Jacqueline Wolf - A Womans Guide to a Healthy Stomach: Taking Control of Your Digestive Health

T his is a different kind of bathroom book. Its a book about bowel functionblowing the lid (so to speak) off the secrecy and shame surrounding female digestive ailments once and for all. This is a reassuring guide for women by a woman. It explains the causes and cures for our most embarrassing, urgent and common stomach problems. Wondering what those PMS cramps might mean? Always guzzling Pepto-Bismol before a big meeting? Read on.

Stomach ailments might just be the last great taboo in American culture. Women are the ones who suffer (Im not just saying thisstatistics back me up), and yet were not whining about it! Seems silly, doesnt it? Bowel function is a necessary fact of life. We all go. But how many times have you hunched in the office bathroom stall, waiting for the boss to comb her hair and wash her hands, before letting loose with a massive explosion? Or wondered if your bad breath was caused by the onions you had for lunchor something more sinister, like acid reflux? Youre not going to cry about this over cocktails with your friends or coffee with your mother. No, its easy to think everyone else is clean and pure, while youre the only woman alive with gas, acid, pain and cramping. But Im here to tell you that your glamorous coworker with the designer clothes and perfect hair has stomach problems just like you, and it isnt always pretty.

Its during times like these, when things arent pretty, that our stomachs become the center of our universe. The stomach is where we feel stress, nervousness, anxiety, pain. Just ask Freud. Yet, strangely, there arent any books or websites that deal with stomach problems in a way that isnt completely satirical (ratemypoo.com) or incredibly technical (I wont bore you).

As a physician, I see this as a huge problem. Because when legitimate illnesses become shrouded in shame, they pose life-altering consequences for those who suffer from them. The repercussions range from the severe (undiagnosed ovarian cancer) to the annoying (planning out your driving route based on the nearest rest stop). By the time many patients reach my office, theyve suffered alone for years, or theyve been brushed off by doctors or told to take an over-the-counter medication.

Why? Bowel issues are hard to diagnose, thanks to symptoms that could really mean anything, and theyre tough to talk about. They involve bad smells and strange noises. You might have constant gas, but who wants to go to a doctor complaining of humiliating farting? You might get constipated during your period, but would this move you to get a GI referral? No, probably not. Thats where I come in. Consider this book your cheat sheet to bowel problems. This isnt a substitute for a doctors visitand please, if you have unusual symptoms, dont hesitate to get checked outbut this is a jumping-off point for women who need answers.

Just as important, I think its helpful to recognize that men have it easier in this arena. (Sorry, guys.) As Ive seen in my practice, stomach complaints are largely a woman thing. Like it or not, men are more apt to boast about farting or joke about bathroom escapades. Prostate exams are a rite of passage that men fret aboutand joke about, too. You cant turn on the TV without seeing a bronzed man in a hot tub singing the praises of Viagra. Its okay for men to talk about and make light of their issues! Why not women?

Im not sure why. But I do know that when it comes to the stomach, women are more prone to suffer quietly, with physical and emotional consequences. We also suffer from issues, like PMS and endometriosis, that just dont affect men. And women are more likely than men to get gallbladder disease, autoimmune disease, irritable bowel syndrome (IBS) and constipation.

This shame and reluctance to seek helpor the tendency to seek it too latehave real-life repercussions. According to the National Institutes of Health, more than seventy million Americans suffer from digestive diseases. In 2004 more than 236,000 Americans died from digestive ailments. Over half of the deaths were due to cancercolorectal cancer accounting for almost 40 percent of all cancer deaths. And in many of these cases, deaths could have been prevented if routine screening had been done and treatment had been sought at the outset of symptoms. In the United States, Canada and Northern Europe, women are more than twice as likely as men to seek the advice of physicians for changes in bowel function. In my gastroenterology practice at Beth Israel Deaconess Medical Center in Boston, 70 percent of my patients are women. And almost universally, these women feel alone and scared. Theres no road map, no resource to reassure them that theyre not imagining their problems or that theyre going to be okay.

Instead, symptoms mean fear: Could my bloating mean cancer? Could my endometriosis mean that I cant get pregnant? I often find myself in the role of psychologist as much as gastroenterologist. And my message for the afflicted woman is this: youre not alone!

Each chapter in this book touches on the physical, emotional and social consequences of womens most common bowel conditions, from endometriosis to irritable bowel syndrome. In many cases, I highlight patients whose diagnoses are illuminating or particularly interesting (though for spaces sake, they are abridged here, and out of concern for privacy, their names, occupations and other possible identifiers have been changed). These women wanted to tell their stories so that other women might know that, yes, were all in this together. Indeed, while digestive dysfunction can point to serious problems, often its a common ailment with a clear-cut solution. How reassuring for the millions of women scouring the Internet in secrecy, running to the bathroom between appointments and avoiding social situations for fear of an eruption to know that theres help. Each chapter also includes Q&As, designed to answer the most common questions I hear in my practice. Youll also find advice on what to ask your doctor and which medications are worthwhile (and which ones arent), as well as nutrition tips.

So find a quiet cornermaybe your bathroom, even?and start reading!

W hy are stomach ailments shrouded in shame and embarrassment for women? We all have to cope with them at some point in our livesa volcanic explosion after a Mexican dinner, a knot in the stomach before a big job interview or after fighting with a spouse. This is normal, and speaks to how acutely stress and discomfort resonate in our stomachs.

But, for some of us, our stomachs are the center of our very being. Many of us live with constant constipation, diarrhea, indigestion, crampingwithout relief and without answers. Often, we suffer quietlyscouring the Internet to self-diagnose or bouncing from doctor to doctor, trying to figure out whats going on. Even worse, many women simply figure that this is the way life has to be, and we dont get the help we need. It doesnt have to be this way!

Chances are, if youre reading this book, you have stomach issues or care about someone who does. This chapter offers basic information about the digestive system and the way it affects our lives when it goes haywire. Ill focus on an overview of common issues that I see in my practice every day and the typical effects these problems have on my patients lifestyles. In the discussion below, when I use the word stomach, its as a general term to describe any problem with the digestive tract below the chest (the abdomen or belly).