Back Clinic Functional Medicine Team. Functional medicine is an evolution in the practice of medicine that better addresses the healthcare needs of the 21st century. By shifting the traditional disease-centered focus of medical practice to a more patient-centered approach, functional medicine addresses the whole person, not just an isolated set of symptoms.
Practitioners spend time with their patients, listening to their histories and looking at the interactions among genetic, environmental, and lifestyle factors that can influence long-term health and complex, chronic disease. In this way, functional medicine supports the unique expression of health and vitality for each individual.
By changing the disease-centered focus of medical practice to this patient-centered approach, our physicians are able to support the healing process by viewing health and illness as part of a cycle in which all components of the human biological system interact dynamically with the environment. This process helps to seek and identify genetic, lifestyle, and environmental factors that may shift a person’s health from illness to well-being.
It can be difficult for individuals and athletes to stay motivated, manage stress and prevent becoming overwhelmed. Can mental toughness and a positive attitude help increase potential and performance levels?
Mental Toughness
Athletes and fitness enthusiasts work on conditioning, skills training, and perfecting techniques. Physical training can take individuals far but another necessary part of maximizing athletic potential is building mental toughness and having the right attitude. Like anything, mental training takes time, effort, and regular adjustments to find ways to shift a losing or bad attitude into a positive one that can bring out the best.
Attitude Is Important
If negativity begins to set in like dealing with an injury, getting rid of self-limiting beliefs can be difficult, as well as generate optimism to rise up and succeed. For athletes or individuals who enjoy competitive sports, developing a positive mental attitude will help with:
Emotions that can affect cognitive functioning strategies.
Energy levels.
Other aspects of physical performance.
Mental Strategies
Mood Improvement
Individuals frustrated by a pessimistic perspective tend to dwell on problems or issues. To shift into a positive mood do something to lift your spirits, even if you don’t think it will help.
Listen to your favorite or uplifting music.
Watch an inspirational movie.
Read a sports psychology book.
Get together or call a teammate or friend that are cheerful and upbeat.
Play different games just for fun.
Take a break, go to the park, walk around, and meditate.
Get into hobbies.
Relax with a therapeutic massage.
Positive Self Talk
Continuing sports psychology research shows that practicing positive self-talk can improve athletic performance. (Nadja Walter, et al., 2019) Sports psychologists describe this through the idea that thoughts create beliefs, that drive actions.
Positive self-talk can take different forms.
For some reciting a specific phrase, sentence, or a single word can effectively manage thoughts, push out the negativity, and focus on taking care of business. Anything that inspires can include:
Focus
Remember the fundamentals!
You know what to do!
You can do it!
You got this!
Research shows that positive self-talk reduces anxiety and increases self-confidence, optimization, efficacy, and performance. (Nadja Walter, et al., 2019) However, self-talk needs to be practiced and part of a regular routine to be effective.
Visualization
Another strategy is using visualization exercises.
This could be using all the senses to imagine the venue where the tournament is taking place, the sound of the crowd, the smells, how the ground or court feels, and/or how the ball or specific sports object feels.
The wisdom is if you can think it, you can do it, once that is determined apply strategies to get there.
Sports Injury Rehabilitation
References
Walter, N., Nikoleizig, L., & Alfermann, D. (2019). Effects of Self-Talk Training on Competitive Anxiety, Self-Efficacy, Volitional Skills, and Performance: An Intervention Study with Junior Sub-Elite Athletes. Sports (Basel, Switzerland), 7(6), 148. doi.org/10.3390/sports7060148
Reiser, M., Büsch, D., & Munzert, J. (2011). Strength gains by motor imagery with different ratios of physical to mental practice. Frontiers in psychology, 2, 194. doi.org/10.3389/fpsyg.2011.00194
Individuals need to eat more fiber for optimal gut health. Can adding avocado to their diet help improve the gut microbe diversity?
