Chronic Disease Management
Digestive Health — Online Evaluation & Treatment
Heartburn that keeps coming back. Stomach cramps and unpredictable bowel habits. Bloating and constipation that never seems to resolve. Digestive problems are incredibly common and often dismissed as something you just have to live with. A licensed healthcare provider can help you understand what is causing your symptoms and discuss treatment options that may improve how you feel.
Start a VisitAbout digestive health
🫃 Digestive conditions — common, chronic, and very treatable
Digestive problems affect tens of millions of Americans. Acid reflux, irritable bowel syndrome, and chronic constipation are among the most common reasons people see a primary care provider — and also among the most commonly undertreated, partly because people assume their symptoms are just something they have to manage around rather than something that responds to medical care.
Many common chronic digestive conditions can be evaluated and, when appropriate, managed through telehealth. You do not need a scope or imaging to start getting better. A licensed healthcare provider can take a thorough history, assess your symptoms, and recommend a treatment plan that can meaningfully improve how you feel day to day.
What this page covers
Acid reflux and GERD (gastroesophageal reflux disease) — one of the most common digestive conditions in the U.S. Irritable bowel syndrome (IBS) — including IBS with diarrhea, IBS with constipation, and mixed IBS. Chronic constipation — evaluation, lifestyle changes, and treatment. Brief guidance on other common digestive symptoms including nausea, bloating, and indigestion. This page covers ongoing digestive conditions. For acute stomach illness, vomiting, or suspected food poisoning, visit our Digestive Issues page.
⚠️ Seek emergency or urgent in-person care for any of these
Severe abdominal pain — especially sudden, sharp, or the worst you have ever had. Vomiting blood or material that looks like coffee grounds. Black, tarry, or bloody stools. Significant unintended weight loss with digestive symptoms. Persistent difficulty swallowing or pain when swallowing. Jaundice (yellowing of the skin or eyes). Fever with abdominal pain. Inability to pass stool or gas with significant abdominal swelling. Severe dehydration or persistent vomiting. These symptoms require in-person evaluation and should not wait for a telehealth appointment.
Condition deep-dive
🔥 Acid reflux and GERD — heartburn treatment online
Acid reflux happens when stomach acid flows back up into the esophagus — the tube connecting your mouth to your stomach. When this occurs often enough to cause troublesome symptoms or complications, it is called GERD (gastroesophageal reflux disease). Symptoms occurring two or more times each week are commonly considered frequent and deserve evaluation. GERD is one of the most common chronic conditions in the United States, and one that a lot of people manage with over-the-counter antacids alone when prescription treatment or a more targeted approach could make a significant difference.
What acid reflux and GERD feel like
- →Burning sensation in the chest or throat (heartburn), often worse after eating, lying down, or at night
- →Sour or bitter taste in the mouth, especially after meals or when lying down
- →Regurgitation — food or liquid coming back up into the throat
- →Chronic cough, especially at night or first thing in the morning
- →Hoarse voice or the feeling of a lump in the throat
- →Worsening symptoms after coffee, alcohol, spicy food, fatty meals, chocolate, or large meals
- →Symptoms that improve when you sit upright or take antacids, but keep coming back
Chest symptoms — do not assume it is heartburn
New chest pain, pressure, pain that occurs with exertion, or pain that spreads to the jaw, shoulder, arm, or back should not be assumed to be heartburn. These symptoms require urgent medical evaluation to rule out cardiac causes. If you are unsure, seek in-person care promptly.
Long-term GERD can cause complications
When reflux is not adequately controlled over time, it can lead to complications such as esophagitis (inflammation of the esophagus), narrowing of the esophagus, or Barrett's esophagus — a change in the esophageal lining that warrants ongoing monitoring. This is one of the reasons consistent treatment and follow-up matter, not just symptom management in the moment.
How acid reflux and GERD are treated
- 🥗 Lifestyle changes — always the starting point Many people see significant improvement with targeted lifestyle changes: eating smaller meals, avoiding food within 2 to 3 hours of bedtime, elevating the head of the bed slightly, reducing alcohol and caffeine, and identifying personal trigger foods. These changes do not replace medication when it is needed, but they significantly reduce symptoms and improve how well medication works.
- 💊 H2 blockers — reducing acid production Medications like famotidine reduce the amount of acid the stomach produces. Available over the counter and by prescription. Useful for mild to moderate GERD, particularly for symptoms that are predictable (before meals or at bedtime). Faster onset than PPIs but shorter duration of effect.
