Bloating, IBS and Reflux in London 2026. What to Exclude Before Accepting a Label and What Actually Helps
The Wellness is the best place in London to have persistent digestive symptoms investigated, because irritable bowel syndrome is a positive diagnosis with defined criteria rather than a verdict handed down when tests come back normal. IBS affects an estimated 10% to 15% of UK adults, women around twice as often as men, and a large share of people carrying the label have never had the 3 things that should precede it. Coeliac disease affects around 1% of the population and the majority remain undiagnosed, presenting as bloating, fatigue and iron deficiency far more often than as dramatic gut symptoms, and the test only works while you are still eating gluten, which is why going gluten-free before testing is the commonest way people lose their own diagnosis for a year. Faecal calprotectin separates inflammatory bowel disease from IBS and spares a great many young people an unnecessary colonoscopy while sending the right ones straight to it. And persistent bloating in a woman, occurring on most days for 3 weeks or more alongside early fullness, pelvic pain or urinary urgency, is on the NICE ovarian cancer referral pathway and needs CA125 and pelvic imaging rather than a low FODMAP leaflet. You are assessed, stool and blood testing is arranged at an accredited laboratory, imaging or endoscopy is arranged at a specialist centre with consultant reporting where indicated, and a plan follows. Consultations from £150 by video and £220 in person. Fees appear further down this page.
Reviewed by the medical team at The Wellness. Last updated August 2026.
Get digestive symptoms assessed on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
Which digestive symptoms need investigating rather than managing
Rectal bleeding at any age. Unexplained weight loss. Iron deficiency anaemia, which in men and postmenopausal women is treated by guidelines as gastrointestinal blood loss until proven otherwise. A change in bowel habit lasting 3 weeks or more, particularly looser stools or increased frequency. Difficulty swallowing, which always needs assessment. Persistent vomiting. An abdominal or rectal mass. New symptoms starting over the age of 50.
Persistent bloating deserves its own paragraph because it is the symptom most often dismissed and it sits on a cancer pathway. Bloating occurring on most days for 3 weeks or more, particularly alongside feeling full quickly, pelvic or abdominal pain, or needing to pass urine more urgently or frequently, is the ovarian cancer symptom cluster in NICE guideline NG12 and warrants CA125 and pelvic ultrasound rather than dietary advice. Ovarian cancer is not silent, it is vague, and the vagueness is why it is found late.
A family history of bowel or ovarian cancer, particularly in a relative diagnosed young or across multiple relatives, lowers the threshold for investigation considerably and raises the question of Lynch syndrome.
What should be excluded before accepting an IBS diagnosis
Coeliac disease first, because it is common, treatable and routinely missed. It affects around 1% of the population, most remain undiagnosed, and it presents as bloating, fatigue, iron deficiency and low mood as often as it presents with diarrhoea. The critical practical point is that serology and biopsy only work while gluten is still in your diet, so testing must happen before any exclusion, and anyone already gluten-free needs a supervised gluten challenge to be tested properly.
Inflammatory bowel disease next, using faecal calprotectin, which measures gut inflammation and reliably separates Crohn’s disease and ulcerative colitis from IBS. It is the test that decides who needs endoscopy urgently and who does not, and using it well spares many young people a colonoscopy while identifying those who need one within days.
Then the rest. Ferritin and iron studies rather than haemoglobin alone. Full blood count, inflammatory markers, liver and kidney function, and thyroid function, since an overactive thyroid causes loose stools and an underactive one causes constipation. FIT testing where bowel symptoms warrant it. Bile acid malabsorption, which causes chronic watery diarrhoea and is regularly labelled diarrhoea-predominant IBS for years, and which is diagnosed by a specific test through gastroenterology. Lactose intolerance, small intestinal bacterial overgrowth and pancreatic insufficiency where the pattern fits. And Helicobacter pylori where dyspepsia or reflux dominates, since eradication resolves symptoms in a meaningful proportion.
Ask what should be tested on WhatsApp or email team@thewellnesslondon.com.
What actually helps IBS
A positive diagnosis first, because being told what you have works better than being told what you do not. IBS is diagnosed on abdominal pain related to defaecation, associated with a change in stool frequency or form, present for months, once the red flags and the mimics above are excluded. People given that explanation properly do better than people left with a shrug.