Avocado Gut Support
A diverse gut microbiome is beneficial to overall health. According to a recent study, eating one avocado a day can help maintain the gut microbes healthy, diverse, and balanced. (Sharon V. Thompson, et al., 2021) The researchers observed positive changes in gut bacteria and increased bacterial diversity in individuals who consumed an avocado every day for 12 weeks. (Susanne M Henning, et al., 2019)
Gut Diversity
The gut microbiome refers to the microorganisms living in the intestines. There are around 100 trillion microorganisms, including bacteria, viruses, fungi, and more, exist in the gastrointestinal tract. (Ana M. Valdes, et al., 2018) Having a diverse microbiome means that the body has a range of different organisms that offer various health benefits. Not having enough bacterial diversity has been linked to: (Ana M. Valdes, et al., 2018)
Arthritis
Obesity
Type 1 diabetes
Type 2 diabetes
Inflammatory bowel disease
Celiac disease
Arterial stiffness
Atopic eczema
Why Avocados?
The Institute of Medicine recommends a daily fiber intake ranging from 19 grams to 38 grams per day, depending on various factors like age. (Diane Quagliani, Patricia Felt-Gunderson. 2016)
Including foods like avocados in a healthy diet can help meet daily fiber requirements.
Fruit fiber like pectin, has been shown to promote a healthy gut microbiome as well. (Beukema M, et al., 2020)
Researchers suggest this could be because of pectin’s positive effect on beneficial probiotics.(Nadja Larsen, et al., 2018)
Although further research is needed fiber is believed to help protect the lining of the colon by increasing the bulk and weight of stool and expediting elimination.
Fiber also adds bulk to an individual’s diet and slows the speed of digestion, which makes the body feel fuller longer.
Improved Gut
Individuals can support a healthy microbiota by making small adjustments in their diet, including:
Eating a variety of fruits and vegetables with the skin, as this is where a majority of the nutrition is.
Fermented foods like yogurt, kombucha, sauerkraut, kimchi, and kefir.
Limiting consumption of processed foods, sugar, and artificial sweeteners.
If there are more avocados that can be eaten before they overripen, they can be frozen.
Peel and slice them first, then place them in freezer bags to have year-round.
They are rich in healthy fat, however, in moderation, they are not likely to contribute to weight gain.
Individuals can work toward having a diverse gut microbiome by paying attention to the foods they eat. Specific foods and dietary patterns can influence the different types of bacterial diversity which can support health.
Smart Choices, Better Health
References
Thompson, S. V., Bailey, M. A., Taylor, A. M., Kaczmarek, J. L., Mysonhimer, A. R., Edwards, C. G., Reeser, G. E., Burd, N. A., Khan, N. A., & Holscher, H. D. (2021). Avocado Consumption Alters Gastrointestinal Bacteria Abundance and Microbial Metabolite Concentrations among Adults with Overweight or Obesity: A Randomized Controlled Trial. The Journal of nutrition, 151(4), 753–762. doi.org/10.1093/jn/nxaa219
Henning, S. M., Yang, J., Woo, S. L., Lee, R. P., Huang, J., Rasmusen, A., Carpenter, C. L., Thames, G., Gilbuena, I., Tseng, C. H., Heber, D., & Li, Z. (2019). Hass Avocado Inclusion in a Weight-Loss Diet Supported Weight Loss and Altered Gut Microbiota: A 12-Week Randomized, Parallel-Controlled Trial. Current developments in nutrition, 3(8), nzz068. doi.org/10.1093/cdn/nzz068
Valdes, A. M., Walter, J., Segal, E., & Spector, T. D. (2018). Role of the gut microbiota in nutrition and health. BMJ (Clinical research ed.), 361, k2179. doi.org/10.1136/bmj.k2179
Quagliani, D., & Felt-Gunderson, P. (2016). Closing America’s Fiber Intake Gap: Communication Strategies From a Food and Fiber Summit. American journal of lifestyle medicine, 11(1), 80–85. doi.org/10.1177/1559827615588079
Beukema, M., Faas, M. M., & de Vos, P. (2020). The effects of different dietary fiber pectin structures on the gastrointestinal immune barrier: impact via gut microbiota and direct effects on immune cells. Experimental & molecular medicine, 52(9), 1364–1376. doi.org/10.1038/s12276-020-0449-2
Larsen, N., Cahú, T. B., Isay Saad, S. M., Blennow, A., & Jespersen, L. (2018). The effect of pectins on survival of probiotic Lactobacillus spp. in gastrointestinal juices is related to their structure and physical properties. Food microbiology, 74, 11–20. doi.org/10.1016/j.fm.2018.02.015
As research increases in regenerative medicine with the potential of being able to regrow thyroid tissue, could regeneration therapy eliminate the need for patients to take thyroid replacement hormones?
