Nearly two out of three Americans report gut health issues — including bloating, constipation, and diarrhea — in any given week. In a nationwide survey conducted in 2015 from October 14 to November 4, about 20% of Americans 18 years or older reported one or more of these three gut health problems when taking the survey. (1)

This statistic may not come as a surprise to you. But problems like bloating, constipation, and diarrhea can be embarrassing for people to talk about, so many don’t discuss their digestive issues and try to deal with them on their own. 

However, you can meet your patient halfway by giving them the tools they need to conquer their gut health issues. This approach requires addressing the underlying root causes, such as bacterial overgrowth, parasites, and other infections.

Symptoms of an Unhealthy Gut

Just like breathing or the beating of the heart, digestion should be automatic since it is controlled by the autonomic nervous system. Yet, sometimes digestion goes awry. Frequent gut distress from bloating, constipation, or diarrhea can make intestinal and stomach health seem elusive.

For some people, these common unhealthy gut symptoms may be only occasional problems. For others, they’re regular occurrences that don’t seem to go away. If the latter is the case for your patient, that’s when it takes a little detective work to figure out what’s really going on in their gut.

Bloating and Excess Gas

Some gas is normal and harmless. When it’s excessive, it could be a sign of a deeper problem. It can also be embarrassing for people when excess gas causes the abdomen to swell like a balloon.  

Studies suggest that bloating affects 10–30% of the general population. Among those with chronic digestive disorders, bloating may affect as many as 96% of individuals. (2)  

Causes of bloating and excess gas

In the short term, something as simple as eating too much and too fast could trigger bloating. However, chronic bloating is a bigger problem. 

Some of the underlying causes of recurrent bloating and excess gas include —

  • Candida overgrowth: Besides altering bowel movements, overgrowth of candida can generate gas and bloating. Excess growth of fungi like candida in the small intestine is sometimes called small intestinal fungal overgrowth (SIFO). (3)
  • Constipation: If people don’t poop often enough, waste can build up and trap gas in the colon, which can lead to bloating. (4)
  • Gastroparesis: Because the stomach isn’t emptying as quickly as it should, this can lead to abdominal pain, bloating, and nausea. Gastroparesis is more common in people with uncontrolled diabetes. In other cases, the cause is unclear. (5)
  • Inflammatory bowel diseases (IBD): Crohn’s disease and ulcerative colitis may alter the digestive system in ways that lead to abdominal pain and bloating. Some evidence even suggests parasites may play a role in IBD. (6, 7, 8)
  • Medication: Some medications can have a bloating side effect.
  • Parasitic infections: Bloating and gas can be among the first signs that parasites have decided to make someone their host. As they multiply in the small intestine, they create inflammation and can trigger gut symptoms. (9, 10, 11)
  • Small intestinal bacterial overgrowth (SIBO): The majority of gut microbes belong in the colon, not the small intestine. If too many migrate to the small intestine, they can generate significant bloating and gas soon after eating. (12)

Strategies to combat bloating and gas

Just as with other chronic digestive issues, you may need to help your patient strategize to reduce bloating in the short term, as well as address underlying issues in the long term. This means addressing the root cause to restore gut health and stomach health. 

Here are some ways to help resolve bloating and excess gas. Keep in mind, many of these strategies are also useful when it also comes to constipation and diarrhea:

1. Try a low-FODMAP diet

Certain dietary factors can lead to bloating gas. Eliminating them while figuring and fixing underlying contributors can give patients some symptom relief.

FODMAPS, or foods high in fermentable carbohydrates, are often bloating triggers. When the bacteria in the gut ferment these carbs, they produce gas. Someone may be prone to intolerance to FODMAPS if they have SIBO or a disrupted microbiome. (13)

Apples, broccoli, cherries, kidney beans, milk, onions, and low-calorie “sugar alcohol” sweeteners like erythritol and sorbitol are among the many other sources of FODMAPS. Only certain high-FODMAP foods may trigger symptoms for your patient. (14)

To identify FODMAP triggers, have individuals eliminate all sources for a few weeks. Then, reintroduce foods one at a time to see if they cause symptoms. Your goal is to add back as many as possible if your patients can eat them without symptoms. Over the long term, a restrictive diet increases their risk of nutrient deficiency.

