Digestive symptoms present along a wide spectrum and are highly variable between individuals. The following are commonly reported by patients attending The Schoeman Clinic with gut health concerns.
Bloating & IBS
Bloating, irritable bowel syndrome (IBS), and persistent digestive disturbance are among the most prevalent and most undertreated conditions in adult healthcare. They are also among the most frequently dismissed.
Overview
When Digestive Symptoms Are More Than a Gut Problem
Bloating, irritable bowel syndrome (IBS), and persistent digestive disturbance are among the most prevalent and most undertreated conditions in adult healthcare. They are also among the most frequently dismissed. Patients presenting with chronic bloating, unpredictable bowel habits, abdominal discomfort, and digestive symptoms that disrupt daily life are regularly told that their symptoms are stress-related, that they should try a high-fibre diet, or that IBS is simply something they will need to manage without the expectation of a meaningful resolution.
This is clinically insufficient. Gut health is not a peripheral concern. The gastrointestinal system is the largest immune organ in the body, produces more than 90 percent of the body's serotonin, communicates bidirectionally with the brain through the enteric nervous system and the gut-brain axis, plays a central role in hormonal metabolism and oestrogen clearance, and governs the absorption of the nutrients on which every other biological system depends. When the gut is not functioning well, the consequences extend far beyond the abdomen.
At The Schoeman Clinic, we investigate digestive symptoms through a comprehensive functional medicine lens, using advanced gut health testing to identify the specific biological drivers of your symptoms and developing a personalised treatment programme that addresses those drivers directly.
Symptoms
Symptoms of Digestive Disturbance
Bloating is one of the most frequently reported and most distressing digestive symptoms. It may be constant or intermittent, associated with specific foods or seemingly unrelated to diet, present predominantly after meals or persistent throughout the day. Significant bloating that produces visible abdominal distension and discomfort is a clinical sign that warrants investigation, not reassurance.
Altered bowel habits, including constipation, diarrhoea, or alternating episodes of both, are characteristic of IBS and other functional gut disorders. The Rome IV criteria provide a clinical framework for IBS diagnosis, but the underlying drivers of the altered bowel pattern require functional investigation to identify and treat effectively.
Abdominal discomfort, pain, or cramping, which may be relieved by bowel movements or worsened by eating, is a common presenting complaint associated with gut dysbiosis, visceral hypersensitivity, intestinal inflammation, and food sensitivities.
Excessive flatulence, belching, nausea, acid reflux, and a sensation of incomplete emptying are frequently reported alongside the more classical IBS symptoms and provide additional clinical information about the site and nature of the underlying dysfunction.
Systemic symptoms beyond the gut are common in patients with significant digestive disturbance and reflect the systemic consequences of gut dysfunction. These include fatigue, brain fog, skin complaints including eczema and acne, joint pain, mood disturbance, food cravings, and recurrent headaches. Recognising these as potentially gut-related is an important step towards comprehensive investigation.
Causes
Causes and Contributing Factors
The causes of chronic digestive symptoms are multiple and frequently overlapping. Effective treatment requires identifying the specific drivers present in each individual patient.
Gut dysbiosis, an imbalance in the composition and diversity of the gut microbiome, is one of the most significant and widespread contributors to IBS and functional digestive symptoms. Dysbiosis may involve a reduction in beneficial microbial diversity, overgrowth of opportunistic or pathogenic organisms, or an impaired ratio between key microbial communities. It can arise from antibiotic use, dietary patterns, chronic stress, infections, and other factors.
Small intestinal bacterial overgrowth (SIBO) describes the excessive proliferation of bacteria in the small intestine, where bacterial populations should be limited. SIBO produces significant bloating, abdominal distension, altered bowel habits, and in some cases nutritional malabsorption, and it requires specific investigation and treatment protocols.
Small intestinal fungal overgrowth (SIFO) involves excessive candida or other fungal organisms in the small intestine and produces a symptom profile similar to SIBO that may not respond to standard SIBO treatment.
Intestinal permeability, commonly referred to as leaky gut, describes a compromised gut barrier that allows bacterial endotoxins, undigested food particles, and inflammatory triggers to pass into systemic circulation. This drives systemic inflammation, immune dysregulation, and a range of symptoms that extend far beyond the gut itself.
Food sensitivities and intolerances, including IgG-mediated delayed food reactions, lactose intolerance, non-coeliac gluten sensitivity, and fructose malabsorption, contribute to digestive symptoms in a significant proportion of patients. Because these reactions are delayed and dose-dependent, they are difficult to identify without targeted testing.