Thyroid Regenerative Therapy
A great hope for regenerative therapy is the ability to grow healthy organs. One of the organs being looked at is the thyroid gland. The goal is to re-grow thyroid tissue in:
Individuals who had to have the gland removed because of thyroid cancer.
Individuals who were born without a fully developed gland.
As science advances and research has expanded from laboratory and animal experiments to test tube human thyroid cell studies, the use of stem cell therapy for this purpose is not there yet, as more extensive research is needed for human consideration.
Human Research
Research on the use of thyroid regenerative therapy for thyroid disease has not published studies in which stem cell therapy has been attempted in human thyroid patients.
The studies that have been done were conducted in mice, and any findings of this research cannot automatically be applied to humans. (H. P. Gaide Chevronnay, et al., 2016)
In human thyroid tissue in test tube studies, the stimulation of cells was achieved in a way that raised the question of making cancerous transformations more likely if it were to be attempted in humans. (Davies T.F., et al., 2011)
Recent Studies
Current research involves advances in embryonic stem cell – ESC and induced pluripotent stem cell – iPSC. (Will Sewell, Reigh-Yi Lin. 2014)
ESCs, also known as pluripotent stem cells, can increase any type of cell in the body.
They are harvested from embryos that were produced, but not implanted, during IVF procedures.
iPSCs are pluripotent cells that have been developed using a reprogramming process of adult cells.
Follicular cells are thyroid cells that make thyroid hormones – T4 and T3 and have been produced from the embryonic stem cells of mice.
In a study published in the journal Cell Stem Cell in 2015, these cells had the ability to grow and were also able to start making thyroid hormone within two weeks. (Anita A. Kurmann, et al., 2015)
After eight weeks, cells that were transplanted into mice that did not have thyroid glands had normal amounts of thyroid hormone.
New Thyroid Gland
Investigators at Mount Sinai Hospital induced human embryonic stem cells into thyroid cells.
They were looking at the possibility of creating a new-like thyroid gland in individuals who have had their thyroid surgically removed.
The future looks promising for the ability to regrow thyroid tissue and eliminate thyroid replacement hormone. However, far more research is needed for this to even be considered a possibility.
Cracking the Low Thyroid Code Assessment Guide
References
Gaide Chevronnay, H. P., Janssens, V., Van Der Smissen, P., Rocca, C. J., Liao, X. H., Refetoff, S., Pierreux, C. E., Cherqui, S., & Courtoy, P. J. (2016). Hematopoietic Stem Cells Transplantation Can Normalize Thyroid Function in a Cystinosis Mouse Model. Endocrinology, 157(4), 1363–1371. doi.org/10.1210/en.2015-1762
Davies, T. F., Latif, R., Minsky, N. C., & Ma, R. (2011). Clinical review: The emerging cell biology of thyroid stem cells. The Journal of clinical endocrinology and metabolism, 96(9), 2692–2702. doi.org/10.1210/jc.2011-1047
Sewell, W., & Lin, R. Y. (2014). Generation of thyroid follicular cells from pluripotent stem cells: potential for regenerative medicine. Frontiers in endocrinology, 5, 96. doi.org/10.3389/fendo.2014.00096
Kurmann, A. A., Serra, M., Hawkins, F., Rankin, S. A., Mori, M., Astapova, I., Ullas, S., Lin, S., Bilodeau, M., Rossant, J., Jean, J. C., Ikonomou, L., Deterding, R. R., Shannon, J. M., Zorn, A. M., Hollenberg, A. N., & Kotton, D. N. (2015). Regeneration of Thyroid Function by Transplantation of Differentiated Pluripotent Stem Cells. Cell stem cell, 17(5), 527–542. doi.org/10.1016/j.stem.2015.09.004
Tuttle, R. M., & Wondisford, F. E. (2014). Welcome to the 84th annual meeting of the American Thyroid Association. Thyroid : official journal of the American Thyroid Association, 24(10), 1439–1440. doi.org/10.1089/thy.2014.0429
Individuals striving to be healthy may not know where or how to start. Can hiring a health coach help individuals start their wellness journey and reach their goals?
