If you're reading this, there’s a good chance you’re suffering from some digestive distress. If so, you’re far from alone. According to the U.S. Department of Health and Human Services, 60 to 70 million people are affected by digestive diseases — and it’s not always easy to decipher what’s happening down below, in your belly and beyond.

That’s where THE WELL comes in: Chief Medical Officer Dr. Frank Lipman and Health Coach Katrine van Wyk break down the meaning behind various digestion symptoms.

It Starts in the Gut

Your gut is home to trillions of bacteria (both good and bad) that help you digest your food and absorb vital nutrients. “Just like our skin protects us from the external world, the gut is your internal barrier to the external world,” explains Dr. Lipman.

And this barrier is very thin — only one cell thick. “When the gut wall gets damaged, metabolites of bacteria or byproducts of food can leak through the gut and enter the bloodstream… which can create inflammation all over your body,” says Dr. Lipman. And this inflammatory response doesn’t just lead to tummy trouble — it can affect your mood, skin and even immunity.

This delicate ecosystem is in constant flux, and what you eat has a tremendous impact on how well it’s working — or not working. But other factors come into play too, like your stress level, sleep patterns, use of antibiotics or other medications and even how often you dine out at restaurants.

The most common culprits of gut issues include:

• SIBO (Small Intestinal Bacterial Overgrowth)
• Candida
• Parasites
• Dysbiosis (imbalance in the gut microbiome)
• Leaky gut
• Malabsorption issues
• Low stomach acid

RELATED: What to Eat When You Have Anxiety

Sussing Out Symptoms

While the occasional upset stomach isn’t cause for concern, consistent digestive issues may be. “These issues seldom come alone; most people have several symptoms and imbalances happening at once,” says van Wyk. “One imbalance that goes untreated often leads to several other problems. For example, low stomach acid might be because of stress or poor diet and the lack of stomach acid then leads to indigestion, bloating and constipation.”

What’s more, sometimes trouble in your gut doesn’t show up in obvious ways. “Leaky gut can exist without the person having typical digestive symptoms, but shows up as skin issues, an autoimmune condition and more,” says van Wyk.

Below, some of myriad symptoms brought on by gut-related issues:

• Gas
• Bloating/Distention
• Reflux
• Heartburn
• Indigestion
• Constipation
• Diarrhea
• Fluctuation between constipation and diarrhea
• Food sensitivities
• Acne and other skin issues
• Joint pain
• Fatigue
• Brain fog
• Weight gain

RELATED: 6 Ways an Out-of-Balance Gut Affects Your Well-Being

How to Deal with Distress

Advice for how to mitigate the discomfort and make things right.

Bloat:

• Try an elimination diet to rule out food sensitivities
• Identify if you have low stomach acid (which can be done with the help of a practitioner and a carefully monitored HCL test).
• Rule out SIBO (small intestinal bacterial overgrowth)
• Try mindful eating — get our free guide to Mindful Eating here
• Chew your food really well
• Take a digestive enzyme
• Intermittent fasting can help give the digestive system a break
• Try THE WELL Cleanse which includes a gut reset and elimination diet
• Sip a little apple cider vinegar or take digestive bitters before meals
• Avoid drinking cold beverages while eating — sip on warm ginger tea instead!
• Choose cooked, warm foods which are easier to digest and take a break from cold foods like salads

“If you find yourself in pain after eating (no matter what you eat), it’s more likely due to an imbalance in the gut microbiome (such as SIBO) or low stomach acid,” explains van Wyk, adding: “If the pains are more chronic or acute you should rule out more serious issues.”

RELATED: 11 Natural Ways to Banish Bloat

Nausea:

• Make sure to balance blood sugar
• Identify food sensitivities through an elimination diet
• Decrease or remove coffee and alcohol

Heartburn:

• Determine if you have low stomach acid
• Drink a little apple cider vinegar or take digestive bitters before meals
• Identify food sensitivities through an elimination diet
• Decrease or remove coffee and alcohol
• Try mindful eating — get our free guide to Mindful Eating here
• Chew your food really well

Constipation:

• Hydrate by eating water-rich foods and drinking warm water throughout the day
• Include enough fiber — but not too much as that also can be irritating!
• Choose more warm, cooked foods
• Try a Magnesium Citrate supplement
• Try a Triphala supplement (Ayurvedic herbal blend)
• Consider doing THE WELL Cleanse which includes a gut reset and elimination diet
• Keep a food journal to help identify possible connections between food, mood and symptoms
• Because there is often a mental/emotional element to chronic constipation (a hard time “letting go”), work to decrease stress through meditation, yoga, breath work and spending time in nature
• Wake up earlier to have adequate time for a bowel movement at home before leaving the house
• Sit in a squatting position for a few minutes in the morning
• Do yoga poses that involve twisting

RELATED: Try This Yoga Sequence to Boost Digestion

Diarrhea:

• Identify food sensitivities through an elimination diet
• Decrease or remove coffee and alcohol
• Pinpoint hormonal imbalances
• Discuss stress as a possible trigger

What’s Behind Your Bowel Movements

Though it’s not the most elegant conversation topic, poop is important to discuss (at least with your doctor!). Your bowel movements can tell you a lot about your digestion and overall health.

This diagram, based on the Bristol Stool Chart, is a useful visual aid.

“If you see pieces of undigested food in your stool it may mean you don’t have enough stomach acid to break down what you eat, or that you need to chew your food better or opt for more warm, cooked foods,” says van Wyk. “If your BM’s are pebble-like, it means you are dehydrated or that the stool is staying in your colon for too long so the water gets reabsorbed into the body.”

van Wyk further explains that “loose stools can be an indication of food sensitivity, liver imbalances, inflammation or a hormonal imbalance/shift. And if your stools float in the toilet it means they contain a lot of fats, either because you consumed a very fatty meal or because you don’t have enough bile to break down the fats.”

Regardless of what’s going on, a good place to start supporting your gut is with an elimination diet, which is “a great tool for identifying food sensitivities and learning what works well for your body — and what doesn’t,” says van Wyk. Plus, it can help bring both awareness and a new mindset to food and eating habits.

However, while an elimination diet can provide a lot of information, it may not suffice as the actual treatment of digestive issues, cautions van Wyk. If you’re struggling with digestive issues, it’s important to get the perspective of a healthcare professional. To book a Functional Medicine or Health Coaching Session at THE WELL, go here.