Chronic diarrhea is the worst! (I know personally from experience.) If you still have diarrhea even after going gluten free, stop scratching your head and feeling baffled about what could be causing it.
Allow me to set the record straight, a gluten free diet isn’t the end all, be all of digestive problems. It won’t fix everything.
Going gluten free may improve some symptoms. But if you still have diarrhea daily, going gluten free isn’t enough to resolve all of the issues. It’s certainly a part of the solution, but you can’t just take one step and hope for stellar results.
My own relationship with diarrhea has taught me that while going gluten free certainly made an improvement, it didn’t fix everything. And that’s why I’d like to take a few moments to illuminate other reasons why you still have diarrhea.
The five reasons why you still have diarrhea are often overlooked or blown off. And it’s not uncommon for your doctor to straight up tell you that it’s all in your head.
Except it’s not… the reason for your troubles is in your gut. It could be a single issue or a combo, but either way, the diarrhea won’t stop until the underlying causes are addressed.
Otherwise, inflammation will persist and leave you feeling like crap as your body is drained further of needed nutrition.
Why You Should Stop Diarrhea
Before we dive into the reasons why you still have diarrhea, it’s important to understand why you need to stop it in the first place.
Chronic diarrhea is defined as having 3 or more episodes of loose stools daily for more than a two week period. (source)
But this is not normal.
I repeat… chronic diarrhea is NOT normal.
There are a number of reasons why that I’ll list here because they can often explain some of your other symptoms.
Chronic diarrhea means that…
1. There’s likely a lot of inflammation in your gut.
2. Nutrients in your food is “getting flushed down the toilet.” Basically the food you eat is moving too rapidly down your digestive tract leaving little time for your body to actually absorb it.
3. Healthy gut flora also gets “flushed” in the process making it very hard for the good bugs to establish themselves in your gut. This leaves your unfriendly gut bugs to take up residence like bacteria and yeast (aka. candida albicans).
4. You can end up with nutrient deficiencies as a result.
5. The stress created in your gut can cause increased anxiety … your gut is, after all, your second brain.
6. You probably have leaky gut syndrome.
As you can see, it’s pretty important to figure out why you still have diarrhea and put a stop to it.
5 Reasons Why You Still Have Diarrhea
Before I was diagnosed with various food sensitivities almost ten years ago, life was pretty good except for one thing…
I had chronic diarrhea for years.
I thought that “stomach problems” were normal, so it never occurred to me that I should mention it to my doctor.
As a result, I’d daily find myself literally running to the bathroom repeating “please don’t let the bathroom be full!” silently.
Many times, I was lucky.
Other times, not so much (talk about embarrassing “accidents”!).
Some meals had me running through the restaurant multiple times. I would try my best to fight off the oncoming waves of pain by jamming my fist into my gut and trying to go another 20 minutes without making a bathroom dash.
I worried that my dinner companion would start to wonder if I was okay.
It’s sad to think that I became skilled at seeming fine when I felt both nauseous and a serious urgency to get to a toilet immediately.
Years later, I discovered that chronic diarrhea had done a number on my system. I sought help for fatigue and generally feeling unwell. Yet I found out that all the symptoms that I didn’t think were a big deal (like my daily headaches, skill rashes, brain fog, etc.) were amplified by chronic diarrhea.
While it might be easy to blame your chronic diarrhea on celiac disease or suspected food sensitivities, that’s likely not a fair assessment. It’s not normal to have diarrhea and unless you figure out the root causes, expect your diarrhea to continue.
That’s why you’ve got to consider that there is a reason behind your diarrhea. It isn’t happening “just because.” Something is up in your gut and it’s your job (along with a trusty practitioner) to figure it out so that you can get back to pooping like a normal person.
Reason #1 You still have diarrhea – Poor Digestion
Being able to properly digest food is key. If food isn’t broken down appropriately, it becomes near impossible for your body to absorb the nutrition locked within it. This means that your body can’t compensate downstream in the small intestine for what didn’t happen in your mouth or stomach.
To be clear, digestion starts in your mouth. Eating quickly in a stressed situation or on the go AND failing to chew each bite an appropriate number of times is a recipe for disaster.
Eating quickly may get you brownie points for efficiency, but it’s a recipe for disaster when it comes to your gut.
Tougher foods (like meat) should be chewed around 30 times per bite!
