Bloating after meals, abdominal discomfort, constipation, diarrhoea or bowel habits that keep changing: digestive problems can take very different forms.

When these symptoms persist or keep coming back, it is natural to look for an explanation: a food, stress, an intolerance, "poor digestion". But similar symptoms can have very different causes from one person to another.

The first question is therefore not "what should I remove from my diet", but "what could explain these symptoms".

Digestive symptoms are symptoms, not a diagnosis

Bloating, abdominal discomfort, constipation or diarrhoea are symptoms, not diagnoses in themselves. They can appear in very different situations: a functional disorder such as irritable bowel syndrome, a genuine food intolerance, inflammatory bowel disease, coeliac disease, the effect of a medication, or simply eating habits that do not suit one particular person.

It is precisely because similar symptoms can have different origins that they deserve to be understood before being treated, rather than being attributed straight away to a single explanation. That is also the spirit of the approach described for colon and stomach problems at Centre Algos.

Starting by understanding what is happening

Before considering anything else, it helps to clarify what is actually happening: which symptoms exactly, at what moment, for how long, related to meals or not, and with what impact on bowel habits. Diagnoses already made, investigations already carried out and current treatments or supplements are also part of that baseline.

This step is practical, not administrative: it avoids exploring again what has already been explored, and makes it quicker to identify what genuinely deserves attention.

When food appears to play a role

Noticing a link between certain foods and the appearance of symptoms can be useful information. But that link is not always as direct as it seems: the timing of the meal, its overall composition, the quantity, or other factors may also play a role.

For that reason, it is usually more useful to observe and document what happens than to remove several foods at once on the basis of an impression.

Intolerance, allergy, or simply a poorly tolerated food?

A food allergy, in the medical sense of the term, involves the immune system through IgE and causes rapid, sometimes severe reactions. It is investigated with specific tools: skin tests, measurement of specific IgE, and sometimes a supervised challenge test.

A food intolerance is different: it does not involve that immune mechanism, and its symptoms are usually digestive rather than skin or respiratory. The widely marketed and often expensive blood tests described as "IgG food intolerance" tests are not validated tools for diagnosing an intolerance. Allergy societies, including the Swiss society, have warned against using them for this purpose: the presence of IgG normally reflects exposure to a food, not a problem. Relying on these panels carries another risk, that of unnecessarily eliminating many foods without having identified the real cause of the symptoms, often after significant expense.

Discomfort experienced after certain foods is a real and legitimate observation. It is not confirmed by this type of test, however, but through an approach adapted to the situation.

Should certain foods be removed?

Removing a food without a specific reason is generally not the useful first step, and a prolonged, unjustified restriction has a cost: less dietary diversity, a risk of nutritional imbalance, and sometimes growing apprehension around food itself. A restriction, when it makes sense, should have a defined objective, a planned duration and ideally a reintroduction strategy, rather than becoming permanent by default.

Some structured dietary approaches have shown genuine value in specific situations. The low FODMAP diet, for example, can reduce abdominal pain and bloating in some people with irritable bowel syndrome. It is not a diet to follow indefinitely: it is built in three stages, a few weeks of elimination, a gradual reintroduction, then personalisation, ideally with professional support rather than followed alone over the long term.

If coeliac disease is suspected, a gluten-free diet should not be started before the necessary investigations have been carried out: doing so can distort the results and make the diagnosis harder to establish. The French Haute Autorité de Santé restated this point explicitly in its recent recommendations. The logic is simple: investigate first, restrict afterwards.

Stress and digestion: a real relationship, but not a universal explanation

The digestive system and the nervous system communicate constantly, and stress can influence digestion in some people by changing digestive sensitivity or bowel habits. Irritable bowel syndrome itself is now classified among disorders of gut-brain interaction, not as an inflammation, an intolerance or the consequence of an imbalanced microbiome.

That does not mean digestive problems are "just in your head" or purely psychological. It is one factor among others to take into account, not a default explanation when no other cause has been looked for.

Microbiome and intestinal permeability: what science says, and what it does not

The gut microbiome is a real and rapidly developing field of research. Links between its composition, metabolism, immunity and digestive physiology are increasingly documented. This is not a subject to dismiss.

But a research link is not the same thing as a diagnosis that can be acted on in consultation. With current knowledge, it is not possible to take a person's bacterial composition and reliably deduce why they have one specific symptom, what their "ideal" microbiome would be, which foods they should eat, or which probiotic they should take. Microbiome tests sold directly to consumers generally go further than science actually allows, and a difference in bacterial proportions does not on its own constitute a diagnosis of "dysbiosis".

