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21 Health Secrets Your Gut Is Trying to Tell You

Is your digestive system a constant source of trouble and pain? Here's what all those nagging symptoms can mean—and how to manage them.

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You need a probiotic

If you experience gastric distress like bloating, gas, constipation, diarrhea, or even acid reflux, you could likely benefit from probiotics. "Daily probiotics support and rejuvenate the microbiome by helping to balance the gut flora, assist digestion, help your body make vitamins and absorb minerals, strengthen the immune system, and improve metabolism," says Frank Lipman, MD, bestselling author and founder of Be Well and the Eleven Eleven Wellness Center in New York City. The gut microbiome is a collection of good bacteria that affect your digestive health and can be improved by eating yogurt and fermented foods like sauerkraut, kimchi, and kefir, or by taking a daily probiotic supplement. "Based on current research, find a probiotic that has as many different strains [of bacteria] as possible," says Erika Angle, PhD, biochemist and CEO of microbiome fitness company Ixcela. "By taking a probiotic, you are skewing the Darwinian competition in your gut, giving different species an equal chance to survive and allowing for a more balanced and diverse microbiome."

A diverse microbiome is a healthy microbiome. Watch for these silent signs that your microbiome could be in trouble.

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You're exposed to too many chemicals

According to recent studies, gut microbiota dysbiosis can be induced by environmental pollutants. "Pain in the gut or bowel habits that are unusual are often signs of a damaged microbiome," Dr. Angle says. Paying more attention to the health of your gut, she says, "begins with monitoring what we put in and on our bodies, because processed foods, chemical exposure through creams, lotions, and detergents, and medications can often have negative side effects that reduce or change the makeup of microorganisms in the gut." Dr. Lipman says junk food, GMOs, conventionally or factory-farmed meats may also impact your inner ecology. "Almost no one reaches adulthood with their microbiome in tip-top shape—it picks up a few dents and dings along the way," he says. Research is still emerging on exactly how these factors impact your microbiome, but eating a diet of whole foods—including pastured, free-range, and wild caught meats meats, eggs, and fish and organic produce whenever possible—and taking a probiotic may benefit it. If you need some motivation to improve your gut health, here's how a healthy gut microbiome could add years to your life.

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You have a weak immune system

A good portion of the immune system is in the gut, and cells in the gut lining produce important antibodies. In addition, bacteria in the gut produce three key B vitamins—biotin, folate, and vitamin B12. In addition, the condition of the gut affects nutrient absorption, which in turn affects the immune system and overall health—so if you're frequently sick, your gut might be to blame. "When your gut is balanced with good bacteria, it works properly to defend your body from infections, colds, and illness," Dr. Lipman says. "If there is an imbalance, the body loses its ability to cope and ward off bad bugs, which leads to frequent sickness." If you feel "off," Dr. Lipman says, a first step may be to restore and balance your microbiome. Research shows if the good bugs in your digestive system aren't fed the proper nutrients, they may fail to thrive and protect against disease. "Certain bacterial species secrete powerful antioxidants known to help strengthen the immune system," Dr. Angle says. "If we have an imbalanced or reduced number of microorganisms, the antioxidants are no longer produced, making us more susceptible to illness." Did you know that the number of nitrite-eating bacteria in your mouth can predict whether you are a migraine sufferer? Learn more surprising things your microbiome reveals about you.

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Your sleep patterns need correcting

Lack of sleep can affect your gut heath—and vice versa. "A growing number of studies now suggest that the vast and diverse microbial ecosystem of the gut has its own daily rhythms," says The Sleep Doctor Michael Breus, PhD. "These microbiome rhythms appear to be deeply entwined with circadian rhythms—research suggests that both circadian and microbial rhythms are capable of influencing and disrupting the other." One way your gut influences sleep is through the production of the chemical serotonin, which influences your sleep/wake cycle. "If asked, most people would say serotonin is created in the brain—however, more than 80 percent of serotonin created in the body is created in the gut," Dr. Angle says. "Serotonin plays an important role across a wide variety of conditions, and can contribute to sleep problems." Here are 50 more surprising things about your brain you didn't know.

