almond butter bites

Almond Butter Oat Bites

Hello Friends…I hope everyone here in the Northeast is staying warm and keeping their spirits up… The 8 feet high snow drifts are unbelievable!  Nothing says HAPPY like a little oatmeal, chocolate, chia, coconut and almond bite-full of yumminess.  I make these no bake energy bites quite often for a little healthy treat.

Almond chia bitesThe good thing about these little delicious bites is that you can get creative and add a little bit of this and that depending on your tolerance.  My recipe makes 12 bite size balls and you should be satisfied with 2.  At this portion size, you truly modify the quantity of FODMAPs that you consumer that are naturally contained in the oats and almond butter–both are ‘moderate sources’ of FODMAPs.  I would not eat a whole tray of these tasty treats…Just keep that in mind!almond butter bitesMy daughter Chelsea and I whipped these up yesterday afternoon after a full day of work. They take just a few minutes to make!

I did want to take a moment and announce the lucky winners to my recent blog give-a-ways!  Jordan won the 21 Day Tummy Cookbook: Yay!!  And Deirdre won the #FODMAPer tote bag!  I am in the midst of another #FODMAPer tote bag give-a-way on Instagram–so check it out for another chance to win!!

I have a few other give-a-ways up my sleeve, including a chance to win one of my recently launched Balanced Boxes for a Digestive Peace of Mind on the go!  The idea of the box came from my desire to make embarking on a low FODMAP diet a bit funner.  I truly want people with IBS to feel less isolated and to enjoy a little pampering.  I started the term #FODMAPer so that in essence, a person with IBS might feel more like part of a community than  alone. Many people with IBS suffer in silence….and yet in westernized countries—IBS is rampant.

And remember, the low FODMAP diet is a learning diet that is utilized to help identify your personal triggers.  It is not meant to be followed long term! It is important to do the challenge phase of the diet and to eat the most liberal diet your body allows you to eat! There will be parts of the low FODMAP diet you may follow long term…but you should be able to add some foods back into the diet after the elimination diet phase.  If the low FODMAP diet only offers partial relief, work with your health care provider to uncover other possible conditions or food intolerances that may be limiting your progress.  Always read reputable articles by health professionals, be weary of people on the internet that sound smart but have no credentials.  

Almond Butter Oat Bites


  • Makes 12 balls: Serving size 2
  • 1/2 cup rolled oats
  • 1/4 cup almond butter
  • 1 tablespoon chia seeds
  • 1/4 cup semi-sweet chocolate chips, rough chopped
  • 1/4 cup sliced almonds
  • 2 tablespoons shredded coconut, optional
  • 1 tablespoon coconut oil
  • 1 tablespoon maple syrup


  1. Prepare a small cookie sheet or tray with parchment paper.
  2. In medium bowl, add all of the ingredients and stir to blend.
  3. Roll mixture by the tablespoon with your hands into one-inch balls and place on parchment paper.
  4. Place cookie sheet in refrigerator to allow the bites to set.
  5. Place balls in air-tight container in refrigerator.
  6. Enjoy for up to 1 week.


Asian soup

Asian Noodle Soup with Gingered Chicken Meatballs

You would think I would have had my full of Asian inspired cuisine after my trip to Japan and Thailand….but somehow I just really needed to make this dish! Asian Noodle Soup with Gingered Chicken Meatballs.  Russ and enjoyed a similar soup-cooked in front of us at the restaurant- while in Japan a couple weeks ago! Asian soupThis soup was so easy and was such a comforting meal.

First I made the meatballs which included ground chicken breast, grated fresh ginger, garlic infused oil, sliced green onion and a little dash of toasted sesame oil, soy sauce, gluten free bread crumbs and an egg.

Ginger is a belly friendly ingredient.  It is low FODMAP, gluten free (of course) and helps the stomach contract and empty.  I was fortunate to have plenty of ginger in my freezer courtesy of Frieda’s produce! Tip: I store my ginger in my freezer–it stay fresh longer and is easy to grate that way.

I used cellophane noodles but you can sub in rice noodles if you’d like. Asian soup bowlI lightly rolled the meatballs and popped them right into the hot broth.  The noodles are cooked in separate bowl by simply pouring hot boiling water over them and letting them sit for about 20 minutes. Then I drained and rinsed the noodles, tossed them on a cutting board and just sliced them up into smaller size strands for less messy eating!

