“Ok, I’ll just deal with it.”

“I felt at the end of my rope, hopeless and lost.”

“Why can’t someone help me?”

These are the thoughts of many patients with chronic gastrointestinal tract issues. Such issues are extremely prevalent in our society; if you don’t suffer from these problems yourself, likely your spouse, child, mother, sister, friend, neighbor or coworker does. I myself do. 

I have had “digestive/stomach” issues just about my entire life. As an adult, I have searched for answers, treatments and relief over and over again. I’ve gone from doctor to doctor, spent tons of time and money on everything — all to no avail — only to finally give up and decide that I will just “live with it” until the next time I can’t take it anymore and head back to the doctor for yet another round of disappointment. It has become a vicious cycle. 

When I was recently offered the opportunity to read Gut Feelings: Disorders of Gut-Brain Interaction and the Patient-Doctor Relationship, I jumped at the chance. I thought I might learn something new and, boy was I right! It’s a treasure trove of information and resources. 

The book is written by co-authors Douglas A. Drossman, MD (renowned gastroenterologist, founder and COO of the internationally recognized nonprofit the Rome Foundation, and president of DrossmanCare) and Johannah Ruddy, MEd (Executive Director of the Rome Foundation, patient advocate and patient herself). 

DISORDERS OF GUT-BRAIN INTERACTION – WHAT IS IT AND WHAT CAN YOU DO?

Disorders of Gut-Brain Interaction or DGBI affect millions of Americans and include irritable bowel syndrome, commonly known as IBS, which is among the most prevalent of chronic gastrointestinal issues.

Early on in the book, Dr. Drossman and Ms. Ruddy explain the significant difference between “illness” and “disease.” Illnesses present as a collection of symptoms and may not necessarily be diagnosed by testing. Diseases, on the other hand, refer to abnormalities in the structure and function of a part of the body and can be verified by tests. The difference between illness and disease, according to the co-authors, is the very basis for the difficulties the medical community has in understanding DGBIs. Tests come back negative, the symptoms persist, the patient feels terrible and helpless and the doctor eventually gives up, leaving the patient without further options.

According to the authors, Western medicine is strongly influenced by “dualism,” which is the belief that the mind and body are separate. That results in the thinking that only structurally based diseases, that can be verified by tests, are considered real and authentic. In contrast, patients who suffer from functional, or non-structural, illnesses such as DGBI and other chronic disorders are often dismissed by doctors; their ailment is considered to be less legitimate, more likely caused by stress or psychological issues or it just can’t be explained at all. 

According to Dr. Drossman, “this common misinterpretation often leads to frustration on the part of doctors when they try to understand, diagnose and effectively treat a condition that tests cannot identify. It erodes the patient-doctor relationship.” Once this relationship goes bad, it’s hard to overcome it. A patient will often stop seeking treatment, go from doctor to doctor or just decide to deal with their symptoms on their own. I know this experience firsthand.

IMPROVING THE PATIENT-DOCTOR RELATIONSHIP

“My care changed when I was able to honestly share my symptoms, thoughts and feelings with my doctor and knew that he was going to listen and try to help; that made me feel validated and empowered.” —Johannah Ruddy, MEd, Co-author

For anyone suffering from an illness such as DGBI, reading Ms. Ruddy’s personal story in Gut Feelings will make you feel much less alone and even bring you hope. She went from being treated in the traditional model of doctor-centered care, which left her feeling dismissed, frustrated and as if she didn’t matter, to a much more effective patient-centered or Biopsychosocial model of care (discussed in the book), which resulted in her feeling heard, understood, validated, empowered and hopeful. The difference is eye-opening. 

This book is just as much for doctors as it is for patients. It provides tips for patients on how to deal with their doctors, as well as information for doctors who want to improve communication with their patients. According to the authors, the patient-doctor relationship really should be a two-way street.

CHOCK-FULL OF INFORMATION AND ADVICE

Among its many topics, the book contains invaluable advice for patients looking for answers and solutions. It explains what is happening in your body and why, including why test results can come out negative even though you are symptomatic. The book provides helpful links to videos that can be watched online and will improve your understanding of the concepts discussed.

Beyond the “why,” Dr. Drossman and Mrs. Ruddy explain the “how”:

  • How to find the best clinical programs to treat DGBI
  • How to talk with your doctors — what to say, what to ask, and what to do when the visit is not going well
  • How to better manage your symptoms 

It’s also worth noting that the back matter of the book includes a substantial number of detailed resources.

Gut Feelings will be helpful to all those with illnesses that no one can “see” and that result in pain, stress, frustration, confusion, embarrassment and distress. It brings a much-needed message to patients and doctors alike: there is, indeed, hope.

To learn more about Dr. Drossman and Johannah Ruddy, check out their Author Profile.

Dr. Drossman is trained in gastroenterology and psychiatry and was the founder and co-director of the Center for Functional GI and Motility Disorders at the University of North Carolina. He is an internationally recognized scientist, clinician, and educator in DGBIs and communication skills training. He has written over 500 peer-reviewed scientific articles, published 15 books, and was awarded numerous federal research grants. He is the founder, former president, and current COO of the Rome Foundation. As president of DrossmanCare, he produces educational videos and develops workshops and training programs in communication skills. His internationally recognized gastroenterology practice receives patients with difficult-to-diagnose and manage DGBIs.

About Johannah Ruddy:

Mrs. Ruddy is a patient and patient advocate with a background in education and a career in non-profit management. As Executive Director of the Rome Foundation, she coordinates operations and educational programs. With DrossmanCare, Ms. Ruddy facilitates workshops in patient-centered care and is a simulated patient in videos on communication skills. Ms. Ruddy can articulate her experiences in a way that educates doctors and motivates patients to self-actuate and assume responsibility in their care. In this regard, her social media presence is well recognized, and she has published four peer-reviewed articles in scientific journals on patient advocacy and the importance of the patient perspective in medical education.