Concierge neurogastroenterology · London
Functional gut assessment, IBS, SIBO and disorders-of-gut-brain interaction — a modern integrated workup.
A structured integrated workup for irritable bowel syndrome (IBS), small intestinal bacterial overgrowth (SIBO), functional dyspepsia and other disorders of gut-brain interaction — combining stool testing, breath tests, motility studies and neurogastro consultation.
Why patients choose us
- 01
The right hands
We route you to a consultant neurogastroenterologist — the specialist who understands the gut-brain axis, IBS subtypes and SIBO decides the plan.
- 02
An integrated workup
Stool tests, breath tests, motility studies and imaging combined into one structured plan — not a scattergun of tests.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Key facts
The functional gut assessment, at a glance.
A quick summary of what the workup is, what it covers and how it is diagnosed.
-
Definition
An integrated workup for IBS, SIBO, functional dyspepsia and disorders of gut-brain interaction.
-
Rome IV criteria
Diagnosis follows the Rome IV symptom-based framework, not a single test result.
-
Organic disease first
Excludes red-flag organic disease — coeliac, IBD, colorectal cancer — before a functional label is applied.
-
Multi-modal
Combines stool markers, hydrogen and methane breath testing, motility studies and imaging where indicated.
-
Microbiome and food
Includes gut microbiome and food-intolerance testing where clinically appropriate.
-
Neurogastro review
Findings reviewed by a consultant neurogastroenterologist, with a structured plan you can act on.
Indicative pricing
What a private functional gut assessment costs in London.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options.
In short
A full integrated workup in our network: £950–£1,800, with a written plan typically within 2–3 weeks.
| Component | Indicative range | Typical duration | Report turnaround |
|---|---|---|---|
| Gastroenterology consultation | £250–£450 | 45 min | Same-day |
| Faecal calprotectin + FIT | £120–£220 | Sample | 3–5 days |
| Hydrogen / methane breath test (SIBO) | £220–£380 | 3 hours | 1 week |
| Comprehensive stool analysis / microbiome panel | £350–£650 | Sample | 2–3 weeks |
| Full functional gut assessment (integrated workup) | £950–£1,800 | Half-day | 2–3 weeks |
| Neurogastro follow-up consultation | £220–£400 | 30 min | Same-day |
Prices vary by clinic and by which components — breath testing, microbiome panels, motility studies — your workup requires. We come back with a firm quote within one working day.
The problem
A gut workup is only as good as who structures it.
A scattergun of stool and breath tests, ordered without a framework, rarely produces a plan. Rome IV, red-flag exclusion and a neurogastroenterology-led structure — that is what turns tests into a diagnosis.
-
Bloating, pain, altered bowel habit?
We structure an integrated workup with Rome IV framing and organic-disease exclusion.
-
A SIBO breath test in isolation?
We put the result in context — with clinical history, red-flag review and a plan you can act on.
-
Told "it is IBS", but no plan?
We arrange consultant neurogastro review with a stepped dietary, pharmacological and psychological plan.
The workup, in order
From consultation to structured plan — what happens, in order.
One neurogastroenterologist from first consultation to written plan — usually within two to three weeks.
Phase 1 · Consultation and history
Concierge, off-stage for you
Phase 2 · Testing
Stool, breath and blood
Phase 3 · Plan
Neurogastro review
- 01
Consultation
Gastroenterology consultation
Consultant assessment with detailed history — Rome IV screening, family history, red-flag review.
- 02
Consultation
Bristol stool and symptom diary
Two-week structured diary — stool form, frequency, pain, bloating, food triggers.
- 03
Consultation
Blood panel
Coeliac serology, faecal calprotectin, CRP, FBC, TFTs, ferritin — to exclude organic disease.
- 04
Testing
Stool testing
Faecal calprotectin, FIT, and where indicated a comprehensive stool analysis or microbiome panel.
- 05
Testing
Hydrogen / methane breath test
Lactulose or glucose breath test to identify SIBO or intestinal methanogen overgrowth (IMO).
- 06
Plan
Colonoscopy if red flags
Direct visualisation with a consultant gastroenterologist if alarm features are present.
- 07
Plan
Structured neurogastro plan
A written management plan from a neurogastroenterologist — diet, medication, follow-up.
Typical end-to-end: 2–3 weeks. Urgent cases with red flags: same week.
What it shows
What a functional gut assessment can diagnose.
The workup covers the commonest disorders of gut-brain interaction — and, just as importantly, excludes the organic disease that must not be missed.
-
IBS-D / IBS-C / IBS-M subtype
Rome IV classification of irritable bowel syndrome by predominant stool pattern.