Oh…and I am so excited about this nice article written about my 21 Day Tummy Cookbook! Have you seen this cookbook yet?  Well, it features all low FODMAP recipes that are made from simple ingredients and that are rich in protein and the anti-inflammation mineral, magnesium…a nutrient most Americans fall short on! Unknown-3

And hey…I am feeling generous again…so if you would like to win a copy of this fab cookbook, leave a comment saying, “I want the cookbook!”  and you will be entered to win. It’s that easy.

And Dietitians:  My upcoming workshop is filling up and I am very excited to teach about more about FODMAPs–including the latest from the outstanding research group at Monash University, small intestinal bacterial overgrowth, and exciting information about the gut microbiome and health.  Interested? Please consider signing up here sooner than later as space is limited!

Oh and here’s the soup recipe!

Asian Noodle Soup with Gingered Chicken Meatballs


  • 32 ounces low FODMAP chicken broth
  • 1 lb. ground chicken breast
  • 1 tablespoon grated ginger
  • 1/2 cup gluten bread crumbs
  • 1 teaspoon sesame oil
  • 2 green onions, sliced (green part only)
  • 1 egg
  • 1 tablespoon garlic infused oil
  • 1 tablespoon reduced sodium soy sauce (I used San-J, tamari)
  • 3 ounces rice or cellophane noodles
  • 1/2 cup diced water chestnuts ( I used canned; drained and rinsed)* optional
  • 1 cup thinly sliced carrots
  • Garnish, fresh cilantro, fresh parsley or sliced green onion-green part only* optional


  1. In medium stock pot, add broth and heat on medium high until boiling.
  2. In medium bowl, add ground chicken, egg, soy sauce, green onion, garlic infused oil, sesame oil, grated ginger and bread crumbs--mix to blend.
  3. Roll meatballs into bite size balls and add carefully to hot broth. (I don't like too much meat in my soups--so I saved about 1/3 of the chicken mixture--made 2 burgers with the meat and froze for later.)
  4. Add sliced carrots and water chestnuts to broth.
  5. Reduce soup to medium and let simmer for 20 minutes or until meatballs are cooked through.
  6. While soup is simmering, boil water in kettle and pour over noodles as directed on label. Let sit, drain and rinse.
  7. Pour noodles on cutting board and lightly chop to more manageable size for easier consumption.
  8. Add noodles to simmering soup for a minute or two.
  9. Serve soup and garnish as desired.

3 coconut sticky rice

Thailand’s Best Dessert: Sticky Rice

What am amazing trip to Thailand!

Glad to be back home (a big jet lagged!) but I enjoyed every single minute in Asia. Especially those elephants….seriously…SO big,  yet so gentle and sweet.IMG_6044Besides these big creatures…what I liked best about Thailand….the food! Serious yumminess. Fresh fruits and veggies galore!! A dietitian’s dream.

I am a fan of coconut…and Thailand did NOT disappoint!

Now that I am back home…I am back in my kitchenhappily in one of my favorite places on earth!

So, I decided to cook up a traditional Thai dish, Mango Sticky Rice…sans mango for my FODMAPers!  I popped a few pieces of fresh naval orange on the rice pudding instead.  This dessert takes some time to create…but to me, it’s worth it.Sticky rice on marbleI adapted my recipe, from this recipe found here on Epicurious.

I followed the recipe but deleted the mango and reduced the sugar in the first coconut milk mixture that is added directly to the rice… instead of 1/3 cup cup sugar, I added just 2 tablespoons. Otherwise, I followed the recipe.  The recipe calls for sweet rice or glutinous rice (there is no gluten in glutinous rice–the word is added as the rice has a sticky or glue like consistency to it.) This is a fun recipe that can be made in advanced and chilled.

