By Dr. Evelyn Le Ellis, ND, MPH, FAIHM | Prolific Well Integrative Medicine

Your digestive system does more than break down food. It helps absorb nutrients, supports immune function, and interacts with many systems throughout your body.

When digestion is not working well, everyday life can become uncomfortable and unpredictable.

You may experience bloating after meals, abdominal discomfort, constipation, diarrhea, acid reflux, or reactions to foods you previously tolerated. You may find yourself avoiding certain meals, worrying about finding a bathroom, or wondering why your symptoms keep returning.

At Prolific Well Integrative Medicine in Olympia, Washington, I provide individualized evaluation and management of digestive health concerns, including irritable bowel syndrome (IBS), bloating, altered bowel habits, reflux, suspected small intestinal bacterial overgrowth (SIBO), and selected food-related symptoms.

My approach combines appropriate medical testing, clinical nutrition, evidence-informed treatment, and practical lifestyle strategies.

The goal is not simply to eliminate more foods or prescribe another supplement. It is to understand what may be contributing to your symptoms and develop a treatment plan that is medically appropriate and realistic for your life.

Schedule a Gut Health Consultation

What Is Integrative Gut and Digestive Health Care?

Integrative digestive care combines conventional medical evaluation with nutrition, lifestyle medicine, and other therapies supported by appropriate clinical evidence.

Depending on your symptoms, evaluation may involve:

• A detailed medical and dietary history

• Review of medications and supplements

• Physical examination

• Blood and stool testing when indicated

• Assessment for food allergies or intolerances

• Screening for celiac disease

• Evaluation for IBS or functional digestive disorders

• SIBO breath testing in selected situations

• Gastroenterology referral or endoscopic evaluation when appropriate

• Individualized nutrition and treatment planning

Not every patient needs extensive laboratory testing.

Sometimes the most useful starting point is reviewing symptom patterns, bowel habits, dietary intake, medication effects, and previously completed testing.

Other times, symptoms suggest a condition that requires more urgent investigation.

My priority is to identify medically important causes first, then develop a practical plan for improving digestive health.

What Digestive Health Conditions Does Prolific Well Evaluate?

1. Irritable Bowel Syndrome (IBS), Bloating, Gas & Abdominal Discomfort

Irritable bowel syndrome is a disorder of gut-brain interaction characterized by recurring abdominal pain associated with bowel movement changes.

Symptoms may include:

• Abdominal cramping or discomfort

• Bloating and excessive gas

• Constipation

• Diarrhea

• Alternating constipation and diarrhea

• Changes in stool appearance or frequency

• Symptoms that worsen after certain meals

What causes IBS?

IBS does not have one universal cause. Altered intestinal sensitivity, gut-brain signaling, bowel motility, previous gastrointestinal infections, and other factors may contribute.

Stress can influence symptoms through gut-brain pathways, but IBS is not simply caused by anxiety or imagined symptoms.

Evaluation focuses on identifying a symptom pattern consistent with IBS while assessing for warning signs and conditions that require different treatment.

Treatment may include dietary changes, soluble fiber, selected medications, gut-directed behavioral therapies, and other evidence-based interventions.

For appropriate patients, a time-limited low-FODMAP diet may help identify dietary triggers. It should generally be followed by structured food reintroduction rather than indefinite restriction.

2. Constipation, Diarrhea & Irregular Bowel Movements

Bowel habits vary from person to person, but persistent changes deserve attention.

Constipation may involve infrequent stools, hard stools, straining, or a sensation of incomplete evacuation.

Diarrhea generally involves loose or watery stools and may be acute or chronic.

Potential contributors include:

• Inadequate fiber or fluid intake

• Medication effects

• IBS

• Thyroid disorders

• Celiac disease

• Infections

• Pelvic floor dysfunction

• Inflammatory bowel disease

• Other digestive or systemic conditions

Treatment depends on the cause.

For constipation, we may review fiber intake, hydration, medications, physical activity, and whether pelvic floor dysfunction is suspected.

For diarrhea, evaluation may include infection testing, celiac screening, inflammatory markers, medication review, or other investigations.

Persistent diarrhea should not automatically be treated as a food intolerance or microbiome imbalance.

3. Acid Reflux, GERD & Gastritis

Acid reflux occurs when stomach contents move backward into the esophagus.

Gastroesophageal reflux disease (GERD) involves troublesome or recurrent reflux symptoms or complications.

Common symptoms include:

• Heartburn

• Sour taste or regurgitation

• Symptoms after meals

• Nighttime reflux

• Upper abdominal discomfort

Gastritis refers to inflammation of the stomach lining. Its causes may include Helicobacter pylori infection, certain medications, alcohol, autoimmune disease, and other factors.