Softer foods get you a break at around 10 to 15 chews.
What’s also problematic is low stomach acid (which has nearly the same exact symptoms as excessive stomach acid). The reason is that the pH of your stomach serves a few purposes:
1. It creates a chemical barrier that protects your gut from bad bacteria (even from your mouth), viruses or parasites from entering your digestive system and causing issues like SIBO (small intestine bacterial overgrowth).
2. The low, very acidic pH is important for protein-rich food to appropriately start breaking down into smaller fragments that can be absorbed. When proteins aren’t appropriately digested, they can be fermented by that bacteria I just mentioned in the small intestine. This leads to bloating, gas, abdominal pain, diarrhea, or even constipation.
3. Certain nutrients like vitamin B12 and minerals which are typically bound to proteins are disconnected so that your body can absorb them.
4. The pH also activates certain enzymes that require a very acidic environment to work. That’s why gluten enzyme pills aren’t guaranteed to work. If your stomach acid is low, enzyme-based pills may not do a darn thing.
This leads me to a second point — fat digestion.
If your gallbladder was removed, it’s likely that your body can’t handle all that extra fat which is what triggers diarrhea. Normally, your gallbladder would concentrate and house bile until you ate something wherein it would be released.
Think of bile like dish soap. When you try to wash a greasy pan, the dish soap emulsifies the oil making it easy to clean. Bile emulsifies the fat so that it can be absorbed.
If you’re missing your gallbladder, bile is constantly dumped into the small intestine. So while there’s always some present, it’s often not enough to get the job done. Too much fat in your food can trigger diarrhea.
And lastly, your pancreas makes enzymes necessary for digestion. If for whatever reason your pancreas isn’t up to snuff, then again your food wouldn’t get properly digested.
That’s why either of the following digestive enzymes would be great to test out to see if they help reduce the diarrhea, gas, and bloating. I use both Allzyme and Digestzyme with clients who need extra digestion support. If you think you’ve got SIBO, taking something like these may be a really big help so that the food you eat isn’t getting fermented by bacteria in your small intestine.
Reason #2 You still have diarrhea – Poor Absorption
If you don’t have good digestion, it’s likely that you won’t have good absorption of nutrients either. That’s why I said that you can’t fix things downstream in the gut.
That said, leaky gut syndrome is also a major problem. This essentially means that partially undigested proteins are sneaking across the gut barrier in ways they shouldn’t. Those proteins then trigger a delayed immune response that we call food sensitivities.
Gluten, casein (dairy), and egg sensitivities were a big reason (along with leaky gut) behind my chronic diarrhea. Removing them solved a lot of problems for me so that I could then work on soothing the inflammation therein.
Another two factors that reduce absorption and cause you to still have diarrhea is when the mucosal membrane lining your GI tract is disrupted. It’s an important part of your digestive system and this is quite common in those with leaky gut. That’s why herbal supplement formulas like GI Revive can be so helpful because the ingredients are crucial to soothing the gut, re-establishing gut integrity, and rebuilding that mucus membrane.
And of course, I have to mention that when Celiac Disease is present (even in those with Dermatitis Hepetiformis, the skin manifestation of Celiac), diarrhea is common. The reason is due to the flattening of the microvilli of the finger-like projections in the small intestine that are there to help maximize your body’s absorptive capacity.
Reason #3 You still have diarrhea – Poor Gut Diversity
There’s been so much focus on your gut’s microbiome — basically the residents that live there. Diversity is key to health!
But having chronic diarrhea makes it really difficult to maintain a healthy and diverse microbiome that can help you digest food and even make some nutrients.
As I mentioned earlier, chronic diarrhea also disrupts the microbiome, “flushing” healthy bacteria out of your system. This then leaves you open to gut infections … and thus more diarrhea.
Another factor that messes up the microbiome is antibiotics. One seven-day stint of antibiotics can compromise your gut flora for up to 2 years. That adds a pretty serious potential consequence to a Z-pack, right?
Two other factors that directly impact the diversity of the microbiome are the quality of your diet and your fiber intake — specifically prebiotic fibers. Good bacteria need quality food — not a processed and refined gluten-free diet loaded with gluten-free flours and lots of sugar.
Taking a diverse probiotic can be helpful in most cases, especially when you still have diarrhea. A good option is this Bifido Digest which offers a blend of strains to help keep the gut on track.
