Can You Cure IBS?

What I Actually See in Real Clients

Most people who come to me with irritable bowel syndrome have already heard some version of:

“You have IBS. Your scopes are normal. You’ll just need to manage it.”

Translation: We don’t know why your gut is this miserable, but nothing is falling apart on the scan, so… good luck.

That message lands like a life sentence.

IBS becomes an identity: “I’m the person who always has to know where the bathroom is.” “I’m the person who can’t eat like everyone else.” “I’m the one with the ‘sensitive stomach.’”

Here’s the part no one told them:

I have clients whose urgency is completely gone. No more mapping their day around toilets. No more backup clothes in the car. No more terror on airplanes.

Does that mean there’s a single “IBS cure protocol” that works for everyone? No.

It means that IBS is not one disease. It’s a pattern. And patterns can change.

I’m Dr. Tricia Thompson, a board-certified physician, former ER doc of 20+ years, and now CEO of Root Cause Doc, where my team and I work with high-responsibility humans who’ve been told “your labs are normal” while their bodies are clearly not okay. IBS is one of the biggest recurring themes.

Let me show you what “cure” really looks like in real life.

The Myth That Keeps IBS Stuck

The most harmful story my IBS clients hear is this:

“IBS is chronic. It’s not curable. You just need to manage stress, take some probiotics, and live with it.”

What the system really means is, “We don’t have a single drug or procedure that fixes this for all comers.”

Fine. That’s honest.

But the leap from “no universal drug” to “you’re stuck like this forever” is not honest.

When we actually slow down and map what happened to a client’s gut—what changed, what they’ve been exposed to, how they digest, how they sleep, what their nervous system is doing—IBS stops being a mysterious curse and starts looking like overload.

Not weakness. Not user error. Overload.

Guts that have been through infections, antibiotics, ultra-processed food, under-eating, over-training, chronic stress, hormone shifts… eventually stop compensating politely.

IBS is often just the name we slap on that moment.

What’s Really Going On Under the IBS Label

In clinic, the label “IBS” shows up on wildly different stories.

One client has thin, urgent stools and cramps every afternoon. Another is having a bowel movement every four days and feels like they never fully empty. A third swings between the two.

When we look closer, we usually find a mix of things like:

• A history of bad food poisoning or traveler’s diarrhea a year or two before symptoms began.

• Bloating that starts high in the abdomen soon after eating — classic small intestinal overgrowth.

• Urgency that hits after fatty meals — often a bile issue.

• Stool tests showing “off” bacterial balance or yeast overgrowth.

• Signs of low stomach acid or weak enzymes — food isn’t being broken down properly.

• A nervous system that never gets off high alert — sleep broken, body wired.

Most of my IBS clients don’t just have one problem. They have three to five of these going on at once.

You can see why “take a probiotic and relax” doesn’t touch it.

Client Story #1: The Executive Who Knew Every Bathroom on I-95

One client I’ll call Amanda led a large team, traveled for work, and could tell you the location of every reliable bathroom between D.C. and Philly.

Her story:

• Urgent, loose stools almost every afternoon.

• Bloating by noon that made her look six months pregnant.

• Normal colonoscopy, labeled IBS-D.

• Told to use Imodium and watch stress.

• Taking a rotating cast of probiotics “just in case.”

When we actually sat down with her story, the turning point was obvious: Five years earlier, she had a vicious case of food poisoning on a trip. She “recovered,” then slowly slid into this new normal.

Testing and pattern both pointed to a post-infectious small intestinal overgrowth plus bile issues.

We did not hand her a complicated low-FODMAP spreadsheet and send her on her way. That’s not how I work.

Instead, we:

• Simplified her food to things her body could clearly recognize for a bit.

• Cleaned up meal timing so she wasn’t grazing from 6 a.m. to 10 p.m.

• Used a targeted antimicrobial protocol and motility support to address the overgrowth.

• Supported bile around heavier meals.

• Repaired sleep and basic nervous system rhythms.

Twelve weeks later, the person who couldn’t drive 30 minutes without scouting a bathroom was going on three-hour strategy meetings without thinking about her gut.