Are acid reflux and gastritis the same thing?

No. GERD involves reflux into the esophagus, while gastritis involves inflammation of the stomach lining. They may produce overlapping symptoms but require different diagnostic considerations.

Depending on the situation, treatment may involve:

• Reviewing meal timing and portion sizes

• Identifying individual symptom triggers

• Avoiding lying down soon after eating

• Weight management when appropriate

• Medication review

• Acid-suppressing medications when indicated

• Testing for H. pylori when appropriate

• Referral for upper endoscopy when medically necessary

Persistent reflux, difficulty swallowing, gastrointestinal bleeding, or unexplained weight loss requires medical evaluation.

4. SIBO Evaluation & Digestive Concerns

Small intestinal bacterial overgrowth (SIBO) refers to excessive bacterial populations in the small intestine that may contribute to digestive symptoms in certain patients.

Potential symptoms include:

• Bloating

• Abdominal distension

• Excessive gas

• Diarrhea

• Abdominal discomfort

• Sometimes constipation, particularly when intestinal methane overgrowth is involved

How is SIBO diagnosed?

Hydrogen and methane breath testing may be considered in selected patients based on their symptoms, risk factors, and clinical history.

However, breath testing has important limitations. Results require careful interpretation, and symptoms alone cannot confirm SIBO.

Not everyone with bloating has bacterial overgrowth.

When SIBO or intestinal methane overgrowth is suspected, I consider possible contributing conditions, testing options, and evidence-based treatments.

Treatment may involve prescription medication, nutrition support, and addressing underlying factors when identifiable.

Repeated antimicrobial or herbal protocols without reassessment are not always appropriate and may introduce unnecessary risks.

5. Food Allergies, Intolerances & Food-Related Reactions

Food-related symptoms can occur for several reasons.

It is important to distinguish food allergy, food intolerance, celiac disease, and other gastrointestinal conditions because their evaluation and management differ.

Food allergies involve an immune response to a specific food and may cause hives, swelling, vomiting, respiratory symptoms, or anaphylaxis.

Food intolerances may involve difficulty digesting certain substances, such as lactose, or sensitivity to fermentable carbohydrates.

Celiac disease is an immune-mediated condition triggered by gluten in genetically susceptible individuals.

Common concerns include:

• Symptoms after dairy products

• Bloating after wheat-containing foods

• Reactions to high-FODMAP foods

• Recurrent digestive symptoms after specific meals

• Concern about gluten sensitivity

• Multiple self-reported food reactions

A food and symptom diary may help identify patterns.

When celiac disease is suspected, appropriate testing should generally be performed before eliminating gluten, because removing gluten can interfere with diagnostic accuracy.

Broad food IgG panels are not recommended for diagnosing food allergies or intolerances.

My goal is to identify meaningful triggers while preserving nutritional adequacy and avoiding unnecessarily restrictive diets.

6. Inflammatory Bowel Disease (IBD) Support

Inflammatory bowel disease includes Crohn's disease and ulcerative colitis.

Unlike IBS, IBD involves intestinal inflammation that can lead to tissue damage and complications.

Symptoms may include:

• Persistent diarrhea

• Blood in the stool

• Abdominal pain

• Unintentional weight loss

• Fatigue

• Nutritional deficiencies

IBD requires appropriate diagnosis, monitoring, and medical treatment, typically in collaboration with a gastroenterologist.

At Prolific Well, integrative support may focus on:

• Nutritional adequacy

• Identification and management of deficiencies

• Bone health

• Appropriate dietary modifications

• Medication and supplement review

• Sleep, stress, and quality-of-life support

• Coordination with gastroenterology care

Nutrition and lifestyle medicine can complement IBD treatment, but they should not replace necessary anti-inflammatory, immunomodulatory, or biologic therapy.

Patients with significant bleeding, severe abdominal pain, fever, dehydration, or other concerning symptoms may need urgent medical attention.

7. Gut Microbiome Assessment When Appropriate

Your gut microbiome includes microorganisms that live throughout the digestive tract.

These organisms participate in processes involving digestion, fermentation of dietary fiber, production of certain metabolites, and immune interactions.

Microbiome research is expanding our understanding of digestive and metabolic health.

However, a microbiome test does not automatically identify the cause of digestive symptoms, and many commercially available microbiome profiles have limited established clinical utility.

When considering testing, I ask:

• What clinical question are we trying to answer?

• Is the test validated for that purpose?

• Will the result meaningfully change treatment?

• Are more established diagnostic tests indicated first?

• What are the financial costs and potential downsides?

For many patients, the first steps involve improving dietary diversity, evaluating specific symptoms, and using established diagnostic methods.