Prebiotics are a specific type of fiber that’s fermentable to bacteria and helps to feed them so that they can thrive. However, prebiotics can cause a worsening of symptoms if you have SIBO.
And the same thing goes for probiotics. If you believe you have SIBO, probiotics aren’t generally a good idea because you already have too much bacteria in an area (the small intestine) where they shouldn’t be.
The only probiotic that can be taken with SIBO is Saccharomyces boulardii. It is also helpful in the case of too much candida in the gut along so long as your main issue is diarrhea (not constipation). Protocol for Life is the brand I recommend to clients.
Reason #4 You still have diarrhea – Food Sensitivities
It’s not uncommon for my clients who came to work with me because of chronic diarrhea to have food sensitivities. Usually, it’s more than just gluten causing problems.
Gluten has a superpower to increase gut leakiness (or permeability), whereas other food sensitivities are the result of leaky gut. (source)
Whenever I ate enough gluten and eggs, I was running to the bathroom as if I was being chased by a tiger. The last time I ate eggs, I thought I was having a heart attack. The pain was so severe that I nearly drove myself to the ER. Once I felt the wave of nausea set in, I spent a considerable amount of time on the toilet… and only then did I started to feel better.
So yes, food sensitivities can have a really intense reaction. But they can also cause issues like brain fog, muscle weakness, skin rashes, headaches, migraines, low immunity, anxiety, depression, and so much more.
While it’s pretty common for someone to try figuring out food sensitivities via an elimination diet, I often feel like it’s a rookie mistake. Often there are foods that someone may not even suspect (like strawberries or asparagus) that could be causing an issue aside from those that are more common like eggs or dairy.
I personally recommend getting food sensitivity testing done before taking out any foods to help avoid any false negatives on the test. It’s faster, easier, and just way more efficient (since life can too easily get in the way causing you to cheat and then you’ve got to start over).
Reason #5 You still have diarrhea – Gut Infections
Speaking of gut flora, one of the most common reasons that my clients still have diarrhea is because of gut infections. Often these clients have been completely blown off by multiple doctors and told that there was nothing that could be done.
It’s sad that they (and likely you) have been told that there are no other options.
Being left afraid to leave your home because you don’t know when a bout of diarrhea will strike isn’t okay.
Sometimes the doctor is willing to do a stool test, but it comes back negative because a traditional lab like Quest or Labcorp may not pick up on low-level infections that trigger diarrhea.
A better option would be the GI Effects Gastrointestinal Function Comprehensive Profile from Genova Labs. It is a functional stool lab that looks not just at potential gut infections from bacteria, yeast, and parasites, but also all the different factors mentioned herein about your digestive capacity and the state of your microbiome.
The second, less-expensive option is the Organix Comprehensive Profile from Genova Labs which is a urine test. It looks at organic acids present in the urine that can identify dysbiosis in the gut. It is the only test that can definitively tell you if you actually have candida. This test also presents a ton of other great information on energy production, methylation capacity, nutrient status, oxidation damage, and liver detoxification capacity.
They both do different things which is why I have many questions for clients before I will make a recommendation of which one to do (or both when necessary and appropriate).
Whatever You Do, Don’t Give Up Hope
As I shared last week on the podcast with Linda, don’t give up. Linda had diarrhea, gas, bloating, mood swings, fatigue, and muscle tremors and weakness. I listened and helped her identify the root causes behind all of her symptoms. Now she’s doing better than she ever imagined!
The key is to seek out the root cause(s) and address what comes up in a logical and efficient manner so that you can get back to pooping like a normal person.
Chronic diarrhea can steal away your life — both the vibrancy as well as your freedom to be social.
Here’s what to do next
If you’re still suffering from an unruly stomach, explosive diarrhea, embarrassing gas, bloating (that makes you look pregnant), fatigue, and brain fog, it’s highly likely you’re stuck because of leaky gut and other root causes. If you don’t take the necessary steps to FINALLY rebuild your gut, you’ll continue to struggle with food sensitivities and many of your current symptoms for the rest of your life (that will likely get worse).
Most of my clients have anywhere from 3-5 common root causes of leaky gut that are keeping them sick. If you’re ready to finally get your life back, click the link below to book a 30-min “Gut Strategy Session” with me, where I’ll go over your health history to help you see which of the common root causes you’re at risk for, and what to do next.
I look forward to working with you,