Common Stomach Problems and Symptoms: What They Might Mean

It's normal to get a stomachache now and then, like after a super-spicy meal or before a big job interview.

But gut woes that stick around for more than a few days could signal more significant problems—from lactose intolerance to ulcerative colitis. And unfortunately, gastrointestinal conditions are not always easy to diagnose.

"There's a lot of overlap, the symptoms aren't always specific—for example, pretty much every GI condition can cause bloating or pain—and it's possible to have more than one issue at once," said gastroenterologist Robynne Chutkan, MD, founder of the GutBiome Institute in Chevy Chase, Maryland., and author of The Microbiome Solution.

Here's how to start understanding your symptoms and strategies for relieving them.

Gut Problem: Diarrhea

Diarrhea and Blood in Your Poop

If you have diarrhea and bloody stools, you could have an inflammatory bowel disease, such as ulcerative colitis or Crohn's disease.

Ulcerative colitis is a chronic inflammatory bowel disease (IBD) that causes ulceration—the wearing away—and inflammation of the large intestine. You might have diarrhea, abdominal cramps, and pain, but the classic symptom is blood in the stool.

"If it's been going on for months and there's a lot of bleeding—you'll see blood mixed with the stool, rather than streaks—it's most likely colitis," said gastroenterologist Lisa Ganjhu, DO, clinical associate professor of medicine at NYU Langone Medical Center. An abnormal immune system response may be involved, but heredity can also play a role.

Mild cases may benefit from lifestyle changes, such as avoiding foods that seem to cause flare-ups and reducing stress. Research has suggested that a low FODMAP diet may help some IBD patients.

Most cases require prescription drugs, such as anti-inflammatories, steroids, or immune suppressors. In some cases, surgery may be needed.

Diarrhea With Abdominal Pain but No Bloody Poop

It could be irritable bowel syndrome with diarrhea (IBS-D), marked by episodes of diarrhea and lower abdominal pain that improves after you go number two.

Your gut may release excess fluid into the GI tract during digestion, or food may move too fast through your system. There's no surefire cure for IBS-D, so the goal is to avoid your triggers. Triggers for IBS, in general, could include particular foods or extreme stress.

If you have IBS-D, you could take a fiber tablet during flare-ups to sop up extra water in the colon. Or consider a low FODMAP diet. Research has shown that this eating style significantly improves abdominal pain for people with IBS.

Exercise can relieve stress as well as help keep your gut moving normally. A handful of prescription drugs may help manage IBS symptoms, but they don't work for everyone and can have serious side effects.

Diarrhea With Occasional Bloating or Abdominal Pain but No Bloody Stool

Your symptoms might result from any food intolerances or sensitivities, such as those related to lactose or gluten.

If your symptoms worsen after you eat dairy, you're likely lactose intolerant. This condition is an inability to digest the milk sugars in cow's milk. Besides diarrhea, you may experience bloating or notice gurgling or other stomach noises after eating or drinking dairy products. Limiting or cutting out dairy can help ease these symptoms.

If your symptoms worsen after eating bread or pasta, these signs point to celiac disease or non-celiac gluten sensitivity.

Celiac disease is an autoimmune disorder in which eating gluten—a protein in wheat, rye, and barley—causes the immune system to attack the small intestine lining. It can produce symptoms such as:

• Abdominal pain
• Bloating
• Diarrhea
• Gas
• Constipation

The disease can also lead to brain fog, rashes, joint pain, depression, or reproductive issues (e.g., infertility) for some individuals.

In the longer-term, intestinal damage can compromise your ability to absorb nutrients. A blood test and biopsy can confirm the diagnosis, and only going 100% gluten-free can heal the gut and stop your symptoms.

With non-celiac gluten sensitivity, gluten won't inflict the type of damage to the small intestine seen in celiac disease, but you can still experience symptoms like fatigue, stomachaches, and muscle cramps. However, most people with gluten sensitivity feel better after cutting out gluten.

Diarrhea Unaffected by Eating Gluten or Dairy and With No Bloody Stool or Abdominal Pain

If your symptoms started within the past few days, it could be food poisoning or a stomach virus.