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Your sympathetic nervous system is on high alert

For many people, stress can manifest in gut-related symptoms. "Digestive problems often go hand-in-hand with stress and stress-related mental disorders," says Linda Rinaman, PhD, a psychology professor at Florida State University who's done research on the gut-brain connection. Dr. Rinaman describes how the gut and brain are constantly talking to each other via the vagus nerve, which runs the length of the body from the brain down the spine and to tailbone, touching all points along the way. It's a vast two-way network relaying messages to and from the brain and the gastrointestinal tract. This may be the reason why we get "butterflies" when we're nervous. "During emotional stress and anxiety, the sympathetic nervous system takes over and essentially shuts down gut functions—you don't need to digest your food when you're being chased by a bear," Dr. Rinaman says. In other words, work or home stress can trigger a "fight or flight" reaction; your body will shunt blood away from your intestine to your extremities. "Gut movements will slow down, and this by itself can create a feeling of nausea, and make the stress seem worse." Over time, chronic stress can take its toll on your gut. Stress management strategies can help, as can eating a healthy diet rich in nutrients and fiber (and not a lot of sugar) to feed the "good bacteria" in your gut microbiome, Dr. Rinaman says. Here are foods that boost your good gut bacteria.

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You need to get more exercise

According to Harvard Medical School, moving your body helps move your bowels. "Exercise-induced alterations in the autonomic nervous system [which controls bodily functions] of the gastrointestinal tract are thought to influence colonic and possibly small bowel motility," Dr. Ramdhaney says. The release of hormones called prostaglandins can rev up your GI tract, and make you more likely to go. "This is the same phenomenon we see with exercise-induced diarrhea, hence the benefits of exercise in improving constipation," Dr. Ramdhaney says. In short, one of the surprising reasons you're constipated can be that you're not getting enough exercise.

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Your vagus nerve is overacting

An unhealthy gut microbiome may lead to mood and emotional problems by way of an out-of-whack vagus nerve, according to the recent FSU study. "The vagus nerve carries 'motor' signals from the brain to the gut that affect digestive processes, and also carries sensory feedback signals from the gut to the brain," says study author Dr. Rinaman. "The signals it carries to the brain can switch over from reporting 'all is well' to reporting 'there's a problem down here.'" For example, eating foods like sugar, seed oils, fried foods, refined flour, chemical additives, and artificial sweeteners can lead to inflammation in the body, which can induce "danger" signals traveling up the vagus nerve to the brain, including signals that worsen symptoms of anxiety and depression. "This influence can actually alter our mood, affect decisions that we make, and redirect our behaviors," Dr. Rinaman says. Learn how new discoveries on the connection between gut bacteria and emotions could lead to breakthrough treatment for anxiety disorders.

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You eat too close to bedtime

One common cause of gut problems like acid reflux, heartburn, and even GERD (gastroesophageal reflux disease) is lying down too soon after eating. "Eat dinner two to three hours before bedtime and avoid lying down after meals," says gastroenterologist Susan Ramdhaney, MD, AGAF, an expert from the American Gastroenterological Association. If your dinner content is high in fat and carbohydrates, eat four to six hours before bedtime and reduce portion sizes, she says. Also, keep a food diary to identify trigger foods. "Trigger foods, such as foods with high-fat content, caffeine, chocolate, spicy foods, carbonated beverages, and peppermint, as well as the use of alcohol and tobacco, can cause a reduction in the lower esophageal sphincter pressure, allowing regurgitation from the stomach into the esophagus," Dr. Ramdhaney says. According to science, following this one diet beats acid reflux better than medication.

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You have something blocking your bowel

If your belly is hard and swollen, it could just mean you're constipated or have gas. But if the condition continues, it could be a sign of a bowel obstruction. "When there is a bowel obstruction, fluid and air in the bowel will either move very slowly or not at all, through the obstructed region of the intestine," says American Gastroenterological Association expert Jonathan Rosenberg, MD, a gastroenterologist at Illinois Gastroenterology Group. "This backed-up fluid and air will cause the bowel to distend and the patient will often experience a hard belly." Research shows such blockages account for 15 percent of ER visits for abdominal pain. Causes of obstructions can range from adhesions to hernias, diverticulitis, intestinal bowel disease (IBD), and even cancer, so it's best to get it checked out as soon as possible. Here are more clear signs you have an unhealthy gut.

