food elimination Archives | Health Takes Guts®

If it feels like everything you eat causes a problem, it can be incredibly frustrating.

You eat something and you bloat.

You eat something else and you get diarrhea.

Another food causes constipation. Another gives you stomach pain. Another makes you feel nauseated.

Pretty soon, you have a list of foods you “can’t eat” that is getting longer and longer.

But why?

There isn’t one answer to this question. And despite how tempting it is to find one thing to blame, digestive symptoms are often the result of several things interacting with each other.

So let’s look at some of the possibilities.

Your gut has to do a lot of work

We tend to think of digestion as a pretty simple process: eat food, digest food, absorb nutrients, eliminate waste.

But your digestive system is doing all of that through a complicated combination of digestive juices, enzymes, muscles, nerves, hormones, immune cells, and microorganisms.

Food has to be broken down.

It has to move through your digestive tract at the right pace.

Nutrients have to be absorbed.

The gut has to distinguish between things that are harmless and things that need an immune response.

And your gut is constantly communicating with your brain.

So when something isn’t working quite right, the symptoms can show up in lots of different ways.

Motility matters

Your digestive tract is not just a tube that food falls through.

It has muscles and nerves that coordinate the movement of food from one end to the other. This is called gastrointestinal motility.

If things move too quickly, you may have diarrhea.

If they move too slowly, constipation can become a problem.

And sometimes the problem is not simply fast versus slow. The coordination of movement can be disrupted at different points along the digestive tract.

Motility problems can also contribute to bloating, abdominal discomfort, nausea, and the feeling that food is just sitting there.

This is one reason why the same food can seem perfectly fine one day and terrible another day. What is happening in your digestive system at the time you eat it matters.

Your gut may be more sensitive than it should be

Here’s another piece that is easy to miss.

Sometimes the problem isn’t that there is something terribly wrong with the food or even that there is an enormous amount of gas in your digestive tract.

It may be that your gut is more sensitive to what is happening inside it.

This is called visceral hypersensitivity.

For example, gas and stool are normal parts of digestion. Everyone has them. But people with disorders such as IBS can experience pain or significant discomfort from amounts of gas or stool that might not bother someone else.
This is one reason I don’t like the idea that digestive symptoms always mean, “This food is damaging me.”

Sometimes your gut is sensing something that is happening normally, but the signal is being experienced as much more uncomfortable.

And that doesn’t mean the symptoms are imaginary.
The symptoms are very real.

Your brain and your gut are talking all the time

This is another place where the old idea of “it’s all in your head” has done a lot of damage.

Your brain and your digestive tract are in constant communication. The gut has its own nervous system, and signals travel in both directions between the gut and brain.

That means stress, emotions, expectations, and the way the brain processes bodily sensations can influence digestive symptoms.

It also works the other way around. What is happening in your gut sends information back to your brain.

So if you have a gut that is already sensitive, being worried about what you eat can become part of the picture.

Maybe your motility is sluggish.
Maybe your gut is more sensitive.
Maybe certain carbohydrates are particularly difficult for you to digest or absorb.
Maybe there has been a change in your microbiome.
Maybe you have an underlying gastrointestinal condition that needs to be diagnosed and treated.
Maybe stress is amplifying symptoms that already have a physical cause.
Maybe several of these things are happening at the same time.

That is why I am much more interested in the pattern than in a list of supposedly “good” and “bad” foods.

What do you do when everything seems to bother you?

This is where I would resist the temptation to keep eliminating foods forever.

A short-term elimination can sometimes be useful. The low FODMAP diet, for example, can help some people with IBS identify dietary triggers. But it is designed to be followed by reintroduction and personalization, not indefinite restriction.

If your diet keeps getting smaller, I think it is time to step back and ask a bigger question:
Why is my gut reacting to so many things?

That question may lead you to a very different solution than simply eliminating another food.

And sometimes the answer is not about finding the perfect diet at all.

Sometimes the goal is to help your digestive system become a little less reactive, understand what is actually triggering your symptoms, and gradually figure out what you can comfortably eat.

That’s a much more useful place to end up than being afraid of your next meal.

“I have a ton of food intolerances. I need to figure out what foods I can eat.”

I hear some version of this from new clients all the time.

They may have already eliminated gluten, dairy, onions, garlic, beans, certain fruits, grains, eggs, nuts, or a long list of other foods. Sometimes they have food sensitivity testing that has given them even more foods to avoid.

And often, the list keeps growing.

At first, it makes sense to think, Well, obviously, the problem is the food.

If a food makes you bloated, gives you diarrhea, causes stomach pain, or otherwise makes you feel terrible, why wouldn’t you stop eating it?

