The Real Reason Your Stomach Hurts

Dealing with an upset child isn't easy for anyone. But when you also have to deal with an upset stomach, the combined stress can be overwhelming. Yet many mothers struggle with these unrelenting demands—often without medical help. Think of your friends who complain of bloating, constipation, and diarrhea but who've never seen a doctor. The ones who've cut out dairy, gluten, alcohol. The activities canceled, the days spent near bathroom instead of out and about.

Research shows that women are more likely than men to have gastrointestinal problems such as chronic constipation and irritable bowel syndrome (IBS). Hormones, anatomy, and the female stress response may contribute to this. Lack of sleep, erratic eating, and worry—hallmarks of parenthood—can also increase gut sensitivity, says Frances Meyer, M.D., assistant professor and gastroenterologist at Johns Hopkins Integrative Medicine & Digestive Center, in Lutherville, Maryland.

Antibiotic overuse and the low-fiber Western diet, rife with sugar, fat, and processed foods, are also changing the balance of bacteria and flora that keep our bodies healthy. This change has been linked to an uptick in Crohn's disease and ulcerative colitis, two forms of inflammatory bowel disease whose typical onset is between ages 15 and 35.

• RELATED: How to Relieve Postpartum Constipation

Despite their discomfort, most adults don't seek treatment for chronic digestive issues. "Many go online and diagnose themselves," says Lin Chang, M.D., vice-chief of the UCLA Vatche & Tamar Manoukian Division of Digestive Diseases. But Dr. Google is a poor substitute. Digestive symptoms are often a puzzle, and as you'll see from the moms' stories here, it can take time and a few wrong turns for even experienced physicians to uncover the root of a patient's problem.

"If a doctor tells you some version of 'You're a woman, it's probably IBS,' don't accept that," says Dr. Meyer. "Find someone who will do a comprehensive history, a full physical, and lab studies, who will listen to your concerns and work with you to help you find relief. Those are the basics every woman deserves.

"When I started having stomach pain, I assumed it had something to do with childbirth."

—Meghan Solis, 40, diagnosed with Crohn's disease in 2006

The pain started about six weeks after I had my second daughter. It was always on the lower right side of my abdomen and felt like period cramps, only 50 times worse.

• RELATED: Postpartum Cramps Are Not Talked About Enough and Mine Were Awful

I went to my OB-GYN, figuring it must have been complication from childbirth, but a pelvic ultrasound found nothing. After six months of pain, my gastroenterologist performed a colonoscopy that determined I had Crohn's disease, a chronic condition that can affect any part of the digestive tract and has no cure. The disease had damaged the lining of my large intestine, and my pain stemmed from scar tissue that was blocking my bowel.

I had never heard of Crohn's, but I figured it was better than colon cancer,which is what the doctors initially suspected. I was told that I may have been predisposed to the disease and that the stress of new motherhood can be a trigger.

Even with treatment, the chronic diarrhea, pain, and exhaustion took over my life. There were a couple of years when I spent more time in the hospital than at home, undergoing surgery for recurrent bowel obstructions.

I had so much guilt about all that I was missing—dance recitals, birthdays. Seeing me sick and in pain was scary for my kids, especially since their father and I divorced about a year after my diagnosis and I was their primary caregiver.

Two things really turned life around for me: One was a second surgery about five years ago that removed almost a foot of my intestine and put me into remission. The other was finding community. I joined a support group for adults with chronic illness and finally had the chance to talk openly with other parents who understood what I was going through. I started running regularly and training with the Crohn's & Colitis Foundation Team Challenge for the Rock 'n' Roll New Orleans Half Marathon. Two years ago, I crossed the finish line with my fiancé (a longtime friend who is now my amazingly loving and supportive husband) and with so many people who, like me, refuse to let their illness keep them down.

I know that Crohn's isn't caused by stress, but peace in my life has certainly helped. I'm healthier now than I have been in a very long time.

"It felt like someone was squeezing my stomach from the inside and letting go, over and over again."

—Kimberly Rockas, 33, diagnosed with gallbladder disease in 2018

I have a clear memory of throwing up as my daughter cried. It was awful: Ava was 13 months and newly walking. I was alone at home and had to lock her in the bathroom with me.

Before I got pregnant, I never had stomach issues. It all started with a bout of acid reflux after a crabcake dinner and got worse from there. I'd get attacks of diarrhea and vomiting that lasted for days. The cramps felt like someone was squeezing my stomach from the inside and letting go again and again.

• RELATED: Is Diarrhea During Pregnancy Normal?

