What we treat: IBS and functional digestive disorders
Most people who come to Root & Branch with digestive issues have already been somewhere else first. They've had the colonoscopy, the bloodwork, the food sensitivity panel. They've been told it's IBS, or that nothing structural is wrong, or that they should try eliminating gluten or dairy or FODMAPs and see what happens. Some of those interventions help. Many don't, or help partially, or help for a while and then stop helping.
The gap between what the standard workup reveals and what patients actually experience is one of the most common frustrations in outpatient medicine. It is also where Chinese medicine tends to do its most useful work, because the tradition is set up to describe digestion in functional and relational terms rather than structural ones.
This page covers what we mean by that, what treatment actually looks like, and what to expect if you decide to come in.
What's actually happening in IBS
IBS is what clinicians call a functional disorder. The structure of the gut is intact, but the function is off. Imaging looks unremarkable, biopsies come back clean, and the bowel is still doing the wrong thing at the wrong time.
The mechanism that ties most IBS presentations together is the conversation between the gut and the nervous system. The gut has its own nervous system, the enteric nervous system, with roughly 500 million neurons running largely independently and in constant two-way communication with the brain through the vagus nerve. When the body has been operating in a low-grade state of alarm for long enough, that communication becomes noisy. Motility shifts. Visceral sensitivity climbs, which means that normal amounts of gas or stool start registering as pain. The gut becomes more reactive, the person becomes more vigilant about the gut, and the pattern reinforces itself over time.
Stress is part of this picture, but the framing most patients have heard ("it's just stress") usually misses the point. The issue isn't that stress is causing IBS in some general sense. The issue is that the wiring between the gut and the autonomic nervous system has been set on a hair trigger, and the system has lost the capacity to settle into the parasympathetic state where digestion actually happens.
How Chinese medicine reads the pattern
In the clinic, we treat IBS as a pattern rather than a diagnosis. Patterns are about relationships between systems, which is why the Chinese medical framework is well-matched to a condition that the structural framework can't fully explain.
The pattern we see most often in IBS presentations is called a disharmony between the Liver and Spleen systems. The shorthand: one part of the body is generating tension and pressure, and another part, the part responsible for steady digestion and transit, is too depleted to hold its ground. The two systems start working against each other, and the bowel is caught in the middle. Combine that with the overwork and lack of sleep that most modern people experience and you get a perfect storm of digestive disorder.
This pattern shows up clinically as the alternating constipation and diarrhea that's typical of IBS, the bloating and cramping that worsens under stress, and the unpredictability that makes patients feel like they can't trust their own digestion. Other patterns appear as well, often layered on top of the foundational one, and part of intake is sorting out which patterns are present and how they're interacting.
What treatment looks like
Treatment is aimed at the underlying pattern, not at suppressing symptoms. The components we typically use:
Custom herbal formulas. A well-formulated Chinese herbal medicine works as a system rather than as a single compound. One or two herbs address the main pattern, others support the primary herbs, moderate their effects, or direct the action toward specific systems. For IBS, the formula usually warms the digestive center, regulates bowel function, and calms overactivity without suppressing it. The formula adjusts as you change.
Acupuncture. Acupuncture has a well-documented effect on autonomic nervous system balance, shifting patients out of sympathetic dominance and into the parasympathetic state where digestion can actually function. For someone whose gut has been on high alert for years, time spent in that shifted state is therapeutic in itself. Several recent trials, including a 2020 multicenter study in Mayo Clinic Proceedings, have shown acupuncture outperforming standard pharmacological treatments for IBS at 12-week follow-up.
Dietary and lifestyle adjustment. This is usually less restrictive than what patients arrive expecting. We're more interested in how you're eating, when, and in what state, than in eliminating long lists of foods. We'll point you toward foods and patterns that suit your specific presentation, and we'll explain the reasoning so you can make your own decisions over time.
What to expect from a first visit
The first appointment runs about 90 minutes. We take a detailed history, look at your tongue, feel your pulse, check your abdomen, and ask questions that may seem unrelated to digestion at first (sleep, energy across the day, how stress lands in your body, what your appetite is doing, what your stools actually look like). Patients leave the first visit with a pattern diagnosis, a starting herbal formula, and a sense of what the arc of treatment is likely to look like.
Most IBS presentations respond meaningfully within the first few weeks of treatment, with deeper changes accumulating over a few months. We'll talk honestly about what's realistic for your specific picture.
If you'd rather get a sense of where your digestion sits before deciding, our digestive health takes about two minutes and gives you some info about where your digestion is currently landing.
Further Reading