-
SIBO / IMO (methane)
Small intestinal bacterial or methanogen overgrowth on breath testing.
-
Bile acid diarrhoea
A commonly missed cause of chronic diarrhoea, confirmed on SeHCAT or trial of sequestrant.
-
Coeliac disease (differential)
Screened by serology, confirmed on duodenal biopsy — excluded early in every workup.
-
Microscopic colitis (differential)
Chronic watery diarrhoea with normal colonoscopy — diagnosed on biopsy.
-
Functional dyspepsia
Postprandial distress or epigastric pain syndromes without structural disease.
-
Chronic constipation subtype
Slow-transit, evacuatory or normal-transit constipation — the subtype changes treatment.
-
Red flag: alarm features (weight loss, rectal bleeding) — 2-week-wait pathway
Alarm features trigger the NHS 2-week-wait suspected cancer pathway. Do not wait for a private slot.
Treatment options
The next steps after diagnosis.
A stepped plan of dietary, pharmacological and psychological interventions — matched to your Rome IV subtype and test findings.
-
Low-FODMAP dietary trial
A structured, dietitian-led elimination and reintroduction protocol — the highest-evidence dietary intervention for IBS.
-
Antispasmodics (mebeverine)
First-line pharmacological option for abdominal pain and cramping in IBS.
-
Peppermint oil
Enteric-coated peppermint oil — evidence-supported for global IBS symptoms and pain.
-
Neuromodulators (TCA, SNRI)
Low-dose tricyclics or SNRIs to modulate the gut-brain axis in refractory symptoms.
-
Rifaximin for SIBO
A gut-selective antibiotic for confirmed small intestinal bacterial overgrowth.
-
Bile-acid sequestrants for BAD
Colesevelam or colestyramine for bile acid diarrhoea confirmed on SeHCAT.
-
Gut-directed hypnotherapy
A NICE-recommended psychological therapy with a strong evidence base in IBS.
-
Structured neurogastro follow-up
Consultant-led review to titrate treatment, adjust diet and monitor response.
Our vetted London network
A small panel of clinics, we picked them.
Partners across central, north, west and south London. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every clinic in our network.
-
Consultant neurogastroenterologists with a subspecialty interest in gut-brain disorders
-
Rome IV diagnostic framework used consistently across the network
-
Accredited hydrogen / methane breath testing to North American Consensus standards
-
Onward colonoscopy or motility pathway if red flags or ambiguous findings emerge
Safety, red flags and caveats
What has to be excluded before a functional label.
A functional gut assessment is safe and non-invasive — but the practical points are the red flags that trigger urgent NHS pathways, and the caveats around breath testing, microbiome panels and food-intolerance tests.
Red flags — 2-week-wait pathway
- · Rectal bleeding
- · Iron deficiency anaemia
- · Weight loss
- · Family history of colorectal cancer
- · Nocturnal symptoms
- · Persistent vomiting
- · Progressive dysphagia
- · Palpable abdominal mass
- · Age > 50 with new symptoms
-
Red flags come first
Rectal bleeding, weight loss, iron deficiency, family history of colorectal cancer — these are excluded before any functional label is applied.
-
Rome IV is symptom-based
Functional gut disorders are diagnosed on symptom criteria, not one blood test — the framework matters.
-
Breath tests have caveats
SIBO breath testing has false positives and negatives — results are interpreted in clinical context, not in isolation.
-
Low-FODMAP is short-term
The elimination phase is 4–6 weeks only — long-term restriction risks nutritional deficiency and microbiome harm.
-
Microbiome tests, with caveats
Commercial microbiome panels are informative but not yet a clinical diagnostic — we say so up front.
-
Food-intolerance testing caveat
IgG food-intolerance tests are not evidence-based — we do not recommend them as a first-line investigation.
-
Coeliac test needs gluten
Coeliac serology and biopsy are only reliable if you are eating gluten — do not cut it out before testing.
-
Colonoscopy where indicated
A normal blood panel does not exclude IBD or cancer — colonoscopy remains the gold standard where red flags exist.
-
Bring prior investigations
Previous endoscopy, imaging and stool results materially shorten the workup and sharpen the plan.
Reading your report
A functional gut report can look dense. It isn’t.
Whatever the finding, the report keeps to the same four parts.
A quiet reminder
The report is written for your doctor, not for you — and that’s normal.
If you would like us to talk you through it before your follow-up, just ask.
- 01 Header
Presentation and Rome IV screen
Your symptoms, duration, Bristol stool pattern, red-flag review and Rome IV subtype.
