Digestive & Gut Health

What a Visit Involves

Digestive visits take time, because the details matter. We go through what your symptoms are, when they happen relative to meals, what makes them better or worse, bowel pattern and stool form, history of food poisoning or antibiotic courses, past abdominal surgery, and what you have already tried. We also screen for symptoms that need conventional workup or referral rather than a functional approach, such as bleeding, unintentional weight loss, difficulty swallowing, or a family history of colorectal cancer or inflammatory bowel disease. Testing may include standard labs, celiac screening, stool studies, or breath testing for SIBO when the pattern fits. Plans usually begin with structured nutrition changes and any indicated treatment, then reintroduce foods deliberately, because long-term restriction is not the goal. Most people are reassessed at 4 to 8 weeks.

Sorting Out Digestive Symptoms

Bloating, irregular bowels, reflux, abdominal pain, and food reactions are extremely common, and they rarely have a single cause. The same symptoms can come from motility problems, altered gut bacteria, celiac disease, inflammatory bowel disease, food intolerance, medication effects, prior antibiotic use, infection, or the effect of chronic stress on gut function. Evaluation starts by mapping the pattern in detail: what triggers symptoms, how long after eating they appear, what improves them, bowel form and frequency, and whether symptoms are constant or cyclical. Red flags such as unintentional weight loss, blood in stool, anemia, nighttime symptoms, difficulty swallowing, or new symptoms after age fifty prompt a gastroenterology referral rather than an in-house workup, because those need direct visualization.

Testing and a Staged Plan

Testing may include celiac screening, inflammatory and stool markers, breath testing when small intestinal bacterial overgrowth is suspected, iron and nutrient studies, and thyroid and metabolic markers, since both influence gut function. Comprehensive stool analysis is used selectively, when the result would genuinely change what is done next. The plan is usually staged rather than attempted all at once. That often means addressing meal structure, fiber type and amount, hydration, and eating pace first, then a targeted and time-limited dietary trial where appropriate rather than an indefinite elimination diet. Removing foods long term without a clear reason narrows nutrition and rarely fixes the underlying issue. Where indicated, specific supplements, probiotics, or prescription therapy are used for a defined period with a clear endpoint, and reintroduction is planned deliberately so we learn what your gut actually tolerates.

Conditions Commonly Addressed

• Bloating
• IBS
• Acid reflux
• Constipation
• Diarrhea
• Food sensitivities
• Increased intestinal permeability
• SIBO
• Gut microbiome imbalance

How the Evaluation Usually Proceeds

• Detailed symptom and timeline history, including what you eat in a typical week
• Screening for warning signs that call for GI referral or colonoscopy
• Baseline labs, including CBC, inflammatory markers, ferritin, and celiac serology when appropriate
• Stool testing when it will change the plan, which can look at digestion, inflammation markers, and microbiome balance
• Breath testing for SIBO when bloating and bowel pattern fit that picture
• Review of medications and supplements that commonly affect digestion

We do not run every test on every patient. Testing is chosen because a result would change what we do next.

What Treatment May Include

• A structured nutrition approach matched to your symptoms, which may be a low FODMAP trial or a simpler elimination and reintroduction plan
• Treatment for SIBO when testing supports it, which may be prescription or botanical, discussed with you
• Support for digestion, such as attention to meal spacing, chewing, and meal composition
• Targeted supplementation, including fiber, probiotics, or digestive support chosen for your pattern rather than by default
• Attention to stress and sleep, which measurably affect gut motility and symptom perception
• Structured food reintroduction so you end with the widest diet you can tolerate

When We Refer Out

• Blood in the stool or black stools
• Unintentional weight loss
• Difficulty or pain with swallowing
• Persistent vomiting
• Iron deficiency anemia without an obvious cause
• Family history that makes earlier colonoscopy appropriate

Functional gut work sits alongside gastroenterology care, not in place of it.

Frequently Asked Questions

Do I need a stool test?

Not always. Stool testing is useful when the result would change the plan, for example when we are looking for inflammation, poor digestion, or a specific pattern of imbalance. Many people improve with a structured nutrition trial and targeted treatment without extensive testing. If a test is recommended, you will be told what it costs and what we are looking for.

Are food sensitivity tests accurate?

IgG food panels are not diagnostic of food allergy and their clinical usefulness is debated. They are best treated as one input, not a verdict. A structured elimination and reintroduction is generally more reliable for identifying foods that actually trigger your symptoms.

How long will I have to restrict foods?

As briefly as possible. Elimination phases are usually a few weeks, followed by deliberate reintroduction. Long-term restriction narrows the diet, reduces fiber diversity, and is rarely a good long-term answer.

Can SIBO come back after treatment?

Yes, recurrence is common, especially when the underlying reason for it, such as slow motility or a prior gut infection, is not addressed. That is why the plan includes motility, meal timing, and follow-up rather than treatment alone.

Do I still need a gastroenterologist?

Sometimes. If you have warning signs, are due for colonoscopy, or need diagnostic imaging or endoscopy, we refer. This care coordinates with GI, it does not replace it.