Chances are, especially if you're female, you or your girlfriend has experienced digestive distress that goes beyond garden-variety premenstrual bloat: We're talking about abdominal pain and nausea, bouts of diarrhea or constipation – and perhaps both – a seriously swollen belly that seems to defy clear linkage to any specific food source and, let's not forget (how could we?), smelly gas.
Pleasant, right? So, if you air the topic at all, you do so with a friend and, when things get really bad, see a doctor, who performs a battery of tests to check your thyroid for proper functioning or your stool for parasites, perhaps scoping your upper and lower intestines for any abnormalities. What often happens next is relatively good news – test results that come back normal. But then you're likely to be left with a catch-all diagnosis of irritable bowel syndrome, which affects as much as 20 percent of Americans. While you're not alone, you may feel left with little hope for help, other than scouring the Web for information.
But the truth is, the gut is way more complicated than doctors ever realized. Current research into the microbiome – the colossal amount of bacteria that inhabit the human body, much of it in the intestinal tract – has turned up links between a person's bacteria and his or her mental health or risk of obesity.
Meanwhile, doctors are only recently making the connection between diet and intestinal health.
Robynne Chutkan, however, has long propounded the relationship between what we eat and how we feel, with the guts serving as central command for overall health. The Washington, D.C.-based gastroenterologist started her practice nearly a decade ago rooted in the healing power of diet and lifestyle for digestive health. In light of her personal battles with digestive health and what she calls an "epidemic" of bloating among her patients, Chutkan has compiled what she's learned in a book, "Gutbliss: A 10-Day Plan to Ban Bloat, Flush Toxins and Dump Your Digestive Baggage."
"The book is a little bit of a road map," she says. And it's one that admittedly comes with some "girl power." Chutkan's practice caters to women (it's called the Digestive Center for Women), for whom bloating is simply more problematic. As she explains it, the female colon is different from a male's; it's longer, more circuitous and more compressed as a result of sharing space in the pelvis with the bladder and reproductive organs.
Compound female anatomy with such lifestyle hazards as consuming processed foods, an overreliance on antibiotics and the use of hormone therapy, and it's no wonder women feel so out of whack, she explains. Taking antibiotics to treat an infection, for example, not only wipes out the bad bacteria but also the good kind, which can further derail patients from reaching bacterial balance and injure the immune system. But teasing out the culprit in a woman's gastrointestinal upset takes time and consideration of myriad factors. "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," she writes in her book.
Chutkan took a pay cut to start a practice that relies on what she calls "integrative" solutions that include guidance on nutrition, stress relief and exercise. She doesn't shy away from X-rays or recommending colonoscopies, but she also routinely prescribes a course of probiotics, supplements of ground psyllium husk powder to bulk up stool and instructions in calm breathing. Although her cases can take tremendous trial and error, she has found that a patient's instinct that something is not quite right ultimately bears out.
To the many women who have suffered digestive troubles that doctors have chalked up as stress, Chutkan has a few feisty words: "You're not crazy, and maybe the obese bald male doctor you saw should take some tips from you on how to get healthy."