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Tummy Trouble Tips

Stomach and intestines illustration

Illustration: Jennifer Bahng

During the holidays, it’s typical to overindulge and pay the price of an occasional stomachache. But more frequent gut troubles—seasonal feast-induced distress aside—can be life-disrupting and awkward to discuss. Symptoms like nausea, abdominal pain, bloating, constipation and diarrhea are linked to many common ­gastrointestinal (GI) conditions that can be diagnosed and treated by a healthcare professional.

But often patients try to identify and cure their “embarrassing” digestive issues before they consult a physician, which can complicate a diagnosis, says Deena Midani, MD, a Cedars-Sinai gastroenterologist. 

“The GI office should be the last place you feel ­embarrassed about discussing your symptoms,” Midani says. “Self-consciousness shouldn’t hold somebody back from getting the medical care they need.” 

Here, Midani helps define and demystify common GI conditions. 

Celiac Disease

Celiac Disease is a serious immune reaction to gluten (a protein in wheat, barley and rye) that causes inflammation in the small intestine.

Test: A physician performs a blood test and an upper endoscopy—a visual examination using an instrument that can also take tissue samples from the small intestine.

Treatment: Eliminate foods with gluten, like bread, pasta and beer.

“When you develop these symptoms, it can take a toll on your daily life,” she says. “Suddenly your world revolves around getting through the day, finding bathrooms or scheduling meals. A supportive physician can guide you through your day-to-day routine, help you troubleshoot when things get worse and reassure you when things improve.”

Non-Celiac Gluten Sensitivity

Non-Celiac Gluten Sensitivity causes gastrointestinal symptoms when you eat foods with gluten, but the condition is not detectable by immune response or intestinal damage.

Test: Under medical supervision, avoid gluten for a few weeks. If your symptoms get better, reintroduce it to your diet and monitor whether symptoms return.

Treatment: Avoid gluten.

“Determining if you’re sensitive to gluten is complicated, and you shouldn’t jump to conclusions. Be honest with yourself about your tolerance. If you can comfortably eat bread or a bowl of pasta, you likely don’t need to follow a strict gluten-free diet.”



Irritable Bowel Syndrome (IBS)

Irritable Bowel Syndrome (IBS) is a disorder of the large intestine that affects mostly women.

Test: While there is still no definitive way to diagnose IBS, a pioneering blood test developed at Cedars-Sinai can detect certain types of the condition thought to be related to a previous GI infection. Otherwise, after excluding other possible conditions, a doctor can confirm a diagnosis if you’ve had symptoms that include abdominal pain at least one day a week for three months. 

Treatment: Dietary changes and stress reduction as well as treating symptoms such as diarrhea or abdominal pain with certain medications can help.

“A lot of my patients are very healthy—they exercise regularly and are doing all the things they’re supposed to do, yet they still have abdominal pain, bloating and changes in their bowels, and it frequently correlates with stress,” Midani says. “These are symptoms affecting patients’ quality of life.”

Lactose Intolerance

Lactose Intolerance is the inability to digest lactose, the sugar in dairy products. Even if you’ve never been sensitive to dairy, you can develop lactose intolerance at any time in your life.  

Test: After you’ve tried an elimination diet, blood or breath tests can confirm whether your body is unable to digest lactose.

Treatment: Limit or avoid dairy. 

“It’s easy to take a break from dairy and see if that causes improvement or resolution of your symptoms. It doesn’t make anything worse.”

Tummy Trouble Tips

If you’re concerned about new digestive symptoms, Midani says it’s important to remember that you don’t have to endure them alone.

“When you’re going through something and you’re nervous it could be serious, it can feel scary,” she says. “You don’t have to do all the guesswork and sort through the wealth of information online without guidance.”

Midani suggests these tips to help you and your ­doctor pinpoint and treat what is bothering you:

  • Avoid taking multiple herbal supplements or extra fiber until you discuss them with a healthcare provider, since they may make symptoms worse.
  • Share with your doctor all the medications you’re taking—some prescriptions can increase bloating, nausea, diarrhea or constipation.
  • Be well-informed. It’s hard to filter what is relevant and it’s easy to get overwhelmed, so discuss your concerns with your physician.
  • Do not ignore your symptoms. Let your doctor know as soon as you have unintentional weight loss, blood in your stool, changes in your bowel habits, persistent nausea or vomiting.