Author

Robynne Chutkan, MD

Browsing

Dear members of the Gutbliss community, We hope you and your loved ones are safe during these incredibly challenging times. In this special edition we’ve put together some COVID-19 gut-focused articles, resources and information to help keep you healthy. From the latest research showing that fresh air and sunlight are important factors in combating coronavirus, to the gastrointestinal signs, which may show up before any respiratory symptoms. We also highlight which medications may increase susceptibility, share our homemade soap recipe to help protect you and your family, and discuss at-risk conditions like inflammatory bowel disease. Living dirty during a pandemic may seem counter-intuitive, but exposure to the outside world may actually be just what the doctor ordered – learn how to do it safely with our live dirty dos and don’ts, and check out our dirt/sweat/veg recommendations for promoting a strong immune system. And stay tuned for our series of…

Certain medications could make you more susceptible to contracting COVID-19 and could worsen infection. NSAIDs: You may have already heard that non-steroidal anti-inflammatory drugs (such as ibuprofen and aspirin used to reduce pain, fever, and inflammation) may aggravate coronavirus infection. Because these drugs may affect the immune response, they can potentially elongate the infection time and increase the possibility of complications. While some studies support this line of thinking, the evidence is minimal and more studies are needed. Experts agree that they know very little about how NSAIDs effect coronavirus infection and are looking further into the association. In the meantime, the recommendation is that patients should use acetaminophen (such as Tylenol) to reduce pain and fever.  Corticosteroids: Because of their immunosuppressive characteristics, the routine use of corticosteroids is discouraged during the COVID-19 pandemic. These recommendations are in place because corticosteroids dampen the immune system, hypothetically increasing the risk of…

Sam: I suffer with numerous digestive issues – bloating, constipation, abdominal pain. However, I note that you recommend a plant-based diet. One of the main triggers of my pain are certain vegetable, legumes, nuts and seeds. Protein in the form of white fish and eggs is the easiest on my digestive system. I tried a vegan diet for months and didn’t see any improvement in my reaction to these foods. Do you have any suggestions? Dr. Chutkan: Sam, first, it’s important to get to the bottom of your GI distress. If you haven’t already, taking a close look at your lifestyle and medical history, and working with a healthcare practitioner that values the food as medicine approach, may be helpful. Second, while I don’t have a definitive diagnosis for your distress, I can speak to the symptoms you’re experiencing. As you’ve discovered, the foods that are most beneficial for gut…

A few years ago, a very nice woman named Lucy came to see me about some symptoms she was having. From the beginning she was convinced she had a parasite, and her story is in many ways, representative of the trials and tribulations of figuring out whether that may indeed be the case. Lucy had seen a number of gastroenterologists before me, and reading between the lines of their notes in her medical records, I could see they thought she was a little bit intense. She was a little bit intense, and rightly so. I would have been, too, if my life had been turned upside down by symptoms that no one could explain and that weren’t getting any better. In addition to bloating, she was also having fatigue, upper abdominal pain, nausea, and what she described as “weird” stools. The first gastroenterologist Lucy saw did an upper endoscopy, thinking…

Annette is a patient born in Argentina who I saw in consultation for Crohn’s disease. Like most people from that part of the world, she received the bacillus Calmette–Guérin, or BCG, vaccine against tuberculosis as a child. Since the vaccine is prepared from a strain of live tuberculosis that has lost its virulence in humans, one of the possible side effects is a false positive skin test for tuberculosis, which is exactly what happened to Annette when she was screened for tuberculosis in middle school. As a result of the positive test, she was treated for active tuberculosis infection with three antibiotics for a total of nine months, even though she never had any signs or symptoms of tuberculosis, and an X-ray of her lungs failed to show any evidence of the disease. In her senior year of high school Annette developed abdominal pain, diarrhea, and weight loss. She was…

Tabatha: I have spent years rebuilding my gut after reading your book, The Microbiome Solution. After 4 years of amazing health, I’m afraid of the damage that my next colonoscopy might do to my rebuilt gut microbiome. Should I be concerned and how can I still do my scheduled colonoscopies with the least amount of damage to my gut? Are there other options than a colonoscopy?  Dr. Chutkan: Tabatha, many of my patients, like you, have spent years working on rehabbing their gut microbiome, so your question is a really valid one. Preparing for a colonoscopy requires fasting and cleansing the colon using strong laxatives 24 hours before the procedure. This process can remove many of the microbes that live inside your gut. Let’s take a look at the science: a 2013 study assessed the effect of traditional colonoscopy prep on the gut microbiota in 10 men and 10 women,…

Hilary didn’t have a history of lots of antibiotic use in the past, but she was a picky eater in childhood who avoided fruits and vegetables like the plague. She was now in her thirties and in good health until a case of severe gastroenteritis, with nausea, vomiting, fever, and dehydration led to a five-day hospitalization. The cause of the gastroenteritis was never identified, but because she had a fever, while in the hospital she was treated with two different intravenous antibiotics and discharged on an additional ten-day course of oral antibiotics. Hilary felt better by the time she completed the antibiotics, but three months after the hospitalization she developed mushy stool that she described as having an oatmeal consistency, as well as severe bloating. Upper endoscopy and colonoscopy were unrevealing, and biopsies were negative for celiac disease, microscopic colitis, or any other abnormalities. A month later Hilary was prescribed…

Lucia came to see me mainly to confirm that she was following the right path. She had a healthy childhood, but was treated with a year of tetracycline in high school for moderately severe acne. During the year she was on antibiotics she didn’t feel quite right, with frequent nausea, an upset stomach, and cradle cap on the back of her scalp. Cradle cap, also known as seborrheic dermatitis, is a yellowish, crusty rash that’s most common on the scalp of newborn babies, primarily as a result of yeast overgrowth. No one connected the cradle cap with Lucia’s GI symptoms or suggested they might be related to the antibiotics. In her twenties Lucia decided to see a gastroenterologist for her bouts of nausea, which had worsened after she started taking birth control pills. Biopsies taken during an upper endoscopy as part of her evaluation revealed the presence of Helicobacter pylori…

Did you know there’s a right and a wrong way to sit on the toilet? Most people don’t realize that their position when having a bowel movement is key to solving lots of GI complaints like bloating, gas, and constipation. The right position can also help improve more serious GI conditions such as diverticulosis, small intestinal bacterial overgrowth (SIBO), and irritable bowel syndrome (IBS). Squatting is the most natural stance for giving birth and, it turns out, for having a bowel movement. A squatting position helps to straighten the anorectal angle and keeps the knees pressed up against the abdomen, increasing intra-abdominal pressure, which helps to push the stool out. Over a billion people throughout the world don’t have access to toilets and squat over a hole instead. Interestingly, people in countries where squatting is the norm have much less constipation and colon cancer, probably because their diets, like their…