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Turbulent Tummies: Typical Troubles & Natural Remedies

Updated: Jan 20

One of the most common reasons folks come to see us in both integrative primary care and functional medicine is for gut health, stomach pain, and digestion problems. In this article, I'll go through the 13 most common causes of tummy woes and provide many pearls of what you can do for prevention, healing and relief!

......And without further ado, here are your common culprits!

  1. IBS

  2. SIBO/Dysbiosis

  3. Heartburn/GERD

  4. Autoimmune Gut Disease (Crohn's and Ulcerative colitis)

  5. Pancreatic Insufficiency

  6. Celiac Disease

  7. Ulcer/Gastritis

  8. Cholecystitis (gallbladder)

  9. Pancreatitis

  10. Food Intolerance

  11. Gastroparesis

  12. Diverticulitis

  13. NAFLD/NASH/Fatty Liver

(Already have a diagnosis? Skip to your section!)

1. IBS (Irritable Bowel Syndrome)

IBS is often associated with recurrent abdominal pain, diarrhea, constipation or both with symptoms such as gas or bloating. Many patients who suffer from IBS may also suffer from dysbiosis (unbalanced gut bacteria), SIBO (small intestinal bacterial overgrowth), underlying food sensitivities or pancreatic insufficiency (lack of digestive enzymes).


  • Constipation

  • Diarrhea

  • Inability to empty bowels (or feels incomplete)

  • Indigestion

  • Nausea

  • Passing excessive amounts of gas

  • Urgent need to defecate

  • Abdominal cramping or discomfort

  • Anxiety

  • Depression

Try this:

  • Enteric coated peppermint oil capsules--1 Cap 3x a day at least 30 to 60 minutes before eating and not to consume the capsule too soon after a meal. IBgard is an example.

  • L0w-fodmap diet (temporarily) with a nutritionist to guide you

  • Elimination diet

  • Food Intolerance Testing with your functional med provider via Genova or KBMO labs

  • Curcumin start at 150mg-200mg a day and gradually increase to around 1500-1800 mg a day

  • Digestive Enzymes-Take About 10 min before meals. I like Bio-Gest by Thorne or Pure Encapsulations Digestive Enzymes Ultra

  • Probiotics-if they make it worse, get tested for SIBO--otherwise, choose one with more than 8 strains and more than 50 billion count--I like ReNew Life Ultra; most people will experience looser stools initially for a couple weeks.

  • Zinc Carnosine 75 mg twice a day, Magnesium 600 mg at night (most importantly for those with constipation dominant IBS)

  • Increase fiber--if fiber is difficult to tolerate, test for SIBO

  • L-Glutamine (don't take if you have cancer) maximum dose is 30 grams per day. This is split into 5 grams taken six times per day--such as glutashield powder or enteromend

  • Bovine Immunoglobulins 5-10 grams a day; I like ImmunoLin or Intestinal Support

  • Ginger Capsules such as Pure Encapsulations Ginger Extract

  • Working with somatic therapist and doing vagus nerve healing

2. SIBO/Dysbiosis

Dysbiosis is an imbalance of good vs. bad bacteria in the gut. When your body is in dysbiosis, your health may decline. Your gut bacteria affects immunity, digestive health, and mental health. SIBO (small intestinal bacterial overgrowth) is often a side effect of dysbiosis.


  • Chronic fatigue

  • Digestive problems

  • Acid reflux or heartburn

  • Food intolerance, gas, and bloating

  • Inflammation and aching joints

  • Acne, skin rashes, and psoriasis

  • ADHD or issues with concentration

  • Anxiety or depression

  • Bloating (often worse at the end of the day)

  • Constant Burping

  • Patient feels better on Low FODMAP diet

  • Patients’ symptoms get better after antibiotic treatment

  • Feel worse after taking probiotics or eating fermented foods

  • An uncomfortable feeling of fullness or gas immediately after eating

  • Loose stools

Try This:

  • Comprehensive microbiome/gut testing with functional medicine provider

  • SIBO Breath Test (Treating SIBO with herbal antimicrobials depends on if the patient is Methane or Hydrogen dominant)

  • Herbal antimicrobials: Allicin, Oregano oil, Thyme, Lemon Balm, Sage, Oregon Grape, Berberine (taken best in combination such as Candibactin, GI-MicrobX, SIBOtic)

  • Food Intolerance Testing

  • Limit Carbohydrates and Sugar (Low-fodmap diet x 12 weeks)

  • Oil of Oregano capsules for 6 weeks can be helpful for all forms of SIBO

  • Spore-based probiotics (may not tolerate until SIBO treated)

