Gut health dietitian and nutritionist

Quick answers

What a gut health dietitian does, and does not do

A dietitian treats the eating side of a digestive problem: finding which foods and patterns drive your symptoms, keeping your diet as wide and nourishing as possible while you find out, and building a plan you can live with. Diagnosis, scopes, breath tests and prescriptions belong with your physician or gastroenterologist. The two work best together, and a good dietitian will tell you when a symptom needs the doctor rather than the diet.

My approach is functional and lab-guided: I look for why the symptoms are happening, use structured elimination and reintroduction rather than permanent restriction, and pay attention to the gut-brain side of digestion, which is real physiology rather than "just stress".

IBS

Irritable bowel syndrome is a disorder of gut-brain interaction: the gut is not damaged, but the signalling is disturbed, which is why tests come back normal. The low-FODMAP diet is the most studied dietary treatment, and it has three phases: elimination for a few weeks, structured reintroduction, and personalisation. Most people are only ever given the first. Regular meals, soluble fiber such as psyllium, and gut-directed hypnotherapy or CBT also have evidence. IBS and low-FODMAP in detail.

SIBO

Small intestinal bacterial overgrowth is treated medically, usually with an antibiotic your physician prescribes. Diet controls symptoms during treatment, keeps you fed through it, and rebuilds tolerance afterwards. Because SIBO is usually a consequence of something else, such as slowed motility or previous surgery, addressing that cause is what makes it less likely to return. SIBO in detail.

GERD and acid reflux

The changes with the strongest evidence are not the famous trigger lists. Weight, where there is excess, smaller meals, and about three hours upright after eating do more for most people, and suspected trigger foods are best tested one at a time. Acid-suppressing medication makes reflux less acidic without stopping it, which is why pattern changes still matter on a PPI. GERD and reflux in detail.

Bloating

Bloating is a symptom with several possible sources: IBS, constipation, SIBO, eating pattern, large or fast meals, and swallowed air among them. The first job is working out which, rather than cutting foods at random. A food and symptom record, kept honestly for a short period, usually narrows it down faster than another round of restriction.

New, persistent bloating, particularly in women over 50, or bloating with weight loss, bleeding or a change in bowel habit, should be assessed by a doctor before any diet is tried.

Constipation

Fiber helps, but it has to rise gradually and with enough fluid, or it can make bloating and discomfort worse. Soluble fiber such as psyllium has good evidence, and prunes and kiwifruit have been studied with positive results. Meal regularity, daily movement and an unhurried toilet routine matter more than they sound. Constipation with bleeding, weight loss, or a new change in habit needs a physician first.

IBD diet support: Crohn's disease and ulcerative colitis

Diet does not replace IBD medication, and nobody should stop a prescribed treatment in favour of a diet. What nutrition does is keep you nourished through flares, correct the deficiencies IBD commonly causes, such as iron, vitamin B12 and vitamin D, and adjust what you eat to the phase you are in. Some people, for example those with strictures, need specific texture or fiber changes agreed with their gastroenterologist. In remission, a varied Mediterranean-style pattern is a common evidence-based starting point.

Celiac disease and gluten

Get tested before going gluten-free. Celiac blood tests and biopsies depend on gluten still being in your diet, so removing it first can make the diagnosis impossible to confirm. If you do have celiac disease, the treatment is a strict, lifelong gluten-free diet, which means learning where gluten hides and how cross-contact happens, and replacing the iron, fiber, folate and other nutrients fortified wheat used to supply.

Not everyone who feels better without wheat has a gluten problem. For some people the trigger appears to be the fermentable carbohydrates in wheat (fructans) rather than gluten itself, which changes what needs to be avoided.

When to see a doctor first

These need medical investigation rather than a diet: blood in the stool or black stools, unintentional weight loss, iron-deficiency anemia, difficulty swallowing, persistent vomiting, fever, waking at night with symptoms, or a first onset of bowel symptoms after 50. A family history of IBD, celiac disease or bowel cancer is also worth raising with your physician.

What patients say

Reviews are individual patients' experiences in their own words. Results vary from person to person and are not guaranteed. All 57 written reviews and the dated Fay rating.

Booking, and what it costs

Two routes, and which one is cheaper depends entirely on your plan rather than on which sounds better.

Through insurance. Medical nutrition therapy is a covered benefit on many plans, sometimes with no copay at all. Booking runs through Fay Nutrition, which checks your benefits before the first appointment so you know the number in advance rather than six weeks later.

Self-pay. A flat $140 per session through CognitiveMind — no benefits check, no prior authorization, no denial arriving after the fact. If your coverage is thin, absent, or has a deductible you will not meet this year, this is often the more predictable of the two.

Telehealth, in any of the 18 states where the licence is active.

Common questions