Gut health has become a marketing category, so it is worth being blunt about what is known. The microbiome research is genuinely interesting and genuinely unfinished. Nobody can currently "rebalance" your microbiome to order, stool tests sold direct to the public rarely change management, and anyone promising either is ahead of the science. Persistent symptoms still need a GP: coeliac disease, inflammatory bowel disease and several other conditions are diagnosed, not sensed.
What is established is less exciting and more useful. Meal regularity matters. Variety of plant foods matters more than any single supplement. Sleep affects gut motility measurably. Alcohol and stress do too, which is why a bad month at work shows up in the bowel. Fibre helps many people and makes a subset distinctly worse, which is why generic advice to eat more of it is unhelpful and sometimes counterproductive.
So a whole-picture appointment starts with two weeks of records — what, when, and how the abdomen felt — and looks for a pattern rather than prescribing a protocol. Usually there is one: a timing problem, two or three specific triggers, a stress pattern, or something that needs testing.
Where a low-FODMAP trial is indicated, it belongs with an Accredited Practising Dietitian and it is a short structured trial with reintroduction, not an indefinite elimination diet. We refer for that. The clinic is in Lane Cove, five minutes from the village.