Hormonal influence on gut function is clinically significant and frequently overlooked. Oestrogen and progesterone receptors are present throughout the gastrointestinal tract; their fluctuation across the menstrual cycle, in perimenopause, and following menopause directly affects gut motility, visceral sensitivity, and the composition of the gut microbiome. Many women report that their digestive symptoms worsen at specific points in their cycle, reflecting these hormonal influences.
Psychological and physiological stress has direct and measurable effects on gut function through the gut-brain axis. Chronic stress impairs the gut barrier, alters microbiome composition, slows or accelerates gut transit, and heightens visceral sensitivity.
Diagnosis
How We Diagnose Digestive Conditions
Assessment at The Schoeman Clinic begins with a comprehensive clinical consultation with your doctor. The consultation explores the full history of your digestive symptoms: their onset, their pattern, their relationship to food, stress, hormonal cycle, and any previous treatments; the full range of associated symptoms both within and beyond the gut; and any previous investigations including colonoscopy, gastroscopy, or standard blood tests.
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GI360 Comprehensive Stool Analysis
The GI360 test is the most clinically detailed gut health investigation we use. It employs validated PCR and culture technology to assess microbial diversity and community balance, identify specific pathogenic organisms including bacteria, viruses, and parasites, measure markers of intestinal inflammation, evaluate digestive enzyme function, and assess gut barrier integrity. It provides a level of microbiome detail that is simply not available through standard clinical investigations. Full information about the GI360 test is available on our existing GI360 test page.
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Zonulin Testing
Zonulin is a validated biomarker of intestinal permeability. Elevated zonulin confirms compromise of the gut barrier and helps direct treatment towards gut barrier restoration protocols. It is performed alongside the GI360 where intestinal permeability is suspected, or as a standalone marker where the clinical picture specifically suggests leaky gut as a primary driver.
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184 IgG Food Sensitivity Panel
The 184 IgG Food Sensitivity Test screens for delayed immune reactions to 184 common foods, identifying specific dietary triggers that may be maintaining gut inflammation, immune activation, and digestive symptoms. Results guide a targeted elimination and reintroduction protocol as part of the broader gut restoration plan. Full information about this test is available on our food sensitivity test page.
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Organic Acids Test (OAT)
The Organic Acids Test provides functional insight into microbial activity within the gut, including markers of yeast and bacterial overgrowth, alongside assessment of mitochondrial function, neurotransmitter metabolism, and nutritional sufficiency. It is particularly valuable in complex presentations where SIBO, SIFO, or significant dysbiosis is suspected alongside systemic symptoms. Full information is available on our OAT page.
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Endoscopy and Gastroscopy
Where structural gut pathology is suspected, including coeliac disease, inflammatory bowel disease, or other conditions requiring visualisation of the gut lining, referral for endoscopy or gastroscopy is arranged through our specialist referral network, including our gastroenterology partner Dr Sarmed Sami, a Consultant Gastroenterologist specialising in digestive health.
Treatment
Our Approach to Digestive Health Treatment
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Functional Medicine Gut Restoration Protocol
Treatment is built on the specific findings of your gut health assessment. Every gut restoration protocol at The Schoeman Clinic is personalised, reflecting the unique combination of dysbiosis, permeability, food sensitivity, motility, and hormonal factors identified in your individual case.
The protocol typically proceeds through a structured sequence: removing identified dietary triggers and pathogenic organisms, replacing deficient digestive enzymes and beneficial bacteria, re-inoculating the gut with targeted probiotic and prebiotic support, and repairing the gut barrier through specific nutritional interventions including L-glutamine, zinc carnosine, collagen, and other barrier-supportive compounds.
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Nutritional Medicine
Dietary intervention is evidence-based and individually tailored. Depending on your results and presentation, this may incorporate a temporary elimination protocol based on your food sensitivity results, a low-FODMAP approach where SIBO is a significant driver, a gut-supportive anti-inflammatory dietary framework, and specific nutritional supplementation guided by your OAT and blood test findings.
Where specialist nutritional therapy support is warranted, we refer to our nutritional therapy partners including IFM Certified Nutritionist Jackie McCusker and BANT Registered Nutritionist Mays Al-Ali.
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Hormonal Optimisation
Where hormonal imbalance is contributing to gut dysfunction, as is frequently the case in women with perimenopausal or menopausal presentations, hormonal optimisation through body-identical hormone therapy is incorporated into the overall treatment plan, drawing on our clinicians' advanced training through WorldLink Medical.