  • Motility Agents (for those with constipation or slow stool transit time) with prescription such as LDN, ginger capsules, magnesium citrate 600 mg , 5-HTP (interacts with many medication so caution), artichoke

  • Increased fermented foods and fiber are critical for dysbiosis after SIBO is treated (often not tolerated until SIBO is resolved)

  • Daily exercise to move the bowels

  • Gut healing agents such as aloe, glutamine, slippery elm, marshmallow root (best taken in combo such as GI-Relief or Enteromend)

  • Prescription antibiotics if necessary

3. Heartburn/GERD


  • Burning sensation in chest (heartburn), usually after eating, which might be worse at night or while lying down

  • Backwash (regurgitation) of food or sour liquid

  • Upper abdominal or chest pain

  • Trouble swallowing (dysphagia)

  • Sensation of a lump in your throat

  • Regurgitation of food or liquids into the mouth

  • Backflow of stomach acid into the esophagus (acid reflux)

  • Difficulty swallowing

  • Chest or abdominal pain

  • Feeling full soon after you eat

  • Shortness of breath

If you have nighttime acid reflux, you might also experience:

  • An ongoing cough

  • Inflammation of the vocal cords (laryngitis)

  • New or worsening asthma

Try This:

  • Chew food sloooowly until is it near-liquid consistency to activate amylase digestive enzyme in your saliva and help start the digestion process

  • Get checked for a hiatal hernia and SIBO, common causes of heartburn

  • Treat SIBO if present

  • Repair hernia if possible

  • Get checked for H. Pylori bacteria and treat if present

  • Digestive Enzymes

  • Ginger capsules

  • Marshmallow, slippery elm, aloe vera, and DGL (such as GIRelief by Thorne)

  • Go on a GERD diet: limit spicy and fried foods, peppermint, carbonated beverages,

  • Small meals more frequently instead of large meals

  • Go for a walk after eating, don't eat before laying down

  • Work with provider to lose weight-obesity highly associated

  • Trial of apple cider vinegar or HCL tablets (with your provider's guidance)

  • 600 mg of magnesium at bedtime

  • Zinc Carnosine 75 mg twice a day

  • Digestive Bitters

  • L-glutamine (avoid if you have kidney disease, liver disease, type 1 diabetes, seizures or Reye's syndrome)

  • Probiotics

  • Decrease stress-consider adaptogens such as holy basil and rhodiola and yoga/meditation practices

  • D-limonene such as brands Yarrow, Life Extensions, Orange Burps & Wellness Resources

4. Autoimmune Gut Disease/Irritable Bowel Disease (Crohn's and Ulcerative colitis)

Crohn's disease is a type of inflammatory bowel disease (IBD). It causes swelling of the tissues (inflammation) in your digestive tract, which can lead to abdominal pain, severe diarrhea, fatigue, weight loss and malnutrition.

Ulcerative colitis is an inflammatory bowel disease (IBD) that causes inflammation and ulcers (sores) in your digestive tract. Ulcerative colitis affects the innermost lining of your large intestine, also called the colon, and rectum. In most people, symptoms usually develop over time, rather than suddenly.

Symptoms of Crohn's:

  • Diarrhea.

  • Fever.

  • Fatigue.

  • Abdominal pain and cramping.

  • Blood in your stool.

  • Mouth sores.

  • Reduced appetite and weight loss.

  • Pain or drainage near or around the anus due to inflammation from a tunnel into the skin (fistula)

People with severe Crohn's disease may also experience symptoms outside of the intestinal tract, including:

  • Inflammation of skin, eyes and joints

  • Inflammation of the liver or bile ducts

  • Kidney stones

  • Iron deficiency (anemia)

  • Delayed growth or sexual development, in children

  • *High frequency of vitamin and mineral deficiencies

Ulcerative colitis symptoms can vary, depending on the severity of inflammation and where it occurs. Signs and symptoms may include:

  • Diarrhea, often with blood or pus

  • Rectal bleeding — passing small amount of blood with stool

  • Abdominal pain and cramping

  • Rectal pain

  • Urgency to defecate

  • Inability to defecate despite urgency

  • Weight loss

  • Fatigue

  • Fever

  • In children, failure to grow

  • *High frequency of vitamin and mineral deficiencies

Try this:

  • Low-Fodmap/Elimination Diet with functional nutritionist

  • Gluten and dairy free diet

  • Extra fiber (not during flare) such as SuperGut Fiber Mix

  • Sodium Butyrate or butyric acid

  • Curcumin (1,000 mg twice a day for 2 months)