- 💊 Proton pump inhibitors (PPIs) — the most effective acid-reducing medication PPIs such as omeprazole, pantoprazole, and esomeprazole are the most effective medications for controlling stomach acid and treating GERD. They are taken once daily, generally 30 to 60 minutes before the first meal of the day unless your provider instructs otherwise, and work best when used consistently. Low-dose versions are available over the counter, but prescription doses and longer-term use may be appropriate when symptoms are more significant. PPIs are generally well-tolerated. For patients taking them long-term, periodic review is worthwhile to confirm continued need and appropriateness.
When GERD needs in-person or specialist evaluation
GERD symptoms that do not improve with appropriate treatment, difficulty or pain when swallowing, unexplained weight loss, vomiting blood, black stools, or symptoms that have been present for many years without evaluation warrant in-person assessment and may need upper endoscopy. A telehealth provider can help you evaluate your symptoms and determine whether a gastroenterology referral is the right next step.
Tired of reaching for antacids every day? A licensed healthcare provider can evaluate your reflux and discuss a treatment plan that may work better.
Start a VisitCondition deep-dive
🫀 IBS — irritable bowel syndrome treatment online
IBS is one of the most common gastrointestinal conditions in the world, affecting an estimated 10 to 15% of adults. It causes real, recurring symptoms — but it does not cause visible damage to the bowel and does not increase the risk of colorectal cancer. That distinction matters, but it does not mean the symptoms are not disruptive. Cramping, unpredictable bowel habits, and bloating that interferes with daily life are real problems that respond to the right management approach.
IBS is a functional gut condition — meaning the gut is working differently, not that there is structural damage. The brain and gut are closely connected, which is why stress and anxiety commonly worsen IBS symptoms, and why treatment often addresses more than just diet.
Types of IBS and common symptoms
- IBS-D (diarrhea-predominant) Frequent, loose stools, often with urgency. May include mucus in the stool. Symptoms often worsen after eating or with stress.
- IBS-C (constipation-predominant) Infrequent, hard, or difficult-to-pass stools. Bloating and abdominal discomfort are common. Some relief after a bowel movement, but the pattern keeps returning.
- IBS-M (mixed) Alternating between diarrhea and constipation, sometimes within the same week. Often the most frustrating pattern to manage.
All types share the core features of IBS: recurring abdominal pain or discomfort that is related to bowel habits, and symptoms that have been present for at least a few months. Bloating, gas, and the feeling of incomplete emptying are also very common.
How IBS is diagnosed
IBS is usually diagnosed based on a characteristic symptom pattern while making sure alarm features or other conditions do not suggest another diagnosis. A provider will consider whether further testing or a gastroenterology referral is appropriate — particularly to evaluate for inflammatory bowel disease or celiac disease — before confirming IBS as the explanation. Telehealth is well-suited for ongoing management of a confirmed IBS diagnosis and for initial evaluation of typical IBS symptoms in otherwise healthy adults without alarm features.
How IBS is managed
- 🥗 Diet — the most powerful lever for most people Diet has a bigger impact on IBS than almost any other intervention. A low-FODMAP diet — which reduces specific fermentable carbohydrates that trigger symptoms in many IBS patients — has the strongest evidence for symptom reduction. Importantly, the low-FODMAP diet is intended as a temporary elimination approach followed by careful food reintroduction to identify your personal triggers, not a lifelong restrictive diet. Increasing dietary fiber benefits IBS-C specifically. Common triggers include onions, garlic, beans, wheat, dairy, and certain fruits, though triggers vary significantly between individuals.
- 🧘 Stress management and the gut-brain connection The gut has its own nervous system that communicates directly with the brain. This is why IBS almost always worsens with stress, anxiety, and poor sleep — and why addressing those factors is a genuine part of IBS treatment, not just a lifestyle suggestion. Cognitive behavioral therapy (CBT) and gut-directed hypnotherapy have good clinical evidence for IBS symptom reduction. Regular sleep, moderate exercise, and stress reduction all help.
- 💊 Medication — targeted to your IBS type Medication for IBS is chosen based on which symptoms are dominant. For IBS-D, antidiarrheals and antispasmodics can help with urgency and cramping. For IBS-C, osmotic laxatives, fiber supplements, and prescription agents that improve gut motility may be recommended. For pain and cramping, antispasmodic medications can provide relief. Low-dose antidepressants may sometimes be used to reduce gut pain and improve overall symptom control, even in people without depression, since they affect how the gut processes sensation. Your provider selects medication based on your symptom pattern, other health conditions, and what you have already tried.
- 🦠 Probiotics Some patients find certain probiotic strains helpful, particularly for bloating and gas, although responses vary and no single product works for everyone. Trying a reputable probiotic for 4 to 6 weeks is a reasonable step for many patients. Your provider can help set realistic expectations.