I saw my doctor, who did blood work (which came back normal) and told me I had IBS and that constipation was causing my vomiting. Taking a stool softener helped for a while, but soon my symptoms returned. The GP did more blood work (normal again) and told me to cut out spicy and fatty foods and anything that upset my stomach. But that was nearly everything. Soon I was down to just white rice and applesauce. My grandmother had to move in to help my husband and me with the kids ( our nephew also lived with us at that time).

Then one day, about a month after that second doctor's visit, my pee came out neon yellow. At 6 p.m. that night, it was bright orange. Nine hours later, it was brown and I was screaming in pain. My husband rushed me to the E.R., where scans showed that my gallbladder was packed with stones. The next day, I had surgery to remove it. The doctor who treated me asked if I had been sick while pregnant. I had been, but my OB-GYN had said my diarrhea, vomiting, and nausea were due to pregnancy. I had no idea that gallbladder disease often develops while women are expecting, owing to hormonal shifts. My OB-GYN should have done an ultrasound to rule out gallstones.

My recovery was difficult, but I'm doing much better now. What angers me is that so much of this could have been avoided. I've come to grips with the fact that over the two years I was sick, I didn't want to hear that anything was really wrong, so I didn't push my GP to investigate further or seek out a second opinion. Now I know that was a big mistake.

"I had bloating and diarrhea. I never thought the cause could be gynecological."

—Karli Goldstein, D.O., diagnosed with endometriosis in 2015

Between the ages of 22 and 30, I was diagnosed with IBS, was suspected of having inflammatory bowel disease, went vegan, cut out gluten, took antibiotics, and at one point, took 20 daily supplements given to me by an integrative physician. Occasionally, I found relief.

But my chronic bloating, abdominal pain, and diarrhea always returned. The diarrhea usually came during my period; the rest of the month, I had rectal pain and constipation. There were times in medical school when my symptoms became overwhelming. I'm glad I persevered: During my OB-GYN rotation, I learned my problem wasn't my digestive tract.

I was working with a surgeon who specialized in endometriosis, a disease that causes tissue usually found inside the uterus to spread into the abdomen. It is traditionally associated with severe menstrual cramps, heavy periods, and pain during sex.

However, I noticed that some of his patients didn't have these complaints. They had symptoms more like mine. I talked with the surgeon and learned that when endometrial tissue invades the bowel and abdominal wall, it creates scar tissue and inflammation that can cause bloating, diarrhea, and cramping—which can lead to a misdiagnosis of IBS.

I had diagnostic surgery, and my doctor found and removed endometrial scar tissue all along my bowel and rectum. I felt better right away. But that didn't last. Through the years, I had also been struggling with infertility, a common outcome of advanced endometriosis. After the surgery, I had ten rounds of IVF, and the hormone stimulation triggered regrowth of my endometriosis. Ultimately, I had two more operations.

The happy part of my story: In 2018 I finally got pregnant, and my husband and I became parents to our beautiful daughter, Charlotte. And with the help of a great doctor and good self-care—which includes a low-carb, low-sugar diet that keeps inflammation in my body at bay—my endometriosis is now under control.

"I spent so much time suffering from abdominal pain and bloating,I felt I wasn't really present for the first few years of my daughter's life."

—Elizabeth Di Biase, R.D.,48, diagnosed with irritable bowel syndrome in 1988

When I was in high school, two gastroenterologists attributed my chronic gas, diarrhea, and abdominal pain to IBS. Neither helped much, other than to give me meds to relax my gut (they didn't).

I figured I just had to learn to live with IBS, which I did—all through college, while working toward my postgrad degree as a registered dietitian, and for years after that.

At 41 I got pregnant, and my symptoms disappeared. They didn't return until after I weaned my daughter, Giuliana. Initially, the problems were mild. But then I took antibiotics for a sinus infection, and the drugs—which can wipe out healthy gut bacteria—brought on two years of misery. Every trip to the bathroom, I had diarrhea. The pain in my abdomen was terrible. I used every diet strategy I knew, but nothing helped. I was so focused on my gut for the first few years of Giuliana's life, I felt I wasn't really present for it.

A naturopath did a breath test to check the hydrogen levels in my gut and said that in addition to IBS, I had small intestinal bacterial overgrowth (SIBO). I took the supplements she prescribed but didn't feel much better. Thinking back, I don't know if SIBO was the culprit. I do know I was desperate.

That was when I started looking into the low-FODMAP diet, which I had read about years earlier but had disregarded because it sounded too complicated. FODMAP stands for fermentable oligo-, di-, monosaccharides, and polyols. These short-chain carbohydrates are found in foods like wheat, dairy, beans, and some fruits and vegetables. They can draw water into the intestine and also ferment quickly. If you are sensitive to FODMAPs, these foods can cause bloating, gassiness, cramping, and diarrhea.