Intestinal permeability illustrates this nuance well. It is a real physiological phenomenon: certain diseases, such as active coeliac disease or some inflammatory bowel diseases, are accompanied by measurable changes in permeability, studied notably through a marker called zonulin. That does not, however, validate "leaky gut syndrome" as it is used online to explain almost everything, from fatigue to brain fog to skin problems. There is no routine commercial test that establishes this explanation as the cause of a set of nonspecific symptoms.

Probiotics: neither miracle nor useless

Probiotics are not a homogeneous group. Their effects depend on the strain used, sometimes on the combination of strains, on the dose, the duration and the precise situation for which they are being considered. A result obtained with a given strain, for a given indication, does not automatically transfer to another product sold under the same generic term.

Saying that "probiotics are good for digestion" in a general way is therefore not a statement that can be made so simply. Supplementation, when it is considered, is chosen according to the situation rather than applied systematically.

How I approach digestive problems in consultation

Faced with digestive problems that persist, I start by clarifying the exact nature of the symptoms: pain, bloating, reflux, diarrhoea, constipation, or a mixed picture, when they appear, how long they last and how they evolve, and their possible link with bowel habits or food, without assuming an intolerance from the outset. The overall process is the same as the one described in the article on the naturopathy consultation.

I take into account diagnoses already made, examinations and tests already carried out, current treatments and supplements, as well as restrictive diets already tried. I also explore the factors that may be relevant to the situation: sleep, stress, physical activity, a possible deficiency, and the approaches already tried and their effect.

From that overall view, I look at whether additional testing could clarify a specific question. Depending on the situation, the plan may also include nutritional work, micronutritional correction or supplementation where there is a reason for it, along with the lifestyle factors that are genuinely relevant for that person.

We discuss the available options, and we build together a plan suited to the person, not a standard protocol applied to every digestive complaint.

Targeted testing, when it makes sense

Depending on the situation, I can propose more targeted blood or stool testing, which sometimes goes beyond the initial work-up usually carried out. The aim is not to multiply investigations, but to answer a specific question emerging from the history, the symptoms and what has already been investigated.

A targeted test therefore answers a particular clinical question. For example, in gastroenterology, a stool analysis may look for a specific marker such as faecal calprotectin, which is used to help distinguish an inflammatory process from a functional disorder when clinically appropriate. This illustrates the difference between a test answering a specific clinical question and a commercial test intended to map the microbiome more generally.

When the elements gathered, whether symptoms, results or the course of the problem, suggest that a gastroenterological opinion or investigation is needed, I recommend it.

When medical assessment must come first

Some signs deserve prompt medical assessment rather than naturopathic exploration first: blood in the stool, unexplained weight loss, persistent or severe pain, repeated vomiting, anaemia, difficulty swallowing, or a clear and recent change in bowel habits, particularly after the age of 50 or with a family history of digestive disease.

Most digestive problems do not signal serious disease. But these elements justify medical assessment without delay, and naturopathy is not there to delay it.

What can realistically be expected from a naturopathic approach?

A naturopathic consultation for persistent digestive problems is not there to replace medical assessment, nor to offer a universal protocol.

What it can offer is the time to understand the picture precisely, consideration of the medical information already available, the possibility of exploring certain questions further through targeted testing where relevant, work on the modifiable factors that genuinely matter in that situation, and a plan built with the person rather than applied systematically.

When medical or gastroenterological follow-up is needed, this approach comes in addition to it and not in its place.

Frequently asked questions

Does bloating mean I have irritable bowel syndrome?

Not necessarily. IBS meets specific diagnostic criteria, centred in particular on abdominal pain associated with changes in bowel habits. Bloating on its own can have other explanations.

Should gluten be removed in case of digestive problems?

Not without a specific reason. If coeliac disease is suspected, a gluten-free diet should not be started before the necessary investigations, because it can distort the results.

Can a naturopath propose tests for digestive problems?

Depending on the situation, I can propose targeted blood or stool tests when a specific question emerges from the consultation. This is not systematic: tests must answer an identifiable clinical question.

Can stress really cause digestive problems?

It can contribute in some people, because the digestive system and the nervous system communicate constantly. But stress should not become a default explanation before other possible causes have been considered.

Can a microbiome test explain my digestive problems?

Not reliably at present. Microbiome research is important and progressing quickly, but commercial tests cannot determine with certainty the cause of a specific digestive symptom or define an individual "ideal" microbiome.

Are probiotics useful for bloating?

That depends notably on the strain, the dose, the duration and the situation. Probiotics are not a generic treatment applicable in the same way to every digestive problem.

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