Symptoms that suggest something other than IBS
Blood in the stool, unintended weight loss, symptoms that wake you from sleep, fever with bowel symptoms, or new significant bowel changes after age 50 are not typical IBS features and require in-person evaluation. These may point to inflammatory bowel disease, colorectal cancer, or other conditions that need different workup and management. A telehealth provider can help assess these concerns and determine whether urgent evaluation is needed.
Condition deep-dive
⏳ Chronic constipation — when to get help and how it's treated
Constipation is so common it is almost universal — but chronic constipation is different from an occasional few days of difficulty. When constipation becomes a persistent pattern, it significantly affects quality of life, and there is effective treatment available that goes well beyond "eat more fiber and drink more water."
Constipation is defined by stool frequency, stool consistency, straining, incomplete evacuation, or a combination of these symptoms. Chronic constipation generally refers to these symptoms being present for three months or more.
Common causes of chronic constipation
- →Low dietary fiber and inadequate fluid intake
- →Physical inactivity
- →Medications — including opioids, certain antidepressants, iron supplements, calcium channel blockers, and antacids containing calcium or aluminum
- →Hypothyroidism — an underactive thyroid commonly causes constipation
- →Diabetes — can affect gut nerve function over time
- →Irritable bowel syndrome (IBS-C)
- →Changes in routine, travel, stress, or eating patterns
- →Pelvic floor dysfunction — muscles that should relax during a bowel movement do not
Why identifying the cause matters
Constipation is a symptom, not a diagnosis. Understanding what is causing it determines what actually helps. Constipation driven by a medication side effect needs a different approach than constipation from low fiber intake or an underactive thyroid. A provider can review your medications, health history, and symptom pattern to help assess possible contributing factors and recommend the most targeted approach rather than a generic one-size-fits-all suggestion.
How chronic constipation is treated
- 🥗 Dietary fiber and hydration Increasing dietary fiber from foods like vegetables, fruits, whole grains, legumes, and nuts softens stools and improves bowel frequency. Increase fiber intake gradually over several weeks and drink adequate fluids — adding fiber without enough water can worsen constipation. This is the right starting point for most people, but it is not always enough on its own.
- 🏃 Physical activity Regular movement significantly improves gut motility. Even 20 to 30 minutes of walking most days helps bowel regularity. If constipation developed or worsened after a period of reduced activity, increasing movement is one of the highest-leverage changes to make.
- 💊 Fiber supplements Psyllium husk (such as Metamucil) is a bulk-forming fiber supplement with good evidence for chronic constipation. Taken daily with adequate water, it adds bulk to stools and improves regularity. Best for mild to moderate constipation and as an add-on to dietary improvements.
- 💊 Osmotic laxatives Polyethylene glycol (MiraLax) draws water into the colon to soften stool and ease passage. Generally well tolerated for regular use and available over the counter. Note that magnesium-containing laxatives such as magnesium citrate may not be appropriate for people with kidney disease. Your provider can advise which option fits your situation.
- 💊 Stimulant laxatives Bisacodyl and senna stimulate the colon to move stool along. Effective for short-term or occasional use. Regular long-term use should be reviewed with a provider. Avoid self-escalating laxative use without discussing persistent constipation with a licensed healthcare provider.
- 💊 Prescription medications For chronic constipation that does not respond adequately to lifestyle changes and over-the-counter options, prescription medications including lubiprostone, linaclotide, and plecanatide increase fluid secretion in the intestine and improve bowel frequency and stool consistency. These are particularly useful for IBS-C and chronic idiopathic constipation. Your provider will review whether prescription treatment is appropriate for your situation.
When constipation needs in-person evaluation
New constipation after age 50, blood in the stool, significant unexplained weight loss, constipation alternating with diarrhea, or constipation that is severe and does not respond to treatment all warrant in-person evaluation and may need colonoscopy or further workup. These features can be associated with colorectal cancer or other structural conditions that need to be ruled out. A telehealth provider can help you assess your situation and determine whether in-person evaluation is needed.
How online care can help
💻 What a telehealth digestive health visit can do
Digestive conditions are often chronic, recurring, and often well suited to telehealth management. You do not need to be seen in person to get an effective evaluation of heartburn, IBS, or constipation. A thorough history of your symptoms, eating patterns, medications, and health background is usually the most important piece of any assessment — and that translates naturally to a telehealth visit.
