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Ever been told your pain is “just a flare,” even when your labs look calm? We sit down with Mayo Clinic gastroenterologist Dr. Xiao Jing (Iris) Wang to unpack why symptoms can linger after inflammation is under control—and what to do about it. From constipation myths to the real mechanics of bloating, this conversation reframes gut discomfort through muscles, nerves, and breath, not just meds.

Dr. Wang breaks down pelvic floor function in clear, memorable language. Learn how the puborectalis sling preserves continence, why years of urgency or “holding it” can hardwire a constant clench, and how that leads to straining and incomplete emptying. She shares practical paths to diagnosis without over-reliance on expensive tests, smart ways to find qualified pelvic PT, and simple at-home tactics like an optimized toilet posture, the “anti‑Kegel,” and biofeedback fundamentals. We also explore why J‑pouch patients need their own testing norms and a different definition of “normal.”

Then we tackle bloating. Groundbreaking research shows many visibly distended bellies aren’t full of excess gas—the diaphragm is pushing down while the abdominal wall pooches out. Dr. Wang demonstrates how diaphragmatic breathing can retrain this pattern and why yoga, gentle twists, and abdominal massage move trapped gas better than most medications. Finally, we zoom out to the brain. When the gut’s “fire” is out but the alarm keeps blaring, neuromodulators, gut-directed hypnotherapy, and virtual reality can close the pain gates. You’ll hear how VR helps patients navigate bathroom anxiety, tolerate unsedated procedures, and feel safer in their own bodies.

Finally we talk to Dr. Wang about the genesis of her children's book called "Boo Can't Poo." It's a humorous story about a constipated ghost named Boo and his efforts to get his bowels back on track. It's a great read for parents who are working to potty train their toddlers but also for all us to re-learn how to poo!

If you’ve wondered whether your pain is real when scans look fine, this is your validation and your roadmap. Subscribe, share with a friend who needs it, and leave a review to help more listeners find practical relief and a new way to think about gut health.

Links:

• Boo Can't Poo book
• Yoga poses for constipation- Yoga Journal
• More yoga poses for constipation- Verywell Health
• Resources on disorder of the gut-brain axis and more from GI Psychology

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When your scope looks great but your day still falls apart, something’s missing. We sit down with Dr. Dawn Beaulieu, a Vanderbilt IBD specialist certified in functional medicine, to unpack a root-cause approach that complements biologics and brings relief where patients feel it most: sleep, fatigue, bowel consistency, and energy.

We get specific about what functional medicine actually is—science-based, holistic, and individualized—then trace how Dr. Beaulieu integrates it into a busy academic IBD center. From the “functional medicine tree” and Five Rs to team-based care with dietitians and social workers, she shows how nutrition, hydration, and nervous system training shift the gut-brain axis. We talk real-world food strategies that work for sensitive guts, why ultra-processed ingredients and dyes upset the microbiome, and how to ramp fiber without misery. She shares outcomes from Vanderbilt’s group programs, where patients improved quality-of-life, sleep, and fatigue in about twelve weeks, with some showing lower fecal calprotectin.

We also tackle supplements with nuance: which nutrients many IBD patients actually need, how to choose third‑party tested brands, and why you can’t out-supplement a bad diet. Dr. Beaulieu sets clear lines on when medication is essential for moderate to severe disease, then explores where GLP‑1 drugs may help overweight patients alongside standard care. Access matters too, so we highlight ways to find certified functional medicine providers, piece together a local team, and use tools like HRV training and Nerva to build daily resilience.

This is a grounded, empowering roadmap for anyone stuck between “remission” and “feeling well.” If the goal is fewer flares and more life, these are the levers you can pull today—without abandoning the therapies that work. Follow the show, share this episode with someone who needs a nudge toward better routines, and leave a review to help more people find the conversation.

Links:

• Find a practitioner- Institute for Functional Medicine
• IBD Learning slides "Functional Medicine and Inflammatory Bowel Disease" with Dr. Beaulieu- Crohn's & Colitis Foundation USA
• Podcast with Dr. Beaulieu on FMP Essentials
• Podcast episode with Dr. Beaulieu on The Dr. Mark Hyman Show

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Remission rates don’t rise by accident—they rise when people, data, and purpose align. This week we were joined by our friend Becky Johnson Rescola, Executive Director and President of Improve Care Now (ICN), to unpack how a learning health network is transforming pediatric IBD care through shared data, quality improvement, and genuine partnership with families.

We trace ICN’s journey from ten centers in 2007 to a 100+ site network with a registry tracking over 33,000 active kids and young adults. Becky explains how consistent measurement and coaching improved remission rates, with growing emphasis on sustained and steroid‑free remission. You’ll hear a real-time example of change in motion: a shared decision-making tool piloted at eight centers to help families weigh adalimumab plus methotrexate, reflecting registry findings that combo therapy speeds remission with adalimumab but not infliximab. We also dig into how registry data supports off‑label insights, helps sponsors understand pediatric outcomes, and even flags potential trial participants through privacy‑preserving queries.

Beyond medications, we explore EMR integration with Epic to reduce data burden, targeted efforts to close gaps in race and ethnicity fields to spot disparities, and the network’s commitment to co‑producing resources with patients and parents. Becky brings the community to life through ICN’s conferences—scholarships, learning labs, and a welcoming vibe that empowers quieter voices to speak up and help set the agenda. From very early onset IBD and tailored transition to adult care, to smarter partnerships across GI and related conditions, the path forward is both practical and ambitious: make evidence usable, make participation easy, and make sure every child benefits whether or not they’re seen at an ICN center.

If this conversation sparks ideas or gives you hope, help us spread the word—follow the show, share it with someone who needs it, and leave a review with the question you want us to tackle next.

Links

• Improve Care Now's website
• ICN- Tools and resources for patients and parents

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