Dr. Amy Nett: Yes. I would absolutely be concerned. Anytime someone has a sensitivity to food, even if that sensitivity is just bloating, to me, that tells me something is going on in the gut. In particular, if starchy carbohydrates are increased, think about whether or not those are FODMAPs, but it’s suggesting to me that there is some sort of imbalance in the microbiome. For that, I would do both SIBO breath testing and I would also do stool testing because it could be due to either an overgrowth of small intestinal bacteria or it could be due to dysbiosis. Any food reactions, food intolerances, that’s a key that you have to test the gut. Also I don’t like it when people react poorly to starchy carbohydrates because for most of my patients I don’t want them being low carbohydrate. I want people eating the starchy carbohydrates. At CCFM, we’re advocates of a moderate-carbohydrate diet. We like people eating sweet potatoes, yams, plantains, taro, yuca. In general, you want your patients to be able to tolerate carbohydrates so that you can get those carbs in them.