What Your Gut Is Trying to Tell You, According to a Gastroenterologist

Our gut speaks to us more than we realize. Whether it’s a bout of bloating after a heavy meal or a persistent cramp that just won’t fade, those sensations are signals.

According to Dr. Salhab, a board certified gastroenterologist known online as @thestomachdoc, our digestive system is constantly communicating with us, reflecting not only what we eat but also how we live, manage stress, and even feel emotions.

Understanding these signals can help us distinguish between minor discomfort and the need for medical attention.

Your digestive system is full of feedback mechanisms, constantly sending you clues about what’s happening inside. Learning to recognize those signals and knowing when to take them seriously can help you support your health before problems grow.

“The gut most commonly ‘speaks up’ with bloating, excess gas, abdominal cramping, changes in bowel habits (constipation, diarrhea, or new urgency), reflux or heartburn, early fullness, nausea, or a sense that your stomach is ‘off,’” says Dr. Salhab.

• stress
• infections
• menstrual cycles
• travel
• medications
• eating too many ultra-processed foods

Listening to your gut means paying attention to the timing and context of these sensations. Notice what feels typical for you and what feels new or unusual.

Small changes in how your body responds can provide valuable insights into how stress, diet, and daily habits may be impacting your digestive health.

According to Dr. Salhab, what people often describe as a gut instinct has deep biological roots.

“A ‘gut feeling’ reflects real biology: the enteric nervous system (your gut’s built-in nerve network), the vagus nerve, immune signals, hormones, and the microbiome are constantly messaging the brain in a two-way conversation,” he explains.

This communication helps explain why stress can lead to nausea or why anxiety may cause your stomach to twist in knots.

“While not every emotion starts in the gut, a meaningful portion of how we perceive stress, calm, and even motivation is influenced by gut-to-brain signals and the metabolites produced by our microbes” says Dr. Salhab.

In other words, the gut constantly sends chemical messages to the brain, and these signals can affect your mood, stress levels, and overall digestion.

Recognizing this connection can help you respond to symptoms with more awareness. If your stomach tends to tighten during stressful periods, it’s not all in your head: it’s your gut and brain in active conversation.

Gut symptoms can vary from mildly annoying to life-altering. Understanding which ones to keep an eye on helps you know when to make lifestyle changes and when to seek medical advice.

Some gut symptoms are easy to dismiss but can indicate deeper issues.

One more clue? “A sudden need to locate bathrooms everywhere you go. That change in confidence can be diagnostic.”

It’s typical to experience occasional digestive upset after a heavy meal or a night of low quality sleep. However, persistent or unpredictable symptoms can signal a more complex condition.

“Irritable bowel syndrome (IBS) involves recurrent abdominal pain related to bowel movements with a pattern of constipation, diarrhea, or both, and tends to wax and wane without causing tissue damage,” Dr. Salhab explains.

In contrast, inflammatory bowel disease (IBD) is characterized by visible inflammation in the digestive tract. “Crohn’s disease and ulcerative colitis can cause bleeding, weight loss, fever, and lab abnormalities; they require medical therapy,” he says.

Food intolerances are another common culprit. “Symptoms improve with targeted dietary changes, though celiac disease is an immune condition and needs formal testing before any diet trial,” he emphasizes.

Paying attention to patterns, triggers, and persistence can help you and your doctor determine what’s behind your symptoms.

What you do every day has a significant impact on your gut health. From the foods you eat to how you sleep, move, and manage stress, your habits determine how well your digestive system functions.

“Chronically low fiber intake, frequent ultra-processed foods, excess alcohol, smoking or vaping, poorly managed stress, short or irregular sleep, sedentary time, dehydration, and frequent unnecessary NSAIDs (like ibuprofen) can all wear down gut resilience,” says Dr. Salhab.

Over time, these factors can make the gut more reactive and less adaptable to everyday stressors.

It’s important to remember that everyday choices can make a big difference. According to Dr. Salhab, these three core habits can help strengthen gut resilience over time:

• Hydrate and simplify. Drink enough water, limit alcohol, and focus on balanced meals that include protein, color, and fermentable fibers rather than chasing quick fixes.
• Prioritize fiber and plant diversity. Aim for a wide range of fruits, vegetables, legumes, nuts, seeds, and whole grains each week to feed beneficial microbes and support digestion.
• Be consistent with movement, sleep, and stress care. Regular physical activity, seven to nine hours of sleep per night, and stress-management practices like breathwork or mindfulness help regulate gut-brain signaling.

These small, consistent habits quietly train your gut over time, creating a foundation that outperforms any supplement or short-term cleanse.

Your gut and brain are in constant conversation, influencing everything from mood and energy to digestion itself. Understanding this relationship can help you care for both more effectively.

“The vagus nerve carries real-time status updates, gut bacteria produce metabolites (like short-chain fatty acids) that can influence inflammation and neurotransmitter pathways, and stress hormones loop back to affect motility and sensitivity,” Dr. Salhab explains. “Think of the gut and brain as teammates on a live intercom.”

When this system is balanced, people often experience steady energy, fewer “brain fog” days, and a calmer stomach. “When it is dysregulated, we see more pain, bloating, urgency, and mood lability,” he adds.

This connection is a reminder that caring for your digestive system also supports emotional balance and mental clarity.

Dr. Salhab encourages a “food-first” approach when it comes to probiotics. “I generally start food-first with fermented options (such as yogurt with live cultures, kefir, or fermented vegetables) and prebiotic fibers (like oats, onions, garlic, bananas, legumes),” he says.

“Probiotic supplements can help select conditions, but benefits are strain-specific and not one-size-fits-all.” He recommends trying one change at a time for four to eight weeks and noting how your body responds.

People who are immunocompromised, pregnant, or have significant GI disease should talk to their doctor before starting any supplement routine.

Even with healthy habits, there are times when your gut needs professional attention. Recognizing when to call a specialist can help you prevent complications and get peace of mind.

“There’s a difference between an occasional flare and a sign that something more serious is happening,” says Dr. Salhab. “You should see a gastroenterologist if you notice any red flags:”

• bleeding
• black stools
• unexplained weight loss
• persistent vomiting
• anemia
• fever
• nighttime symptoms
• trouble swallowing

He adds that it’s also worth scheduling a visit if:

• symptoms persist for several weeks despite basic changes
• over-the-counter remedies stop working
• you have a strong family history of gastrointestinal disease
• new symptoms appear after age 40

Noticing these patterns can help you catch treatable conditions early and support long-term gut health.

Your gut is a powerful communicator, sending signals about your diet, stress, and overall well-being. From subtle bloating to persistent discomfort, it often tells you exactly what it needs. You just have to listen.

As Dr. Salhab emphasizes, gut health isn’t about chasing a single “superfood” but about steady, everyday habits: eating a variety of plants, getting enough sleep, moving regularly, managing stress, and seeking care when needed. Small daily choices quietly train your gut over time, building a foundation that outperforms any quick fix.

And if your gut sends stronger or persistent signals, don’t ignore them. As Dr. Salhab reminds us, the most important thing you can do for your gut is to “stay curious, stay consistent, and seek care when something feels off.”