Hiring A Health Coach
It’s easy to get caught up in the desire to make changes, but it is another thing to actually set a consistent plan in motion. Hiring a health coach can help individuals understand the information, develop an effective wellness routine that suits their lifestyle, and achieve health and wellness goals. A primary healthcare provider could be a resource and have referrals to reputable health coaches in the area.
What Do They Do?
Health coaches are experts in helping individuals reach health and wellness goals. This can be:
Reducing stress
Improving self-care
Focusing on nutrition
Starting exercise
Improving quality of life
A health coach helps create a plan and makes it happen.
Health and wellness coaches use motivational interviewing and evidence-based approaches to empower individuals in their wellness journey. (Adam I Perlman, Abd Moain Abu Dabrh. 2020)
They help identify areas that need improvement, develop a plan, and encourage the individual all the way like a personal fitness trainer.
Health coaches work with physicians and/or other health professionals in a clinical setting or as individual providers.
Their role is to provide a holistic approach to health and wellness.
A health coach is someone who helps organize and balance various aspects of an individual’s life so they can learn to maintain optimal health.
They will help overcome barriers when struggling.
A health coach listens and provides support for whatever an individual’s goals may be.
A health coach is there until the goal is reached.
Qualifications
It is important to ensure the providers being considered have the necessary qualifications. Because some certification programs offer a focus on specific areas like nutrition, it’s recommended to identify what is needed before choosing a health coach. Health coaches do not need a university degree, however, many certifications are affiliated with colleges and have educational partnerships that qualify coursework and award college credits. Training to become a health coach consists of: (Shivaun Conn, Sharon Curtain 2019)
Health
Fitness
Goal setting
Coaching concepts
Nutritional concepts
Motivational interviewing
Stress management
Changing behaviors
Health Goal Examples
Health coaching is not a one-size-fits-all approach. A primary healthcare provider or physician provides a diagnosis and medical plan, and a health coach helps guide and support the individual through the plan. However, hiring a health coach does not require a medical condition to employ services. A few examples of health goals that health coaches address include:
There are many types of health coaches and some may specialize, therefore try to determine the expertise needed to achieve the goals.
Budget
Determine how much money will be invested, as many insurance providers do not cover the cost of a health coach.
Health coaches may charge between $50 to $300 per session.
Some will offer packages, memberships, and/or discounts.
Certifications
Look into their certification.
Is it accredited?
This will ensure choosing a coach who has received the training and expertise needed to provide quality care.
Compatibility
Consult with potential coaches.
Ask questions and see if they are compatible with specific health goals.
Interview as many as needed.
Availability/Location
Virtual sessions, in-person meetings, and/or a combination?
How long are the sessions?
Frequency of meetings?
Finding a coach that is flexible and convenient will help maintain a healthy coach/client relationship.
Multidisciplinary Evaluation and Treatment
References
Perlman, A. I., & Abu Dabrh, A. M. (2020). Health and Wellness Coaching in Serving the Needs of Today’s Patients: A Primer for Healthcare Professionals. Global advances in health and medicine, 9, 2164956120959274. doi.org/10.1177/2164956120959274
Conn, S., & Curtain, S. (2019). Health coaching as a lifestyle medicine process in primary care. Australian journal of general practice, 48(10), 677–680. doi.org/10.31128/AJGP-07-19-4984
For individuals with aches and pains throughout their body, can a foot detox help bring relief?
Foot Detox
A foot detox involves soaking the feet in an ionic bath to help remove toxins from the body. They can also be performed using acupressure, scrubs, foot masks, and pads. Combined with eliminating toxins, detox is also believed to help enhance blood circulation and provide body pain and discomfort relief. However, current evidence is limited and there has been no evidence to support that toxins can be released from the feet using an ionic bath. However, they have been found to provide other benefits, which include:
Relaxation
Lower stress levels
Enhanced skin health and hydration.
Reduced inflammation in individuals with skin disorders.
Foot detoxes are considered generally safe, but individuals are recommended to speak to their healthcare provider.
Potential Benefits
The potential health benefits include:
Reduces inflammation and swelling.
Improves stress levels and mood.
Can help with weight management.
Can help with heart health and increased blood circulation.
