"All disease begins in the gut" -- Hippocrates
I see countless folks with a variety of gastrointestinal symptoms – from top to bottom! Everything from lack of consistent appetite, sugar cravings, acid reflux, bloating, burping, belly pain, cramping, gas, constipation, diarrhea… and on and on. Sometimes, this isn’t even the reason that the appointment was made. However, since functional medicine and tons of research has brought to attention that gut health is central to all health, I ask about digestive symptoms at every visit.
As a doctor, my first job in evaluating these symptoms is to rule out a certain set of concerning conditions; including but not limited to – gastritis and ulcer disease, gallbladder disease, and inflammatory bowel disease. More often than not, these more serious conditions are not present, but we still need to get to the root of dysfunction to get someone feeling better and support overall health.
I use a thorough interview and exam, lifestyle adjustments, dietary adjustments, supplements, breath and stool testing and other things to evaluate and treat patients. I also look for factors outside the GI system that contribute; for example, when someone has poor sleep and high stress, sugar cravings and variable bowel movements are almost guaranteed. However, I am unquestionably getting more information and seeing further improvements for my patients when they have a nutrition consultation.
Working with a dietitian skilled in digestive disorders is a CRITICAL piece in evaluation and management of symptoms. Sometimes, things that we are doing that we think or have been taught are healthy for us, are precisely the practices that lead to gut problems and digestive disorders. Did you know that:
Undereating/restricting throughout the day will almost inevitably lead to food cravings and occasional or frequent binge eating (and bingeing sets up a domino effect of uncomfortable symptoms and feelings). This isn’t about willpower – it’s biology. Your body needs fuel.
Frequent snacking, even small amounts and even very nutritious foods can prevent your bowels from completing the thorough process of digestion, fluid flow and muscle movement through the bowels (the migrating motor complex!). This can lead to sluggish bowels and constipation.
If you’re eating too few carbohydrates, your overall dietary intake is imbalanced, and this can have big consequences for your microbiome.
Bottom line – if you’ve got any sort of ongoing digestive symptoms – see a dietitian with knowledge in digestive disorders. Consider Elizabeth Freyre, RD, who sees clients in my office and also virtually. What to expect when working with her:
The initial consult is about 80 minutes and will be an in-depth assessment of recent, past and current eating patterns as well as GI signs/symptom investigation to help guide an initial plan of care that you would trial for 1-3 weeks.
GI follow-ups are approximately 50 minutes and are scheduled as needed.
If a client is coming for only GI concerns, they will average 1-3 visits.
Note: Highly restrictive eating patterns and diets are not recommended and will not be included in the plan of care.