Everyone’s Talking About Gut Health. Let’s Talk About Yours.
Chloe Melas has canceled plans from the toilet, tears streaming down her face. She has missed work events and struggled to pay attention to conversations while worrying about another dash to the bathroom.
“It’s really hard to complete a task when you are racing to the bathroom all day,” she says.
For a long time, people looking at her social media saw family photos and work events, not what it sometimes took to get through the day.
In The Girl’s Guide to Guts, Melas looks back on a symptom she initially tried to dismiss: blood in her stool. “I remember looking at the toilet paper and immediately having an uneasy feeling in the pit of my stomach,” she writes. She pushed the concern aside until it kept happening. Then a phone call with her mother left her spooked. “She told me I needed to see a doctor immediately.”
Melas and her coauthor, Judy Batalion, both live with ulcerative colitis, a form of inflammatory bowel disease. In their book, they share the parts of living with bowel disease that other people rarely see and help readers find words for difficult conversations. They call their effort to raise awareness about bowel disease the “bowel movement movement.”
But talking about gut health in general can be easier than talking about your own symptoms.
Maybe you call it a “sensitive stomach.” You get bloated, struggle with constipation, or make sudden dashes to the bathroom. You know which outings will be difficult and where you’ll need a bathroom. You’ve figured out how to manage, but you haven’t necessarily talked to anyone about it.
How much are you working around your symptoms?
Cleveland Clinic gastroenterologist Jessica Philpott, MD, PhD, suggests asking yourself how your digestive symptoms affect your day. Are they changing what you eat, where you go, or how you spend time with people you love? Symptoms can creep up gradually. You make a few adjustments to work around them, get used to those, then make a few more.
For Batalion, even a generous dinner invitation can require negotiation. While traveling for a book event, someone offered to pick her up afterward and cook for her at 9 p.m. She found herself sending emails explaining her limited diet and why the plan wouldn’t work.
“I’m still unable to just make plans in a carefree sort of way,” she says, even when she is feeling well.
“A person that is having to limit their activity because of their gut symptoms, that’s a sign to me that there’s something wrong,” Dr. Philpott says.
If you’re making similar adjustments and haven’t discussed your symptoms with your doctor, it’s time to make an appointment.
Some symptoms deserve prompt medical attention, Dr. Philpott adds, including new blood in your stool, significant unexplained weight loss, fever, or severe abdominal pain.
Taking the next step
These three steps can help you prepare for an appointment and leave with a clearer sense of what comes next.
- Write down what has changed. Before your appointment, note when symptoms started, what has changed, and whether you’ve started any medications, Dr. Philpott suggests. Include relevant family history. And tell your doctor what this is doing to your day. Are you leaving early? Missing things? What would you like to get back to?
- Ask how you’ll get answers. You may not get an answer at the first visit. Dr. Philpott says the evaluation may start with an exam and blood or stool tests, followed by more testing or a referral to a gastroenterologist. In The Girl’s Guide to Guts, Batalion and Melas offer questions to help those conversations along: What could be causing these symptoms, and how will we find out? What should I expect from treatment?
- Know when to check back—and when to call. Ask what comes next and when to check back if treatment isn’t helping. Batalion has one question she asks every provider: “What am I looking for, and when is it an emergency?” She wants to know “when to be nervous and when not to be nervous.”
The emotional side of gut symptoms
Living with gastrointestinal (GI) symptoms takes an emotional toll, too. Batalion describes feeling constantly on alert. For Melas, disrupted plans and the strain on her relationships have been especially hard.
“I think it’s important to recognize that anxiety is a completely normal response to unpredictable GI symptoms,” says Dr. Stephen Lupe, a gastrointestinal psychologist at Cleveland Clinic. “Our brains are designed to plan, predict, and evaluate potential threats. That’s part of what has kept us alive as a species.”
The connection goes both ways: Stress can affect how the gut works and how sensitive it feels, while symptoms can give you more to worry about. That doesn’t mean your symptoms are imaginary or that you caused your condition by worrying, Dr. Lupe says.
Knowing where the bathrooms are or thinking ahead about meals may help you feel comfortable leaving home.
“But when that planning begins to turn into avoidance, when fear of symptoms prevents someone from going out with friends, traveling, eating at restaurants, or participating in activities they enjoy, that’s when additional support may be beneficial,” he says.
GI psychology focuses on the stress, worry, and disruptions that can come with digestive conditions. It works alongside medical care, not instead of it. Depending on the condition, approaches such as cognitive behavioral therapy, gut-directed hypnosis, and relaxation training can help with fear and stress and may ease some digestive symptoms.
‘Being a person again’
Batalion’s gut issues started in childhood. When she was a teenager and her symptoms continued, her doctors tried numerous medications, including experimental ones. At her sickest, she could barely leave home. Even a walk or a subway ride felt out of reach.
After surgery to remove her colon, ordinary outings became possible again.
“I could go to the movies. I could go shopping. I could go out for the day,” she says.
Getting these ordinary things back brought what she calls “tremendous relief and pleasure.” For Batalion, recovery meant “being a person again.”
You may have gotten used to planning your day around your gut. If that means missing things you enjoy, tell your doctor. What you’d like to get back to should be part of the conversation, too.
Learn more
For more information and support, these resources can help you better understand digestive conditions and navigate care.
- Rome Foundation: Information on the gut–brain connection and conditions such as irritable bowel syndrome.
- Celiac Disease Foundation: Resources on celiac disease, gluten-free living, and finding a healthcare professional familiar with the condition.
- Crohn’s & Colitis Foundation: Education, practical tools, and support for people living with Crohn’s disease and ulcerative colitis.
- International Foundation for Gastrointestinal Disorders: Information on digestive conditions, along with help finding resources and care.
- The Girl’s Guide to Guts by Chloe Melas and Judy Batalion: Practical, sometimes irreverent advice on navigating life with bowel disease.
What’s helped you?
Has a question, conversation, or piece of advice helped you better understand your gut health? Share it in the comments.
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