“History is the most important test you’ll ever run. The patient already knows their body, your job is to listen and recognize the patterns.”

– Dr. Ilana Gurevich

Ready to stop guessing and start growing? 👇

Here’s what’s happening behind the scenes for so many practitioners:

Your client comes to you with bloating, pain, constipation, diarrhea, food sensitivity chaos, and exhaustion.

They’ve already tried:

• cutting gluten
• cutting dairy
• doing a low FODMAP diet
• taking probiotics
• taking supplements (so many supplements)
• “just managing stress”

And yet… they’re still uncomfortable every single day.

They’re frustrated.

They don’t trust their body.

They’re losing hope.

And you? You’re trying to be the calm expert in the room… while secretly thinking:

“Why is this not clicking faster?”

That’s exactly why this conversation matters.

Because if you’re dealing with IBS root cause work, test selection matters a lot.

One of the biggest insights that came out of my conversation with naturopathic GI expert Dr. Ilana Gurevich is this:

Here’s a simple way to think about it:

Small intestine (upper + middle GI)

This is where digestion and nutrient absorption happens.

It’s also where symptoms like:

• bloating after eating
• bloating that gets worse throughout the day
• periumbilical pain (“knife in the belly” pain)
• sometimes even reflux or belching
  …can point to something like small intestinal bacterial overgrowth (SIBO) or IMO methane overgrowth.

Large intestine (lower GI)

This is where water is pulled out of stool and the “exit strategy” happens.

Symptoms like:

• chronic constipation
• chronic diarrhea
• major bowel pattern changes
  …often live here.

But if the core issue is in the small intestine, a stool test can miss the real problem.

And that’s where things get expensive and slow.

Let’s get really practical.

If you’re hearing your client say things like:

• “I wake up flat… and then I bloat more as the day goes on.”
• “It builds after meals.”
• “My pain feels centered around my belly button.”
• “I’m gassy but it’s not really coming out.”
• “I feel swollen and tight in my abdomen.”

That’s a classic small bowel pattern.

And this is where a hydrogen methane breath test can be the better first move.

Because if gas builds in the stomach? They belch.

If gas builds in the large intestine? They fart.

But if gas builds in the small intestine? They bloat.

Simple. Brutal. True.

Can we just say this out loud?

The low FODMAP diet isn’t a treatment.

It’s a symptom-management strategy.

And in real life, it often becomes:

• confusing to follow
• socially isolating
• emotionally exhausting
• and way too easy to stay stuck in forever

Because yes… it may slow fermentation.

But it doesn’t tell you:

• what’s causing the overgrowth
• what’s driving motility issues
• what the real root cause is
• how to get off the hamster wheel

Your clients deserve more than “just avoid everything you love forever.”

Here’s one of the biggest “DO NOT PASS GO” moments from this conversation:

If a client says:

“This all started after food poisoning… and I’ve never been the same.”

That’s a huge red flag for post-infectious IBS — and research has shown that up to 70% of post-infectious IBS could be caused by SIBO.

Translation?

That one question in your intake can save your client months of struggle.

So yes: your intake is everything.

Listening is everything.

Want another sneaky culprit?

Lactose intolerance IBS overlap is real.

It’s estimated that 20–40% of IBS patients may have lactose intolerance.

And the reason this matters so much is because…

Your clients don’t want to let go of dairy.

They’ll say:

• “I already cut dairy.”
  …and then casually mention cream in coffee, cheese, butter popcorn, random sauces, or “just a little.”

No shame. It’s just human.

But here’s the magic:

Data changes behavior.

If someone sees their results and realizes dairy is a trigger?

They stop negotiating with themselves.

That’s why testing can speed up outcomes and compliance.

Let’s talk logistics, because your clients care about this too.

Stool testing:

• can be incredibly valuable (in the right cases)
• often takes weeks for results
• can be expensive
• and yes… involves the joy of transporting poop

SIBO breath testing:

• often cheaper
• can be done from home
• results can come back fast
• and it’s a simple, clean way to rule things in or out

And here’s the kicker:

A negative test is still valuable.

A “no” gives you direction.

It lets you move forward faster.

After decades of testing various forms of testing, Dr. Ilana Gurevich relies on the AllClear breath test. You can reach this trusted option by going to AllClearHealthcare.com.

If you’re a health entrepreneur building an online practice, this part matters.

One of the most powerful strategies in the cash-pay space is a lab test funnel marketing model.

Meaning:

Instead of trying to sell a $3,000–$10,000 program to someone who just found you…

You start with an entry-level offer that feels like:

 

And breath testing is often a lower barrier than stool testing.

Which means:

• more people say yes
• you attract action-takers
• you build trust faster
• and you convert more followers into clients

If you want to offer this kind of testing invitation inside your business, here’s the direct link to grab it.

This is one of the geeky parts… but it’s important.

There are two common substrate options for SIBO breath testing:

Glucose breath test

• more specific
• fewer false positives
• but more false negatives

Meaning: if it’s positive, it’s very likely true… but a negative might miss things.

Lactulose breath test

• more sensitive
• fewer false negatives
• but more false positives
  Meaning: if it’s negative, it’s very likely truly negative… but positives need good interpretation.

Also, lactulose can move too fast for certain high-diarrhea patients, and glucose can be rough for clients with blood sugar sensitivity.

So once again…

History + pattern recognition wins.

Your clients aren’t failing because they’re not trying hard enough.

They’re failing because:

• they’re exhausted
• they’ve been dismissed
• they’ve been told it’s “just IBS”
• they’ve been handed a diet and an antidepressant
• and they’ve never been shown a clear path forward

And the truth is…

When you test smarter, you help them:

• feel hope again
• stay engaged in the process
• trust your expertise faster
• and finally get traction

You’re not just choosing tests.

You’re choosing outcomes.

To connect with Dr. Ilana Gurevich, reach out to her on Instagram and subscribe to her podcast “Turn Nerds”.

For more information, you can DM @RealJoyHouston for more info or to ask questions or give feedback on the interview.

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