TMI Talk with Dr. Mary

Episode 48: Gut Health, IBS, SIBO, and Menopause: What Clinicians Need to Know with Shefaly Ravula, PA-C


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We dig into where traditional gastroenterology often falls short—and how functional medicine can fill in the gaps. I’m joined by Shefaly Ravula, PA-C a Physician Assistant and Functional Medicine Certified Practitioner, who shares how her background in GI and nutrition evolved into a more personalized, whole-person approach.

We cover common clinical red flags, what to do when patients have “normal” GI tests but still feel terrible, and how to blend diagnostics with nutrition and long-term strategy. We also explore how menopause impacts gut health, the nuance around HRT, and why patient education is everything when it comes to sustainable results.

This episode is packed with insight for healthcare professionals and curious listeners alike who want to better understand the gut-brain-body connection.


What You’ll Learn in This Episode

  • Red flags that may point to deeper gut dysfunction (chronic bloating, constipation, diarrhea)
  • How microbiome stool tests compare to SIBO breath testing
  • Why antibiotics, low FODMAP diets, and gut supplements only offer temporary relief
  • The connection between IBS and SIBO—and how many are misdiagnosed
  • How functional medicine combines traditional diagnostics with root-cause care
  • The relationship between estrogen, motility, microbiome health, and inflammation in menopause
  • Why HRT decisions should be individualized, not one-size-fits-all
  • How pelvic floor dysfunction and trauma can influence GI symptoms
  • What providers can do, even in short visits, to screen more effectively

Timestamps:

00:00 Introduction to the Episode

00:12 Meet Shafaly Founder of Precision Gut Health

00:55 Episode Overview: Key Topics and Takeaways

02:32 Dr. Mary's Approach to Whole Body Healing

03:17 Shafaly’s Journey into Functional Medicine

06:13 Challenges in Integrating Functional Medicine

14:31 Understanding IBS and SIBO

18:30 The Role of Testing in Gut Health

24:09 Antibiotics and Gut Health: A Complex Relationship

29:11 Patient Advocacy and Navigating the Medical System

32:27 Chronic Constipation and Structural Issues

33:04 The Multifaceted Nature of IBS

33:56 The Role of Trauma in IBS

35:01 The Importance of Personalized Medicine

40:43 Challenges with Restrictive Diets and Antibiotics

46:16 Menopause and Gut Health

50:31 The Controversy of Hormone Replacement Therapy (HRT)

57:41 Conclusion and Contact Information

You can find Shefaly below:

IG: @precisionguthealth

https://precisionguthealth.com

If you are a health or movement professional and want to stay in touch with future episodes, webinars, courses, events and more. Subscribe to my email list here

I’ll see you in a week!

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TMI Talk with Dr. MaryBy Dr. Mary Grimberg

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