A renowned physician shares her complete 10-day digestive tune-up for women, with important revelations about good gastrointestinal health.
Many so-called cures for women’s bloating and indigestion, from juice cleanses to specialty diets, are based on junk science. For women seeking true relief from that overall feeling of discomfort in any size jeans, Dr. Robynne Chutkan has the perfect plan for feeling light, tight, and bright in ten days. Gutbliss offers:
Just a few small changes in diet, lifestyle, and exercise can make a huge difference in a woman’s digestive health, but the changes have to be the right ones. Going beyond the basics of top sellers such as Wheat Belly, Dr. Chutkan’s Gutbliss empowers women to take control of their gastrointestinal wellness.
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Robynne Chutkan, M.D., FASGE, is one of the world’s leading gastroenterologists and has been widely featured in the media, including frequent appearances on The Dr. Oz Show. She is the founder of the Digestive Center for Women and a faculty member at Georgetown University Hospital in Washington, D.C.Excerpt. © Reprinted by permission. All rights reserved.:
Gutbliss started out as a book about food. I was alarmed by what I was seeing in people’s digestive tracts and the growing prevalence of bloating and other gastrointestinal complaints. To me, food was the obvious but frequently overlooked connection. So I set out to write a book about how our food was making us sick. Along the way, I had the incredible good fortune to meet Howard Yoon, my literary agent, who helped me mold my passion about food and the gut into a broader conversation that included the obstacles to digestive wellness and how to go about removing them. Whether you like this book or not (and I hope you do!), it is undoubtedly a much better one because of Howard’s wisdom, patience, and belief that I had something important to say. And for the opportunity to say it, I am eternally grateful to Lucia Watson and Bill Shinker at Gotham/Avery, to Gabrielle Campo, who guided me through the entire process, and to Toni Sciarra Poynter, who provided invaluable editorial assistance.
To my husband, Eric, who at this point knows far more than he ever imagined he would about bowel movements and gut bacteria, and whose support never wavered as I abandoned my post for several months at a time to focus on completing this book. Without his encouragement and overall picking up of the slack at home this book would never have been possible. And to my amazing daughter, Sydney, who loves to talk about bowel movements and gut bacteria, and who spent so many hours keeping me company in my study while this manuscript was being written. You are a constant source of inspiration.
Bette Greenhause and I have been keeping company since my first day on the job at Georgetown in 1997. Without her, the Digestive Center for Women would never have come to fruition. I do not think I could practice medicine without her. To the late Dr. Henry Janowitz and Dr. Jerry Waye, who taught me much about both the art and the science of gastroenterology. To Gena Hamshaw, whose journey from editor to doctor I am honored to be a part of. To all my friends who put up with canceled dinners and no-shows while I wrote this book and cheered me on toward the finish line. A special thank-you to Dr. Ida Bergstrom, Alicia Sokol, Jill Hudson, and Elise Museles. Vernon Jordan, Doug Heater, and Robert Raben are my three wise men. I am grateful to them for always pointing me in the right direction. To my parents, for teaching me the invaluable lesson that with good living comes mostly good health.
A huge thank-you to Dr. Mehmet Oz, for giving me the opportunity to share my passion for digestive wellness with America. And most of all, to the many patients along the way, who have taught me so much. It has been an honor and a privilege.
“Why am I so bloated?” That’s a question I hear nearly every day in my gastroenterology practice. Over the course of my medical career, I’ve gone from helping a handful of women a week with bloating, sluggish fullness, and constipation to feeling like I’m dealing with a full-on epidemic. For many, the symptoms are daily, relentless, and life altering, but even when they’re not that severe, they’re always annoying.
The causes of bloating vary tremendously, from common benign conditions to rare, life-threatening illnesses. Some may be connected to behaviors you don’t even think about. (Do you talk with your mouth full? You could be swallowing enough air to go up a dress size!) Some you may have heard of but need more information and aren’t quite sure whether you should be worried. (Is celiac disease the same as gluten intolerance?) Some may surprise you. (Taking antacids to settle your stomach can make your jeans un-zippable!) In this book you’ll learn about these issues and many more, including how to tell if your bloating is serious . . . or if you’re just seriously bloated.