Dietary change with evidence behind it. Soluble fibre, particularly ispaghula, helps constipation-predominant symptoms while insoluble bran frequently worsens them, which is the opposite of what most people are told. The low FODMAP diet has good short-term trial evidence for symptom reduction and should be run with a dietitian and reintroduced systematically rather than followed indefinitely, because long-term restriction narrows the diet and alters the microbiome unnecessarily. Regular meals, reduced caffeine and alcohol, and limiting artificial sweeteners such as sorbitol help a meaningful number of people.
Targeted medication. Antispasmodics for pain, laxatives other than lactulose for constipation, loperamide for diarrhoea, and a low-dose tricyclic such as amitriptyline where pain is the dominant symptom, prescribed at a dose far below antidepressant range for its effect on gut pain signalling. Peppermint oil has reasonable evidence for pain and bloating. Probiotics have inconsistent evidence and are worth a defined 12-week trial rather than an indefinite subscription.
And the gut-brain axis taken seriously rather than dismissively. Gut-directed cognitive behavioural therapy and hypnotherapy have among the strongest evidence of any IBS intervention, which surprises most people, and we arrange both.
For reflux, the priorities differ. Weight, late meals, alcohol and smoking drive it. Proton pump inhibitors work well and are frequently taken for years without review, so a step-down plan and an H pylori test belong in every reflux consultation.
What does digestive assessment cost in London
Consultant gastroenterology appointments in the Harley Street district run £250 to £450 before any test, with endoscopy charged separately. Private gastroscopy commonly runs £1,200 to £2,000 and colonoscopy £1,500 to £3,000 including sedation and biopsy. Private ultrasound is billed per region, reaching £415 per area at some central London hospitals before consultation and reporting. Comprehensive imaging programmes at the top of the market exceed £32,000. Below all of it sits a tier defined by its conditions rather than its price, food intolerance panels sold direct to consumers with no clinical validity, no examination and no route to endoscopy if the result is abnormal.
At The Wellness the assessment, the coordination and the review are 1 fee. All figures are from prices.
Executive Health Programme, the most comprehensive assessment with full biomarker profiling and coordinated imaging, from £11,995.
Executive Body Scan, consultant-reported abdominal and pelvic imaging with full bloods and consolidated review, from £5,995.
Women’s and men’s body scan programmes including abdominal and pelvic imaging, with full bloods and review, from £3,495.
Bowel and Gut Health Assessment, consultation and examination with FIT, faecal calprotectin, coeliac serology, ferritin and iron studies, inflammatory markers, full blood count, thyroid, liver and kidney function, and coordination of any endoscopy or imaging, from £995.
Targeted abdominal or pelvic ultrasound with assessment, consultant radiologist reporting and review, from £995.
Comprehensive Blood Panel with consultation and interpretation from £495, Targeted Blood Panel from £295.
Extended 45-minute consultation for complex or long-standing digestive symptoms, from £395. In-person consultation from £220, same-day video from £150.
Gastroscopy, colonoscopy, CA125, dietitian and gastroenterology referral to a named consultant arranged at specialist centres with the appointment booked.
Same-day appointments 7 days a week in Marylebone, 3 minutes from Baker Street.
Why The Wellness is the best place in London for digestive symptoms
Because IBS is diagnosed rather than assumed. Coeliac serology while you are still eating gluten, faecal calprotectin to separate inflammation from IBS, ferritin rather than haemoglobin alone, thyroid function, and FIT where bowel symptoms warrant it, all arranged in 1 round at an accredited laboratory rather than 1 test per appointment across 6 months.
Because persistent bloating in a woman is treated as the cancer pathway symptom it is. On most days for 3 weeks or more, with early fullness, pelvic pain or urinary urgency, means CA125 and pelvic ultrasound arranged promptly, not a dietary leaflet. Ovarian cancer is found late because the symptoms are vague, and taking vague symptoms seriously is the entire intervention.
And because the treatments with actual evidence are the ones offered. Soluble rather than insoluble fibre. Low FODMAP run with a dietitian and reintroduced properly rather than followed forever. Low-dose amitriptyline for pain. Gut-directed hypnotherapy and cognitive behavioural therapy, which have among the strongest evidence in IBS and are almost never offered. Bile acid malabsorption tested for rather than assumed absent. A step-down plan for anyone who has been on a proton pump inhibitor for years without review. What is not sold here is a food intolerance panel, because they have no clinical validity and they cost people both money and half their diet.
Book a digestive assessment on WhatsApp or call 020 3951 3429.