For more education, read Unlocking the Secrets of the Microbiome: How Gut Health Transforms Your Well-Being.

What Are Common Signs That Your Digestive Symptoms Need Evaluation?

Occasional digestive discomfort is common. Persistent or worsening symptoms deserve attention.

SymptomPossible considerationsBloating after mealsIBS, constipation, food intolerance, SIBO, other causesFrequent diarrheaInfection, medication effects, IBS, celiac disease, IBDPersistent constipationDiet, medications, pelvic floor dysfunction, thyroid diseaseHeartburn or regurgitationGERD or other upper gastrointestinal conditionsUpper abdominal discomfortDyspepsia, gastritis, ulcer disease, other causesBlood in stoolHemorrhoids, inflammation, colorectal disease, other causesUnexplained weight lossMalabsorption, inflammatory disease, or other medical conditions

Seek prompt medical evaluation for rectal bleeding, black or tarry stools, unexplained weight loss, persistent vomiting, progressive difficulty swallowing, or significant changes in bowel habits.

Severe abdominal pain, vomiting blood, fainting, or signs of significant dehydration may require emergency care.

How Do We Evaluate Digestive Health at Prolific Well?

Step 1: Understand Your Digestive History

We begin by discussing your symptoms, bowel patterns, dietary habits, medications, supplements, medical history, and previous evaluations.

I also want to understand how digestive symptoms affect your everyday life.

Step 2: Identify Appropriate Testing

Depending on your symptoms, testing may include:

• Complete blood count and metabolic testing

• Celiac disease screening

• Thyroid testing when indicated

• Stool testing for infections

• Fecal calprotectin when intestinal inflammation is suspected

• H. pylori testing

• Selected SIBO breath testing

• Nutrient testing when deficiency is suspected

• Gastroenterology referral for colonoscopy or endoscopy when appropriate

Not every patient needs every test.

Step 3: Develop a Personalized Treatment Plan

Treatment may include:

• Medical nutrition therapy

• Appropriate fiber and hydration strategies

• A structured low-FODMAP trial when indicated

• Food reintroduction and dietary liberalization

• Prescription medications

• Treatment of identified infections

• Targeted supplementation when justified

• Gut-directed behavioral therapies

• Management of contributing medical conditions

• Specialist collaboration

The plan should be based on the diagnosis, not a generic gut cleanse.

Step 4: Monitor Progress

We review symptom response, nutritional status, treatment tolerance, and whether further evaluation is needed.

The goal is sustainable improvement while maintaining a varied, nourishing diet whenever possible.

Why I Take a Whole-Person Approach to Gut Health

In my practice, I often see patients who have already eliminated gluten, dairy, sugar, or several other foods because they are trying to feel better.

Some have purchased multiple supplements or completed restrictive digestive protocols without understanding what is actually causing their symptoms.

I understand why this happens. When your stomach hurts, you feel bloated after eating, or your bowel habits are unpredictable, you want relief.

But I do not believe that the answer is always another elimination diet or another expensive test.

The digestive system interacts with nutrition, medications, the nervous system, immune function, and metabolic health.

That is why I look at the whole picture while remaining focused on identifying the specific condition that needs treatment.

Sometimes the answer is straightforward, such as addressing constipation or lactose intolerance.

Other times we need to evaluate for celiac disease, inflammatory conditions, infection, or another diagnosis.

My philosophy is to investigate thoughtfully, treat appropriately, and help patients return to eating with greater confidence rather than fear.

What Can You Do to Support Digestive Health?

While treatment should be individualized, several foundational habits may support digestive health.

1. Eat a variety of fiber-containing foods. Vegetables, fruits, legumes, nuts, seeds, and whole grains provide different types of fiber. Increase fiber gradually when appropriate, especially if bloating is an issue.

2. Stay adequately hydrated. Fluid needs vary with activity, climate, medications, and health conditions.

3. Move regularly. Physical activity can support overall health and may help some people with constipation.

4. Pay attention to symptom patterns. A brief food and symptom diary may be more useful than eliminating many foods at once.

5. Review medications and supplements. Iron, magnesium, antibiotics, anti-inflammatory drugs, and other products can affect digestion.

6. Avoid unnecessary dietary restriction. A highly restrictive diet may increase the risk of nutrient deficiencies and make eating more stressful.

7. Seek evaluation for persistent symptoms. Ongoing abdominal pain, diarrhea, constipation, or reflux deserves an appropriate assessment.

You do not need a perfect diet to begin supporting your digestive health.

Gut Health Care in Olympia, Tumwater, Lacey & the South Sound

Prolific Well Integrative Medicine provides digestive health evaluations in Olympia, Washington, serving patients from Tumwater, Lacey, Tenino, Shelton, Centralia, Chehalis, McCleary, Elma, Aberdeen, and surrounding South Sound communities.

