So, sometimes fruit and vegetable intolerance can be the result of an immune response.

However, more often than not, women have a different problem.

Have you ever ended up on the floor of your bedroom, doubled over with pain from gas, bloating, nausea, and shooting pains after eating a seemingly innocuous piece of produce?

You thought kale salad was a virtuous choice! And you were positive that broccoli is quite beneficial for women’s hormonal health. Finishing your meal with an organic apple seemed to be a calorie-conscious, healthy way to end a meal. And now you are sitting on the floor, jeans unbuttoned, gasping with pain.

So, why is your stomach punishing you? It’s enough to make a girl want to give up on healthy eating.

Let’s discuss three possible reasons for this scenario:

1. FODMAPS sensitivity.

FODMAPs are essentially short chain (one-, two-, or few- sugar molecule). carbohydrates that your small intestine has trouble digesting and absorbing. Since your body cannot break these substances down well, they start to ferment in your gut, leading to a buildup of painful gas and bloating. Common FODMAPs culprits include any fruit or vegetable with a high fructose or fructans percentage, like apples, watermelon, bananas, cauliflower, onions, and garlic. FODMAPs foods tend to build up in the system during the day. Consequently, many people can eat an apple in the morning and feel fine, but as the day progresses, bloating and gas build up past the pain threshold.

2. SIBO.

SIBO, or Small Intestinal Bacterial Overgrowth, is a growing problem for women especially. Good bacteria (probiotics) reside in large numbers in your large intestine. This is where the bacteria ought to be. Good bacteria digest waste products, create digestive enzymes, manufacture B vitamins and K vitamins, and crowd out pathogenic bacteria. In the large intestine, water mixes with waste products and bacteria to create the waste elimination mechanism called poop. There is the potential for many problems here. Maybe the good bacteria are not colonizing the large intestine properly. Maybe you are not drinking enough water. Maybe there is a proliferation of pathogenic or even commensal bacteria, causing a buildup of methane in the gut.

Then you have constipation.

Maybe you are not absorbing nutrients from food because you do not have proper enzymes present in the stomach. Maybe your body is not absorbing water properly. Maybe you have a sensitivity to gluten, dairy, or a host of other foods that end up flattening the villi on your intestinal cells, causing food and water to rush past without absorbing nutrients properly.

Then you have diarrhea.

Many times, the bacteria that is supposed to be present only in the large intestine migrates backwards, up to the small intestine. The small intestine should be a relatively sterile environment. Its function is to break down and assimilate nutrients, not package up waste. But if bowel motility is compromised, the microbiome slowly begins to colonize the small intestine.

And now you have SIBO.

SIBO symptoms look a lot like FODMAPS sensitivity. Many times, the two dysfuntions go hand in hand and you will spend each day in pain, wondering why your stomach is constantly fighting against you.

3. Pathogenic Gut Infection.

There is a strange and inevitable cascade that happens with gut dysfunction. Helicobacter Pylori is a pathogenic bacteria that infects about half of the world’s population. It is spread person to person through saliva, feces, or contaminated food and water. Odds are, you or someone you know is infected. Often times, this is not a problem. You can live with a little H Pylori and never know it. But in compromised individuals (like those with adrenal fatigue, chronic fatigue, thyroid or hormonal disorders), the body is unable to keep the H. Pylori at bay. It begins to proliferate in the stomach. There, it attaches to the stomach wall, burrowing in, and begins to make itself at home. In order to survive, it secretes an enzyme called urease that lowers the pH of the stomach. The stomach becomes less acidic and is therefore unable to do its job of killing everything you ingest that can hurt you. Like parasites.

So when the next parasite inevitably finds its way onto your sushi, or organic pear, or artisan lettuce, your stomach acid doesn’t have the strength to kill it. So it migrates down into your lower gut, wreaking havoc on your digestive system. Interestingly, a gut parasite infection looks a lot like a FODMAPs sensitivity. And SIBO.

Um. Ew.

So, what do we do?

Lay off the raw veggies and fruit for a time.

Now please, dear reader, remember that all diet alterations are to be used therapeutically, and for a set period of time. Did I tell you to never eat raw fruit or veggies again? No. But you can support your digestive health and still receive a good dose of phytonutrients by cooking your produce down and adding some good fat. I am essentially recommending baby food for those with compromised gut function. Boil it, mash it, put it in a stew. Use fruits or veggies that are low in fermentable fibers. Carrots, leeks, parsnips, pumpkin, squash, and berries are all fairly low fructose/ fructans. Cook, mash, and add plenty of good fat like ghee or coconut oil. I tell you, not one client has been upset when I prescribe Baby Food. It is a fun way to get in your veggies.

Increase good proteins and fats.

Ditch your processed, high-sugary food items. The sugar feeds candida and parasites. And candida and parasite poop feeds other little nasty critters in your gut. By making the majority of your diet clean, good-quality animal fats and proteins, you feed the good bacteria of your gut, which produces butyric acid, which strengthens the structure and function of your colon. And believe me, it behooves you to have a healthy colon. Eat coconut oil, which kills viruses and pathogens. Eat ghee, which has almost no casein or lactose. Both of these taste delicious. Grass fed ground beef is inexpensive and plentiful. Saute ground beef with butternut squash and add 2 tablespoons of coconut oil. Your taste buds, your tummy, your hormones, and your adrenal glands will breathe a sigh of gratitude.

Consider clinical testing.

Many times, a simple elimination/ substitution diet will alleviate gastrointestinal symptoms. But if you are at the end of your rope and feel like no current intervention is working, consider getting professional testing done on your gut. I don’t mean a colonoscopy. (Those have their place, but are virtually useless for chronic constipation, diarrhea, or other IBS symptoms. Please ask me how I know this.) To use myself as an example, years of dietary tweaks, eliminations, and protocols could not tell me that I had not only a severe H. Pylori infection, but also a parasite called entomoeba hartmanni. Consequently, I had daily, wrenching stomach aches for over 15 years. Running some hard data on my gut allowed me to begin an herbal protocol on myself and eradicate all of the nasties living inside my poor intestines. I literally- seriously- have no more bloating or pain after eating. Ever. I can hardly believe it. The deal with the eradication protocol is this- pharmaceutical antibiotics will work well to kill off the living pathogens. However, their course of action is not long enough to kill the lil’ baby parasite eggs that are incubating in your gut. The herbal protocol takes 30-90 days and kills off all of the bad guys. Then, you repopulate with the good guys.

As a nutritionist, I like to start with the easy things first. Namely, diet. And then rest, and exercise, and stress relief, and finally- supplements. So if you see yourself in the scenario above, you have permission to baby yourself a bit. Puree yourself some nourishing vegetables, add some well-cooked meat, and top with some heavenly fats. See if your tummy doesn’t thank you.