Other common digestive symptoms we can help with
Beyond GERD, IBS, and constipation, a licensed healthcare provider can evaluate and help manage nausea and indigestion, bloating and gas, and mild to moderate diarrhea that is not explained by acute illness. For any of these, a provider can assess the pattern, identify possible contributing factors, make dietary and lifestyle recommendations, and prescribe medication when appropriate. If specialist involvement is needed, your provider can help coordinate that referral.
| What a telehealth digestive visit can do | What requires in-person or specialist care |
|---|---|
| Evaluate acid reflux and GERD symptoms and recommend or prescribe treatment | Upper endoscopy (EGD) for persistent or complicated GERD |
| Continue or initiate PPIs and H2 blockers when clinically appropriate | Suspected Barrett's esophagus or esophageal complications |
| Evaluate IBS symptoms and recommend dietary, lifestyle, and medication approaches | New bowel symptoms after age 50 requiring colonoscopy |
| Review and prescribe selected IBS medications when appropriate | Suspected inflammatory bowel disease (Crohn's, ulcerative colitis) |
| Evaluate chronic constipation and recommend a targeted treatment plan | Suspected colorectal cancer or significant structural concern |
| Prescribe prescription laxatives and motility agents when appropriate | Severe abdominal pain, blood in stool, or unintended weight loss |
| Review medications that may be contributing to digestive symptoms | Suspected celiac disease — requires blood testing and GI specialist |
| Coordinate gastroenterology referrals when needed | Hepatitis, gallbladder, or pancreatic concerns |
Digestive conditions are a strong fit for telehealth
Most digestive evaluations start with a detailed history — what your symptoms feel like, when they occur, what makes them better or worse, what you eat, what medications you take, and what you have already tried. That conversation translates very naturally to a telehealth visit. A licensed healthcare provider can make a strong assessment, recommend treatment, and prescribe medication when appropriate without requiring you to travel to a clinic.
What to expect
🗓️ Your visit, start to finish
Here is what a digestive health visit looks like from intake to plan.
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1
Describe your symptoms
Complete a short intake covering your main digestive symptoms, how long you have had them, how often they occur, what seems to trigger or worsen them, your diet and eating patterns, current medications, other health conditions, and what you have already tried. |
2
Meet with your provider
A licensed healthcare provider reviews your intake and asks follow-up questions to understand your full picture. Your provider will give you an honest assessment of whether your situation is well-suited to telehealth management or whether in-person evaluation or specialist referral is the right next step. |
3
Get a plan
Your provider reviews the likely cause of your symptoms, recommends dietary and lifestyle changes specific to your situation, and prescribes medication when appropriate. When prescription treatment is appropriate, it may be sent electronically to the pharmacy you select. Your provider also advises if further testing or a specialist referral is needed. |
4
Follow up if things do not improve
Digestive conditions often need some trial and adjustment. If symptoms are not improving, if new symptoms develop, or if medication needs to be reassessed, follow up. Your provider can adjust the plan based on how you respond. |
What to bring to your visit
A description of your main symptoms and how long you have had them. What makes symptoms better or worse — foods, timing, stress, activity. Your current medications including any antacids, laxatives, or supplements you take regularly. Any prior digestive diagnoses, procedures, or specialist visits. Whether you have had recent blood work or imaging related to your digestive symptoms.
Care connected to your pharmacy
🏪 Your prescriptions. Your pharmacy. Ongoing.
Most medications used to treat acid reflux, IBS, and constipation are available as affordable generics. Prescriptions may be sent to your preferred pharmacy when clinically appropriate. Availability and insurance coverage vary by plan and location.
- ✓Prescriptions sent electronically to your selected pharmacy when clinically appropriate
- ✓Most digestive medications available as low-cost generics
- ✓No required membership to access our telehealth services
Frequently asked questions
❓ Digestive health — your questions answered
Can I get acid reflux or GERD treatment through telehealth?
Yes, in most cases. Acid reflux and GERD are among the conditions most naturally suited to telehealth evaluation. A licensed healthcare provider can assess your symptoms, recommend lifestyle changes specific to your situation, and continue or initiate a PPI or H2 blocker when clinically appropriate. If your symptoms are severe, long-standing, or not responding to treatment, your provider may recommend an in-person evaluation or gastroenterology referral, including endoscopy when warranted.
Is it worth seeing a provider for IBS or should I just manage it myself?
It is worth getting a proper evaluation, especially if you have not had one. IBS symptoms overlap with other conditions that need different treatment, so a provider visit confirms the picture and rules out other causes. Beyond that, many people with IBS are managing symptoms without the most effective interventions available — a low-FODMAP dietary approach, appropriate medication for their IBS type, and gut-brain strategies all have good evidence and are not always well-known outside a clinical conversation. A provider can also help if symptoms are changing or worsening, since that warrants reassessment.
What is the difference between IBS and IBD?