In-person and telehealth visits are available when clinically appropriate.

Prolific Well Integrative Medicine
1820 Black Lake Boulevard SW, Suite 101C
Olympia, WA 98512

Phone: (360) 339-6169

Schedule a Digestive Health Consultation

Frequently Asked Questions About Gut & Digestive Health

What kind of doctor should I see for bloating and digestive problems?

A primary care clinician can evaluate many common digestive concerns, including bloating, constipation, diarrhea, and reflux. A gastroenterologist may be needed for persistent, complex, or concerning symptoms. At Prolific Well, Dr. Evelyn Le Ellis provides initial evaluation and appropriate integrative management within her clinical scope.

Can a naturopathic doctor help with IBS?

Yes. A Washington-licensed naturopathic physician can evaluate IBS symptoms, assess for other causes, and recommend appropriate nutrition, lifestyle, and medical treatment. Referral to gastroenterology may be needed in certain situations.

Is bloating always caused by SIBO?

No. Bloating can result from constipation, IBS, food intolerances, altered gut sensitivity, medications, and other conditions. SIBO is only one possible explanation.

How do I know if I have SIBO?

Symptoms alone cannot confirm SIBO. Hydrogen and methane breath testing may be considered in selected patients, but testing has limitations and should be interpreted alongside clinical findings.

Can gut health affect hormones?

The gastrointestinal system participates in nutrient absorption and metabolism, and gut microorganisms may influence certain hormone-related pathways. However, current evidence does not support attributing most hormone symptoms to microbiome imbalance without appropriate medical evaluation.

Should I take probiotics for IBS or bloating?

Probiotics are not universally helpful. Effects vary by strain, condition, and individual response, and evidence is inconsistent for many digestive indications. Some people experience increased gas or bloating. Recommendations should be individualized.

Should I get a comprehensive stool microbiome test?

Not necessarily. Commercial microbiome tests may provide interesting information, but many are not sufficiently validated to diagnose specific conditions or guide treatment. Established diagnostic testing is usually prioritized.

Can food intolerance testing identify everything I should avoid?

No. There is no single reliable test that identifies every food intolerance. Clinical history, targeted testing, and structured dietary trials may be more useful. Food IgG panels are not recommended for diagnosing food intolerance.

Can I improve digestive health without a restrictive diet?

Often, yes. Depending on the diagnosis, treatment may focus on bowel regularity, adequate nutrition, fiber modification, medication management, and other targeted interventions without extensive food elimination.

Do you treat inflammatory bowel disease?

Prolific Well can provide supportive integrative care for patients with IBD, including nutrition and general health management, while coordinating with gastroenterology. IBD-specific medical treatment and monitoring remain essential.

Does insurance cover gut health consultations?

Coverage depends on your insurance plan, network, diagnosis, testing, and services provided. Certain specialty tests or non-covered services may require out-of-pocket payment.

Where can I find a gut health doctor in Olympia, WA?

Dr. Evelyn Le Ellis, ND, MPH, FAIHM, provides integrative digestive health evaluations at Prolific Well Integrative Medicine in Olympia, Washington, including care for IBS, bloating, constipation, diarrhea, reflux, and selected SIBO concerns.

Meet Dr. Evelyn Le Ellis, ND, MPH, FAIHM

I am a Washington-licensed naturopathic physician and founder of Prolific Well Integrative Medicine in Olympia, Washington.

My background includes a Doctor of Naturopathic Medicine degree from Bastyr University, a Master of Public Health from the University of Washington, and a Bachelor of Science in Biochemistry from Baylor University.

My clinical interests include digestive health, clinical nutrition, hormone health, thyroid disorders, cardiometabolic medicine, integrative primary care, and healthy aging.

I believe healthcare should help patients understand their symptoms and develop practical strategies for improving their quality of life.

Learn More About Dr. Evelyn Le Ellis

Ready to Understand Your Digestive Symptoms?

You do not have to keep guessing which foods to avoid or which supplement to try next.

A thoughtful evaluation can help identify possible causes of bloating, abdominal discomfort, constipation, diarrhea, reflux, and other digestive concerns.

At Prolific Well Integrative Medicine, my goal is to help you understand your digestive health and develop an individualized treatment plan grounded in appropriate medical care and sustainable lifestyle strategies.

Schedule Your Gut & Digestive Health Consultation

Medical disclaimer: This page provides general educational information and does not replace individualized medical advice, diagnosis, or treatment. Persistent or concerning gastrointestinal symptoms require appropriate medical evaluation. Emergency symptoms should be assessed promptly.