A few highlights from our Thailand trip:

  • Patara Elephant Farm:  Russ and I did a 1/2 day visit which we found was plenty of time to enjoy the elephants, learn more about them and their habitat. Patara is known to treat the elephants humanely.  Click here for their site.
  • Tribal crafts: Russ and I enjoyed the night bazaar in Chiang Mai and found some really cool local crafts–very inexpensive scarves, coin purses and festive pom pom key chains. Check my instagram feed as I will be doing a little give-a-way soon!
  • Coconut everything: coconut water, candy, rice, and sorbet.  The sorbet was made of coconut milk and fresh coconut flesh….a-m-a-z-i-n-g!
  • Gracious and kind people.
  • Thai massages–so inexpensive and so relaxing.  Russ and I actually fell asleep during our massages!
  • Koh Samui–especially our hotel. We upgraded to a villa and it was well worth the extra money. It was the most beautiful hotel room I have ever stayed at…with our own little pool, 4 posted bed with canopy netting and a wall size glass wall looking out on a private garden with a water fountain and pond.  The food at the morning buffet included SO many low FODMAP options too! Yay!

And for the animal lovers….here are a few elephant pics for you!

Russ and I getting sprayed by these big elephants!
IMG_6341And me…just lovin’ up and feeding my elephant for the day named Mah-deet.IMG_5961This little guy is about 18 years old and the dad of two little cute elephants.  We rode the elephants bare back up to their farm.  What an amazing experience.

Stay safe in you live in New England with all this crazy snow …grateful I missed that last two storms while I was away!  And… give this sticky rice a whirl…if you like coconut, you’ll like it! MMmmmmmm….3 coconut sticky rice

great buddha

10 Things I Love about Japan

It’s hard to believe I have been in Japan for 9 days now!  We are heading out to Thailand tonight so thought I would share a few of my favorite things in Japan:

1.  Japanese People:  I have never met a more kind and welcoming group of people.  They go out of their way to help direct you when you are looking for directions. (Not that I ever got lost! Ha! ;) )  One gentleman stopped what he was doing, took out his iPad and looked up the direction of the train station for me.  They bow–a lot! :) And always greet you when you enter a store or restaurant…immediately. Super nice. Super friendly.

Japanese people

2. Bamboo Forests:  For me, this was my favorite experience. I found being around the tall bamboo was quite peaceful.  I enjoyed the Hokokuji Temple in Kamakura outside of Tokyo where I enjoyed a wonderful Matcha Green Tea amongst the bamboo.tall bamboo

Matcha Tea at Hokokuji Temple.

Tea at the shrine

Russ and I also enjoyed the Bamboo Forest in Arashiyama in Kyoto too. So tranquil.russ bamboo

3. Tea time:  Whether it was just a cup of green tea with a meal or a zen moment with matcha tea in a temple, you can’ t help but feel a sense of calm and peace take over with a cup of green tea in hand.

4. Packaging and presentation:  The Japanese have a beautiful way of presenting their wares whether it be candies or silk scarves…everything is just so! The food is also beautifully prepared and presented.  Uniforms are common in the school aged children heading to school and in restaurants or hotels. candy

5. Rice crackers:  I just love the many varieties that are available!rice crackers

6. Matcha ice cream:  Where else can you get green tea ice cream?  I couldn’t eat a whole cone…but happy to share with my guy!

7. Tempura: Like nothing you have experienced in the States.  So light and tasty.tempura

8. Shrines: It’s somewhat overwhelming how many shrines there are in Japan.  My favorite included:   Hokikuji Temple,  Kinkaku-ji (Golden Pavilion), Hase-dera in Kamakura. And if in Kamakura, a must see is the Great Buddha.

Loved this Great Buddha!great buddha

The Golden Temple is world-renown. Here it is on our visit…snow topped!golden temple

The grounds of the Hokokuji temple were exquisite and pristine. rock pile Hokokuji templeSo pretty.Stairs to the Hokokuji Temple

If you are looking for peace and zen…this is your place!Stone walk Hokokuji temple

9. Rickshaws:  Russ and I took one of these cart rides for a little spin through Kyoto’s bamboo forest.  Super fun! And warm…which was nice on this snowy day in Kyoto!rickshaw

10: Monkeys: Arashiyama Monkey Park was very cool.  Take a steep 20 minute hike up the hilltop to see the wild monkeys.  These guys were quite amazing to see.monkey

And lastly, an honorable mention.  My 11th favorite top thing in Japan….heated toilet seats. It’s a nice feature.  Just sayin’ Ha! :)

As for the food here…it’s been a mixed experience. Some meals have been stellar…and some downright scary (at least for me).  I like to know what I am eating…and with the language barrier and some of the unusual foods eaten here…I will admit I was a bit nervous about indulging. I wish I was a bit more daring…but with a sensitive belly…it’s hard to be!

