When GI Symptoms Don’t Have a Name

Jan 28
3 min read

Many people come to me after months — sometimes years — of GI symptoms that don’t neatly fit into a diagnosis.

They’ve had tests. They’ve tried cutting foods. They’ve Googled. And they’re still dealing with bloating, diarrhea, constipation, pain, or unpredictable digestion.

When there isn’t a clear label yet, the most important thing to know is this: your symptoms are real, and they’re worth taking seriously.

My Role (and What It Isn’t)

As a dietitian, it’s not my role to diagnose medical conditions. But I do provide medical nutrition therapy using a structured, evidence-based process called the nutrition care process.

That means I:

Assess patterns in food, digestion, and daily life
Identify nutrition-related problems (not medical diagnoses)
Test targeted nutrition or behavior interventions
Monitor and adjust based on how your body responds

A big part of this work is listening — often more deeply and for longer than most medical visits allow.

What the Assessment Feels Like

Appointments don’t feel like an interrogation or a checklist.

They feel like a conversation.

Each person’s situation is different, and symptoms rarely tell their story all at once. It’s more like pulling on a loose thread and seeing where it leads. Over time, patterns emerge.

With over 25 years of experience, I’ve learned how to ask the kinds of questions that gently uncover what matters — without rushing or forcing a conclusion.

Finding Clues (That Often Get Missed)

Sometimes symptoms are related to foods — but not in the way people expect.

For example:

Mushrooms naturally contain mannitol, a sugar alcohol that can cause diarrhea in people who are sensitive
Excessive gum chewing can introduce air and sugar alcohols, leading to gas and bloating — something a client once discovered only after we talked it through

Other times, lifestyle plays a role:

Meal timing
Stress
Travel
Busy schedules that disrupt eating patterns

These are the kinds of details that often don’t show up on tests — but they matter.

Creating a Space Where You’re Believed

One of the most important parts of this work is trust.

I tell my clients this early on: you are the expert on your own body. I bring expertise in food and nutrition — but it takes both of us working together to find the path forward.

I create space for people to talk honestly about what they’re dealing with:

Chronic diarrhea that makes leaving the house stressful
Avoiding social events out of fear of getting sick
Constipation so severe that using an office bathroom feels overwhelming

I’ve heard it all. I’m never shocked. And nothing is “too much” to talk about.

Small Experiments vs. Big Changes

There’s no single “right” way to approach chronic GI symptoms — the plan has to match the person.

Some clients are undernourished because eating feels difficult or unsafe. In those cases, I’m very gentle and precise with changes.

Others are well nourished but extremely busy, so interventions need to be simple and realistic.

And some people feel desperate — they’ve tried everything and want a more structured elimination approach to finally get answers. That can be appropriate too, when done thoughtfully and with support.

The key is choosing the right tool at the right time — not defaulting to the most restrictive option.

Pacing Change So It Actually Sticks

I’m very intentional about avoiding overwhelm.

We usually work on just one or two goals at a time, using SMART goals and something called a confidence ruler.

I’ll ask:

“On a scale of 1–10, how confident are you that you can do this?”

If the number is low, we adjust — immediately.

This isn’t about setting impressive goals that fall apart. It’s about finding the right level of effort — enough to matter, but realistic enough to succeed.

I often describe it like a small snowball at the top of a hill. It starts small, but as it rolls, it gains momentum. That’s how real change happens.