2. Check for SIBO

Small intestinal bacterial overgrowth (SIBO) is often overlooked as the source of painful gas and bloating. Healthcare practitioners usually use breath tests to help diagnose it. (15)

Certain factors may contribute to SIBO, so eliminating them may improve the condition. Antacids and proton pump inhibitors can lead to overgrowth and imbalance of the microbes in the small intestine because they lower stomach acid. (16)

Adding a digestive enzyme supplement may help reduce symptoms until the overgrowth is resolved. You can also have patients try taking herbs with antibiotic properties. Studies suggest oil of oregano may be as effective as antibiotics to get bacterial overgrowth under control. (17, 18)

3. Parasite cleanse

Clearing out parasites is critical to restore gut health and get rid of bloating. Your patient can complete a cleanse by taking parasite-combating herbs and use them to help eliminate critters in stools. Boosting oxygen levels may also help deter parasite growth in the gut. (19)

Avoiding sugar and detoxing heavy metals could also help resolve parasite infections and candida overgrowth. Specific carbon-based binders may help remove heavy metals. Composed of humic and fulvic acid extracts, it also helps clean up the toxins that bacteria, fungi, and parasites produce. (20, 21, 22)

Remember to support the drainage of toxins when your patients go after parasites and other unwelcome pathogens. This includes the colon, as well the kidneys, liver, and lymphatic system. 

Constipation

Constipation is generally characterized as having less than three bowel movements a week. Stools can become hard and may be a strain to eliminate. This can be painful and may cause hemorrhoids. (23, 24, 25)

Bowel movements are a significant way the body eliminates toxins because the liver processes contaminants filtered from the blood then secretes them into the bile. The bile is then released into the gut during digestion, and some is swept out excrement. 

Two to three bowel movements a day is the standard. If someone isn’t “going” regularly, then they can’t detoxify well. At a minimum, this means going at least once a day. When doing a detoxification program, the goal is two to three times a day.

Constipation causes

Many factors can slow down stools. Some of these include —

  • Candida overgrowth: Just like bloating, a candida infection can cause either constipation or diarrhea. (26)
  • Dehydration: If the body lacks adequate water, the colon will extract more water from stools to help the body stay hydrated. (27)
  • Environmental toxins: Exposure to herbicides, pesticides, and heavy metals may damage the nerves that help regulate colonic movement. (28)
  • Holding it in: One of the colon’s jobs is to reabsorb water from stools before the body eliminates them. The longer one puts off pooping, the more water the colon will pull out of stools. This makes them drier, firmer, and more difficult to eliminate. (23)
  • Lack of exercise: Physical activity tends to stimulate the colon. If your patients aren’t moving enough in general, they may not be moving much in the restroom either. This is also why constipation can become a challenge if someone is bed-bound. (23, 29)
  • Low fiber diet: Fiber helps bulk up stools and soaks up water. This makes them softer and more comfortable to eliminate. (30)
  • Medications: Antacids, antidepressants, blood pressure medicines, and  painkillers are common drugs that can slow down bowels. Overusing laxatives may also cause constipation. (23)
  • Medical conditions: Issues such as hypothyroidism, multiple sclerosis, and Parkinson’s disease can alter the functioning of the intestines, which can lead to constipation. (23)
  • Parasitic infections: Ironically, some parasites cause diarrhea while others can cause severe constipation. (31)
  • Pregnancy: A growing baby can cause the mother’s bowels to slow down, especially during the last months of pregnancy. (23)
  • Supplements: Calcium and iron supplements sometimes trigger constipation. Certain forms (such as calcium carbonate) and higher doses of these minerals may pose a greater risk of this. (27, 32)

Constipation often involves more than one of these risk factors. But, there are ways to reduce the odds of this problem and restore gut health.