Urgency: gone. Not “better.” Gone. Did she occasionally have a looser day after a wild weekend or a virus? Sure. But IBS was no longer the main character.

Client Story #2: The Constipation Veteran Who Finally Had a “Boring” Gut

Another client, Lisa, had been constipated since college.

Every four days, maybe. Lots of straining. Always feeling half-done. IBS-C by the book.

She’d been told for decades to “drink more water and add fiber.” When that didn’t work, she decided that was just her body.

By the time she found us, she also had joint pain, morning brain fog, and felt “inflamed everywhere,” with labs that were technically normal.

Her story and labs painted a different picture:

• Signs of low stomach acid from years of acid suppressors.

• Under-treated thyroid.

• Very low-fiber, beige diet in an attempt to avoid gas.

• Pelvic floor not coordinating properly.

  
  

We supported digestion, worked with her prescriber to finally optimize thyroid management, referred her to pelvic floor PT, and slowly rebuilt a more colorful, fiber-containing way of eating her gut could actually handle.

Six months later, she was having daily or near-daily bowel movements. The cramps quieted. The bloating faded.

When I asked how she’d describe her gut now, she laughed and said, “Honestly? It’s boring. And I’ve never been so happy to be bored.”

That’s the quiet “cure” no drug label will ever celebrate.

How IBS Moves From “Life Sentence” to “Background Noise”

So what does it actually take to get there?

In our world at Root Cause Doc, the process is less “one magic protocol” and more a very intentional sequence.

First: Make Sure We’re Not Missing Anything Dangerous

IBS is a diagnosis we earn after ruling out things like inflammatory bowel disease, cancer, serious infections, and bleeding.

Blood in the stool, black tarry stool, unintentional weight loss, fevers, night sweats, new bowel changes after 50 — those are not “watch and wait.” That’s “go get a proper work-up.”

Once that’s done and clear, then we get to really work.

Second: Map the Story, Not Just the Symptoms

I don’t just want to know that you’re bloated. I want to know when it started, what was happening around that time, how it behaves across the day, and what else is going on in your body.

Did this start after a trip? A divorce? A surgery? Pregnancy? A year of back-to-back antibiotics?

Do mornings tend to be better and evenings worse? Do certain foods predictably trigger either urgency or “cement”?

That timeline tells us where to look first.

Third: Give the Gut a Chance to Respond

Before we add in fancy interventions, we stop attacking the system.

That usually means a simple, human food baseline (real protein, real plants, real fats), a break from daily alcohol, and actually sitting down to eat instead of inhaling lunch between emails.

No starvation. No 37-food blacklist. Just treating the gut like an organ we care about instead of a trash compactor.

Fourth: Fix the Way You Digest, Not Just What You Eat

If stomach acid is low, bile is sluggish, and enzymes are weak, you can eat the most perfect “gut-healthy” diet on Instagram and still feel awful.

We often need to support the front end of digestion and get you out of all-day grazing so your gut’s built-in cleaning cycles can actually run.

Only once that machinery is working better do we earn the right to go after overgrowths, yeast, or specific imbalances.

Fifth: Aim, Then Fire

This is where we use targeted tools: specific antimicrobials, bile support, microbiome rebuilding, pelvic floor therapy, histamine support—based on what’s actually on your map.

Not a supplement shopping spree. A sequence.

Sixth: Don’t Ignore the Gut–Brain Highway

Your intestines have their own nervous system, and it is in constant conversation with your brain.

If you’re sleeping five fractured hours, living on caffeine, and never dropping out of fight-or-flight, your gut will stay twitchy no matter what you swallow.

This doesn’t mean “your IBS is all in your head.” It means real gut repair includes getting your whole system out of constant alarm mode.

So… Can IBS Be Cured?

If by “cured” you mean a world where no human ever has a gut flare again, no.

If you mean this:

• Urgency is gone.

• Bloating is rare and explainable.

• Bowel movements are mostly normal.

• You understand your body and know what to do when life throws curveballs.

Then yes — I’ve watched IBS become a past chapter for a lot of people who were told they’d be “managing” it forever.

The label IBS is optional. 

Your ability to live a full, un-panicked life in your own body is not.

To your best health and not living for the bathroom, 

Dr. T