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You're bleeding internally

Red blood in your poop will probably freak you out, but black stool can also be a sign of bleeding somewhere in your gut. "Black-colored stool may be a sign of internal bleeding from somewhere in the digestive tract, such as the stomach or small bowel," says gastroenterologist Jack Braha, DO, chief of gastroenterology at Mount Sinai Brooklyn. Unless you've eaten dark-colored veggies like beets, taken iron supplements, or dosed yourself with Pepto Bismol, black stool may be a cause for concern. Bright red blood in your stool also warrants a visit to your doctor. "Red blood may come from bleeding hemorrhoids after straining or having a hard bowel movement, but may also be the first sign of a serious issue such as inflammatory bowel disease, diverticulosis, or colorectal cancer," Dr. Braha says. "The color of the blood cannot reliably tell us if it is something dangerous or not." Your doctor can determine whether testing is needed. Check out the other things your bowel movements can tell you about your health.

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It's time for a colonoscopy

Don't let fears of having to drink gallons of yucky prep liquid to empty your bowels keep you from having a necessary colonoscopopy. Not only have colon preps gotten a lot more concentrated in recent years but having a colonoscopy could save your life, especially if you have concerning signs: "Typical 'alarm' symptoms include blood or pus in the stool, weight loss, fever, an abdominal mass, and stools that wake you from sleep," Dr. Rosenberg says. "Also, while not a symptom, a family history of colon cancer or inflammatory bowel disease (IBD) may indicate a need for a colonoscopy." Even if you don't have any symptoms, patients over 50 should talk to their doctor about a colonoscopy for cancer screening. Try these tips healthy adults should start now to prevent colon cancer.

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You need more fiber in your diet

If you're finding it too hard (literally) to go number two, you may be constipated. "Constipation may have varied meanings to different people, based on their impression that their bowel habits have changed. Stool may be too hard or too small, or defecation may be too difficult or too infrequent," says Dr. Ramdhaney. Constipation can often be brought on by diet, so try eating more fiber and drinking more water to make your stool looser, larger, and easier to pass. Constipation that persists, however, can indicate serious GI disease as well as non-GI diseases, including diabetes, multiple sclerosis, Parkinson's disease, and hypothyroidism, Dr. Ramdhaney says. So if constipation lasts longer than three months, especially if accompanied by blood in stool, weight loss, or decreased appetite, get checked out by a doctor. You might also be able to fix the problem with these 15 foods that are natural laxatives.

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You may have chronic constipation

If you have ongoing difficulty with constipation, with no known cause, you might have chronic idiopathic constipation (CIC), marked by hard stool and a feeling that you just can't get it all out. If you're dealing with constipation that won't go away, don't be too shy to have a frank talk with your doctor. "In my experience, patients fail to seek treatment because they are too embarrassed to talk about their bowel movements or they are unaware that there is treatment above and beyond what they find in the drugstore or supermarket," says Dr. Braha. "The bottom line is that we have to make the conversation about our bowel movements—going poop—easier and more comfortable for our patients."

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You could have liver trouble

You might not even realize it, but the liver is actually part of the digestive system. "Nutrients from our food, ingested toxins, and medications are absorbed into the bloodstream from the intestines, and the first stop is the liver, which is involved in many metabolic processes that help create energy or breakdown dangerous substances," Dr. Braha says. Symptoms such as weight loss, decreased appetite, fatigue, abdominal swelling, and alterations in your mental state could be the first signs of liver disease, including hepatitis, cirrhosis, or cancer. "As the liver begins to enlarge, patients may experience abdominal pain on the right side near the rib cage," Dr. Braha says. If you have these symptoms, see your doctor, especially if you have other risk factors like drug or alcohol use or obesity. Here are 13 ways you could be secretly hurting your liver.

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You're eating too many fatty foods

Besides the obvious side effects from this bad habit—like weight gain—eating fatty foods may contribute to the formation of gallstones. "One common type, called a cholesterol gallstone, is felt by most experts to occur when your liver excretes more cholesterol than your bile juice can normally dissolve," Dr. Rosenberg says. "Elevated blood cholesterol is associated with obesity, and obesity is associated with increased production and excretion of cholesterol into the bile." Although there are genetic factors you can't change that contribute to gallstones, eating less saturated fat may help prevent them. Instead, eat these superfoods for a healthy gallbladder diet.