On the low-FODMAP diet, you eliminate a broad range of foods, then systematically reintroduce them. This helps identify which ones you can tolerate and which you can't. I coached myself through the process but recommend that anyone considering the diet do it with the help of a registered dietitian.

Within two weeks after I started the diet, my symptoms were 70 percent better. As I added foods back in, I was able to identify trigger foods (garlic and onions are biggies!) It hasn't been a cure-all; I still sometimes have gut issues and have to be diligent in managing stress. But it's given me a sense of control. If my stomach starts acting up, I know I can lower my intake of FODMAPs, which then resolves my symptoms.

Common Stomach Conditions, Decoded

If you've had digestive symptoms for three months or longer, it's time to consult your primary-care physician or a gastroenterologist. (Always seek help immediately for acute symptoms like bloody stool, unexplained weight loss, or severe pain.) Will Bulsiewicz, M.D., a gastroenterologist in Charleston, South Carolina, and author of Fiber Fueled, runs down the basics of some of the most common diagnoses.

Gastroesophageal Reflux Disease (GERD)

Heartburn, a searing sensation in your stomach or the middle of your chest, results from stomach acid that backs up into the esophagus. Many of us experience it on occasion, especially after a big or late-night meal. But when "acid reflux" strikes regularly, it could be a sign of GERD, a chronic digestive disease that impacts about 20 percent of Americans. In addition to the pain, red flags include bad breath, tooth decay, queasiness, abdominal pain, and trouble swallowing.

Irritable Bowel Syndrome (IBS)

This disorder wreaks havoc on the intestines and is the most common "functional" bowel disorder—meaning it affects how the digestive tract functions but isn't caused by structural abnormalities and doesn't damage organs and tissue. Symptoms include abdominal pain, diarrhea, constipation, bloating, and cramps.

Inflammatory Bowel Disease (IBD)

This is a condition in which there is chronic inflammation in the gut—and it can cause significant physical damage. There are two primary forms: ulcerative colitis (UC), which affects the colon and rectum; and Crohn's disease, which can affect any part of the digestive tract from the mouth to the anus. Hallmark symptoms for both Crohn's and UC include diarrhea, bloody stools, weight loss, and abdominal pain. IBD is also associated with complications beyond the digestive tract, including arthritis, rash, or ulcers in the mouth.

Gallbladder Disease

The gallbladder is a small, pear-shaped sac beneath the liver that stores bile, which helps break down and digest fat in the small intestine. Sometimes hard particles or "stones" form and block bile ducts, inflaming the gallbladder. Symptoms of a gallstone "attack" include nausea, vomiting, diarrhea, fever, and pain in the upper right abdomen that often radiates to the upper back. If a stone blocks the duct to the intestine, a backup of bile can cause dark urine, light stools, fever, rapid heartbeat, and jaundice.

Endometriosis

Often painful, this condition occurs when endometrial tissue spreads beyond the uterus (where it belongs) to other parts of the abdomen, including the ovaries and fallopian tubes. The typical symptoms of endometriosis are pelvic pain, especially during menstruation, heavy periods, pain with intercourse, and infertility. Because endometrial tissue inflames the abdomen and may also invade the rectum and intestine, it can also cause digestive symptoms like bloating, diarrhea, constipation, and nausea.

Leaky Gut Syndrome

There's lots of buzz around the idea that poor diet, antibiotics, and other aspects of modern life can wear down intestinal lining, allowing bacteria and food substances to penetrate the tissue beneath it and spread to the bloodstream. Proponents of this notion claim that chronic health issues, including IBS, are the body's reaction to these microbes. There's no question that gut permeability is real, but researchers aren't sure whether increased permeability causes disease or results from it. If you have unexplained symptoms, it can be tempting to embrace an "all-solving" explanation like leaky gut, but see a doctor to be safe.

Postural Orthostatic Tachycardia Syndrome (POTS)

The brain automatically regulates blood pressure, gut function, and other important tasks. But for people with POTS, the majority of whom are women ages 13 to 50, the brain can fail to do so, particularly when you stand up after being in a lying position. The most common symptoms are dizziness, rapid heartbeat, and fainting, but in some cases, digestive issues like diarrhea, constipation, nausea, abdominal pain, and bloating also occur.

This article originally appeared in Parents Magazine's August 2020 issue as "The Real Reason Your Stomach Hurts." Want more from the magazine? Sign up for a monthly print subscription here