5 Things Your Gut Wishes You Knew
/Many women I talk with are already doing a lot of things that are supposed to be good for their gut.
They eat vegetables. Add chia or flax to breakfast. Drink plenty of water. Choose whole grains. Eat fermented foods. Dutifully try to reach their fiber goals.
And yet…the bloating, gas, constipation, urgency—or simply the sense that digestion isn't working quite the way it used to—can still show up.
Part of the problem may be that we've reduced gut health to a list of foods we're supposed to eat.
Fiber. Fermented foods. Legumes. Whole grains. Cruciferous vegetables. Chia and flax.
These are all nourishing foods.
But in our effort to feed the microbiome, we sometimes forget about the digestive system responsible for processing all of them.
Digestion is influenced by much more than a list of good and bad foods. Hormones, motility, meal size, stress, sleep, movement, medications, pelvic-floor function and the amount and type of fiber you eat can all influence how food feels in your body.
A food can be nutritious and still be difficult for you to digest in a particular amount or at a particular moment.
That doesn't make it a bad food. And it doesn't mean there's something wrong with your gut.
It may simply mean we need to look a little more closely at portion, preparation and context—not just ingredients.
Here are five things I wish more women knew about digestive health.
1. More fiber isn't always the answer
Fiber supports bowel regularity, metabolic health and the gut microbiome. But increasing it too quickly—or concentrating several sources into one meal—can also create gas, pressure, bloating and urgency.
Research gives us an interesting look at why.
In an MRI study examining what happens inside the digestive tract after consuming different fermentable carbohydrates, researchers found that different carbohydrates produced very different effects. Fructose increased water in the small intestine, while fructans—found in foods such as garlic and onions—increased gas production in the colon.
That doesn't mean these foods are unhealthy.
Fermentation of certain fibers by our gut bacteria produces short-chain fatty acids that help nourish the cells lining the colon and support intestinal health.
The more useful lesson is this:
Type, amount and context matter.
Think about a smoothie containing greens, berries, chia, flax, protein powder and added fiber. Or a large raw salad topped with chickpeas, cruciferous vegetables and seeds.
Every individual ingredient may be nutritious. But your digestive system still has to process the total load.
If a meal regularly leaves you bloated or uncomfortable, you may not need to eliminate those foods. Try reducing the number of concentrated fiber sources in that meal, choosing cooked rather than raw vegetables, or spreading them across the day.
Feeding your microbiome and overwhelming your digestive system are not the same thing.
2. Your gut changes as hormones change
If foods you tolerated beautifully at 35 suddenly don't feel quite the same at 50 or 60, you're not necessarily imagining it.
Our digestive ecosystem changes throughout life, and menopause appears to be one of the factors that may influence it.
In a 2022 study of more than 1,300 Hispanic and Latina women, researchers found that postmenopausal women had somewhat lower gut microbial diversity and a microbial composition that was more similar to men's than that of premenopausal women. Researchers also found changes in microbial genes involved in estrogen metabolism.
This doesn't mean we can point to menopause as the cause of every new digestive symptom.
But the research does support something many women already notice: the digestive system can change as hormones change.
That means the foods and habits that worked beautifully earlier in life may need some adjustment.
Rather than trying harder to follow the same rules, it may be time to become curious about what your body needs now.
3. “Healthy” foods can still cause digestive symptoms
Legumes, cruciferous vegetables, whole grains and fermented foods are all deeply nourishing.
They can also contribute to symptoms when portions are large, intake increases suddenly, or the digestive system is already struggling to keep things moving.
Highly fermentable carbohydrates are a good example.
In controlled research involving people with irritable bowel syndrome, reducing highly fermentable carbohydrates—often referred to as FODMAPs—has been shown to improve overall digestive symptoms.
But that doesn't mean everyone with bloating should go on a low-FODMAP diet. And it certainly doesn't mean foods containing fermentable carbohydrates are inherently bad for your gut.
The more useful takeaway is that dose and context matter.
Before eliminating a nutritious food, experiment with:
a smaller portion
a different preparation method
eating it less frequently
cooking it rather than eating it raw
combining it with fewer other highly fermentable foods
The goal isn't to create an ever-shrinking list of “safe” foods.
Whenever possible, the goal is to build greater digestive capacity and confidence with a wide variety of nourishing foods over time.
4. Bloating doesn't automatically mean “bad bacteria”
This is one of the gut-health assumptions I'd most like to retire.
Bloating can involve fermentation and gas. But it can also involve constipation, altered motility, food intolerance, gut sensitivity, pelvic-floor function or the way the gut and brain communicate.
And often, more than one factor is involved.
There's also an important distinction between bloating and distension.
Bloating describes the sensation of pressure, fullness or swelling. Distension is a measurable or visible increase in abdominal size.