Off to Thailand!



Japanese garden

Japan: Not All Who Wander are Lost.

Hello from Asia.

travelRuss and I are in Japan!russ and II am grateful that I married someone with a taste for adventure. We just got here on Saturday evening so I am just getting adjusted to the time difference, the food, and the train schedule. Tokyo is a very clean city and the people here have been so gracious and kind.

Traveling always provides a new and fresh perspective for me. Time to  focus more on all that I am grateful for in my life. Clarity of mind to think about my hopes and plans for the future. Being abroad in a country far from home with a very different culture also encourages me to step outside of my box and try new things.

<My pictures this post are taken from my iPhone…so not the best quality…but wanted to share some of my trip with you!>

The Japanese gardens are quite beautiful here.

russ on bridgeRuss worked today, so I did a little exploring.  I took the train to Asakusa, the home of Tokyo’s oldest shrine.  I was proud of myself…I didn’t get lost! Ha! :)


There was a service going on…so I took a pic from the outside looking in…inside of shrineOutside the shrine was a large vessel with smoking incense.  Visitors wave the smoke to toward their faces as the smoke is believed to have healing power.

smokeWhen in Japan, there are many shrines to peruse and lots of shopping to be done ….so… that is what I did! I walked around the Nakamise Shopping Arcade and then walked to Kappabashi Street full of vendors selling pottery, cooking knives and other interesting shops.  I found the cutest cookie cutter in the shape of a spoon I had to have. 

Rice crackers are for sale everywhere and come in all shapes and sizes.rice crackers

I found these little rice crackers dressed up in kimonos…had to have them too!rice cracker people

I got a little daring and got a little sweet pastry from a local merchant.  Not sure what it was….but it tasted good.  Ha!

Getting food that I like has been a little tricky for me.  I am very glad I brought supplies from home including small individual Barney’s almond butter, Nature’s Path Gorilla munch trail mix I made up with Gorilla munch, peanuts, gluten free pretzels and a few chocolate chips, and Go Macro peanut butter granola bars.  :)  Just a few of my favorite products for on the go!

For my friends in New England, stay safe and warm.






tomatoes and feta

Seared Tomatoes with Feta, Oregano & Olives

Well…hello, Mediterranean flavors….so nice to eat you.

I purchased a package of  heirloom cherry tomatoes, some fresh oregano, Greek feta and  kalamata olives.tomatoes and fetaIn a hot skillet with a little grape seed oil, I seared the tomatoes until browned on every side. Turned off the heat and tossed some feta over the tomatoes allowing the cheese to melt slightly.

Then, I removed the tomatoes and feta mixture and sprinkled a little fresh chopped oregano and olives.  MMMMmmmm! I expected this dish to taste good…but it exceeded my expectations. No joke.

I was inspired by this recipe on a cooking show I was watching while working out at the gym!  Nothing like working out while watching a cooking show …talk about getting hungry! Ha! :)  Hope you like this recipe as much as I did! seared tomatoes

Seared Tomatoes with Feta and Oregano


  • 1 pint cherry tomatoes
  • 1 tablespoon grapeseed oil
  • 1/4 cup feta cheese, crumbed
  • 1 tablespoon chopped fresh oregano
  • 1/4 cup kalamata olives, de-pitted and sliced


  1. In medium skillet over medium heat, add oil and tomatoes--be careful of splattering.
  2. Let tomatoes brown up on all sides.
  3. Turn off heat and add feta until slightly melted.
  4. Move tomatoes into serving dish and sprinkle with oregano and olives.

Off to Japan.  

Keep up with my travels by following me on Instagram @katescarlata

Have you Heard of Histamine Intolerance?

Today’s topic: Histamine.


As much as I love working with my patients….I also, truly love to spend time learning.  It’s not unusual for me to print out 3-4 research articles, hop into bed at night with my highlighter and do some light reading. :) Ha!

