Signs of an Unhealthy Gut – and What to Do About It

When your gut runs smoothly, it’s business as usual. You eat comfortably and your bowel movements are regular. You don’t think about your digestive system because it’s doing what it’s supposed to do.

But if your gut goes haywire it’s not always obvious. Given your gut’s importance to your overall health — your gut supports immune function too — it’s wise to know what to look for.

“When your gut is healthy it breaks down the food you eat into nutrients that fuel your body and then removes everything else as waste,” says Dallas-based dietitian Kelly Taliaferro, who specializes in irritable bowel syndrome (IBS) and digestive disorders at Hues Nutrition. “If your gut isn’t healthy it can’t digest, absorb or remove waste properly.”

Warning signs of an unhealthy gut

Constipation

A healthy gut produces between three bowel movements a day and three bowel movements a week. Your stool should be formed, and your bowel movement should be a comfortable, quick and easy experience.

“Your bowel movements can tell you a lot about your gut health,” Taliaferro says. “If you’re having less than three bowel movements a week, hard stools, straining or incomplete bowel movements, that’s a sign that your gut needs some support.”

Two of the most common causes of constipation are:

• Not eating enough fiber
• Not drinking enough water

“Fiber and water help regulate gut motility and stool consistency, promoting softer and more frequent bowel movements,” Taliaferro says.

Also, certain medications and certain medical conditions, such as pelvic floor dysfunction, can affect gut motility and contribute to constipation.

Diarrhea

“Diarrhea can happen for a lot of reasons,” Taliaferro says. Inadequate fiber intake is one of them here too. “Fiber, especially soluble fiber, helps hold stools together and keep them formed,” she says.

Sometimes, diarrhea can also be a sign of infection, malabsorption or inflammation. Consult your doctor if you’re experiencing diarrhea three or more times a week for more than a couple months.

Medications can also sometimes cause diarrhea by increasing gut motility.

Upset stomach

Nausea, heartburn and pain can each be symptoms of an unhealthy gut.

“Overeating, stress and even the way we eat — like rushing through meals — can all affect stomach function,” Taliaferro says.

Don’t worry if you occasionally have an upset stomach.

“There’s cause for concern if there’s a pattern,” Taliaferro says. As with diarrhea, if you have an upset stomach several times a week for more than a couple of months, see a healthcare provider.

Bloating or distension

“Bloating and distension aren’t exactly the same thing,” Taliaferro says. “Bloating is more like an internal sensation, while people with distension say they look six-months pregnant.”

Being constipated can create bloating and distension due to the amount of stool and gas in the gut.

Carbohydrate intolerance, such as lactose intolerance and bacterial overgrowth, can change how nutrients are absorbed and then lead to discomfort. The discomfort usually presents as bloating or distension, though both are possible at the same time.

Troublesome skin conditions

Some skin conditions seem to be associated with an altered gut microbiome. They include atopic dermatitis, acne vulgaris, rosacea and hidradenitis suppurativa.

Sometimes unexplained rashes can be a sign of a systemic problem that’s also affecting the gut — histamine intolerance or a systemic nickel allergy, for example, Taliaferro notes.

And certain skin conditions carry an increased risk of gut diseases, among them IBD.

“The tricky thing is that a skin condition isn’t always a sign of an unhealthy gut, and an unhealthy gut often doesn’t manifest as a skin condition,” Taliaferro says. “In my practice, I pay extra attention to skin conditions that have a better-documented relationship to gut health, or skin conditions that don’t respond to treatment well or are unexplained.”

Lifestyle changes for a healthy gut 

Eat enough fiber

The general population should aim for 25 to 35 grams of fiber each day, Taliaferro says.

“Most Americans fall short on fiber even though we know it’s a gut-health hero,” she says. “Fiber has a host of benefits for digestion, including regulating gut motility, feeding good gut bacteria and keeping us healthy.”

Most plants have fiber, “but they’re not all equal,” Taliaferro says. Her favorite high-fiber foods include raspberries, oats, pumpkin, carrots and kiwi.

Drink enough water

Everyone’s water intake is unique, based on their gender, age, activity level, the weather and, in some cases, medication.

“The best way to tell if you’re hydrated is to check your urine,” Taliaferro says. If it’s pale yellow, much like the color of hay, you’re well-hydrated.

“Water is just as critical for digestion as fiber,”she says. “Water helps food move smoothly through the gut and helps keep our gut bacteria and cells healthy. Without water, digestion slows down, contributing to constipation.”

Eat a variety of whole plant-based foods

Feeding your gut bacteria is one important step in maintaining gut health.

“Different bacteria in your gut have different food sources they prefer, so the more diverse your diet is, the more diverse your gut microbiome will likely be,” Taliaferro says.

Aim for whole plant-based foods. Recent research shows that eating at least 30 different plants per week may help gut microbiome diversity.

“Your gut bacteria support your immune system, produce beneficial short-chain fatty acids and can even produce certain vitamins,” Taliaferro says. They include vitamin K, B12, B6, riboflavin, niacin and folate, she notes.

Focus on fruits, vegetables and greens. Whole grains such as millet, quinoa, kamut, farro and barley also support a healthy gut microbiome. So do nuts, such as walnuts and almonds, and seeds, including hemp seeds, chia seeds and flaxseeds (be sure to grind flaxseeds for better absorption).

Eat slowly and mindfully

Eating too fast can:

• Lead to overeating
• Make your digestive system work harder
• Reduce your ability to chew food well, leaving large pieces that impair healthy digestion
• Hamper the release of digestive enzymes, leading to bloating, gas, indigestion, diarrhea and constipation

“In our fast-paced society it’s easy to find ourselves scarfing down meals,” Taliaferro says. “Try chewing each bite to an applesauce consistency before swallowing. Enjoying longer mealtimes, when possible, and putting phones away to avoid distractions are great ideas too.”

Get enough sleep

Lack of sleep can:

• Contribute to your gut microbiome going out of balance (dysbiosis)
• Cause inflammation
• Mess with your gut-brain communication
• Impair your ability to handle stress, contributing to hormone imbalances and reducing gut motility

To keep your gut functioning optimally, aim for seven to nine hours of quality sleep every night.

“Sleep is an opportunity for the body to heal and repair itself,” Taliaferro says. “During the night, digestion slows down and our gut can rest.”