What stomach issues are cause for concern?

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Nearly everyone encounters digestive discomfort at some point in their lives. Patients who choose to visit a gastroenterologist may be experiencing symptoms like heartburn, abdominal pain, bloating, irregular bowel movements and similar issues.

You may be having a difficult time trying to decide if your symptoms warrant checking with a doctor. There are a few symptoms—what I like to call red flags—that should send you to your provider right away.

Have you lost a significant amount of weight without intending to? If you’re eating about the same as always but you’re losing weight, you should check in with a physician.

Have you seen any blood in your stool? Either red blood or black, tar-like stools might indicate a more serious condition.

Are you anemic? Oftentimes, checkups include routine blood work, and low hemoglobin should trigger a follow-up.

Another concern is change. Have you experienced an abrupt change in bowel habits that are affecting your daily life?

Your primary provider can evaluate symptoms and help you figure out if something serious is happening. These red flags may indicate serious conditions that are best found and treated early, and a referral to a gastroenterologist may be warranted.

Gastrointestinal problems can be difficult to diagnose. Some symptoms are similar to serious conditions but may not be a concern. I like to remind my patients to compare their symptoms to what they’ve experienced in the past and not to those of their friends.

Of course, some of your issues may be related to your diet. For example, I see patients who are fine most of their lives and then develop lactose intolerance. Keeping a food and symptom diary may be helpful in identifying trigger foods. Elimination diets are another way to determine if you’ve become sensitive to a particular food or food group. Cutting out too many foods at once may cause vitamin or micronutrient deficiencies. These diets should be performed under the careful guidance and monitoring of a healthcare provider.

Elimination diets can be restrictive, but they’re not necessarily permanent. If certain foods cause symptoms, you can choose to give them up or find ways to deal with the symptoms.

Before your doctor can make recommendations, you’ll spend time discussing your history and symptoms. So much of our training as doctors is about learning to listen to our patients. We know through experience when changes may be concerning. We can reassure you or maybe recommend further testing.

For some conditions that have no definitive testing, like irritable bowel syndrome, we recommend additional management methods. Once diet has been tackled, I like to recommend a program of self-care that includes stress management, daily exercise, relaxation techniques and perhaps enlisting the support of a mental health counselor or cognitive behavioral therapist. We should approach care from all of these angles with the goal of eliminating discomfort and improving daily life.

Ultimately, if you’re uncomfortable and not feeling well, go to your healthcare provider for an evaluation. Be prepared to describe your symptoms, including a timeline of when they started and any changes you’re experiencing. People come to a gastroenterologist with problems they’re often uncomfortable discussing. I’m likely to ask about belching and bloating, as well as your bowel habits. I’m privileged to know that patients trust me to have these conversations.


Tara Menon is a gastroenterologist specializing in hepatology and nutrition at the Inflammatory Bowel Disease Center at The Ohio State University Wexner Medical Center