IBS (irritable bowel syndrome) and IBD (inflammatory bowel disease) are very different conditions that sometimes get confused because of similar abbreviations. IBS is a functional condition — the gut works differently but there is no visible inflammation or damage. IBD, which includes Crohn's disease and ulcerative colitis, involves actual inflammation and damage to the digestive tract. IBD typically causes blood in the stool, fever, significant weight loss, and symptoms that wake patients at night — features not typical of IBS. IBD requires gastroenterology involvement for diagnosis and management. If you have features that do not fit typical IBS, your provider will discuss whether further workup is needed.
I have been constipated for years. Is that something a provider can actually help with?
Absolutely — and this is one of the most common situations where people accept something as unchangeable that is actually very treatable. Chronic constipation has multiple effective treatment options beyond generic dietary advice. A provider can review your medications (many common medications cause or worsen constipation), assess for underlying causes like hypothyroidism, and work with you through a stepwise treatment plan. For patients whose constipation has not responded to over-the-counter options, prescription medications are specifically approved for chronic constipation and IBS-C and make a meaningful difference for many people.
What foods should I avoid for acid reflux?
Common triggers include fatty or fried foods, spicy foods, chocolate, coffee and other caffeinated drinks, carbonated beverages, alcohol, tomato-based foods, citrus fruits, and mint. Eating large meals and lying down within 2 to 3 hours of eating also reliably worsen reflux. That said, trigger foods vary between individuals. A provider can help you identify your specific patterns and distinguish between universal triggers worth avoiding and personal ones worth tracking.
Are PPIs safe to take long-term?
PPIs are generally safe and well-tolerated for most people. Long-term use has been associated with modest reductions in magnesium and B12 absorption in some patients, and there has been research on bone density with very long-term use — though findings are mixed. For patients who genuinely need a PPI long-term (confirmed GERD, Barrett's esophagus, or other clear indication), the benefit generally outweighs these modest risks. For patients taking PPIs out of habit without a clear ongoing indication, a review with a provider to assess whether the dose or duration is still appropriate is worthwhile. One important note: do not stop a prescribed PPI abruptly without discussing it with your provider first, since rebound acid production can temporarily worsen symptoms.
Can stress really cause digestive problems?
Yes, very directly. The gut has its own extensive nervous system that communicates constantly with the brain — a relationship often called the gut-brain axis. Stress, anxiety, and emotional distress physically affect gut motility, gut sensitivity, and the balance of gut bacteria. This is why IBS flares with stress, why people feel nauseated before stressful events, and why digestive symptoms are common in people with anxiety or depression. Managing stress is not just a feel-good suggestion in the context of digestive health — it is a legitimate and often very effective part of treatment, particularly for IBS.
Is this visit HSA or FSA eligible?
MyPhysician360 visits may be HSA and FSA eligible. Check with your plan administrator to confirm based on your specific plan.
Helpful resources
📚 Learn more about digestive health
Authoritative patient resources from leading digestive health organizations.
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🔥 Acid reflux and GERD Understanding GERD — Symptoms and Treatment American College of Gastroenterology Visit ACG → |
🫀 IBS Irritable Bowel Syndrome — Symptoms, Causes, and Treatment National Institute of Diabetes and Digestive and Kidney Diseases Visit NIDDK → |
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⏳ Constipation Constipation — Overview and Treatment Options National Institute of Diabetes and Digestive and Kidney Diseases Visit NIDDK → |
🍽️ Low-FODMAP diet for IBS The Low-FODMAP Diet — Patient Guide International Foundation for Gastrointestinal Disorders Visit IFFGD → |
Your gut is trying to tell you something. Let's figure out what.
A licensed healthcare provider can evaluate your digestive symptoms, assess possible causes, and help you build a treatment plan that works. No waiting room. No required membership. Available in most states.
HSA & FSA eligible — check with your plan administrator | No required membership
Medical disclaimer: The information on this page is for general educational purposes only and does not constitute medical advice. Digestive symptoms require individualized evaluation by a licensed healthcare provider. Severe abdominal pain, blood in the stool, vomiting blood, unintended weight loss, inability to pass stool or gas with abdominal swelling, severe dehydration, or significant changes in bowel habits require prompt in-person evaluation and are not appropriate for telehealth management alone. Suspected inflammatory bowel disease, celiac disease, colorectal cancer, or structural gastrointestinal conditions require in-person assessment, laboratory testing, and gastroenterology involvement. Colonoscopy and upper endoscopy require in-person procedures and are not provided through this service. Prescribing decisions are made by a licensed healthcare provider on an individual basis. MyPhysician360 services are available in most states. Services are not currently available in Mississippi or Alaska.