36 Trusted SourcePubMedGo to source]
• Lactose intolerance and other food sensitivities/intolerances [43 Trusted SourcePubMedGo to source]
• Celiac disease and gluten sensitivity [9 Trusted SourcePubMedGo to source, 12 Trusted SourcePubMedGo to source]
• Leaky gut [10 Trusted SourcePubMedGo to source, 11 Trusted SourcePubMedGo to source]
• Chronic pancreatitis and exocrine pancreatic insufficiency (EPI) [44 Trusted SourcePubMedGo to source, 45 Trusted SourcePubMedGo to source]
• Inflammatory bowel disease [9 Trusted SourcePubMedGo to source]
• Crohn’s and ulcerative colitis often include diarrhea [46 Trusted SourcePubMedGo to source, 47 Trusted SourcePubMedGo to source, 48 Trusted SourcePubMedGo to source]
• Antibiotic use and Clostridium difficile [9 Trusted SourcePubMedGo to source]
• Too much or too little thyroid hormone [49 Trusted SourcePubMedGo to source]
• Menstruation [37 Trusted SourcePubMedGo to source]
• Histamine intolerance [38 Trusted SourcePubMedGo to source]
• Bile acid malabsorption (BAM) [50 Trusted SourcePubMedGo to source]
• SIBO [13 Trusted SourcePubMedGo to source, 14 Trusted SourcePubMedGo to source]
• Mold illness [51 Trusted SourcePubMedGo to source, 52 Trusted SourcePubMedGo to source]
Low-FODMAP diet is helpful if diarrhea is caused by leaky gut and IBS [53 Trusted SourcePubMedGo to source, 54 Trusted SourcePubMedGo to source].

Probiotics for resolution of leaky gut as well as for use in H. pylori infection.

Pancreatic enzyme replacement therapy (PERT) in people who have Exocrine Pancreatic Insufficiency (EPI). 5% of people over the age of 70 and 10% of people over the age of 80 have EPI, which may lead to maldigestion and malabsorption with fatty stools, diarrhea, abdominal pain, and/or weight loss [44 Trusted SourcePubMedGo to source, 55 Trusted SourcePubMedGo to source].
Abdominal Gas/Bloating • A bacterial overgrowth (such as SIBO) [18 Trusted SourcePubMedGo to source, 56 Trusted SourcePubMedGo to source]
• Bowel obstruction, renal stones, overeating [18 Trusted SourcePubMedGo to source]
• IBS and a high fiber diet in many people with IBS
• Menstruation
• Non-celiac gluten sensitivity, celiac disease [12 Trusted SourcePubMedGo to source]
• Food sensitivity/intolerance such as lactose intolerance [43 Trusted SourcePubMedGo to source, 57 Trusted SourcePubMedGo to source, 58 Trusted SourcePubMedGo to source, 59 Trusted SourcePubMedGo to source, 60 Trusted SourcePubMedGo to source]
• Atrophic/autoimmune gastritis [61 Trusted SourcePubMedGo to source, 62 Trusted SourcePubMedGo to source]
• Exocrine pancreatic insufficiency (EPI) [44 Trusted SourcePubMedGo to source, 45 Trusted SourcePubMedGo to source]
• (IBD) inflammatory bowel disease [9 Trusted SourcePubMedGo to source]
Probiotics

Low-FODMAP diet [53 Trusted SourcePubMedGo to source, 54 Trusted SourcePubMedGo to source]

Digestive enzymes improve bloating, gas, and abdominal pain [22 Trusted SourcePubMedGo to source, 23 Trusted SourcePubMedGo to source].
Reflux  • Low esophageal motility [25 Trusted SourcePubMedGo to source]
• Low stomach acid, certain autoimmune diseases, or the long-term use of proton pump inhibitors (PPIs) [63 Trusted SourcePubMedGo to source]
• Malfunctioning sphincters [25 Trusted SourcePubMedGo to source]
• Atrophic gastritis [64 Trusted SourcePubMedGo to source]
• Non-celiac gluten sensitivity [12 Trusted SourcePubMedGo to source]
• H. pylori, especially in the case of LPR [65 Trusted SourcePubMedGo to source]
Avoiding common trigger foods such as oily, spicy, acidic, and fried foods.

Betaine HCl for low stomach acid.

Melatonin

Probiotics

Because of the prevalence of H. pylori infection in LPR, test for and treat with herbal antimicrobials. 
Abdominal Pain • IBS, especially in those who do not do well with a high-fiber diet [5 Trusted SourcePubMedGo to source]
• SIBO [33 Trusted SourcePubMedGo to source]
• Constipation [30]
• Non-celiac gluten sensitivity, celiac disease [12 Trusted SourcePubMedGo to source]
• Food sensitivity/intolerance such as lactose intolerance [43 Trusted SourcePubMedGo to source, 57 Trusted SourcePubMedGo to source, 58 Trusted SourcePubMedGo to source, 59 Trusted SourcePubMedGo to source, 60 Trusted SourcePubMedGo to source]
• Histamine intolerance [38 Trusted SourcePubMedGo to source]
• Kidney stones, ulcers, diverticulitis, gallbladder inflammation, bowel obstruction, stomach or intestinal cancer [30]
• Crohn’s: Pain is more often in the right lower quadrant of the abdomen and in the upper abdomen [66]
• Ulcerative colitis: Pain is more often in the lower abdomen [47 Trusted SourcePubMedGo to source, 66]

Probiotics

Low-FODMAP diet

Digestive enzymes
Nausea • Intestinal infections by bacteria, viruses, or fungi such as COVID-19 or food poisoning [67 Trusted SourcePubMedGo to source, 68]
• Non-celiac gluten sensitivity, celiac disease [12 Trusted SourcePubMedGo to source]
• Food allergies or sensitivity/intolerance such as lactose intolerance [57 Trusted SourcePubMedGo to source, 59 Trusted SourcePubMedGo to source, 69]
• Atrophic/autoimmune gastritis [61 Trusted SourcePubMedGo to source]
• Mold illness [51 Trusted SourcePubMedGo to source, 52 Trusted SourcePubMedGo to source]
• Morning sickness, migraines, or medications [69]
• GERD, ulcers, or intestinal obstruction [69]
• Seasickness or motion sickness [69]
Probiotics especially if the nausea is due to GERD [29 Trusted SourcePubMedGo to source]

Intermittent fasting

3D illustration of the human intestines

Common Gastrointestinal Disorders and Treatment

If you have been experiencing multiple different GI symptoms for a long time, you may be dealing with one of the most common causes of GI symptoms that I see in the clinic: SIBO, H. pylori infection, IBD, IBS, or leaky gut.

The good news is that the same simple steps can generally be followed to heal your gut, no matter which diagnosis you receive. These steps are: 

  • Reset your gut with an anti-inflammatory diet, such as a Paleo or low FODMAP diet.
  • Support a healthy gut microbiome and digestive system with probiotics, and potentially digestive enzymes.
  • Remove any bad bugs causing symptoms with herbal antimicrobials.

Let’s look a bit closer at these conditions and why these treatments work for each of them. 

ConditionCommon SymptomsResearch on Treatments
SIBO (small intestinal bacterial overgrowth)• Gas, bloating, constipation, diarrhea, fatigue, brain fog, and abdominal pain.
• High prevalence of SIBO in IBS and IBD cases [70 Trusted SourcePubMedGo to source, 71 Trusted SourcePubMedGo to source].
Low-FODMAP diet: A large body of research has shown that a low-FODMAP diet improves symptoms of IBS and IBD, which may overlap with SIBO [31 Trusted SourcePubMedGo to source, 72 Trusted SourcePubMedGo to source, 73 Trusted SourcePubMedGo to source].

Probiotics: These help reduce bacterial overgrowth and the high hydrogen concentrations found in SIBO. They also improve the symptoms of SIBO.

Digestive enzymes: In SIBO, the digestive system has difficulty digesting certain carbohydrates and sugar. Adding digestive enzymes can help aid digestion and reduce symptoms [22 Trusted SourcePubMedGo to source].

Herbal antimicrobials have been found to be as effective as rifaximin and triple antibiotic therapy for SIBO [74 Trusted SourcePubMedGo to source].
IBS (irritable bowel syndrome) • Gas, bloating, constipation, diarrhea, fatigue, brain fog, and abdominal pain.
• IBS pain can be in different areas when it presents in the abdomen. 
Low-FODMAP diet: to resolve leaky gut and immune response.

In typical gastroenterology, IBS is diagnosed when there are chronic GI symptoms with no discernible cause. However, research does show that IBS is related to leaky gut and an improper immune response [75 Trusted SourcePubMedGo to source].
 
Probiotics: To help heal leaky gut as IBS is associated with leaky gut.

Fecal tests to rule out infections.
IBD (Crohn’s and ulcerative colitis) • Gas, bloating, constipation, diarrhea, fatigue, brain fog, and abdominal pain.
• In IBD, Crohn’s can affect any part of the GI tract, while colitis affects the colon.
• The pain of IBD is more often in the right lower quadrant of the abdomen and upper abdomen in Crohn’s while pain is more often in the lower abdomen in ulcerative colitis, in the colon [66]. 
Both forms of IBD are inflammatory diseases of the digestive tract, also often related to an improper immune response and leaky gut [46 Trusted SourcePubMedGo to source].

Probiotics: To help heal leaky gut as both forms of IBD are associated with leaky gut.

Fecal tests to rule out infections.
Helicobacter Pylori infection• Gas, bloating abdominal pain, brain fog, fatigue, and nausea.
• Reflux and GERD.
• Ulcers.
Probiotics: Multi-strain probiotics can prevent H. pylori infection and help treat infection [76 Trusted SourcePubMedGo to source, 77 Trusted SourcePubMedGo to source].

Herbal antimicrobials: These improve the elimination rate of the bacteria and peptic ulcer healing compared to regular therapy with berberine [78 Trusted SourcePubMedGo to source].

Your Gut Support Plan

gastrointestinal symptoms: 3 Steps for Gut Health infographic by Dr. Ruscio

Living with gastrointestinal symptoms can cause a lot of stress and create worry every time a new symptom pops up. While it is helpful to know what some of the different kinds of gastrointestinal diseases there are, it is also important to remember that leading a gut healthy lifestyle may resolve your symptoms. 

If you want to start improving your gastrointestinal symptoms, rather than changing everything at once, which makes tracking what is working more difficult, start first with a gut reset and gut support by trying an anti-inflammatory diet with probiotics. I suggest starting with the Paleo diet (removes inflammatory grains, dairy, and legumes) first as it is a bit easier to follow than jumping right into a low-FODMAP diet (and this more restrictive diet may not be necessary). Try this diet with probiotics for four weeks and track your symptoms to note any improvements.

If after four weeks you are still experiencing digestive symptoms, you may want to add in digestive enzymes to aid in digestion and remove any microbes that may be causing issues by taking herbal antimicrobials, again tracking symptoms. 

While treating gastrointestinal distress can take a while, taking a stepped approach and recording your progress will help you not only troubleshoot what improves your symptoms, but give you agency over your own health. 

We know that treating chronic GI symptoms can be overwhelming. My book, Healthy Gut, Healthy You,” can help you learn more about gut healing and resolving gastrointestinal symptoms. If you would like a more personalized plan of treatment, please reach out to our clinic

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