And here's where things get especially interesting.
Researchers have identified a muscular response called abdominophrenic dyssynergia.
Normally, the diaphragm and abdominal muscles coordinate to accommodate changes inside the abdomen. In some people with visible abdominal distension, that coordination changes: the diaphragm moves downward while the abdominal wall relaxes, pushing the abdomen outward.
In a 2024 randomized controlled trial, researchers used biofeedback to help participants retrain this muscular response—and abdominal distension improved.
In other words:
A visibly bloated abdomen isn't always the result of excessive gas.
And it certainly isn't proof that the “wrong” bacteria have taken over your gut.
That's one reason I'm cautious about jumping straight from a symptom like bloating to restrictive diets, antimicrobial protocols or supplements intended to “fix” the microbiome.
First, we need to understand what may actually be contributing to the symptom.
5. Your bowel habits are useful data
Yes, how often you have a bowel movement matters.
But so do stool form, urgency, straining and whether you feel completely emptied.
The Bristol Stool Chart was developed as a clinical tool to classify stool into seven types.
Types 1 and 2—small, hard or pebble-like stools—generally suggest slower intestinal transit. Types 6 and 7 are loose or poorly formed and generally indicate faster transit. Types 3 and 4 are typically considered the easiest and healthiest to pass.
One unusual bowel movement rarely tells us very much.
A recurring pattern can.
And constipation isn't simply about not going often enough.
If you're having a bowel movement every day but regularly straining or feeling as though you haven't completely emptied, that's useful information too.
It also doesn't automatically mean you need more fiber.
Straining or incomplete emptying can have many contributors—from changes in gut motility, hydration, medications or supplements to pelvic-floor coordination, digestive function, stress, sleep, circadian rhythms or changes in routine and activity.
This is where paying attention to your own patterns becomes much more useful than blindly adding another scoop of fiber powder.
There are also times when observation and dietary experimentation aren't enough.
Persistent changes in bowel habits, rectal bleeding, black or tarry stools, unexplained weight loss, anemia, vomiting, fever or ongoing abdominal pain warrant medical evaluation.
Before You Eliminate Another Food, Try This
If you're frequently uncomfortable after meals, spend a few days looking at the total digestive load of the meal rather than searching for a single offending ingredient.
Is one meal stacking several sources of fiber and fermentation?
For example:
A smoothie might contain berries, greens, chia, flax, protein powder with added inulin and a greens powder.
Lunch might be a large raw salad with cruciferous vegetables, chickpeas, seeds and kombucha.
None of those foods is inherently problematic.
But you might discover that your digestive system handles them much better when they're distributed more gently throughout the day.
Try simplifying the meal while keeping it nourishing. Choose one or two concentrated fiber sources instead of four or five. Cook some of your vegetables. Reduce the portion rather than eliminating the food.
Then notice how you feel over the next couple of hours.
Less pressure? Less bloating? More comfortable fullness? No difference at all?
That's useful information.
If you feel better, gradually add foods back one at a time. You may discover that you tolerate all of them—just not all at once.
Gut Health Is More Nuanced Than “Good” and “Bad” Foods
The more we learn about digestive health, the less interested I am in rigid lists of foods everyone should eat—or foods everyone should avoid.
Our digestive systems are dynamic.
They respond to food, but also to hormones, stress, sleep, movement, medications, meal size, bowel motility and the rhythms of our lives.
That means supporting your gut isn't necessarily about finding the perfect diet or putting every “gut-healthy” ingredient into the same bowl.
It's about understanding your own patterns.
What can you digest comfortably? What changes when you're stressed or haven't slept well? Does a smaller portion make a difference? Cooked versus raw? Are your bowel habits telling you something? Has your digestion changed as you've moved through menopause?
The goal isn't a perfectly behaved gut.
It's a digestive system you understand—and know how to support as your body changes.
References:
Murray K, et al. Differential Effects of FODMAPs on Small and Large Intestinal Contents in Healthy Subjects Shown by MRI. American Journal of Gastroenterology, 2014.
Peters BA, et al. Menopause Is Associated With an Altered Gut Microbiome and Estrobolome. mSystems, 2022.
Halmos EP, et al. A Diet Low in FODMAPs Reduces Symptoms of Irritable Bowel Syndrome. Gastroenterology, 2014.
Moshiree B, et al. AGA Clinical Practice Update on Evaluation and Management of Belching, Abdominal Bloating and Distention. Gastroenterology, 2023.
Barba E, et al. Thoracoabdominal Wall Motion–Guided Biofeedback Treatment of Abdominal Distention. Gastroenterology, 2024.
Lewis SJ, Heaton KW. Stool Form Scale as a Useful Guide to Intestinal Transit Time. Scandinavian Journal of Gastroenterology, 1997.