However, most reports surrounding the benefits of foot detox are not proven by research investigating whether the health claims are scientifically accurate. One study in 2012 found that foot detoxes did not produce the intended results and could not help remove toxins from the body. (Deborah A. Kennedy, et al., 2012) Other research surrounding foot baths and massages showed that they could help reduce symptoms of mood disorders like schizophrenia because of the relaxing effect they produce. (Kazuko Kito, Keiko Suzuki. 2016)
Ways Toxins are Removed From the Body
Toxins are filtered out of the body in a variety of ways. Breathing out expels carbon dioxide from the body. Another way is through the body’s natural processes. The body has organs and other systems to filter out and release toxins.
Specific organs, such as the liver, kidneys, and lymph nodes, filter and remove harmful and unneeded substances. (UW Integrative Health. 2021)
The health claims surrounding toxin removal through the feet are currently insubstantial because no evidence supports the effectiveness and the anecdotal evidence is not based on science.
Foot detoxes can be an enjoyable experience that can help relieve sore feet, relax the body, and offer relief for certain foot ailments. They could be an excellent addition to a self-care routine. Some of the most commonly used natural foot detoxes include the following.
Epsom Salt Foot Bath
Combining Epsom salts with warm water and soaking the feet for 20–30 minutes can help promote relaxation.
Apple cider vinegar foot baths are made by diluting 1 cup of vinegar in warm water and soaking the feet for 20–30 minutes.
There is limited research available to confirm the health claims.
The studies that have been done have found the reverse effect, that bathing the feet in apple cider vinegar and water can irritate the skin. (Lydia A Luu, et al., 2021)
Baking Soda and Sea Salt
Sea salt combined with baking soda dissolved in a bath and soak the feet for up to 30 minutes. While research is limited, some evidence supports the health benefits associated with sea salt that include: (Ehrhardt Proksch, et al., 2005)
Reduces inflammation in skin conditions, like atopic dermatitis.
Foot baths should be avoided for the following:
There are open sores on the feet that could be irritated by salt and other foot bath ingredients.
Individuals with a pacemaker or any electrical body implant.
Pregnant women.
Consult a healthcare provider before trying any new health protocols.
Foot Orthotics Benefits
References
Kennedy, D. A., Cooley, K., Einarson, T. R., & Seely, D. (2012). Objective assessment of an ionic footbath (IonCleanse): testing its ability to remove potentially toxic elements from the body. Journal of environmental and public health, 2012, 258968. doi.org/10.1155/2012/258968
Kito, K., & Suzuki, K. (2016). Research on the Effect of the Foot Bath and Foot Massage on Residual Schizophrenia Patients. Archives of psychiatric nursing, 30(3), 375–381. doi.org/10.1016/j.apnu.2016.01.002
UW Integrative Health. Improving your health by removing toxins from your body.
Akyuz Ozdemir, F., & Can, G. (2021). The effect of warm salt water foot bath on the management of chemotherapy-induced fatigue. European journal of oncology nursing: the official journal of European Oncology Nursing Society, 52, 101954. doi.org/10.1016/j.ejon.2021.101954
Vakilinia, S. R., Vaghasloo, M. A., Aliasl, F., Mohammadbeigi, A., Bitarafan, B., Etripoor, G., & Asghari, M. (2020). Evaluation of the efficacy of warm salt water foot-bath on patients with painful diabetic peripheral neuropathy: A randomized clinical trial. Complementary therapies in medicine, 49, 102325. doi.org/10.1016/j.ctim.2020.102325
Luu, L. A., Flowers, R. H., Gao, Y., Wu, M., Gasperino, S., Kellams, A. L., Preston, D. C., Zlotoff, B. J., Wisniewski, J. A., & Zeichner, S. L. (2021). Apple cider vinegar soaks do not alter the skin bacterial microbiome in atopic dermatitis. PloS one, 16(6), e0252272. doi.org/10.1371/journal.pone.0252272
Proksch, E., Nissen, H. P., Bremgartner, M., & Urquhart, C. (2005). Bathing in a magnesium-rich Dead Sea salt solution improves skin barrier function, enhances skin hydration, and reduces inflammation in atopic dry skin. International journal of dermatology, 44(2), 151–157. doi.org/10.1111/j.1365-4632.2005.02079.x
Kanwar A. J. (2018). Skin barrier function. The Indian Journal of Medical Research, 147(1), 117–118. doi.org/10.4103/0971-5916.232013
For individuals with stomach issues, can maintaining gut flora balance promote and improve gut health?