Your Inner Doctor
The information in this book incorporates aspects of both conventional and alternative medicine to create an intuitive, commonsense approach to digestive wellness. The goal is not to scare you into having an unnecessary procedure or taking a pill you don’t need, but to encourage you to explore the cause of your symptoms and to implement some useful basic strategies, many of which are already in your toolbox.
I believe that buried deep beneath the information overload we all receive from consumer marketing is our own innate sense of what we need to make ourselves well. I like to call it our “inner doctor.” This book will help you access that deep inner sense, building your understanding by providing reliable information on what helps and what hinders when it comes to your digestive health.
Many digestive problems that a decade ago we thought were “all in people’s heads” we now know are caused by very real gastrointestinal disturbances—conditions like bacterial overgrowth and gluten intolerance. I refuse to believe that millions of women who suffer from bloating but don’t have a diagnosis are “crazy” or “just stressed out.” I’ve seen how often, by thinking outside the box, we’re able to find both the problem and the remedy.
I want to help you trust your inner doctor. If you think there’s something going on, there probably is, and you need to keep searching till you find the right person who can help you figure it out. They may not always have a white coat on and an MD behind their name. Much of what I know I’ve learned from patients, nutritionists, biofeedback practitioners, holistic health coaches, naturopathic doctors, acupuncturists, farmers, and even my yoga instructor. I hope the information in this book will serve as a guide to help you understand what’s going on in your body and offer you some real solutions.
My Promise to You
I’ve spent a lot of time inside the digestive tract, observing what’s gone wrong and why. This book contains the information I think is most important to share, in short, digestible (pardon the pun) chapters. When I don’t know something, I’ll tell you I don’t know. When I think a particular practice is shady or suspect, I’ll tell you that, too. I’ll give you the information that has been helping my patients make real improvements in their digestive health—including a comprehensive 10-Day Gutbliss Plan to heal yourself from the inside out, based on twenty years of experience. It’s helped thousands of women tighten their tummies and end their discomfort. Many have reported a surge in energy and mood, too! This easy-to-follow integrative approach to digestive wellness will help you banish bloat, flush toxins, and dump your digestive baggage—the healthy way.
The world these days can be an intimidating place. We worry about environmental toxins, drugs can be dangerous, and Mother Nature would hardly recognize much of what’s available at the grocery store. But left to its own devices, the human body is still a marvel, with an amazing capacity to recover and heal itself, particularly when injurious practices are identified and stopped. My sincere hope is that you’re able to use the information in this book to find your own gutbliss and that when you and I meet, it’ll be at the farmer’s market or on the yoga mat, and not in my office.
Finding My Gutbliss
In 2004 I decided to leave the hallowed halls of academia and set up my own practice. Georgetown Hospital had been my first job when I finished my training in New York in 1997, but after almost eight years, hospital-based medicine no longer seemed to have the answers my patients and I were looking for. I owed a lot to the institution—my career had flourished there: I had a sixteen-page résumé of published articles, book chapters, and speaking engagements throughout the United States and Europe; I had helped to train over thirty gastroenterologists; I had colleagues I respected and admired; and I enjoyed the teaching opportunities. My salary was more than generous. My professional life was bountiful and I should have been happy, but I wasn’t. I had lost my faith.
Over the years my priorities had gradually shifted from high-tech procedures that diagnose and treat disease to no-tech lifestyle modifications that prevent them. It was becoming difficult for me to emphasize the industry message in my speaking and teaching that colonoscopy saves lives (which it does) without giving equal billing to what I had come to believe: that diet and lifestyle were more important in achieving and maintaining digestive health than any procedure I could recommend. Philosophically, I felt a lack of alignment. I was interested in an integrative and more holistic approach to digestive diseases and I wanted that to be part of my message. My colleagues seemed more interested in technical innovation. Their mission and approach hadn’t changed, but mine had.
The practice of gastroenterology had also changed and was feeling more and more like a business venture, with the patients as the consumers and endoscopy as the product. Many gastroenterologists now owned their own endoscopy units, as well as the pathology services used to process their biopsy specimens. While this allowed for better quality control and closer collaboration, it also greatly incentivized doctors to do more procedures and biopsies.