But there is an important question that can get missed:
Why are so many different foods bothering you in the first place?

If you have one food that consistently causes a problem, maybe that food really is the problem.

But when you are reacting to 20 or 30 or 50 different foods, I start thinking about the digestive system itself.

That doesn’t mean the foods aren’t causing symptoms. They are. The question is whether the foods are the root cause of what is happening.

Your symptoms are real. The food may not be the whole story.

First, let’s clear up something important.

When I say that I want to look beyond the food, I am not saying your symptoms aren’t real.

If you eat a particular food and then become bloated and uncomfortable, you really did become bloated and uncomfortable.

And there are plenty of legitimate reasons a person may not tolerate a particular food.

Lactose intolerance is a good example. If you don’t produce enough lactase, the enzyme needed to digest lactose, eating too much lactose can cause gas, bloating, abdominal discomfort, and diarrhea. That’s a real food intolerance.

Food allergies are another matter entirely. A food allergy involves an immune response and can sometimes be dangerous. It is not the same thing as a digestive intolerance.

And conditions such as celiac disease are different again. Gluten triggers an immune response that damages the small intestine. That is not simply a food that happens to make your stomach feel bad.

So yes, sometimes the food really is the issue.

But that doesn’t explain every situation in which a person’s list of “bad foods” keeps getting longer.

When everything seems to bother you

Here’s the pattern that catches my attention:

- You start with one or two foods.
- You eliminate them.
- You feel somewhat better, so you assume you’ve found the answer.
- Then another food starts bothering you.
- So you eliminate that one.
- Then another.
- And another.

Eventually you may find yourself with a diet that looks something like:
“I can’t eat gluten. Or dairy. Or beans. Or apples. Or broccoli. Or eggs. Or anything with garlic. Or anything spicy. And definitely not restaurant food.”

At some point, I want to stop and ask:
What’s going on here?

Because the problem may no longer be a collection of unrelated foods.

There may be something about the way your digestive system is functioning that is making a whole range of foods difficult to tolerate.

That is a very different problem.

And it calls for a very different solution.

Your gut has a lot of jobs to do

Digestion is not simply a matter of putting food into your mouth and hoping for the best.

Your digestive system has to break food down, move it through the gastrointestinal tract, digest and absorb nutrients, interact with trillions of microorganisms, communicate with your immune system, and eventually get rid of what you don’t need.

There are a lot of places where things can go a little sideways.

For example, symptoms can be related to:

How well you digest particular carbohydrates or other components of food
The way food moves through your digestive tract
Changes in the gut microbiome
Irritation or inflammation in the gastrointestinal tract
Immune reactions
A condition such as celiac disease, inflammatory bowel disease, or another gastrointestinal disorder
A genuine food intolerance or allergy

And sometimes there is more than one thing going on.

This is why simply making a longer list of foods to avoid doesn’t necessarily solve the problem.

Sometimes the “trigger food” is telling you something useful

This is where it gets interesting.

Let’s say you eat a bowl of lentils and get extremely bloated.
You could conclude:
Lentils are bad for me.

Maybe they are. Or maybe there is more to the story.

Perhaps your digestive system is having difficulty handling the fermentable carbohydrates in the lentils. Perhaps the amount you ate matters. Perhaps your symptoms are influenced by what else you ate that day. Perhaps your gastrointestinal tract is already irritated or unusually sensitive.

The food is still connected to the symptom.
But the food may be acting more like a trigger than the underlying cause.

This distinction matters because if you only identify triggers, you can end up with a very long list of foods you don’t eat.

If you identify what is making your gut so reactive in the first place, you may have more options.

This is where I get concerned about endless elimination

There is nothing inherently wrong with temporarily removing a food to see whether symptoms improve.

Sometimes that is exactly what we need to do.

But elimination is a tool. It is not necessarily the end goal.

Even structured diets such as the low FODMAP diet are designed around this idea. The initial restriction is followed by reintroduction and personalization, with the goal of figuring out which foods and amounts you actually tolerate rather than permanently eliminating everything that contains FODMAPs.

And this matters because food restriction can take on a life of its own.

If you are constantly thinking about whether a food will make you sick, checking ingredients, avoiding restaurants, bringing your own food everywhere, or becoming afraid to try anything new, your diet may be getting smaller and smaller while the underlying problem remains unresolved.

Researchers and clinicians are increasingly recognizing this concern in people with IBS and other gastrointestinal conditions. Dietary restriction can become excessive, and fear of symptoms can itself contribute to increasingly restrictive eating.

I don’t want that for my clients.

I want to know what you can eat.