Gut Flora Balance
Maintaining gut flora balance is part of optimal digestive health. Gut microbiota, gut microbiome, or gut flora, are the microorganisms, including bacteria, archaea, fungi, and viruses that live in the digestive tract. The type and amount of bacteria present depend on their location in the body which could be the small intestine and colon. This is the storage housing for waste/stool, and the colon comprises hundreds of different types of bacteria, which have specific jobs and functions.
Unhealthy Flora
The more common pathogens are bacteria that can cause illness if left unchecked, including germs like streptococcus/strep throat or E. coli/urinary tract infections and diarrhea. Other common germs found in the colon include: (Elizabeth Thursby, Nathalie Juge. 2017)
Clostridioides Difficile
C. diff overgrowth can cause watery foul-smelling stools daily, and abdominal pain and tenderness.
Enterococcus Faecalis
Enterococcus faecalis is a cause of post-surgical abdominal and urinary tract infections.
Escherichia Coli
E. coli is the most common cause of diarrhea in adults.
This bacteria is present in almost every healthy adult’s colon.
Klebsiella
Klebsiella overgrowth is associated with a Western diet that consists of various meat and animal products.
Bacteroides
Bacteroide overgrowth is associated with colitis, which causes painful inflammation of the colon.
Healthy Flora
Healthy bacteria like Bifidobacteria and Lactobacillus, help maintain gut flora balance and keep the unhealthy bacteria in check. Without healthy flora, the entire colon can become overrun by bad flora, which can result in symptoms like diarrhea and/or illness. (Yu-Jie Zhang, et al., 2015) These protective, microscopic germs have important functions that include:
Assisting with vitamin synthesis – vitamins B and K in the small intestine.
Increases immune system function.
Maintaining regular bowel movements.
Maintaining a clean colon naturally without the need for colon cleansers.
Destroying the unhealthy bacteria.
Preventing unhealthy bacteria overgrowth.
Breaking up gas bubbles from food fermentation.
Bacterial Dismantling
Whether labeled as healthy bacteria or unhealthy, they are both single-celled organisms that can be destroyed quite easily. Sometimes, it is necessary, like when having to take antibiotics to kill a strep throat infection. However, the antibiotics also kill the beneficial bacteria, which can lead to compounding problems that can include: (Mi Young Yoon, Sang Sun Yoon. 2018)
Bowel irregularity – diarrhea and constipation.
Yeast overgrowth – can cause itching, burning around the anus and lead to vaginal and oral yeast infections.
Dysbiosis – the technical name for a lack of healthy bacteria or a bacterial imbalance.
Complications for individuals suffering from irritable bowel syndrome.
There are different ways to destroy bacteria including.
Prolonged diarrhea – can flush out the bad and good bacteria.
Stress
Completing a bowel prep, like those required for a colonoscopy.
Diagnosing Gut Flora Issues
Many times, problems with gut flora will correct themselves, and no action is required. However, individuals facing chronic bowel problems, like colitis or inflammatory bowel disease, may require medical intervention of their colon’s bacteria.
Comprehensive Digestive Stool Analysis/CDSA is a stool test that checks what type and amount of bacteria are present, nutrient absorption rates/digestion speed, and how well food is digested.
If there is a significant difference in the proportion of unhealthy versus beneficial bacteria, a healthcare provider may suggest taking a probiotic or a live microbial supplement to help repopulate and maintain gut flora balance.
Gut Dysfunction
References
Thursby, E., & Juge, N. (2017). Introduction to the human gut microbiota. The Biochemical journal, 474(11), 1823–1836. doi.org/10.1042/BCJ20160510
Zhang, Y. J., Li, S., Gan, R. Y., Zhou, T., Xu, D. P., & Li, H. B. (2015). Impacts of gut bacteria on human health and diseases. International journal of molecular sciences, 16(4), 7493–7519. doi.org/10.3390/ijms16047493
Yoon, M. Y., & Yoon, S. S. (2018). Disruption of the Gut Ecosystem by Antibiotics. Yonsei medical journal, 59(1), 4–12. doi.org/10.3349/ymj.2018.59.1.4
Quigley E. M. (2013). Gut bacteria in health and disease. Gastroenterology & hepatology, 9(9), 560–569.