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Specialist Referral
Where structural pathology, inflammatory bowel disease, or conditions requiring specialist gastroenterological investigation are identified or suspected, we coordinate referral to Dr Sarmed Sami, our Consultant Gastroenterologist partner. We remain involved in your care throughout and work collaboratively with specialist partners to ensure that your management is comprehensive and integrated.
Why us
Why Choose The Schoeman Clinic for Digestive Health?
Patients presenting to The Schoeman Clinic with gut health concerns have often already been told that their bloating and IBS are stress-related, that there is no further investigation warranted, or that they should simply avoid certain foods and accept their symptoms. We take a fundamentally different clinical position.
Persistent digestive symptoms have biological causes that can be identified through appropriate functional testing and addressed through targeted, personalised treatment. Our GI360 testing provides a level of microbiome and gut function detail that standard clinical investigations do not approach. Our functional medicine framework allows us to investigate the full range of contributing factors, from microbial imbalance and gut barrier dysfunction to hormonal influence and food sensitivity, within a single, cohesive clinical programme.
The Schoeman Clinic is CQC-registered and adheres to NICE IBS guidelines, IFM frameworks, SIBO and SIFO clinical protocols, WorldLink Medical standards, and GMC guidance throughout all patient care.
Continue
Where to go next.
Related conditions
Condition
Perimenopause
ConditionMenopause
ConditionPMOS
ConditionEndometriosis
ConditionThyroid Conditions: Hypothyroidism and Hashimoto's Thyroiditis
ConditionChronic Fatigue and Burnout
ConditionNeurophysiology and Hormonal Brain Health
ConditionInsulin Resistance, Weight Gain and Difficulty Losing Weight
ConditionLongevity and Healthy Ageing
Questions
Frequently asked questions
If your question is not answered here, our patient office will take it personally.
Book a consultationYes. An IBS diagnosis identifies a symptom pattern but does not identify its cause. The underlying drivers of IBS in any given patient may include dysbiosis, SIBO, food sensitivities, gut barrier dysfunction, hormonal imbalance, or a combination of these factors. Identifying those drivers through functional gut testing and addressing them through targeted treatment frequently produces substantial and sustained improvement in symptom severity, beyond what symptom management approaches alone can achieve.
IBS (irritable bowel syndrome) is a functional gastrointestinal disorder characterised by altered bowel habits and abdominal discomfort in the absence of detectable structural or inflammatory damage to the gut wall. IBD (inflammatory bowel disease), which includes Crohn's disease and ulcerative colitis, involves measurable inflammation and structural damage to the gut lining, visible on endoscopy and associated with specific blood and stool inflammatory markers. The distinction is important both clinically and for treatment, and where IBD is suspected, specialist gastroenterological investigation is arranged through our referral network.
Standard stool tests ordered in conventional clinical settings primarily screen for acute infections including specific pathogens, blood, and in some cases basic parasitology. The GI360 test uses validated PCR technology to assess the full breadth of microbial communities in the gut, including the diversity and abundance of beneficial bacteria, the presence of opportunistic or pathogenic organisms at subclinical levels, markers of intestinal inflammation, digestive enzyme function, and gut barrier integrity markers. The depth of clinical information it provides is categorically different from a standard stool culture.
Yes, through multiple well-established mechanisms. The gut microbiome produces neurotransmitters including serotonin and GABA that directly influence mood and anxiety. Gut dysbiosis drives systemic inflammation, which crosses the blood-brain barrier and impairs cognitive function and emotional regulation. Poor nutrient absorption driven by gut dysfunction depletes the building blocks of neurotransmitter production. And the direct neural communication of the gut-brain axis means that gut dysfunction can produce or amplify psychological symptoms independently of any other contributing factor.
Next step
Book a Digestive Health
Consultation
If bloating, IBS, or persistent digestive symptoms are affecting your quality of life and you want a thorough, functional assessment of what is driving them, we are here to help.
Clinics
96 Harley Street
London W1G 7HY
4 St Marks Place
Wimbledon, London SW19 7NP
Patient office
The Schoeman Clinic is a CQC-registered private medical clinic. All clinical content on this page has been written or reviewed by Dr Gina Schoeman MB ChB, MBA, Dip Derm, MRCGP, MBCAM, AFMCP. This page is intended for informational purposes and does not constitute individual medical advice. Please book a consultation to receive advice tailored to your specific circumstances.