When I was writing my Complete Idiot’s Guide to Eating Well with IBS back in 2009, I included a few sentences introducing histamine intolerance to my readers. I find this condition very interesting ….and I am convinced it’s more common than it is diagnosed. I personally am on a mission to learn more and as always…share what I learn.

Disclaimer:  I don’t want every person with IBS that follows my blog to feel the need to remove all histamine from their diet! Nor do I want you to feel overwhelmed by this complicated topic I am about to embark on.  I do know that some people that follow my blog may very well have histamine intolerance. For this small subset of folks, the goal is to enlighten you to get the help you need.

What is histamine? Histamine is a natural substance, a biogenic (meaning: resulting from the activity of living organisms such as, fermentation) amine that is present in many foods and produced by a small subset of human cells, including mast cells, basophils, platelets, histaminergic neurons and enterochromaffine cells. Wow! That is a mouthful!  

Histamine is a neurotransmitter (brain chemicals that communicate information throughout our brain and body) produced in an allergic reaction, often associated with causing itching, redness, swelling, cough or rash. Histamine regulates sleep and also aids in digestion by playing a role in stomach acid secretion.

What is histamine intolerance?  Histamine intolerance results from an accumulation of histamine and the inability of the body to completely degrade it. In healthy people, dietary histamine can be rapidly detoxified by enzymes called amine oxidases, particularly, Diamine Oxidase (DAO) enzyme.  Some individuals have low levels of these enzymes; therefore, are at greater risk for histamine toxicity.  Gastrointestinal diseases can contribute to a decline in these histamine degrading enzymes.

Similar to FODMAPs, histamine can have a  cumulative effect on symptoms. Small amounts may be tolerated but multiple sources of histamine in the diet will ‘fill your personal threshold bucket’ and symptoms will ensue.  In order to assess if histamine is a problem for you, it is necessary to restrict all of the histamine-associated foods.  A food intake and symptom log are essential while undergoing both the elimination and the re-introduction phase of histamine foods.  Working with a dietitian knowledgeable in the low histamine diet is key.  Food lists for histamine are variable online.  It is my understanding that this in part is due to the fact that analysis of histamine in food has not been done for decades.  Another area of needed research!

Symptoms of histamine intolerance:

  • Diarrhea
  • Headache
  • Flushing
  • Rash/Urticaria (hives)/eczema
  • Arrhythmia (irregular heart beat)
  • Low blood pressure-due to vasodilation caused by the histamine
  • Wheezing
  • Runny nose
  • Watery eyes
  • Angioedema-swelling of face/hands/lips
  • Heartburn-due to increased acid production
  • Itching- typically of the skin
  • Abdominal Pain

The ingestion of histamine-rich food or of alcohol or drugs that release histamine or block DAO may provoke allergic-like symptoms in patients with histamine intolerance. Symptoms can be reduced by a low histamine diet and/or managed by antihistamine medications.

Do I think all patient’s with IBS have histamine intolerance? NO! But… histamine intolerance can contribute to abdominal pain, diarrhea, and heartburn–certainly common IBS symptoms, for some people.  Dr. William Chey, MD, Professor of Medicine, Director of the GI Physiology Laboratory, and Co-Director of the Michigan Bowel Control Program at the University of Michigan weighs in on this discussion, “Anyone who has hay fever already knows that histamine plays an important role in allergic responses caused by things like pollen and animal dander – many popular medications like Benadryl and Claritin block the effects of histamine. The fact that some foods contain histamine has been largely overlooked. It is quite plausible that consuming foods which contain large amounts of histamine or stimulate the release of histamine from cells in the gut could cause GI symptoms in some people.”

Unfortunately, we don’t have a definitive (accurate) test to determine DAO enzyme levels or their functioning capacity or histamine levels, at this time. If you present with 2 or more of the common symptoms of histamine intolerance, improve on a histamine free or low histamine diet and anti-histamine medications, you fit the criteria for having histamine intolerance.  A more severe disease state, an occult systemic mastocytosis should be excluded as your diagnosis by measurement of serum tryptase.  This is a condition in which a person has abnormally high amounts of mast cells.  You don’t need to have mastocytosis to have histamine intolerance.