Should individuals with existing gastrointestinal problems eat bananas?
Bananas
Bananas can be easy to digest and are often recommended for nausea and diarrhea, however, not everyone can tolerate them. (MedlinePlus. 2021)
Bananas are high in fructose, sorbitol, and soluble fiber, which makes them a common trigger for gastrointestinal problems.
Additionally, individuals not used to eating a high-fiber diet may find it helpful to gradually increase fiber and drink more water to alleviate unpleasant symptoms.
If there is a suspicion of intolerance, IBS, or malabsorption, it is recommended to speak with a healthcare provider for an evaluation.
Bananas can make the stomach hurt due to:
Irritable bowel syndrome (IBS)
Cramping
Gas
Bloating
Other gastrointestinal (GI) problems.
Individuals can experience stomach discomfort if there is a fructose intolerance or a rare banana allergy.
Stomach Pain
Bananas are used to replenish potassium and other essential nutrients lost from vomiting or diarrhea.
Some individuals can experience bloating and gas after eating them.
One reason is because of their soluble fiber content.
Soluble fiber dissolves in water and is more readily fermented in the colon than insoluble fiber.
Bananas also contain sorbitol – a naturally occurring sugar that acts as a laxative and can cause gas, bloating, and diarrhea when consumed in large amounts. (U.S. Food and Drug Administration. 2023)
Irritable Bowel Syndrome – IBS
Bananas can be a common trigger food for individuals with IBS.
Bananas are also high in fructose/simple sugar especially when they have overripened.
Individuals who have IBS are advised to avoid bananas because they can trigger many of the same side effects as undigested lactose/sugar in milk. (Johns Hopkins Medicine. 2023)
Ripe bananas are considered to be high in FODMAPS – fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.
Individuals following a low FODMAP diet to manage IBS may want to avoid or limit consumption.
Fructose malabsorption is when the body cannot digest or absorb fructose correctly. This causes bloating gas and abdominal discomfort.
Hereditary fructose intolerance is very rare. It happens when the liver cannot assist in the breakdown of fructose.
This condition often causes more severe symptoms and requires additional treatment besides removing fructose from an individual’s diet. (UW School of Medicine and Public Health. 2019)
Most can tolerate small amounts of fructose found in fruits like bananas.
If you’re eating bananas that are too green or unripe, you may also experience stomach discomfort.
Unripened bananas contain high amounts of resistant starch. In large quantities, this can cause mild symptoms like gas and bloating. (Jennifer M Erickson, et al., 2018)
Jackson Siegelbaum Gastroenterology. Colon gas and flatus prevention.
U.S. Food and Drug Administration. Sorbitol.
Capili, B., Anastasi, J. K., & Chang, M. (2016). Addressing the Role of Food in Irritable Bowel Syndrome Symptom Management. The journal for nurse practitioners: JNP, 12(5), 324–329. doi.org/10.1016/j.nurpra.2015.12.007
Johns Hopkins Medicine. 5 foods to avoid if you have IBS.
Monash University. Bananas re-tested.
Dayıoğlu A, Akgiray S, Nacaroğlu HT, Bahçeci Erdem S. The clinical spectrum of reactions due to banana allergy. BMB. 2020;5(2):60-63. doi: 10.4274/BMB.galenos.2020.04.013
Family Medicine Austin. Banana allergy.
UW School of Medicine and Public Health. Fructose-restricted diet.
Erickson, J. M., Carlson, J. L., Stewart, M. L., & Slavin, J. L. (2018). The Fermentability of Novel Type-4 Resistant Starches in In Vitro System. Foods (Basel, Switzerland), 7(2), 18. doi.org/10.3390/foods7020018
The Johns Hopkins Guide to Diabetes. What is resistant starch?
IFM's Find A Practitioner tool is the largest referral network in Functional Medicine, created to help patients locate Functional Medicine practitioners anywhere in the world. IFM Certified Practitioners are listed first in the search results, given their extensive education in Functional Medicine