Sip electrolyte-rich fluids (broth, coconut water, Gatorade) to help relieve symptoms. However, you'll also want to call a healthcare provider if you have a fever over 101 degrees or your diarrhea lasts more than a few days.

Gut Problem: Bloating

Bloating in General

Beyond conditions already noted, other things that commonly result in bloating include:

• Gastroesophageal reflux disease (GERD)
• Weight gain
• Overeating
• Constipation
  

You'll want to contact a healthcare provider if bloating lasts for days or weeks. It's also important to seek medical care if bloating occurs with the following symptoms:

• Stomach pain
• Bloody or dark, tarry stools
• Diarrhea
• Worsening heartburn
• Vomiting
• Weight loss

Bloating That Increases Over the Day

Sometimes bloating can occur simply because you're eating throughout the day. However, you may also be swallowing air—the technical term for doing this is aerophagia. To help avoid it, you can reduce your soda intake, stop chewing gum, or eat slower.

Bloating as a Result of Other Health Conditions

You could also have small intestinal bacterial overgrowth (SIBO), in which bacteria in the small intestine have gotten out of whack. SIBO might occur due to pouches or blockages in the small intestine due to diseases (e.g., Crohn's disease), surgery, issues with your immune system, or some IBS cases.

Treatment for SIBO typically includes antibiotics, medicines that speed up movement in the intestines, intravenous (IV) fluids, or nutrition given through the vein in cases of individuals who are malnourished.

Additionally, healthcare providers may recommend limiting certain hard-to-digest carbohydrates, including lactose, fructose, and resistant starch.

Other serious issues that result in bloating could be conditions such as:

• Dumping syndrome (GI symptoms that happen when food moves quickly through the GI tract)
• Pancreatic insufficiency (when the pancreas does not produce enough digestive enzymes
• Ovarian cancer

If any bloating is caused by another health condition, seeing a healthcare provider will help determine which one and help you receive the proper treatment for your symptoms.

Gut Problem: Constipation

Chronic Constipation

You could have slow transit constipation. This is the technical term for when your colon doesn't move efficiently, making you chronically backed up.

If the constipation is mild, try eating more fruits, vegetables, and whole grains and drinking lots of fluids. Also, talk to a healthcare provider if the constipation is severe, you have not had a bowel movement in three days, or you have bloating or stomach pain.

Constipation and Severe Abdominal Pain After Eating

You might have Crohn's disease, another type of IBD. Crohn's disease can cause abdominal pain (especially in the right lower quadrant), diarrhea, sometimes bloody stool, fatigue, and weight loss. Over time, bowel obstruction can lead to constipation and even malnutrition.

As with ulcerative colitis, an abnormal immune response may be a factor. "Your body's antibodies are essentially chewing up the colon," explained Dr. Ganjhu.

While ulcerative colitis affects only the inner lining of the colon and rectum, Crohn's disease can affect all the layers of the bowel and the entire GI tract, anywhere from your mouth to your butt.

Treatment often involves lifelong immune-suppressing drugs plus steroids for flare-ups. Ask a healthcare provider whether a modified diet could improve your symptoms. Some cases may require surgery.

Constipation With Weight Gain, Fatigue, or Feeling Extra Sensitive to Cold

These symptoms could indicate an underactive thyroid (aka hypothyroid), which slows many of the body's systems, including digestion. After your diagnosis is confirmed with blood tests, treatment is daily thyroid medication.

Constipation Relieved by Pooping

It might be irritable bowel syndrome with constipation (IBS-C). The hallmarks of IBS-C are episodes of constipation and abdominal pain that are relieved with a bowel movement. The culprit could be certain foods, gut bacteria problems, or stress.

Constipation and Bloating That Worsens Only Around Periods or Ovulation

See an ob-gyn to get checked for a possible gynecological condition such as endometriosis, ovarian cysts, polycystic ovary syndrome (PCOS), or fibroids. These conditions may also cause GI symptoms such as bloating, constipation, or abdominal pain.

A Quick Review

Some of the most common stomach issues include diarrhea, bloating, and constipation. It's important to determine the cause of these problems and understand how and why they may overlap.

Additionally, these symptoms on their own or in combination can mean different things for your health. Thus, you'll want to contact a healthcare provider for medical attention to rule out any serious issues and receive the best treatment for your case.