Unfortunately, many adopters of the Paleo diet are personally familiar with digestive disorders.1 For those who are not, common digestive problems include heartburn/GERD, IBD, and IBS.2,3,4,5 These conditions are not without their unpleasant symptoms.6 Typically, sufferers of digestive disorders report bloating, diarrhea, gas, stomach pain, and stomach cramps.7 If these symptoms persist on an ongoing basis, you can begin to understand how they become uncomfortable in life.8 Treatment is typically a combination of medication, as well as diet and lifestyle changes.9
Interestingly, a new study in Gastroenterology “Confocal Endomicroscopy Shows Food-Associated Changes in the Intestinal Mucosa of Patients With Irritable Bowel Syndrome,” was recently conducted, showing that confocal laser endomicroscopy (CLE) may help some who cannot seem to figure their digestive disorder issues.10 This technique would be a ‘next step’ when conventional testing fails to provide patients with an adequate diagnosis. This is a fairly big breakthrough, as many sufferers of digestive disorders remain undiagnosed, or are diagnosed incorrectly.11 There is also the opportunity to understand the pathophysiology of gastrointestinal symptoms directly related to food.12
However, in terms of the Paleo diet, this study is also important because it shows that milk, wheat, yeast and soy were the foods that elicited a reaction among those who were tested. This should come as no surprise to those faithful to the Paleo approach! By eliminating grains alone, we tend to see an improvement in most people suffering from digestive issues.13,14,15 This study is also important because it tracked the participants for one year – showing that CD3 positive lymphocytes were significantly reduced after this time period.
What does all this science mean for the average layperson? Quite simply, if you suspect or suffer from an untreated or unknown digestive ailment, CLE may be a good ‘next step.’ If you want digestive symptoms to go away, you should start consuming a Paleo diet – no procedure needed! All kidding aside, it is best to see a healthcare professional if suffering from a digestive issue – even if the end treatment is simply avoiding certain foods. But one need not understand all the science (no matter how fascinating it may be) in order to reap the benefits associated with better food choices. This is part of the appeal and ‘magic’ of the Paleo diet – it simply works!
However, if you suspect anything irregular is happening in your digestion, it’s best to address and not ignore the symptoms. Left untreated, digestive disorders can lead to malnutrition, among other serious consequences and other health issues.16 Leaky gut, for example, is a big problem (even for many who do not realize it is occurring), but once we heal the gut, we can more easily heal the rest of the body.17 One other note here is fruit consumption may be the culprit to many digestive disorders, due to its FODMAP content.18,19,20 A slightly modified Paleo diet may be in order here, but again, it is best to work with a doctor or other healthcare practitioner, in order to find out what works best for you – and your digestion.
 Boers I, Muskiet FA, Berkelaar E, et al. Favourable effects of consuming a Palaeolithic-type diet on characteristics of the metabolic syndrome: a randomized controlled pilot-study. Lipids Health Dis. 2014;13:160.
 Lacy BE, Weiser K, De lee R. The treatment of irritable bowel syndrome. Therap Adv Gastroenterol. 2009;2(4):221-38.
 Hanauer SB. Inflammatory bowel disease: epidemiology, pathogenesis, and therapeutic opportunities. Inflamm Bowel Dis. 2006;12 Suppl 1:S3-9.
 Nikolaus S, Schreiber S. Diagnostics of inflammatory bowel disease. Gastroenterology. 2007;133(5):1670-89.
 Cho JH. The genetics and immunopathogenesis of inflammatory bowel disease. Nat Rev Immunol. 2008;8(6):458-66.
 Lydiard RB. Irritable bowel syndrome, anxiety, and depression: what are the links?. J Clin Psychiatry. 2001;62 Suppl 8:38-45.
 Baumgart DC, Sandborn WJ. Crohn’s disease. Lancet. 2012;380(9853):1590-605.
 Patrick L. Gastroesophageal reflux disease (GERD): a review of conventional and alternative treatments. Altern Med Rev. 2011;16(2):116-33.
 Tytgat GN. Review article: treatment of mild and severe cases of GERD. Aliment Pharmacol Ther. 2002;16 Suppl 4:73-8.
 Fritscher-Ravens A, Schuppan D, Ellrichmann M, Schoch S, Röcken C, Brasch J, Bethge J, Böttner M, Klose J, Milla PJ, Confocal Endomicroscopy Reveals Food-Associated Changes in the Intestinal Mucosa of Patients with Irritable Bowel Syndrome, Gastroenterology (2014), doi: 10.1053/j.gastro.2014.07.046.
 Tursi A. Gastrointestinal motility disturbances in celiac disease. J Clin Gastroenterol. 2004;38(8):642-5.
 Salminen S, Bouley C, Boutron-ruault MC, et al. Functional food science and gastrointestinal physiology and function. Br J Nutr. 1998;80 Suppl 1:S147-71.
 Sanz Y. Effects of a gluten-free diet on gut microbiota and immune function in healthy adult humans. Gut Microbes. 2010;1(3):135-7.
 Ciacci C, Cirillo M, Cavallaro R, Mazzacca G. Long-term follow-up of celiac adults on gluten-free diet: prevalence and correlates of intestinal damage. Digestion. 2002;66(3):178-85.
 Visser J, Rozing J, Sapone A, Lammers K, Fasano A. Tight junctions, intestinal permeability, and autoimmunity: celiac disease and type 1 diabetes paradigms. Ann N Y Acad Sci. 2009;1165:195-205.
 Hodges P, Gee M, Grace M, Sherbaniuk RW, Wensel RH, Thomson AB. Protein-energy intake and malnutrition in Crohn’s disease. J Am Diet Assoc. 1984;84(12):1460-4.
 Fasano A. Leaky gut and autoimmune diseases. Clin Rev Allergy Immunol. 2012;42(1):71-8.
 Barrett JS, Gibson PR. Fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) and nonallergic food intolerance: FODMAPs or food chemicals?. Therap Adv Gastroenterol. 2012;5(4):261-8.
 Fedewa A, Rao SS. Dietary fructose intolerance, fructan intolerance and FODMAPs. Curr Gastroenterol Rep. 2014;16(1):370.
 Murray K, Wilkinson-smith V, Hoad C, et al. Differential effects of FODMAPs (fermentable oligo-, di-, mono-saccharides and polyols) on small and large intestinal contents in healthy subjects shown by MRI. Am J Gastroenterol. 2014;109(1):110-9.