Dr. Sam Madeira, NMD
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    Gut health & microbiome

    Gut health, SIBO & microbiome care

    Bloating, irregular digestion and growing food sensitivities affect energy, mood and skin too. Dr. Sam Madeira, NMD helps adults in Arizona, Montana and Washington find out what’s driving their gut symptoms and rebuild a healthy microbiome, by telehealth.

    Book a free discovery callHow telemedicine care works

    Free · 30 minutes · by Zoom · no obligation

    Medically reviewed by Dr. Sam Madeira, NMD, licensed naturopathic physician · Updated

    Why gut health matters beyond digestion

    Your gut and the gut microbiome, the many microbes that live there, influence immune function, inflammation, hormones, mood and energy. That’s why gut problems often travel with fatigue, brain fog, skin issues and food sensitivities, and why fixing the gut can help in unexpected places.

    Common drivers of gut problems

    • Small intestinal bacterial overgrowth (SIBO) and other microbiome imbalances
    • A weakened gut lining, often called “leaky gut” (increased intestinal permeability)
    • Infections and the aftermath of antibiotics
    • Food reactions and mast cell activation
    • Chronic stress and poor sleep
    • Environmental exposures such as mold toxins

    How Dr. Madeira approaches gut health

    1. A detailed history of your symptoms, diet, medications and timeline.
    2. Targeted testing where it adds value, such as SIBO breath tests or stool testing.
    3. A personalized plan: nutrition, botanical medicine and digestive support, matched to what’s driving your symptoms.
    4. Rebuild and maintain a resilient microbiome, with follow-up to adjust as you improve.

    From The Dr. Madeira Show

    Listen and learn more

    Frequently asked questions

    What is SIBO?

    Small intestinal bacterial overgrowth (SIBO) is an excess of bacteria in the small intestine, which can cause bloating, gas, abdominal pain and changes in bowel habits. It is commonly evaluated with a breath test.

    Is leaky gut real?

    “Leaky gut” is a popular term for increased intestinal permeability, which researchers study in several conditions. Rather than focusing on a label, Dr. Madeira looks for the specific drivers of your symptoms, such as infections, food reactions, stress and microbiome imbalance.

    How do you improve gut health?

    It depends on what’s going on. Care may include identifying triggers, targeted testing, personalized nutrition, botanical medicine, and support for digestion and the microbiome. Stress and sleep matter too.

    When should I see a doctor urgently for gut symptoms?

    Seek prompt medical care for blood in the stool, black stools, unexplained weight loss, persistent vomiting, severe abdominal pain, or difficulty swallowing.

    Can gut problems be treated by telehealth?

    Yes. History, review of results and treatment planning work well by video, and tests such as breath and stool tests can be done at home or at a local lab. Dr. Madeira sees adults who live in Arizona, Montana or Washington and are in one of those states during each visit.

    Sources

    1. MedlinePlus: Small bowel bacterial overgrowth
    2. NIDDK: Symptoms & Causes of Irritable Bowel Syndrome
    3. Pimentel et al. (American Journal of Gastroenterology, 2020): ACG Clinical Guideline: Small Intestinal Bacterial Overgrowth (practice guideline)
    4. Rezaie et al. (American Journal of Gastroenterology, 2017): Hydrogen and Methane-Based Breath Testing in Gastrointestinal Disorders: The North American Consensus (consensus statement)
    5. Klem et al. (Gastroenterology, 2017): Prevalence, Risk Factors, and Outcomes of Irritable Bowel Syndrome After Infectious Enteritis: A Systematic Review and Meta-analysis (45 studies, 21,421 people with enteritis)
    6. Colecchia et al. (American Journal of Gastroenterology, 2026): Antibiotic Use During Gastrointestinal Infections Increases the Risk of Developing Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis (31 studies, 422,350 patients)

    Telemedicine care for adults in Arizona, Montana and Washington.

    Related: MCAS · Mold illness · Brain fog

    Thinking about next steps? See how care works, programs and pricing and patient reviews, or browse the frequently asked questions.

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    “Dr. Madeira is compassionate and truly listens. He takes the time to look beyond band-aid solutions and digs deeper to look at the root cause.”

    Dr. Shelly Sethi, D.O.

    From Google reviews. Individual experiences and results vary.

    Free discovery call

    Tired of guessing what’s wrong with your gut?

    Book a free 30-minute discovery call with Dr. Madeira. We’ll start with your why: what you want your health and life to look like, what’s been getting in the way, and whether working together feels right for you.

    • 30 minutes by Zoom, free, with no obligation
    • We talk about your goals and what’s been getting in the way
    • A non-clinical conversation: no diagnosis or treatment yet
    • For adults who live in Arizona, Montana or Washington
    Book a free discovery callSend a message

    Concierge, private-pay practice (no insurance accepted) · 100% telemedicine for adults in Arizona, Montana & Washington.