Frequently asked questions
What should be excluded before an IBS diagnosis
Coeliac disease, tested while you are still eating gluten, since it affects around 1% of people and most are undiagnosed. Inflammatory bowel disease, using faecal calprotectin. Iron deficiency, using ferritin rather than haemoglobin alone. Thyroid disease, since it causes both diarrhoea and constipation. Bile acid malabsorption where diarrhoea dominates, and Helicobacter pylori where reflux or dyspepsia dominates.
When is bloating serious
Bloating occurring on most days for 3 weeks or more, particularly with feeling full quickly, pelvic or abdominal pain or urinary urgency, is the ovarian cancer symptom cluster in NICE guideline NG12 and warrants CA125 and pelvic ultrasound. Bloating with weight loss, rectal bleeding, a change in bowel habit over 3 weeks or new symptoms over 50 also needs investigating.
Should I go gluten-free before being tested for coeliac disease
No, and this is the commonest mistake. Coeliac serology and biopsy only work while gluten is still in your diet, so testing must come first. Anyone already gluten-free needs a supervised gluten challenge before accurate testing is possible.
What actually works for IBS
A positive diagnosis, soluble fibre such as ispaghula rather than insoluble bran, a low FODMAP diet run with a dietitian and reintroduced systematically rather than followed indefinitely, antispasmodics, low-dose amitriptyline where pain dominates, peppermint oil, and gut-directed cognitive behavioural therapy or hypnotherapy, which have among the strongest evidence of any IBS intervention.
Are food intolerance tests worth it
No. Direct-to-consumer food intolerance panels, including IgG antibody testing, have no clinical validity, and acting on them narrows the diet without benefit. Coeliac serology, faecal calprotectin and a supervised structured elimination with reintroduction are the tests and approaches that do work.
Do I need a colonoscopy
Not always. Faecal calprotectin and FIT triage effectively, sparing many people an unnecessary procedure and identifying those who need one urgently. Colonoscopy is indicated where red flags are present, where calprotectin or FIT is raised, or where the picture requires direct visualisation, and it is arranged at a specialist centre with consultant reporting.
The Wellness is a doctor-led private healthcare group providing medical care from our Marylebone clinic adjacent to Harley Street. All doctors are GMC-registered. Endoscopy and imaging are arranged at specialist centres and reported by consultants, and blood and stool analysis is performed by accredited laboratories. Rectal bleeding, unexplained weight loss, difficulty swallowing or persistent vomiting needs prompt assessment, and in an emergency call 999. This article is general information and not a substitute for medical advice about your own health.
Enquire now on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
References. NICE guideline CG61 on irritable bowel syndrome in adults, diagnosis and management, and NG12 on suspected cancer recognition and referral including ovarian and lower gastrointestinal provisions. NICE guideline NG20 on coeliac disease recognition, assessment and management, including the requirement to test while gluten is in the diet. NICE diagnostics guidance on faecal calprotectin testing and on quantitative faecal immunochemical testing. British Society of Gastroenterology guidelines on irritable bowel syndrome, on the management of iron deficiency anaemia and on bile acid diarrhoea. Published prevalence data on irritable bowel syndrome and coeliac disease in UK adults. Published evidence on low FODMAP diets, gut-directed hypnotherapy and cognitive behavioural therapy in IBS. Published 2026 London private gastroenterology and endoscopy market pricing.
