Why she came to see me: It was immediately clear that Carolyn was troubled when she arrived at my office. Hunched over, with a slight grimace on her face, she told me about the bout of intestinal distress she’d recently experienced, a spell that had been going on for the last two months and that was marked primarily by persistent bloating, gas and constipation—in short, nearly the entire gamut of digestive problems. While her primary care physician had given her a “probable diagnosis” of irritable bowel syndrome, she intuited that something else was amiss, and wanted to address the issue naturally before turning to more medication.

How I evaluated her: Over the course of a thorough discussion, I learned that Carolyn had endured complications with her gut health since her late teens. That was the era in which her pediatrician first prescribed Carolyn antibiotics to treat her acne. “The medicine didn’t clear it up; instead, it caused some major side effects in my digestion,” she said. Nevertheless, she heeded different doctors’ orders throughout her twenties (and part of her thirties) and continued to try antibiotics and other medications to remedy the acne that persisted into adulthood. For nearly six years, however, both her acne and her stomach troubles had diminished. Now that she was up for tenure at a private university—which naturally arrived with a great deal of stress—her stomach woes had returned with a vengeance.

“I’ve become so uncomfortable that I don’t want to put on a bathing suit, let alone participate with my paddling team,” she said. What’s more, the stress caused by both her career and her digestive health was compelling her to turn to sweets…and often. “It’s ridiculous, I know,” she admitted, noting that she’d gained weight and wasn’t exercising as much as she used to. She also mentioned that she’d been feeling simultaneously apathetic and anxious, which only exacerbated her urge to hunker down with cookies, candy and Netflix. It wasn’t until a recent, severe stomach ache forced her to miss an important faculty meeting that she realized she needed to get help—and fast.

In addition to reviewing her symptoms and their patterns, I conducted a full physical exam, which included a blood test to determine if she had anemia (a relatively unknown side effect of IBS). Furthermore, I ordered a lactose intolerance test, a stool culture to assess for intestinal flora imbalances and parasites, and a blood test, through ELISA/ACT Biotechnologies, to see if she had any food allergies.

The test I ordered looks at “delayed food reactivities,” which means that a patient can eat a food on Sunday but have an immunological reaction on Monday, Tuesday or Wednesday—or, to phrase it differently, anywhere from 24-72 hours after the food was consumed. As I discussed with Carolyn, the fact that food can take time to present adverse reactions is one of the reasons it can be so difficult to determine which foods a person is sensitive to (tests such as these are akin to elimination/challenge diets, as well as blood tests that address immediate reactions to a food). Further, as I also explained, most cases of IBS are associated with delayed food reactions—and removing these foods can have profound health benefits.

What my evaluation revealed: Overall, Carolyn was mostly healthy—she was neither anemic nor lactose intolerant, and she didn’t have parasites. At the same time, her tests did demonstrate that she had an intestinal flora imbalance—namely, yeast overgrowth and food reactivities.

Based on her symptoms and medical history, it was abundantly clear that the medications she’d taken over the years had done a number on her digestive health. What’s more, the specific foods she was reactive to were foods that she consumed regularly, primarily gluten products like crackers, pasta and those aforementioned cookies. There were other compounds she was reactive to as well, including paprika and a food additive called guar gum, which we discovered she inadvertently consumed twice a day in her morning and afternoon protein shakes. This, too, was presumably contributing to her symptoms.

How I addressed her problem: As I explained to Carolyn, digestion consists of several processes to make what you eat a part of every cell in your body. When the digestive system becomes compromised—whether due to medications, a diet that includes low-nutrient, high-sugar, high-calorie foods, an allergy, or an infection—it can wreak havoc on your whole health, including your spirit and motivation.

A large part of this comes down to the small intestine. Your small intestine has a difficult and complex job sorting through everything you eat and separating what should be absorbed from what should be eliminated. If your small intestine, like Carolyn’s, is chronically irritated, it will allow more toxins and other undesirable chemicals to pass into your bloodstream. This can lead to food allergies, poor liver detoxification, fatigue, skin rashes and acne as well as a host of additional complications—not to mention recurrent, even debilitating, intestinal upset.

Her large intestine had also been compromised over the years, mainly by an excessive amount of yeast, which was most likely due to years of taking antibiotics. This was a huge contributing factor to her gas, bloating and constipation as well.

To this end, I put Carolyn on a one-month intestinal detox—a strategy that would help restore the friendly bacteria in her gut, decrease her discomfiting symptoms and return her to health.

This detox entailed a low-carbohydrate diet that consisted of less than 50 grams of carbohydrates per day. I have dubbed this a modified ketogenic diet—a plan that follows the traditional keto diet’s requisite of eliminating carbs (albeit with a bit more wiggle room) and deriving the lion’s share of one’s calories from healthy fats such as olive oil and avocadoes. (My amended plan also includes adequate protein and lots of low-carb, fiber-rich vegetables like broccoli and spinach, which would, in this case, help ease Carolyn’s constipation.) I also urged Carolyn to avoid all of the items to which she showed a food reactivity, particularly gluten products.

Furthermore, I gave her a product called Candaclear, a terrific supply of antifungal herbs and supplements that can help eradicate yeast, partly through its inclusion of probiotics. (This product is marketed to consumers as Clear Four; “Candaclear” is part of the manufacturer’s professional line.)

I additionally encouraged Carolyn to take 300mg of magnesium citrate per day (magnesium operates as a gentle laxative) and to drink three cups of pau d’arco tea daily. This South American tea, whose roots trace back to 1873, is famed for its antifungal properties, such as lapachol and beta-lapachone.

Finally, I asked Carolyn to give up those sweets she loved, as well as fruit and alcohol.

The patient’s progress: While skeptical about her willpower over sweets—“it’s the only thing that comforts me sometimes,” she said—Carolyn’s pending promotion, unpleasant symptoms and desire to be at her best served as excellent inspiration. Her sugar cravings “radically decreased” within a few days’ time, which is often the case when one’s digestion gets back on track and the absorption of key nutrients improves.

A week after the start of her intestinal detox, she found that her clothes fit better, her bloating had significantly diminished and her constipation had given way to a bowel movement every day. The closer she adhered to the diet I gave her, and the more exercise and sound sleep she got, the better she felt—less fatigued and more energetic, with greater clarity, focus and stamina to face life’s challenges.

“I feel lighter, freer, and yet stronger,” she claimed—so much so she’d rejoined her paddling team. She saw the month-long intestinal cleanse as less of a 30-day commitment than a lifelong guide to optimal health, which was, in the end, quite similar to the tenure position she was ultimately offered.

Click here to buy Dr. Laurie Steelsmith’s books, Natural Choices for Women’s Health, Great Sex, Naturally and Growing Younger Every Day: The Three Essential Steps for Creating Youthful Hormone Balance at Any Age.