Histamine and Food: High concentrations of histamine are found in products of fermentation such as aged cheeses, sauerkraut, wine, processed meats and  canned fish. Vegetables such as spinach, eggplant have histamine too.  In addition to histamine containing foods which I have provided only a partial list, there are foods that have the capacity to release histamine. Foods that have been linked with histamine release include: citrus fruit, papaya, strawberries, pineapple, nuts, peanuts, tomatoes, spinach, chocolate, fish, pork, egg whites and additives and spices.

Alcohol is not only rich in histamine but also inhibits the DAO enzyme to help degrade histamine.

Drugs that release histamine or inhibit diamine oxidase (DAO) can be found in this reference, in TABLE 5 which is also cited below.  Some medications included in this list are metoclopramide (reglan), Cimetidine, and Amitriptyline.

Here are some general tips to minimize histamine in diet:

  • Avoid or reduce eating canned foods.
  • Avoid or reduce eating overly ripened and/or fermented foods (aged cheeses, alcoholic drinks, products containing yeast, stale fish)
  • Histamine levels in foods vary, depending on how ripe, matured the foods are–with higher levels the more ripe or aged.
  • As much as it is possible, only buy and eat fresh food.
  • Don’t allow foods to linger outside the refrigerator – especially meat products or eat left-overs.
  • Choose fresh (not aged) meats, fresh white fish or choose those that have been flash frozen.
  • Consult a registered dietitian knowledgeable in histamine to help manage your diet modifications and help you balance your diet

If you are a health care professional or pretty savvy with medical jargon, check out this review article about histamine intolerance.

Could alterations in our gut bacteria play a role in histamine intolerance?

Um, yes.  Gut bacteria are capable of producing histamine. Little microorganisms in our intestine can produce histidine decarboxylase—converting protein in our gut to histamine. Amy Burkhart, MD, RD, an integrative medicine practitioner in Napa, California notes,”Though its benefits are controversial, I have had patients with dysbiosis/small intestinal bacterial overgrowth experience improvement on a low histamine diet. The low histamine diet is challenging and not necessary for all dysbiosis patients but can be beneficial in selected cases. Once the dysbiosis improves the tolerance to histamine containing foods also tends to improve.”

For further information on histamine containing food lists and research on this condition, here are some articles/resources/references for you to check out:

The Histamine Chef  Great site for all sorts of information written by a journalist–with many research articles provided and expert interviews.  Check out the interview with expert Dr. Janice Jonega

Dr. Janice Jonega’s site and fact sheet on histamine intolerance.

Amy Burkhart’s site (Amy is an MD and RD)  with a great article on histamine here.

Royal Prince Alfred Hospital Allergy Unit has some good resources on food intolerances (Sydney, Australia hospital)

Am J Clin Nutr 2007; 85:1185-96 Histamine and histamine intolerance  Excellent review article!

And if you lasted this long….Yay! You have a chance to win one of my latest products! A FODMAPer tote!! Now for sale on my website here!  For a chance to win,  simply leave the comment: #fodmaper  and I will select one random winner soon!

IMG_1124_2 copy


Bacon wrapped pineapple

I love creating party appetizer recipes and this one makes the low FODMAP diet taste soooooo good.

The salty bacon paired with the sweet and tangy pineapple is a winning combo.IMG_0980editJust wrap half a slice of thinly sliced cooked bacon around a bite size piece of pineapple. Drizzle with a little pure maple syrup and feel the love.

IMG_0974editTo save time–I bought pre-baked bacon and heated it up in the microwave.  Wrapped it around the pineapple pieces and drizzled with a little pure maple syrup.  I baked these tasty morsels  for about 5 minutes to just warm up the pineapple. If you want, you can cook for a few minutes longer to brown up the pineapple and crisp the bacon a bit. Either way…it is all good. :)

pineapple bite

Bacon wrapped pineapple


  • Adapt ingredient quantities to number you are serving --FODMAPers limit to about 5 pieces
  • 10 slices pre-cooked bacon, cut in half (Or cook up raw bacon slices until slightly crisp)
  • 20 bite size pieces of pineapple
  • 1 tablespoon pure maple syrup


  1. Preheat oven to 350 degrees.
  2. Warm bacon in microwave --just making bacon a bit more pliable to wrap (15 seconds) around pineapple. