From acid reflux to intestinal pain and stomach upset, digestive distress causes discomfort for millions of Americans.  While symptoms are often masked with prescriptions, assessing symptoms and understanding the root cause of the irritation is essential for treating and preventing irreversible damage that may be happening under the surface.  Below are 5 common causes of digestive distress often missed by conventional practitioners.

1.     Leaky Gut

Leaky gut is a condition that develops when the tissues of the intestinal wall become damaged and “leaky” allowing undigested food and pathogens to enter circulation.  Damage to this barrier creates a host of problems and symptoms such as chronic illness, stomach pain, food allergy, inflammation and autoimmunity (1).  Over 70% of the immune system resides in the gut, tasked with killing dangerous microbes that enter via food and beverage as well as maintaining the protective barrier of the intestinal wall that serves to let good stuff in and keep bad stuff out.  Some of the many potential insults against the gut tissue can include toxins, infections, inflammatory foods and even chronically high blood sugar.  If this is a root cause of digestive distress, interventions including diet, lifestyle and supplementation are usually necessary to heal and restore the function of the gut.

2.     Infections

Many people harbor gastrointestinal infections, unknowingly, such as yeast, bacteria, parasites and virus. These organisms live all around us in water, soil, on surfaces that we are in contact with and in foods that we eat. Some of these organisms or microbes can make us very sick, causing symptoms like ulcers, diarrhea, chronic inflammation, headaches, itchiness, food allergies and autoimmunity.  Those with a chronic infection may experience digestive symptoms but symptoms can spread to many areas of the body outside of the digestive tract.
Common bacterial infections include H. pylori, C-Diff and E. Coli. Studies suggest that H. pylori is present in approximately 50% of the population and while many people with H. pylori experience ulcers, many people have no symptoms (2).  All the while the bacteria are reducing the stomach’s ability to produce stomach acid (HCl), making digestion inefficient and increasing risk of infection and other side effects.
Other familiar bacterial infections are E. Coli Clostridium Difficile Colitis (C-Diff).  E. Coli is bacteria found in everyone, but certain strains and overgrowth are linked to inflammatory bowel diseases such as colitis and Crohn’s Disease (3). E. Coli thrives in the damaged and inflamed tissues of the gut mucosa.  C-diff is often contracted in hospitals and nursing homes C-Diff is rampant and antibiotic use is linked to increase risk of infection. Symptoms of C-diff include watery diarrhea, fever, loss of appetite, nausea, and abdominal pain/tenderness (4).

Parasites are another source of infection.  They live and reproduce within the gut and some can infect many other organs.  Parasites such as Giardia Lamblia can destroy the intestinal villus charges with breaking down and absorbing nutrients.

Yeast and fungi are yet another class of microbes with potentially dismal side effects.  For instance, Candida albicans is a yeast/fungus that is part of the normal intestinal gut flora but is pathogenic when overgrowth occurs, or when it enters the circulation and lodges in peripheral tissues (5). Some symptoms of overgrowth include headaches, fatigue, itching, gas and bloating as well as irritation in the mucous membranes of the vagina and urinary tract.

3.     Vagus nerve dysfunction – motility and sphincter control

The vagus nerve serves as the longest cranial nerve in the body, and is involved in regulating gut function as well as cardiovascular, respiratory, immune, and endocrine systems. An underactive vagus nerve can lead delayed gastric emptying, referred to as gastroparesis, as well as reduced immune function, increased inflammation, and a host of other problems (6). This means that food does not move from the stomach and through the digestive tract efficiently and can cause a multitude of symptoms such as stomach pain, nausea, heartburn, spasms in the stomach, or weight loss.
In a healthy state, food is pushed from the into the small intestine by peristalsis, the rhythmic contraction and relaxation of intestinal muscles. However, if the vagus nerve is damaged, digestion is impeaded.  Chronic illness, diabetes, surgery, alcoholism, and trauma are all causes of decreased vagal nerve function.

4.     Microbiome imbalance

The microbiome refers to the community of microbes that live within the gut.  Many of these little bugs are extremely helpful for maintaining health by promoting a healthy immune system, good digestion and while producing and regulating micronutrients and neurotransmitters.  Healthy bacteria must compete for resources with other microbes like virus, yeast and pathogenic bacteria.  If the balance shifts within the gut to overgrowth of pathogenic microbes, many symptoms can arise such as gas, bloating, pain, food allergies, and autoimmunity.  The same infections that are listed above can cause the microbiome to become imbalanced and lead to conditions such as SIBO (7).  SIBO, small intestinal bacterial overgrowth, is a condition in which excessive bacteria growth and thrive in the small intestine and is being seen increasingly in people suffering from autoimmunity, allergies, and poor digestion.

Probiotics have become a popular way of boosting healthy microbials within the gut but for most people, probiotics alone, will not restore an imbalanced microbiome.  Instead, it is essential to identify the predominant overgrowth (yeast, virus, or bacteria) with appropriate testing and treat it with antimicrobials while supporting the healthy bugs with tailored probiotics and prebiotic sources.  Processed foods and sugars feed pathogenic microbes while diverse fibers and a whole food diet work to nourish and support healthy gut flora.

5.     Sympathetic dominance or overload

The central nervous system is divided into sympathetic and parasympathetic response.  Sympathetic is often called “fight or flight” and is responsible for our response to threats but also mental and physical activity like the beating of the heart (8).  The other side of the nervous system, parasympathetic, is dominant during “rest, digest and reproduction”.  It is logical that if you are in immanent danger, you do not need to rest, digest, or reproduce.  However, many people live in a constant state of sympathetic dominance because of chronic stress, infection, inflammation and the like.  If that is the case, the functions associated with the parasympathetic nervous system can be dysfunctional.

When the sympathetic nervous system is overloaded, the digestive process down-regulates, and the vital enzymes and motility needed to move, and breakdown food are deficient.  This can set the stage for many issues including those covered in the other 4 sections above.  If a person is suffering from sympathetic dominance, it is critical to support the digestive process, while supporting the systems involved in stress response and management.  While digestive symptoms may be prevalent in this condition, there are countless other health risks simmering under the surface.

As you can imagine after reviewing these commonly missed causes of digestive distress, it is critical to have a full evaluation if you are suffering from digestive symptoms.  Optimal digestive function is essential to total health and can be the most effective place to initiate healing.  Ignoring or masking symptoms with prescriptions may help to feel better in the short term but will only lead to more difficult and extensive health problems down the road.

1.       Fasano A. Zonulin, regulation of tight junctions, and autoimmune diseases. Annals of the New York Academy of Sciences. 2012;1258(1):25-33. doi:10.1111/j.1749-6632.2012.06538.x.
Ercolini AM, Miller SD. The role of infections in autoimmune disease. Clinical and Experimental Immunology. 2009;155(1):1-15. doi:10.1111/j.1365-2249.2008.03834.x
2.       Brown LM. Helicobacter pylori: epidemiology and routes of transmission. Epidemiol Rev. 2000;22(2):283-97
3.       Rhodes JM. The role of Escherichia coli in inflammatory bowel disease. Gut. 2007;56(5):610-612. doi:10.1136/gut.2006.111872.
4.       https://www.cdc.gov/hai/organisms/cdiff/cdiff-patient.html
5.       Hirai K, Inukai T, Nakayama H. Promising Therapies for Fungal Infection Based on the Study to Elucidate Mechanisms to Cope with Stress in Candida Species Med Mycol J. 2017;58(2):E79-E86. doi: 10.3314/mmj.17.007
6.       Browning KN, Verheijden S, Boeckxstaens GE. The vagus nerve in appetite regulation, mood and intestinal inflammation. Gastroenterology. 2017;152(4):730-744. doi:10.1053/j.gastro.2016.10.046
7.       Dukowicz AC, Lacy BE, Levine GM. Small Intestinal Bacterial Overgrowth: A Comprehensive Review. Gastroenterology & Hepatology. 2007;3(2):112-122. https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0025459/