It may be hard to believe that something as nutritious as salad or lettuce could cause stomach pain. However, some people find they have stomach cramps and diarrhea after eating salad, and sometimes it's pretty severe.
In general, lettuce is often easy on the stomach and not gas-producing. But in some cases, eating salad could lead to digestive upset or even severe symptoms like vomiting or diarrhea.
4 Reasons Salad Could Cause Stomach Pain
So, what might be causing your stomach pain? Some possible causes, according to Niket Sonpal, MD, an internist and gastroenterologist in New York City, include:
1. The lettuce may be contaminated.
Raw vegetables like lettuce are a common source of food poisoning from germs like Escherichia coli (E. coli). Symptoms of an E. coli infection include severe stomach cramps, diarrhea (often bloody), and vomiting. Symptoms of food poisoning can be mild or serious and often start several hours to a few days after you eat contaminated food.
To reduce your risk of food poisoning from fresh veggies like lettuce, be sure to wash them thoroughly under running water, keep them separate from other foods like raw meats, and refrigerate them properly. It can also help to regularly check the news to see if there are lettuce recalls and avoid any recalled products.
2. You may be eating too much fiber at once.
You may be thinking it's "just a salad" and "salad is healthy," but eating a lot of salad in one sitting may be too much at once for your gastrointestinal system to handle, Dr. Sonpal says.
The reason: Lettuce contains fiber, an essential nutrient for healthy digestion. Half of a cup of romaine lettuce, for example, contains about 2 grams of fiber. On its own, that’s not a lot, but eating a big helping at once or together with other high-fiber foods (like beans, whole grains, or some fruits and veggies) can lead to gas, bloating, or cramps, especially if you’re not used to that much fiber in one sitting.
According to the 2020-2025 Dietary Guidelines for Americans, adults should aim to eat between 28 and 34 grams of fiber a day. If you want to boost your fiber intake, do so slowly over a few weeks to let your adjust. Drink plenty of water, too, which helps you get the most benefit from it.
3. You may have constipation.
If you eat lettuce or salad and find you're gassy, it could be due to underlying constipation that is trying to make its way 'out,' Sonpal says. "Eating salads and lettuce puts a heavy fiber 'load' on the intestines, and, if you are slightly backed up, your bowels will work a bit overtime to get it all out," says Sonpal.
If this is the case, stools will be hard initially and then may become softer, he says. "Ironically, this does not mean you should stop eating salads," he says. "It actually means continue and add more fiber."
4. It's what else that's in that salad bowl.
The pain also could be caused by all the fixings in your salad, Sonpal says. Perhaps it's the dairy in the creamy ranch dressing and you are lactose intolerant. Or it's the croutons and you're sensitive to gluten. Or the hot peppers, spicy foods, nuts, or seeds can do you in.
Any of these ingredients can cause gas, cramps, and diarrhea in some people who are sensitive to them. If you suspect it may be another food in your salad, do some experimenting. "Slowly remove each component of the salad to narrow down what it is that is truly getting to the crux of matter," Sonpal says.
How to Avoid Stomach Pain From Salad or Other Foods
If you love salad but it doesn’t always love you back, is it possible to still eat it and avoid the pain? Some ways to reduce your risk of stomach upset include:
Try supplements before you eat. You can buy a number of over-the-counter supplements, such as Alpha-galactosidase (Beano, BeanAssist), simethicone (Gas-X, Mylanta), or activated charcoal (Actidose-Aqua, CharcoCaps) that can help control gas when taken before you eat.
Slow down. When you eat slowly and chew your food well, you're less likely to swallow air, which can cause painful gas. Also, if you watch your portions and keep them small, you're making it easier for your stomach to digest your food.
Make sure drinks are just right. Drinks that are too hot or too cold can cause gas.
Don't slouch. Sit up straight when you're eating and after. Slouching puts pressure on your intestines and can cause gas.
Get moving. Regular exercise helps to keep you regular and from being constipated, which can cause gas pains.
Try another green. If lettuce just doesn’t sit well with you, try another leafy green like spinach and see if that helps, says Sonpal.
The Takeaway
Lettuce and other raw veggies consumed without proper cleaning, prep, or storage can lead to food poisoning, which can cause symptoms like stomach pain, vomiting, and diarrhea.
Salads and their ingredients often contain fiber; while fiber is essential for healthy digestion, eating more than you’re used to in one sitting can trigger gas and bloating for some people.
Be mindful of other ingredients in salads, like lactose (found in dairy-based dressings) or gluten (found in croutons), that could trigger stomach upset if you have a food sensitivity or intolerance.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
Barbra E et al. Abdominal distension after eating lettuce: The role of intestinal gas evaluated in vitro and by abdominal CT imaging. Neurogastroenterology & Motility. August 2019.
Roxana Ehsani, RD, is a Miami-based licensed dietitian-nutritionist, board-certified specialist in sports dietetics, and media spokesperson, consultant, and content creator for food and nutrition brands. She is an adjunct instructor for sports nutrition at Virginia Tech in Blacksburg.
Ehsani appears as a food and nutrition expert for television stations across the nation and in national publications, including Runner's World, Women's Health, Glamour, and more, and is a contributing writer for EatingWell. She has a strong background in sports nutrition and has worked with professional, Olympic, collegiate, and high school teams and individual athletes, whom she sees through her private practice.
Beth W. Orenstein is a freelance medical writer based in Northampton, Pennsylvania. A magna cum laude graduate of Tufts University, Orenstein has written for EverydayHealth.com, and the National Psoriasis Foundation and is a regular contributor to American Legion Magazine's Living Well and Radiology Today.