- 02 Investigations
Bloods, stool and breath results
Coeliac serology, calprotectin, FIT, hydrogen and methane breath curves — with reference ranges.
- 03 Findings
Differential and diagnosis
The working diagnosis — IBS subtype, SIBO/IMO, functional dyspepsia — and what has been excluded.
- 04 Plan
Structured neurogastro management plan
Dietary, pharmacological and psychological interventions in a stepped plan you can act on.
Recognised by major UK insurers
Cover depends on your policy and clinic; we confirm with your insurer before booking.
Frequently asked
Everything we get asked about functional gut assessment.
Quick answers on Rome IV, SIBO, colonoscopy, cost and the evidence around food-intolerance testing.
-
What is a functional gut assessment?
A structured, integrated workup for irritable bowel syndrome (IBS), small intestinal bacterial overgrowth (SIBO), functional dyspepsia and other disorders of gut-brain interaction — combining stool testing, breath tests, motility studies and neurogastroenterology consultation.
-
What is a disorder of gut-brain interaction?
It is the modern name — from the Rome Foundation — for what used to be called functional gastrointestinal disorders. It reflects that these conditions arise from disturbed communication between the gut and the brain, not from structural disease. IBS, functional dyspepsia and chronic idiopathic constipation are the commonest examples.
-
What is SIBO and how is it tested?
Small intestinal bacterial overgrowth is an excess of bacteria in the small bowel that causes bloating, wind, pain and altered stool. It is tested with a hydrogen and methane breath test after a lactulose or glucose challenge. Methane-dominant results indicate intestinal methanogen overgrowth (IMO), which is treated differently.
-
Do I need a colonoscopy?
Only if red-flag or alarm features are present — rectal bleeding, weight loss, iron deficiency anaemia, new symptoms over age 50, family history of colorectal cancer, or a raised faecal calprotectin. Rome IV allows a positive diagnosis of IBS without colonoscopy when there are no alarm features.
-
How much does a private functional gut assessment cost in London?
A gastroenterology consultation is £250–£450; a SIBO breath test is £220–£380; a full integrated workup is typically £950–£1,800. We confirm a firm figure within one working day.
-
Are food-intolerance tests worth doing?
The commonly marketed IgG food-intolerance tests are not evidence-based and we do not recommend them as a first-line investigation. A structured, dietitian-led low-FODMAP elimination and reintroduction protocol is the highest-evidence dietary approach.
Sources and guidelines
- British Society of Gastroenterology. Guidelines on the management of irritable bowel syndrome.
- NICE. Irritable bowel syndrome in adults: diagnosis and management (CG61).
- Rome Foundation. Rome IV diagnostic criteria for functional gastrointestinal disorders.
- European Society of Neurogastroenterology and Motility.
Last reviewed 2026-07-30 · Next review 2027-07-30 · Reviewed by Pulse Atlas Editorial Board,
Related tests
Looking for a different test?
-
Hydrogen breath test
Dedicated SIBO / IMO breath testing to North American Consensus standards.
Learn more -
Gut microbiome testing
Comprehensive stool microbiome analysis — informative, with caveats.
Learn more -
Colorectal physiology
Anorectal manometry, balloon expulsion and defecating proctography for constipation and incontinence.
Learn more -
All tests
Browse every test and procedure we arrange.
Learn more -
Hypertension
Related condition guide.
Learn more -
Type 2 Diabetes
Related condition guide.
Learn more -
Cognitive Behaviour Therapy
Related treatment option.
Learn more -
Complementary Alternative Medicine
Related treatment option.
Learn more
In practice, in London
Getting functional gut assessment sorted in London, without the guesswork
With functional gut assessment, the London question is usually about report turnaround and the radiologist reading it — not whether the scan is available. Waiting lists on the NHS for functional gut assessment vary widely by borough and by how the GP letter reads. Privately in London, we can normally offer a slot inside the same week, sometimes within 48 hours if there’s a cancellation. The difference isn’t clinical quality — the consultants are frequently the same faces you’d see on the NHS — it’s the calendar.
A typical private booking for functional gut assessment in London starts with a consultant conversation — sometimes in person on Harley Street or Marylebone, sometimes on video if that suits better. Any imaging or diagnostics happen at a nearby CQC-registered facility, and reports usually land within 24 to 72 hours. The whole loop, from first call to written report, is often done inside a fortnight. For functional gut assessment specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.
Fit matters more than people expect. For functional gut assessment, the right consultant depends on what you actually need — a second opinion, a definitive diagnosis, a bridge into treatment, or reassurance that nothing’s being missed. We match on that, not on who has the biggest brochure. If a test isn’t the right next step, we’ll say so before you book anything.