Strategies to combat constipation

You may notice that strategies to overcome constipation may also help with diarrhea and are also similar to combating bloating. This is because these strategies promote gut health in general. 

1. Change diet

Dietary changes could go a long way toward alleviating constipation. Besides making sure individuals are getting plenty of fiber and water, they can also:

  • Add fermented foods. For example, kimchi and sauerkraut — if they’re not heat-treated — are rich, natural sources of probiotics and fiber. Probiotics are beneficial bacteria that can promote gut health and support regular elimination. (33)
  • Avoid gluten. If you suspect your patient has gluten as a trigger, make sure they get tested for celiac disease. If that test is clear, they may still have some sensitivity to gluten. Because gluten can also cause either constipation or diarrhea, have them avoid it entirely for a few weeks, then have them try eating it again. (34)
  • Omit dairy. Dairy products can cause diarrhea, but they may also be a factor in constipation, especially in children. If you suspect it’s a culprit, try removing all dairy to see if it’s preventing your patient from pooping regularly. (35)
  • Watch certain fruits: Fruits are a good source of fiber. Still, certain ones may be problematic. Unripe bananas are high in a type of starch that is resistant to digestion, which may slow the gut too much. Persimmons may also trigger constipation due to certain phytochemicals in them. (36)
  • Write a food-symptom diary. Food sensitivities can trigger constipation. Careful record-keeping and watching for patterns may help your patient identify what’s causing their constipation.

2. Get moving

Exercise and physical activity can help get the gut moving, as well as lower the chances of diseases like diabetes and obesity. (37)

Have your patients find activities they enjoy, and encourage them to get out and do them. It can be as simple as walking or joining a recreational sports team.

3. Parasite cleanse

If you suspect that parasites or candida overgrowth are preventing your patient from having regular bowel movements, then it’s important to remove the toxins from the body via a parasite cleanse.

They may also need to follow a candida support protocol to help restore gut health. Coffee enemas may give some relief from sluggish bowels, too.

4. Use Carbon-Based Binders

Because heavy metals and chemicals like herbicides can damage the nerves of the digestive tract, detoxing from these contaminants may help alleviate constipation.

Carbon-based binders like Carbon Technology are available in supplement form and can help bind heavy metals and chemicals to its surface and assist the body’s natural detoxification processes. This powerful carbon is also a rich source of nutrients and contains building blocks that could help repair damage to the gut wall. (38, 39, 40, 41, 42)

5. Try bowel-moving herbs

Intestinal moving herbs — such as ginger root and senna leaf — promote normal muscle contractions in the gut to help prevent constipation. Combinations of such herbs are especially helpful since they may have slightly different benefits in the digestive tract.

6. Obey the urge

Remind your patients that when their body tells them it’s time to “go,” they should listen to it right away. Nature’s call may not come at an ideal time, but it’s not good to put it off simply because it’s inconvenient.

Going when the body urges can help create a healthy routine of eliminating. Pooping will require less effort when working with what the body naturally wants to do.

7. Check the side effects of medicines and supplements

Check to see whether the pills your patients are taking list constipation as a potential side effect. If so, research to see if there are alternatives that won’t cause constipation.

The underlying causes of constipation are usually several, not just one. Applying a variety of these strategies could help resolve constipation and support gut health.

Diarrhea

Individuals may have the exact opposite of constipation when it comes to gut health — diarrhea. Or, they might alternate between the two over time.

Diarrhea is so common, typically characterized by loose or watery stools — and often an urgent need to run to the restroom. It’s sometimes a short-term issue that may last just a day or two. In other cases, it’s a long-term or chronic problem and is a clue to more serious digestive health issues. It’s generally called chronic diarrhea if someone has dealt with it for at least four weeks. (43)

Frequent watery bowel movements increase the risk of dehydration. Chronic diarrhea could also lead to malnutrition since it reduces the time the gut has to absorb nutrients.

