Acknowledgments Gutbliss started out as a book about food. I was alarmed by what I was seeing in people's digestive tracts and the growing prevalence of bloating and other gastrointestinal complaints. To me, food was the obvious but frequently overlooked connection. So I set out to write a book about how our food was making us sick. Along the way, I had the incredible good fortune to meet Howard Yoon, my literary agent, who helped me mold my passion about food and the gut into a broader conversation that included the obstacles to digestive wellness and how to go about removing them. Whether you like this book or not (and I hope you do!), it is undoubtedly a much better one because of Howard's wisdom, patience, and belief that I had something important to say. And for the opportunity to say it, I am eternally grateful to Lucia Watson and Bill Shinker at Gotham/Avery, to Gabrielle Campo, who guided me through the entire process, and to Toni Sciarra Poynter, who provided invaluable editorial assistance. To my husband, Eric, who at this point knows far more than he ever imagined he would about bowel movements and gut bacteria, and whose support never wavered as I abandoned my post for several months at a time to focus on completing this book.

Without his encouragement and overall picking up of the slack at home this book would never have been possible. And to my amazing daughter, Sydney, who loves to talk about bowel movements and gut bacteria, and who spent so many hours keeping me company in my study while this manuscript was being written. You are a constant source of inspiration. Bette Greenhause and I have been keeping company since my first day on the job at Georgetown in 1997. Without her, the Digestive Center for Women would never have come to fruition. I do not think I could practice medicine without her. To the late Dr. Henry Janowitz and Dr.

Jerry Waye, who taught me much about both the art and the science of gastroenterology. To Gena Hamshaw, whose journey from editor to doctor I am honored to be a part of. To all my friends who put up with canceled dinners and no-shows while I wrote this book and cheered me on toward the finish line. A special thank-you to Dr. Ida Bergstrom, Alicia Sokol, Jill Hudson, and Elise Museles. Vernon Jordan, Doug Heater, and Robert Raben are my three wise men. I am grateful to them for always pointing me in the right direction. To my parents, for teaching me the invaluable lesson that with good living comes mostly good health.

A huge thank-you to Dr. Mehmet Oz, for giving me the opportunity to share my passion for digestive wellness with America. And most of all, to the many patients along the way, who have taught me so much. It has been an honor and a privilege. Introduction "Why am I so bloated?" That's a question I hear nearly every day in my gastroenterology practice. Over the course of my medical career, I've gone from helping a handful of women a week with bloating, sluggish fullness, and constipation to feeling like I'm dealing with a full-on epidemic. For many, the symptoms are daily, relentless, and life altering, but even when they're not that severe, they're always annoying. The causes of bloating vary tremendously, from common benign conditions to rare, life-threatening illnesses.

Some may be connected to behaviors you don't even think about. (Do you talk with your mouth full? You could be swallowing enough air to go up a dress size!) Some you may have heard of but need more information and aren't quite sure whether you should be worried. (Is celiac disease the same as gluten intolerance?) Some may surprise you. (Taking antacids to settle your stomach can make your jeans un-zippable!) In this book you'll learn about these issues and many more, including how to tell if your bloating is serious . . . or if you're just seriously bloated. Your Inner Doctor The information in this book incorporates aspects of both conventional and alternative medicine to create an intuitive, commonsense approach to digestive wellness.

The goal is not to scare you into having an unnecessary procedure or taking a pill you don't need, but to encourage you to explore the cause of your symptoms and to implement some useful basic strategies, many of which are already in your toolbox. I believe that buried deep beneath the information overload we all receive from consumer marketing is our own innate sense of what we need to make ourselves well. I like to call it our "inner doctor." This book will help you access that deep inner sense, building your understanding by providing reliable information on what helps and what hinders when it comes to your digestive health. Many digestive problems that a decade ago we thought were "all in people's heads" we now know are caused by very real gastrointestinal disturbances-conditions like bacterial overgrowth and gluten intolerance. I refuse to believe that millions of women who suffer from bloating but don't have a diagnosis are "crazy" or "just stressed out." I've seen how often, by thinking outside the box, we're able to find both the problem and the remedy. I want to help you trust your inner doctor.

If you think there's something going on, there probably is, and you need to keep searching till you find the right person who can help you figure it out. They may not always have a white coat on and an MD behind their name. Much of what I know I've learned from patients, nutritionists, biofeedback practitioners, holistic health coaches, naturopathic doctors, acupuncturists, farmers, and even my yoga instructor. I hope the information in this book will serve as a guide to help you understand what's going on in your body and offer you some real solutions. My Promise to You I've spent a lot of time inside the digestive tract, observing what's gone wrong and why. This book contains the information I think is most important to share, in short, digestible (pardon the pun) chapters. When I don't know something, I'll tell you I don't know. When I think a particular practice is shady or suspect, I'll tell you that, too.

I'll give you the information that has been helping my patients make real improvements in their digestive health-including a comprehensive 10-Day Gutbliss Plan to heal yourself from the inside out, based on twenty years of experience. It's helped thousands of women tighten their tummies and end their discomfort. Many have reported a surge in energy and mood, too! This easy-to-follow integrative approach to digestive wellness will help you banish bloat, flush toxins, and dump your digestive baggage-the healthy way. The world these days can be an intimidating place. We worry about environmental toxins, drugs can be dangerous, and Mother Nature would hardly recognize much of what's available at the grocery store. But left to its own devices, the human body is still a marvel, with an amazing capacity to recover and heal itself, particularly when injurious practices are identified and stopped. My sincere hope is that you're able to use the information in this book to find your own gutbliss and that when you and I meet, it'll be at the farmer's market or on the yoga mat, and not in my office. Finding My Gutbliss In 2004 I decided to leave the hallowed halls of academia and set up my own practice.

Georgetown Hospital had been my first job when I finished my training in New York in 1997, but after almost eight years, hospital-based medicine no longer seemed to have the answers my patients and I were looking for. I owed a lot to the institution-my career had flourished there: I had a sixteen-page résumé of published articles, book chapters, and speaking engagements throughout the United States and Europe; I had helped to train over thirty gastroenterologists; I had colleagues I respected and admired; and I enjoyed the teaching opportunities. My salary was more than generous. My professional life was bountiful and I should have been happy, but I wasn't. I had lost my faith. Over the years my priorities had gradually shifted from high-tech procedures that diagnose and treat disease to no-tech lifestyle modifications that prevent them. It was becoming difficult for me to emphasize the industry message in my speaking and teaching that colonoscopy saves lives (which it does) without giving equal billing to what I had come to believe: that diet and lifestyle were more important in achieving and maintaining digestive health than any procedure I could recommend. Philosophically, I felt a lack of alignment.

I was interested in an integrative and more holistic approach to digestive diseases and I wanted that to be part of my message. My colleagues seemed more interested in technical innovation. Their mission and approach hadn't changed, but mine had. The practice of gastroenterology had also changed and was feeling more and more like a business venture, with the patients as the consumers and endoscopy as the product. Many gastroenterologists now owned their own endoscopy units, as well as the pathology services used to process their biopsy specimens. While this allowed for better quality control and closer collaboration, it also greatly incentivized doctors to do more procedures and biopsies. The gastroenterologists I knew were people who cared deeply about their patients, but many of them struck me as overly committed to doing procedures. I wanted to provide patients with equally relevant lifesaving information-like the fact that switching to a plant-based diet can cut your risk for colon cancer in half; or that exerci.