While elimination or restrictive diets are common recommendations for those with digestive issues, they are not necessarily a cure-all. Let’s take a closer look.


If you’ve been suffering from digestive issues for any length of time, then you probably have at least heard of (if not tried) the wide array of diets out there to “treat” your symptoms.  Many patients suffering from chronic diarrhea, constipation, abdominal pain, bloating, and acid reflux have tried multiple different elimination diets to alleviate their pain.

You may have tried the low FODMAP diet your doctor suggested, or perhaps you’ve given SCD or the GAPS diet a fair chance, but those diets may have felt too restrictive or just too difficult to stick with.  It’s mentally exhausting and frustrating trying diet after diet hoping that something finally makes you feel better.

However, it’s important to remember that you’re also likely exhausted because you may not be getting all the nutrients your body requires on a restrictive diet. And you’re frustrated that you can’t seem to add any foods back into your diet without your symptoms coming right back.

The line of thought is that by eliminating FODMAPs (which stands for Low Fermentable Oligo-, Di-, and Monosaccharides and polyols), the bad gut bacteria will be “starved out” and will lead to improvement in symptoms.  This particular diet strictly eliminates all slowly absorbed or indigestible short-chain carbohydrates.

While it may sounds like a great solution to digestive issues in theory, it might be doing more harm than good.

  1. When you eliminate foods (and sometimes whole food groups), you aren’t getting the necessary nutrients to help your body heal.  This can leave you deficient in many precious vitamins and minerals.
  2. Restrictive diets can set you up for a disordered relationship with food, and sometimes a full-blown eating disorder.  You’re more likely to worry about and obsess over food rather than just enjoying it.
  3. Restrictive diets don’t address the other important aspects of our health, like stress, sleep, and exercise.  Often, those things have a more profound impact on the gut bacteria than what you’re eating.
  4. Long-term, restrictive diets might do more harm than good, with studies showing that being on a restrictive diet (like Low FODMAP) long-term can cause negative changes to the gut flora.  Typically restrictive diets eliminate foods that are actually good for you and would help promote growth of healthy gut bacteria.  

The hard truth is that restrictive diets don’t actually solve the problem; they only alleviate symptoms in the short-term.

The real cause of digestive issues like chronic diarrhea, constipation, bloating, and acid reflux may actually be a disrupted gut microbiome – an imbalance of good gut bacteria and harmful, pathogenic bacteria.  Blame the imbalance on a poor Standard American diet, too much stress, lack of exercise, and exposure to chemicals and toxins.

So what can we do? To really treat your gut issues, we have to focus on rebalancing the gut bacteria.  This is accomplished by eating a nutrient-dense diet, incorporating probiotics and prebiotics, and setting up your lifestyle for success.

In order for real healing to begin, we have to first test the gut to know what we’re dealing with.  For example, your symptoms may be due to an imbalance of gut bacteria which can be caused by SIBO (small intestine bacterial overgrowth), parasites, fungal overgrowth, Leaky Gut Syndrome, or some combination of all of those things.  

Testing will illuminate a path to healing that treats the root of the issue.

You may learn that a course of antimicrobials, prebiotics, probiotics, and changes in your diet and lifestyle all together will be needed to treat the real problem. After all, treatment is individualized and doesn’t look the same for everyone.

However, it is important to remember that restrictive diets have their place in some cases where symptoms are still experienced despite working to heal your gut through more nourishing means.  Here are a few steps to consider:

1. Work with a specialist.

Work with a functional medicine or specialized health practitioner to get your gut tested. Most conventional doctors will only prescribe medication to treat the symptoms (i.e. an anti-diarrheal drug) rather than testing the gut for potential causes of the issue.  In functional medicine, breath testing, stool testing, and food intolerance testing among others will be used to identify causes of your digestive issues and structure a treatment tailored specifically to you.

2. Start eating a nutrient-dense, colorful diet, and supplement as needed.

If you haven’t already, consider limiting added sugars, refined carbohydrates, and industrial oils like canola oil and safflower oil.  Focus on real foods so if diet changes are required, it won’t feel like a complete shift in your lifestyle. Talk with your health practitioner for supplement protocols for treating gut conditions that may be right for you.

3. Track your symptoms and re-test the gut.  

If you’ve had treatment but are still experiencing symptoms, you may need to introduce a short-term restrictive diet like Low FODMAP.  It’s helpful to track your progress so you know what symptoms have improved and what still needs work.

4. Reintroduce foods you love.

It’s  possible to go back to eating things you love once your gut is healed and there’s plenty of good bacteria in there!  This looks different for every person, depending on what “trigger foods” may make you feel less than optimal. Continue focusing on real food, but notice if your body will finally be able to tolerate things you enjoy after you’ve given it an opportunity to heal.

Ultimately, your best bet is to get your gut tested, identify the underlying cause, and structure a treatment protocol tailored specifically to you.

And once you heal, you can find a way to enjoy the foods you love again.


Kasey Goins, PA-C is a Physician Assistant and Functional Medicine Practitioner Student based in Kalamazoo, MI, with a passion for helping individuals recover from chronic digestive issues and fatigue through real food and holistic medicine.  She loves baking and is constantly making messes in the kitchen. To get started on your own health journey, visit her at Well-Fed Soul and grab the free 3 Day Anti-Inflammatory Meal Plan.