Amanda Malachesky breaks down why IBS is often just a placeholder diagnosis—and why uncovering the true root cause is the real work of healing.
Amanda’s Journey Into Digestive Health
Josef Kreitmayer:
Hello, welcome. We welcome today, Amanda Malachesky. She’s a certified functional nutrition and lifestyle practitioner, as well as a recovered IBS patient. She created the Calm Digestion Method, an online program focused on root cause resolution for chronic gut issues. She also hosts the Confluence Nutrition YouTube channel and has published the book Your Custom IBS Solution. Welcome, Amanda. Wonderful to have you here.
Amanda Malachesky:
Thank you so much. It’s my pleasure to be here.
Josef Kreitmayer:
Would you like to tell us about your background and how you got into digestive health?
Amanda Malachesky:
Like many in this field, I came to it through personal health struggles. In my mid-30s, I began having serious digestive issues and abdominal pain. My doctor said everything looked normal, but I knew something was wrong. Things got worse in my early 40s—more bad days than good. I hit dead ends with conventional approaches, even after training as a health coach and running functional lab tests. It took years of persistence to piece together a solution.
Eventually, I was able to resolve my issues and became a practitioner, studying with several schools and learning to support people through diet, supplementation, and lifestyle changes. My journey with IBS gave me insight and empathy, and now I’ve spent several years working exclusively with people dealing with IBS. It’s helped me separate what’s truly effective from what’s just noise. My mission is to help people get to the root cause and cut through the confusion.
From IBS Diagnosis to Root Cause Clarity
Josef Kreitmayer:
You mentioned the complexity of digestive health and how it shaped your approach. How does that experience inform how you work with clients?
Amanda Malachesky:
Most people I work with have spent countless hours researching online because they aren’t getting the help they need from conventional doctors. Typically, doctors rule out major conditions—cancer, IBD, and celiac disease. Once that’s done, patients are left with the vague label of IBS. But that’s not a diagnosis—it just describes a set of symptoms like bloating, diarrhea, or constipation lasting six months or more.
We have to go deeper and ask, why is this happening? There are around 50 potential root causes, and it’s my job to help clients explore and uncover which ones apply to them.
Josef Kreitmayer:
So IBS is often a placeholder for “we don’t know what’s wrong.” And you mentioned that 60% of IBS cases may be driven by SIBO.
Amanda Malachesky:
Exactly. That’s a significant correlation. I even experienced reflux myself during the pandemic and realized it resolved once I treated my SIBO with rifaximin and neomycin. I see clients with classic SIBO symptoms—constipation, diarrhea, or both—who also have reflux. Especially in constipation-dominant cases, the gas buildup can slow motility and contribute to reflux.
Unpacking SIBO, Testing, and Symptoms
Josef Kreitmayer:
How do people typically come to you, and how do you begin unpacking their root causes?
Amanda Malachesky:
If someone’s had all the major scopes and ruled out serious conditions, and they haven’t tested for SIBO, we often start there. Testing can be tricky to access or afford, but it’s possible through doctors or direct ordering. I also use the FoodMarble Aire 2, a home device that can help detect SIBO with practitioner guidance.
We might also adjust diet, which can reduce symptoms even if it doesn’t resolve the root issue. The nervous system and stress are critical, too. Stress isn’t the cause, but it worsens symptoms for many. We look at supplements, enzymes, probiotics, and stomach acid support when appropriate. If all else fails, we might run a stool test like the GI-MAP to check for parasites, H. pylori, yeast, and other imbalances.
Structural issues, like hiatal hernia, adhesions from surgeries, or endometriosis, can also interfere with motility. And medications like opioids can cause constipation. We review what’s helped, what hasn’t, and use that to focus our efforts.
SIBO Breath Testing and Interpretation
Amanda Malachesky:
The breath test involves a prep diet, drinking a sugar solution (glucose or lactulose), and taking breath samples every 15–20 minutes. We’re measuring hydrogen, methane, or hydrogen sulfide gases—gases that only bacteria produce. If the gases spike within the first 90 minutes, it suggests SIBO. Beyond 90 minutes likely indicates fermentation in the large intestine, which is normal.
FoodMarble is a helpful home tool, but it should be used properly. Without proper timing or practitioner setup, it can be misleading. It offers useful trends, especially for high or medium readings, which can indicate whether lab testing is worthwhile.