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You may have an ulcer

If you feel pain in your stomach and often find yourself reaching for antacids after eating, you should be evaluated for an ulcer or damage to your stomach lining. "Frequently, people with ulcers have dyspepsia or upper abdominal pain, with discomfort moving to the left or right of the abdomen or sometimes to the back," Dr. Ramdhaney says. "These symptoms may get worse after eating with increased belching, feeling of fullness, nausea, vomiting, or inability to tolerate meals with high-fat content." Although some ulcers don't cause any symptoms, if you have signs of an ulcer you should see your doctor before complications—such as vomiting blood or what looks like coffee grounds, passing black or reddish stool, sudden abdominal pain and bloating, and sometimes weight loss—occur. Make sure you know all the ulcer symptoms that mean you should go see your doctor.

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You have a stomach bug

Sudden, short episodes of diarrhea may be a symptom of food poisoning or a bout of "stomach flu." Here's how to tell the difference. "When loose stools—an increase in the frequency, volume, and consistency of stool—happens acutely, it can be the sign of an infection of the gastrointestinal tract," Dr. Ramdhaney says. "These include viral infections such as norovirus, rotavirus, or adenovirus; bacterial infections, more commonly Salmonella, Campylobacter, Escherichia coli, Shigella or Clostridium difficile; or protozoa  infection [with a parasite, eww!] such as Giardia." Bacterial or parasitic infections can be treated with medication, but you'll probably have to ride out a viral bug. Here are the many medical reasons why you shouldn't ignore heartburn.

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You're allergic to something

Certain foods may seem to bother your tummy, but it can be hard to figure out what they are. "Often pain can be addressed by changing one's diet through elimination and experimentation—for example, if you know that every time you eat almonds, you have pain, then perhaps you have a food sensitivity or allergy to almonds and should see a specialist who can help test for other food sensitivities," Dr. Angle says. You can try keeping a food diary to spot the pattern. You may also have frequent loose stool or diarrhea, Dr. Ramdhaney says. If this occurs often, "it is time to consult the gastroenterologist to rule out causes including malabsorption diseases such as celiac disease [a gluten allergy] or lactose intolerance [a dairy allergy]," she says. Don't ignore these symptoms of lactose intolerance.

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You might have irritable bowel syndrome (IBS)

Loose stool may also be a sign of irritable bowel syndrome, Dr. Ramdhaney says—though confusingly, constipation is also a sign of the same condition. That's because IBS comes in two versions. "IBS, irritable bowel syndrome, is a common digestive disease affecting millions of Americans that is divided into multiple sub-groups, one of the most common being IBS with constipation (IBS-C), the other IBS with diarrhea (IBS-D)," Dr. Braha says. "Most patients with IBS-C describe abdominal pain or discomfort, such as a belly ache or cramp, that is associated with constipation and quite frequently will improve after they have a bowel movement." Unfortunately, the cause isn't known, although Dr. Angle says an unbalanced microbiome might have something to with it. Right now, there is no cure. If your symptoms have been going on for at least six months, see your doctor for help in coming up with a management plan. Read how severe IBS-C nearly ruined this woman's life—until one treatment changed everything.

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Your gut is inflamed

Not to be confused with IBS, inflammatory bowel disease (IBD) is an umbrella term for ulcerative colitis (UC) and Crohn's disease, chronic inflammation that can appear in different parts of the GI tract. "While patient's with IBD also have abdominal pain and alteration in bowel consistency—usually diarrhea only—they will also typically have symptoms related to significant inflammation of the bowel, including blood or mucus in the stool, weight loss, fever, and nighttime bowel movements," Dr. Rosenberg says. "Patients with IBD will also frequently have evidence of inflammation outside of the bowels, including joint pains and skin rashes." IBD has been thought of an autoimmune condition, but recent research shows it might not be the body attacking itself as much as the body overreacting to bacteria in the gut. Something called a "low-residue diet" could be the answer for Crohn's, colitis, and other GI problems.

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Your gut may be leaking

Vague GI symptoms like bloating, digestive problems, and pain could be caused by a newly identified condition just being recognized by doctors: leaky gut syndrome—also called intestinal permeability. These are the silent signs you have leaky gut syndrome. "In leaky gut, the spacing between cells in the gut lining is wider than it should be, and the integrity of the gut lining is compromised," Dr. Angle says. "When these particles escape the intestine and flood the body cavity, they are recognized as foreign by the immune system." Your body mounts an attack, creating a chronic state of immune system activation, leading to chronic inflammation and a strained immune system. Dr. Ramdhaney notes that leaky gut syndrome is often a result of intestinal surgical resection for Crohn's disease, cancer, or other GI problems. According to Harvard Medical School, other causes may include genetics and a poor diet.