Is It Stress? Food Intolerances? A Gut Bug? Stop Guessing, Get Tested

One of life’s biggest mysteries…when digestion is off. It’s normal to have an upset stomach from time to time, or an occasional bowl movement that isn’t formed or easy to pass, but when digestive symptoms persist, naturally, you begin to wonder… is is something I ate? Am I stressed? Do I have a bug? Why am I feeling this way and why am I not getting better?

While most bouts of digestive disturbance are not worrisome and go on to resolve themselves, if you’ve been experiencing unpleasant or disruptive digestive symptoms for more than 6 weeks or symptoms are steadily worsening, take the guesswork out of it and get a thorough evaluation done.


  • Excessive or very odorous gas
  • Excessive burping
  • Food regurgitation or trouble swallowing
  • Canker sores or mouth ulcers
  • Acid-reflux
  • Nausea or vomiting
  • Bloating, fullness or distention
  • Reduced appetite or early satiety
  • Hives, swelling, tingling or rashes after eating
  • Abdominal cramping or pain
  • Constipation or loose stool
  • Undigested food, mucus or blood in your stool

In general, we can divide digestive disturbance into 4 broad categories, and a thorough evaluation should consider all possible origins.


Here, breath tests, blood tests, and stool analysis will help to determine if a bacteria, fungus, virus or parasite is responsible. Because bugs can be tricky to catch with one sample, repeat testing is often necessary. If you were previously healthy with normal digestion, do not have a strong family history of digestive disorders and feel you’ve been unwell since a trip/travel or particular meal, we have a strong suspicion about infection.


Conditions like food allergies, inflammatory bowel disease, celiac or other autoimmune diseases can present with persistent digestive symptoms. Although less common than infection or functional conditions, ruling out inflammatory bowel conditions is important. Typically blood work and stool samples are done to screen, this can happen at the same time your doctor checks for infection, and the diagnosis confirmed with imaging and biopsy.


More sinister causes like cancer or extra-digestive causes such as bladder, prostate, ovarian or uterine conditions shouldn’t be neglected. Again, blood work, imaging, and physical exam can greatly help narrow the possibilities.


The catch-all category comprising of stress-related gut dysfunction, food reactions/intolerances, low stomach acid, enzymes or motility dysfunction to name a few. Once your doctor has ruled out other causes, infectious or inflammatory causes, they can then begin to work on the assumption that a component of your digestion or lifestyle is contributing to your symptoms. Although a functional condition is typically less worrisome than an infectious or inflammatory cause, resolving symptoms can be much more challenging as often there isn’t a clear-cut path for treatment.

Too often, patients dismiss their symptoms, and often, unfortunately, they are dismissed by their doctor as well. When I see a patient for an initial intake and I note one of the symptoms above, I dive deep into a thorough health history, symptom picture and physical exam. More often than not, I conduct a step-wise screening approach, ruling out infectious, inflammatory and other conditions before assuming it’s stress, foods or lifestyle. Once we’ve determined the origin of the symptoms, we can then begin to treat!

If you’ve been suffering from gut troubles, don’t sit on it, come in and get checked out!

In Health,

Dr. Alaina

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You might also want to read our previous blog, Accutane, Retinoids & Acids For Acne – What You Need To Know


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