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Areas of Care · Digestive Health

An IBS diagnosis rules things out.
It doesn't explain them.

Being told your workup was negative matters — it means the serious causes were excluded. But it isn't the same as knowing why you feel this way, and there's usually more to find.

First, safety

What gets ruled out before anything else

Some symptoms need conventional workup or a gastroenterologist before any functional evaluation. If any of these apply, that comes first — and I'd rather refer you and be wrong than not.

The process

How I work through digestive symptoms

  1. 1

    Map the pattern before ordering anything

    Timing relative to meals, what improves and worsens it, bowel habit, stress, sleep, antibiotic and medication history. This narrows the possibilities more than any single test.

  2. 2

    Check the things with clear answers

    Celiac serology — accurate only while you're still eating gluten. Thyroid function, iron studies, and inflammatory markers. Each has a defined result and a defined next step.

  3. 3

    Add functional testing only when it changes treatment

    Stool testing and breath testing for SIBO both have a place when the clinical picture already points that way. Ordering everything available produces data, not answers.

  4. 4

    Change one variable at a time

    A short structured trial with a clear endpoint beats an open-ended elimination diet. I'd rather you remove two things for four weeks and know, than avoid twenty foods indefinitely and not.

Where this fits

Where digestive work happens

Continuous care

Integrative Primary Care Membership

Ongoing care with one provider tracking this over time — longer visits, messaging between them, and continuity as things change.

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Deeper, structured support

Functional Medicine

A time-limited program when symptoms are persistent or complex and benefit from advanced testing, a personalized plan, and closer support.

Book a Root Cause Review See the programs →
Common questions

Digestive questions, answered plainly

This page is general education, not medical advice for your situation. What's right for you depends on your history, medications, and results.

Is SIBO testing worth doing?

Sometimes. Breath testing has real limitations — false positives and negatives are both common — so it's most useful when the clinical picture already points that way and the result would change treatment.

Should I try eliminating gluten or dairy?

Possibly, but get tested for celiac disease first if you haven't been. Testing is only accurate while you're still eating gluten, so removing it first closes that door for months.

Do I need a stool test?

Only if the result would change what we do. For some people it does. For others it produces a long colourful report and no clearer plan. We'd decide together rather than ordering it by default.

When do I need a gastroenterologist instead?

Bleeding, unintended weight loss, trouble swallowing, unexplained anemia, a family history of IBD or colon cancer, or new symptoms after age 50 all warrant referral. Those come before functional workup.

Can gut symptoms cause fatigue or brain fog?

They frequently travel together. Malabsorption affects iron and B12, poor sleep from night-time symptoms affects everything, and chronic symptoms are genuinely exhausting. That's why the workup usually looks wider than the gut.

Is a probiotic a good starting point?

It depends what you're treating. Probiotics have decent evidence for specific situations and weak evidence as a general daily supplement. Strain and dose matter more than the label claim.

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