Diarrhea causes

Some of the factors that can cause short-term episodes of diarrhea include —

  • Antibiotics: These medicines result in loose stools in up to 30% of people. Diarrhea may happen while taking antibiotics. Or, it may develop up to two months later due to the antibiotics killing beneficial gut bacteria. (44)
  • Food poisoning: Consuming foods and beverages contaminated with dangerous microbes — such as E. coli and Salmonella — can produce inflammation and toxins in the gut. This may trigger diarrhea to help purge the toxins quickly. (45)
  • Stress: Acute stress and anxiety may cause stomach cramping and trigger the colon to empty. (46)
  • Viruses: Diarrhea is frequently a symptom of norovirus and rotavirus infections. Sometimes people call infection with these bugs “the stomach flu.” (47)

Many short-term causes of diarrhea often resolve themselves and don’t need any special treatment. Still, due to the risk of dehydration, even short-term diarrhea can be dangerous. Infants, young children, and older adults are especially vulnerable to dehydration. (48)

Some cases of food poisoning can also be severe and require treatment. Newer research also shows that food poisoning is sometimes the root cause of irritable bowel syndrome (IBS) with diarrhea. In such a case, diarrhea becomes a chronic issue. (49)

Examples of other chronic issues that could lead to diarrhea include —

  • Candida overgrowth: While this yeast is a necessary part of the microbiome, if the candida yeast grows out of control, it can lead to diarrhea. (50, 51)
  • Celiac disease: Diarrhea is a common sign of this severe autoimmune reaction to gluten. That’s a protein in barley, rye, wheat, and related grains. (52)
  • Inflammatory bowel disease (IBD): Crohn’s disease and ulcerative colitis are the two main types of IBD generally classified as autoimmune disorders and can cause diarrhea, which may be bloody. (53)
  • Medications: Antibiotics aren’t the only drugs that can trigger diarrhea. Many medicines for chronic health conditions could also cause loose stools. More than 700 different drugs list diarrhea as a potential side effect. (43)
  • Parasite infections: People can unknowingly acquire these nasty, uninvited guests through contaminated food or water. Though the risk is especially high when traveling to some foreign countries, people can also get parasitic infections close to home. (54)

Strategies to combat diarrhea

Just like bloating and constipation, it’s essential to have strategies to reduce diarrhea in the short term as well as address underlying issues in the long term. 

1. Examine diet and eliminate trigger foods

It’s not normal for certain foods to trigger diarrhea, but sometimes they do. Digestive reactions to foods may be permanent, but often they’re not. 

If your patients have celiac disease, they need to avoid gluten permanently. Additionally, if they have lactose intolerance, they’re deficient in the enzyme required to digest milk sugar. They may struggle with that long term unless it’s caused by an underlying factor that can be resolved. (55, 56)

“True” food allergies are also generally permanent, though children may outgrow some of them. Food allergies usually trigger severe symptoms beyond diarrhea and can be life-threatening. As a rule, individuals should never try to eat foods to which they’re allergic. (57)

But, if they have food sensitivities, they may regain their tolerance of foods if they fix the root cause. Food sensitivities won’t show up on standard food allergy tests that check for elevated IgE antibodies. Food sensitivity symptoms are triggered by different types of immune responses. (58)

If your patients have food sensitivities, omitting food triggers can help them control their symptoms while they work to resolve the underlying causes, such as parasites.

Additionally, chronic illness with Lyme disease, candida overgrowth, and mold toxicity can activate immune cells called mast cells to release histamine. That could also contribute to food sensitivities. (59, 60, 61)

More specifically, elevated histamine levels in the body could increase sensitivity to foods high in histamine, such as avocados, ripe tomatoes, and spinach. (62, 63)

Like mentioned previously, have individuals keep a food journal of what they’re eating and their symptoms, including diarrhea. Though they may get symptoms within a few hours after eating, sometimes the symptoms are delayed. So, you may have to look for patterns.

