What We Eat Affects Everything

How men and women digest differently, diet changes our skin, and gluten remains mysterious: A forward-thinking gastroenterologist on eating one's way to "gutbliss"
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(YvesHerman/Reuters; TobyMelville/Reuters; DeanFosdick/AP)

Robynne Chutkan, MD, is an integrative gastroenterologist and founder of the Digestive Center for Women, just outside of Washington, D.C. She trained at Columbia University and is on faculty at Georgetown, but her approach to practicing medicine and understanding disease is more holistic than many specialists with academic backgrounds. She has also appeared on The Dr. Oz Show (of which I’ve been openly skeptical in the past, because of Oz’s tendency to divorce his recommendations from evidence).

Chutkan’s first book comes out today. You might pick out an Oz-ian air to the title: Gutbliss: A 10-Day Plan to Ban Bloat, Flush Toxins, and Dump Your Digestive Baggage. Oz even endorses it on the back of the jacket: “Dr. Chutkan blasts away the bloat as she tastefully explains the guts of our problems.”

Dr. Chutkan helped me reconcile some of this—blast away a little bloat, if you will—on simplifying medicine, subspecialists embracing therapies aimed at overall wellness, why a gastroenterology clinic would be sex-specific, and how to think about the whole gluten-free idea; among other answers to questions I wouldn’t have thought to ask.

The title of your book is catchy and uses this evocative term "gutbliss." Id not heard it before. Did you come up with it, and what does it mean?

I did come up with it. The earlier part of my career, my first eight years after my training I was at Georgetown full-time in an academic practice seeing patients in my area of expertise, which is Crohn’s disease and Ulcerative Colitis. I was treating people who had serious medical problems, we were doing complex procedures, and prescribing complicated drugs with a lot of side effects. And then things sort of shifted for me. I began to feel like academic medicine didn’t pay enough attention to the contribution of diet and lifestyle and stress, to digestive health, which felt, to me, like an obvious connection.

So I decided to open an integrative practice where we focus on additional things besides the illness, like the things that created the illness. I switched from being at the top of the pyramid treating people at the end-stage of the disease, to the base of the pyramid counseling more people  who were starting to have symptoms, but didn’t necessarily have bad diseases yet. So "gutbliss" for me evokes this idea of how you can create wellness in your digestive tract. And this blissful gastrointestinal tract has a lot to do with how you eat and how you live, since most diseases don't just fall out of the sky into your lap.

I had started a nonprofit in ’09 called Gutrunners, which was sponsored by one of the large GI societies, and we put on races at our national GI meetings, and the idea was to focus on the contribution of nutrition and exercise in preventing digestive disorders. So, this whole “gut” thing for me was very natural.

People advised against calling the book Gutbliss and said, “Oh, it’s sort of in your face; it makes me think of stool and intestines.” But I think the intestines are beautiful and marvelous, so I wanted to include that. And I wanted to show how something that is, in many ways, closeted, mainly bowel movements and intestinal function, could actually be this wonderful, blissful thing. In fact, there’s a little bit of focus on this in the book. There’s a chapter on “Beauty and the Bloat,” on how what you put into your body, mainly your GI tract, profoundly affects how you look. So that was how I came up with the term “gut bliss.” Sort of combining the intestines, which people think of as not so lovely, with a blissful state of health.

You mentioned some things we could eat that might influence appearance. 

Skin disorders like rosacea, which a lot of people confuse with acne is a good example. A lot of people are using harsh things on their skin for this sort of redness on the cheeks and nose. Rosacea’s actually an autoimmune disease and, like most autoimmune diseases, we don’t actually know what causes it, but there’s a very strong association with something called dysbiosis, a bacterial imbalance and overgrowth of the wrong kinds of bacteria in the gut.

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When I work with people on their diet, whether it’s cutting back on dairy, or switching them from a starchier, sugary processed diet, to a more plant-based way of eating, their skin often clears up. And I sort of joke with my friends because they’re like, “Aren’t you a butt doctor? Why are you so obsessed with the skin?” And I’m like, “Well, I’m more than a butt doctor.”

But, I find there’s such a fascinating skin-gut connection. One of the things I talk about in the book is the idea that the skin actually represents the outside of our GI tract, and the GI tract represents the inside of our skin.

You probably don’t know this because you probably don’t wear makeup, but when you put makeup on, like foundation and eye makeup and so on in the morning, by the end of the day it’s gone. Literally gone—it looks like you don’t have anything on. Where does it go? It gets absorbed into our body. And the opposite thing can happen when you eat certain foods; you can see the effect coming out on your skin. There’s this incredible connection between the two. And the same way we overuse antibiotics and expose our digestive tract to chemicals that alters this delicate balance between good bacteria and bad bacteria, we do the same thing to our skin. We use harsh soaps that contain chemicals that kill off a lot of the skin bacteria that are really important for healthy skin, and then our skin is dry and unhealthy and peeling. So there are a lot of parallels there. I think most of us have had that experience of seeing a person who has a real inner glow. Maybe if you’re 20 you just have good genes and you can have pizza and beer every day and still glow. But if you’re over 40, often there is a fair amount of kale involved. There could be some cookies and ice cream too, but usually the people who have that glow are doing something right, and it often involves getting sweaty on a regular basis and eating the right food.

The tagline of the book is A ten-day plan to ban bloat, flush toxins, and dump your digestive baggage. Can you give us a preview of what that is working towards, or some of the steps?

Presented by

James Hamblin, MD, is a senior editor at The Atlantic. He writes the health column for the monthly magazine and hosts the video series If Our Bodies Could Talk.

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