Estimated reading time: 6 minutes
The Patient I Meet Every Week
This is the story of a patient I meet every week.
Well prepared for their visit. They’ve done their research. They’ve sent all their medical records ahead of time. They bring their list (or bag) of supplements. They’ve seen multiple practitioners.
There’s a general energy of apprehension, even skepticism. I can almost hear their thoughts:
“Am I going to find the answers I need or is this going to turn into another expensive and exhausting venture?”
There’s a simple uncomfortable truth:
Some of the most confused patients I see aren’t the ones with the fewest answers. They’re the ones with the most.
They’ve accumulated test results, theories, diagnoses, food lists, and treatment protocols. Yet despite all of this information, they’re often less certain about what actually matters than when they started.
In many cases, the next stage of care isn’t more advanced testing, a more specific protocol, or uncovering a single unifying theory that finally unlocks their gut health.
It’s:
Clarity. Simplicity. Direction.
Why More Testing Feels Like Progress
Many people seek answers when their symptoms persist. It’s inherently human.
Being told “everything is normal” doesn’t feel like progress.
It often feels unclear. Possibly even dismissive.
On the other hand, exploring further testing sounds like a promising option. It feels actionable. The information becomes validation. You can use information to make decisions.
After all, people want their digestive concerns to make sense. They want a cause. They want a treatment.
Celiac disease is a prime example of this.
When we have a diagnosis like celiac disease, life changes forever, but it also becomes remarkably clear. We understand the problem. We understand the treatment. We understand what happens when we don’t treat it.
Notice I didn’t say it was easy. It’s just clear.
Many people with chronic digestive symptoms are searching for a similar experience. A single diagnosis. A single root cause. A single explanation that finally makes everything make sense.
They DO exist. They are NOT common.
Digestive disorders rarely behave like this. That doesn’t mean their management needs to be complicated either.
Let’s take a look at what can happen in the pursuit of answers.
When Information Starts Outpacing Clarity
A gut microbiome test. A food sensitivity test. Another breath test. These provide more information.
They provide more answers.
Here’s the truth:
In many cases they don’t provide more clarity.
In fact, they often provide:
- More theories
- More abnormalities
- Multiple competing diagnoses
- More uncertainty
Without a clearer plan.
Information and clarity are not the same thing.
In fact, at a certain point more information becomes counterproductive.
Each test identifies something.
Each finding generates a new theory.
Each theory generates a new treatment.
The patient now has multiple supplements, dietary recommendations and competing explanations for their symptoms.
But are they any closer to understanding what is actually wrong or what matters most?
The intention was to identify the root cause and personalize care. Instead, the result was:
Confusion. Complexity. Stasis
The Hidden Costs Nobody Talks About
The risks of overtesting aren’t just financial.
Consider the following example:
You are currently on a restrictive diet. You can’t quite nail down which foods are causing issues. The list grows smaller. Frustration grows. You need clarity. You think: Perhaps a personalized food sensitivity test would cut through the uncertainty.
However, the last thing a person eating only 5 foods a day needs is a list of further foods they can’t eat. Instead, they need to understand why every food causes issues. I recently wrote about this exact situation:
Overtesting can also contribute to:
- More complex treatment protocols
- Feeling broken
- Constantly second-guessing decisions
Another common trap can occur with SIBO testing. It often looks like this:
Patient tests positive for SIBO
↓
Begins treatment
↓
Maybe feels better for a while
↓
Gut symptoms re-emerge and are attributed to SIBO
↓
Repeats the cycle
↓
Sees another two practitioners about treating their SIBO
SIBO begins to tell the whole story, when maybe it’s only part of the story. This can be a difficult narrative to change. And it’s one that keeps many patients stuck.
Sometimes more testing delays doing the things that matter most. Simplifying the supplement stack, stopping the food restriction that isn’t helping. Building safety in your gut again.
Good Testing Can Change Lives
I want to be very clear. Appropriate, timely testing is incredibly important to patient care.
Take for example:
A CT scan in a patient with progressive weight loss and abdominal pain.
A fecal calprotectin in a patient with bloody diarrhea.
A colonoscopy when a new change in bowel habits warrants further investigation.
Blood work in a patient with worsening fatigue and bloating.
Frankly, sometimes good testing is having to say: You need a CT scan, not a microbiome test
Some of the most important diagnoses I make begin with appropriate testing.
Below are a few questions I use to help me decide whether additional testing is likely to move us forward.
Questions To Ask Before Ordering a Test
Before considering another test, I want to know:
Do the results from this test meaningfully change how I would approach treatment?
What will we do differently if this is negative?
What will we do differently if this is positive?
Would the result of this test give us more answers or more questions?
Will this test provide clarity—or will it create a story that’s difficult to move beyond?
If the answers aren’t clear, we reconsider.
What Most People Are Actually Looking For
Sometimes we have enough information, and enough of a workup to start treatment right away. Full stop.
I’ll use a common example. A patient comes in who has recently had scopes of both ends done, appropriate bloodwork and investigations. They have symptoms consistent with IBS-diarrhea that have been ongoing for years. However, after their specialist’s visit they often leave feeling dismissed, labeled and offered generic nutrition advice.
They don’t realize that the reassuring and thorough workup they’ve completed gives me enough information, along with their history, to reasonably identify their IBS signature, suggest the treatments they would best respond to and the likely tools they’ll need to build a successful plan.
We often don’t need another test. Another explanation. Another root cause.
Again, chronic gut issues are rarely straightforward.
Confidence doesn’t equal certainty.
Direction doesn’t necessarily mean immediate progress.
Clarity doesn’t mean things always go to plan.
We don’t need certainty to move forward.
We need enough confidence that the scary stuff has been ruled out, enough clarity to understand what’s going on, and enough direction to choose what to do next.
As a naturopathic doctor, there’s also an irony I’ve come to appreciate.
Sometimes one of the most disruptive questions we can ask is:
“What’s the root cause?”
At some point, continuing to search for a deeper explanation can prevent us from acting on a perfectly reasonable explanation we already have.
Often, what people are actually looking for isn’t more information. They want to feel confident that nothing important has been missed. They want to understand what’s most likely happening. And they want to know what to do next.
What Should Better Care Strive For?
Better care doesn’t strive for perfection.
It means investigating when investigation is likely to matter. It means personalizing care based on the individual in front of us. And it means remaining curious about emerging explanations and under-recognized conditions.
It means recognizing when we have enough information to act, even when that information feels imperfect or incomplete.
And when something doesn’t fit, when treatment isn’t working as expected, or when new information emerges, we remain willing to ask better questions and change direction.
Digestive health, without unnecessary complexity.