If certain foods are likely diarrhea culprits, have patients avoid them entirely for a few weeks. Once their symptoms are under control, they can challenge a suspected food by eating a small amount. This could help tell whether the item is indeed a problem. (64)

2. Get rid of parasites

If parasites are the reason behind diarrhea, completing a parasite cleanse could help get the gut back to normal.

Parasites can inflame the digestive tract and lead to increased intestinal permeability (leaky gut). This could increase the risk of food sensitivities and allergies. Parasites can also upset the balance of microbes in the gut, which could trigger loose stools as well. (65, 66, 67, 68)

Parasites are often difficult to detect in laboratory tests, even though they’re wreaking havoc in the gut. Because they’re so prevalent, it’s generally simpler to assume your patients have them and work on getting rid of them.

Purging parasites could also help your patients avoid other problems down the road. For example, these critters can also cause issues like hair loss and emotional symptoms.

3. Conquer candida

If the microbiome becomes imbalanced, candida infection can take over and cause some significant health issues, such as chronic diarrhea.

Just like for constipation, following a candida support protocol could help eliminate the yeast overgrowth and the problems that come with it.

4. Avoid antibiotics when possible

Though there are specific ailments where antibiotics are required, they’re often overprescribed. Studies suggest that up to half of antibiotic prescriptions are unnecessary. (69)

Antibiotics are only effective against bacteria. They do nothing against viruses and fungal infections. Protect the health of the gut microbiome and reduce the risk of antibiotic-associated diarrhea by avoiding unnecessary prescriptions. 

5. Manage stress

Stress levels have a significant negative impact on the body — the gut included.

Have patients examine their life and look for ways they can minimize tension. They may find going for a walk helpful while others may get relief through journaling. Something as simple as slowing down and focusing on breathing for a few minutes can also help. Have them find what works best for them.

It’s also important to slow down when eating. Encourage your patients to sit down and eat at a leisurely pace. Food is meant to be enjoyed, not inhaled.

The Gut and the Rest of the Body

Gut health can have a massive impact on the entire body. If you don’t address why someone has bloating, constipation, or chronic diarrhea, their health problems could multiply over time. For instance, because chronic diarrhea can lead to dehydration, the mitochondria don’t function well when the body is dehydrated, and that can drain energy. (70)

Poor absorption of vitamins due to SIBO could increase the risk of impaired immune function, night blindness, and neuropathy or nerve pain. Parasites can also contribute to poor nutrient absorption. (17, 71, 72)

Moreover, researchers have linked an unhealthy gut microbiome to anxiety, depression, and impaired immune function. Poor microbiome health may also increase obesity and heart disease risk. (73, 74, 75)

Additionally, when candida is the culprit of digestive difficulties, it may lead to:

  • Brain fog (76)
  • B vitamin and magnesium deficiency (77)
  • Eczema (itchy red rash) (78)
  • Joint pain (79)
  • Urinary tract infections (80)

Clearly, gut and stomach health can have far-reaching effects.

Restore Gut Health Now

Bloating, constipation, and diarrhea are often caused by pathogens like parasites, Lyme bacteria, and candida, as well as poor microbiome health. No matter the symptom, fixing the root cause is ultimately essential to resolving gut problems and restoring gut health.

So, do everything you can to help your patient clear out pathogens. This should include using herbs that support good digestion and help kill critters. You also need to have them  support their drainage pathways, as well as omit food triggers and get regular physical activity.

There’s no need for individuals to feel chained to the bathroom due to loose stools or be so restricted in what they can eat that they avoid social gatherings. Help your patients tackle their gut issues now so they can live life to the fullest, as well as reduce their risk of health issues in the future.