Interpreting Results and Test Limitations
Amanda Malachesky:
Glucose testing tends to be slightly more accurate than lactulose, according to recent meta-analyses. Both have sensitivity and specificity around 60–70%, so they’re not perfect. But unless you’re undergoing an invasive gold standard test under anesthesia, these breath tests are our best non-invasive option.
Accuracy depends heavily on prep diet compliance and interpretation. For example, if someone eats fermentable foods the day before or if the reader misinterprets the normal large intestine gas spike as SIBO, they may get a false positive.
Using Breath Tests for Food Sensitivities
Amanda Malachesky:
FoodMarble also has a FODMAP sensitivity kit to test how individuals react to fermentable carbohydrates like lactose, sorbitol, fructose, and inulin. These can be big triggers for IBS and reflux due to the gas and pressure they create. Identifying which specific FODMAPs are problematic allows people to avoid overly restrictive diets.
Josef Kreitmayer:
What food intolerances do you see most often?
Amanda Malachesky:
The most common are gluten, dairy, sugar, and sometimes starches. Histamine foods—fermented, aged, or certain produce—can also trigger allergy-like or digestive symptoms. Oxalates in foods like spinach, almonds, and chocolate can be problematic for some. Most often, though, the issue lies with FODMAPs.
How to Approach Elimination Diets
Amanda Malachesky:
Many people get overwhelmed by restrictive diets. The low-FODMAP diet is meant to be a short-term experiment, not a permanent solution. You’ll usually know within two weeks if it’s helping. If not, drop it. If it does help, you move into a reintroduction phase to identify which specific foods are problematic and at what quantity.
Elimination diets should be used to test hypotheses, not as indefinite lifestyle changes. Food sensitivities are often secondary to deeper issues like SIBO, so the ultimate goal is to resolve the root cause and reintroduce foods over time.
Treating SIBO and Preventing Recurrence
Amanda Malachesky:
I initially used herbal antimicrobials to treat my SIBO, but they weren’t enough. Eventually, I took rifaximin and neomycin, which drastically improved my digestion in just a few days. I needed multiple rounds to fully clear the SIBO, and then followed up with a prokinetic to support motility and prevent recurrence.
Many people relapse because they skip that last step. Prokinetics help the small intestine stay clear by supporting the migrating motor complex, which is crucial for preventing bacterial overgrowth.
Migrating Motor Complex and Meal Spacing
Amanda Malachesky:
Spacing meals 3–4 hours apart and having a long overnight fast helps support the migrating motor complex, which moves material through the small intestine. This is important both for SIBO and for reflux, especially avoiding late-night eating.
How Amanda Works With Clients
Amanda Malachesky:
Most people find me through YouTube. I work almost exclusively through my Calm Digestion Method program. We begin with an assessment, explore potential root causes, and then run guided experiments—dietary changes, supplements, protocols—to pinpoint what helps.
It’s a six-month or longer process. There’s so much conflicting information out there, and I help clients sort through it and figure out what’s truly right for them.
Josef Kreitmayer:
And your ideal client?
Amanda Malachesky:
Someone dealing with bloating, constipation, diarrhea, or all three. If reflux is their main concern, I usually refer them out unless it’s tied to SIBO.
About Amanda’s Book: Your Custom IBS Solution
Amanda Malachesky:
My book, Your Custom IBS Solution, captures the same process I guide people through in my program. It walks readers through identifying root causes and finding personalized solutions. The core idea is that everyone has their unique mix of issues, and healing often requires addressing several layers, not just one root cause.
Parasites and Uncommon Triggers
Amanda Malachesky:
Parasites aren’t as common as people think, but they can be a problem. I had Blastocystis hominis, which not everyone reacts to, but I improved after clearing it. If symptoms suggest a parasite but it doesn’t show up on a GI-MAP, I use another lab with more sensitive testing.
Final Advice for Those Just Starting
Amanda Malachesky:
Don’t lose hope. It can feel overwhelming, especially when you’ve tried so many things without answers. But persistence and asking the right questions are key. Every experiment you try, even the ones that don’t work, provides valuable information. That knowledge helps you better understand your body and brings you closer to healing.
Josef Kreitmayer:
Thank you so much, Amanda. For those interested in connecting with Amanda or joining her Calm Digestion Method program, check the links below the video.
Amanda Malachesky:
Thank you, Josef. I appreciate the opportunity.