The gastroenterologists I knew were people who cared deeply about their patients, but many of them struck me as overly committed to doing procedures. I wanted to provide patients with equally relevant lifesaving information—like the fact that switching to a plant-based diet can cut your risk for colon cancer in half; or that exercise and a low-fat diet can prevent gallstones—not just perform procedures.
A screening colonoscopy takes from fifteen to thirty minutes to perform. The reimbursement to the physician when done in an outpatient facility that they own can be several times what they make for an office visit of the same length. It’s not hard to do the math and see why the nature of my specialty was changing. The economics simply don’t encourage problem solving and exploration beyond the endoscope.
At the same time that gastroenterologists are being incentivized to do more procedures and spend less time talking to patients, the nature of digestive illnesses is changing, too. We’re seeing more conditions related to diet, lifestyle, and environmental factors, and diagnosing and treating those conditions requires more than just a quick endoscopy.
Not all gastroenterologists are singularly focused on the revenue stream that endoscopic procedures like colonoscopies provide. Many have the kind of medical practices that embrace more integrative solutions, educating their patients about the importance of dietary intervention and other preventive measures, and exploring alternative diagnoses, while performing endoscopy in a responsible manner.
But providing comprehensive digestive care is not always easy or straightforward. It requires extra time for us to sit down and talk with patients about what they’re eating and how they’re living. It requires research into things we’re unfamiliar with, and consideration of the possibility that maybe our colleagues in the alternative medicine world know a thing or two. That kind of care means a lot of additional education in things we learned nothing about in medical school and that we can’t touch and see with our endoscopes.
Thanks to the Internet, some patients know more about their digestive disorder than their gastroenterologist, although they may not have the tools and context that allow them to manage it. So they’re turning to their yoga instructors, massage therapists, life coaches, and social network for medical advice. Visits to alternative practitioners outnumber visits to conventional doctors four to one, even though they usually aren’t covered by insurance. Conventional gastroenterology, while flourishing in the realm of advanced procedures and screening of healthy populations, is falling short in providing people with what they really need: reliable information on how to achieve and maintain digestive wellness.
I knew these were vitally important issues that needed to be addressed with patients. But I was still spending most of my time doing procedures and prescribing complicated drugs with lots of side effects. My philosophy had changed; now my practice needed to change, too.
An Integrative Solution
In 2004, while pregnant with my first child and renovating a house down to the studs, I decided to open a practice that was more in line with my philosophy of an integrative approach to digestive disease. In addition to providing patients with resources in nutrition, stress reduction, and exercise, there were three basic principles I wanted to adhere to:
I gave notice at Georgetown, found an ideal location, applied for a tax ID number, and opened my doors. I called the practice the Digestive Center for Women, although it turns out women aren’t the only ones interested in more integrative solutions to their digestive troubles, and men constitute about 20 percent of our patients. I remained a voluntary faculty member at Georgetown and continued to perform procedures at the hospital, although the number of procedures was much lower than what I had previously been doing.
Slowly but surely, patients came.
Many of them had already been evaluated and diagnosed by very competent gastroenterologists. They didn’t come because I was smarter than their last doctor; they came to have a dialogue and to get ideas and feedback on what they could do to improve their digestive health. We talked in detail about symptoms, test results, nutrition, and stress and the possible relationship among them. I didn’t always have the answers, but I usually knew where to look.
I built an integrative practice that relied a great deal on the excellent skills of my collaborators: a biofeedback practitioner, integrative nutritionists, exercise physiologists, and referrals to practitioners in counseling, acupuncture, and massage.
I continued to see patients with complex problems related to Crohn’s disease and ulcerative colitis, which had been my area of expertise at Georgetown. I found that these patients, too, benefited greatly from an integrative approach that included nutritional intervention and stress reduction.
My focus shifted from scientific papers in medical journals on the role of endoscopy to articles in yoga, health, and women’s magazines on the role of diet and lifestyle in preventing and treating digestive diseases. My talks at national gastroenterology meetings were now about obesity and the gastroenterology practice of the future, which would incorporate cooking classes, biofeedback, meditation workshops, and exercise sessions, not just endoscopy facilities.
I was grateful for the opportunity to merge my personal beliefs with my professional practice and engage a larger audience with what I believed to be the truth about digestive health. I decided to write a book to share what I had learned over ...
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