  • Omega 3- Fatty Acids

  • In-Depth nutrient testing

  • Magnesium, iron (if needed based on labs)

  • Comprehensive functional gut /microbiome testing with functional provider

  • SIBO testing

  • Food Intolerance Testing

  • Ox Bile (Allergy Research Group or BioGest by Thorne)

  • GI Synergy (Apex Labs)

  • GastroFiber (Standard Process)--for those who don't get enough fiber in diet

  • Schisandra (Mediherb)

  • GI Relief by Thorne

  • Super Digestive Enzymes (Life Extensions) or BioGest (Ox Bile + Enzymes) by Thorne

  • Wormwood Complex (Standard Process) or SedaCrohn® 500 mg 3x daily (during flares or up to 10 weeks intermittently for symptoms)

  • Iberogast

  • Andrographis paniculata (Acanthaceae)

  • Boswellia serrata (Burseracea/Indian frankincense)

  • Cholacol (Standard Process) for constipation and/or indigestion (contains bile salts)

  • Probiotic such as RenewLife Ultra or Prescript Assist 2 caps/day

  • L-Glutamine 500 mg 2x/day (Thorne),

  • Vitamin D3(Thorne)-dose determined by blood levels

  • B Complex #12 2x/day (Thorne)

  • Regular daily exercise to increase gut health and motility

  • Saccharomyces boulardii by NOW or Pure Ecapsulations (IF yeast present in stool testing)

  • Acupuncture

Avoid potential triggers:

  • Raw vegetables

  • Caffeine

  • Sorbitol, xylitol, or other sugar alcohols

  • Alcohol

  • Spicy foods

5. Pancreatic Insufficiency

A condition when the pancreas does not make enough digestive enzymes. Without the proper amounts of digestive enzymes, patients struggle to break down foods and absorb nutrients properly. As a result, the food that passes through your intestines is not entirely digested and can lead to bloat, gas, loose stools, and, eventually, malnutrition. Your providers can easily check a pancreatic elastase level to aid in the diagnosis.


  • IBS or SIBO symptoms like gas, bloating, constipation, and diarrhea

  • Fatty stools

  • Unexplained weight loss (not everyone)

  • Diarrhea

  • Abdominal pain

  • Feeling of fullness

  • Abnormal lipid digestion causing malnutrition; depletion of lipid-soluble vitamins (A,D,E,K); selenium, zinc, B12, calcium, and iron

  • Dry skin, brittle nails and hair loss

  • Depression

  • Edema (tissue swelling)

  • Fatigue or dizziness.

  • Feeling cold all the time

  • Irritability

  • Memory and concentration issues

  • Muscle loss.

Try This:

  • Pancreatic enzyme replacement therapy (PERT)

  • Digestive Enzymes from Pure Encapsulations or Thorne

  • Ox Bile (Biogest by Thorne)

  • Get full nutrient testing and supplement if needed

  • Avoid Alcohol (can damage an already struggling pancreas)

  • Check for causes of pancreatic insufficiency such as

  1. Celiac disease

  2. Diabetes/Pre-diabetes

  3. Inflammatory bowel disease (IBD)

  4. Pancreatic cancer

  5. Chronic Pancreatitis

6. Celiac Disease

An immune reaction to eating gluten, a protein found in wheat, barley and rye.

If you have celiac disease, eating gluten triggers an immune response in your small intestine. Over time, this reaction damages your small intestine's lining and prevents it from absorbing some nutrients (malabsorption). The intestinal damage often causes diarrhea, fatigue, weight loss, bloating and anemia, and can lead to serious complications.

In children, malabsorption can also affect growth, development and behavior.

Symptoms for adults:

  • Diarrhea

  • Fatigue

  • Weight loss

  • Bloating and gas

  • Abdominal pain

  • Nausea and vomiting

  • Constipation

More than half the adults with celiac disease have signs and symptoms unrelated to the digestive system, including:

  • Anemia, usually from iron deficiency (fatigue, bruising, difficulty concentrating, shortness of breath, difficulty exercising)

  • Loss of bone density (osteoporosis) or softening of bone (osteomalacia)

  • Itchy, blistery skin rash (dermatitis herpetiformis)

  • Mouth ulcers

  • Headaches and fatigue

  • Nervous system injury, including numbness and tingling in the feet and hands, possible problems with balance, and cognitive impairment

  • Joint pain

  • Reduced functioning of the spleen (hyposplenism)

Children with celiac disease are more likely than adults to have digestive problems, including:

  • Nausea and vomiting

  • Chronic diarrhea

  • Swollen belly