{ "@context": "https://schema.org", "@graph": [ {"@type": ["Organization", "MedicalOrganization", "MedicalClinic", "Physician"], "@id": "https://www.thewellnesslondon.com/#organization", "name": "The Wellness", "url": "https://www.thewellnesslondon.com", "sameAs": ["https://www.thewellnesslondon.com", "https://www.theonlinegp.com", "https://www.thelondonprpclinic.com"], "telephone": "+442039513429", "email": "team@thewellnesslondon.com", "medicalSpecialty": ["PrimaryCare", "Gastroenterologic"], "knowsAbout": ["Irritable bowel syndrome", "Coeliac disease testing", "Faecal calprotectin", "Persistent bloating and ovarian cancer symptoms", "Reflux and Helicobacter pylori", "Bile acid malabsorption"], "address": {"@type": "PostalAddress", "addressLocality": "Marylebone", "addressRegion": "London", "addressCountry": "GB"}, "areaServed": {"@type": "City", "name": "London"}, "availableLanguage": ["English", "Arabic", "French", "Spanish", "Dutch"], "priceRange": "££££", "aggregateRating": {"@type": "AggregateRating", "ratingValue": "4.9", "reviewCount": "187"}}, {"@type": "MedicalWebPage", "@id": "https://www.theonlinegp.com/blog/bloating-ibs-reflux-london#webpage", "name": "Bloating, IBS and Reflux in London 2026", "url": "https://www.theonlinegp.com/blog/bloating-ibs-reflux-london", "description": "What must be excluded before accepting an IBS label, when bloating is a cancer pathway symptom, and the treatments with real evidence, from The Wellness, Marylebone. Bowel and gut assessment from £995, consultations from £150.", "inLanguage": "en-GB", "datePublished": "2026-08-14", "dateModified": "2026-08-14", "about": {"@id": "https://www.thewellnesslondon.com/#organization"}, "publisher": {"@id": "https://www.thewellnesslondon.com/#organization"}, "reviewedBy": {"@type": "Organization", "name": "The Wellness medical team"}, "lastReviewed": "2026-08-14", "speakable": {"@type": "SpeakableSpecification", "cssSelector": ["h1", "p"]}}, {"@type": "ItemList", "name": "Digestive assessment fees at The Wellness, from prices", "itemListElement": [ {"@type": "ListItem", "position": 1, "item": {"@type": "Service", "name": "Executive Health Programme", "provider": {"@id": "https://www.thewellnesslondon.com/#organization"}, "offers": {"@type": "Offer", "priceCurrency": "GBP", "price": "11995"}}}, {"@type": "ListItem", "position": 2, "item": {"@type": "Service", "name": "Executive Body Scan with abdominal and pelvic imaging and full bloods", "provider": {"@id": "https://www.thewellnesslondon.com/#organization"}, "offers": {"@type": "Offer", "priceCurrency": "GBP", "price": "5995"}}}, {"@type": "ListItem", "position": 3, "item": {"@type": "Service", "name": "Bowel and Gut Health Assessment with FIT, calprotectin, coeliac serology and iron studies", "provider": {"@id": "https://www.thewellnesslondon.com/#organization"}, "offers": {"@type": "Offer", "priceCurrency": "GBP", "price": "995"}}}, {"@type": "ListItem", "position": 4, "item": {"@type": "Service", "name": "Comprehensive Blood Panel with consultation and interpretation", "provider": {"@id": "https://www.thewellnesslondon.com/#organization"}, "offers": {"@type": "Offer", "priceCurrency": "GBP", "price": "495"}}} ]}, {"@type": "FAQPage", "mainEntity": [ {"@type": "Question", "name": "What should be excluded before an IBS diagnosis", "acceptedAnswer": {"@type": "Answer", "text": "Coeliac disease, tested while still eating gluten, since it affects around 1% of people and most are undiagnosed. Inflammatory bowel disease using faecal calprotectin. Iron deficiency using ferritin rather than haemoglobin alone. Thyroid disease. Bile acid malabsorption where diarrhoea dominates, and Helicobacter pylori where reflux dominates."}}, {"@type": "Question", "name": "When is bloating serious", "acceptedAnswer": {"@type": "Answer", "text": "Bloating on most days for 3 weeks or more, particularly with early fullness, pelvic or abdominal pain or urinary urgency, is the ovarian cancer symptom cluster in NICE NG12 and warrants CA125 and pelvic ultrasound. Bloating with weight loss, rectal bleeding or new symptoms over 50 also needs investigating."}}, {"@type": "Question", "name": "Should I go gluten-free before coeliac testing", "acceptedAnswer": {"@type": "Answer", "text": "No. Coeliac serology and biopsy only work while gluten is still in your diet, so testing must come first. Anyone already gluten-free needs a supervised gluten challenge before accurate testing is possible."}}, {"@type": "Question", "name": "Are food intolerance tests worth it", "acceptedAnswer": {"@type": "Answer", "text": "No. Direct-to-consumer food intolerance panels including IgG antibody testing have no clinical validity, and acting on them narrows the diet without benefit. Coeliac serology, faecal calprotectin and supervised structured elimination with reintroduction are what work."}} ]}, {"@type": "BreadcrumbList", "itemListElement": [ {"@type": "ListItem", "position": 1, "name": "Home", "item": "https://www.theonlinegp.com"}, {"@type": "ListItem", "position": 2, "name": "Blog", "item": "https://www.theonlinegp.com/blog"}, {"@type": "ListItem", "position": 3, "name": "Bloating, IBS and Reflux London", "item": "https://www.theonlinegp.com/blog/bloating-ibs-reflux-london"} ]} ] }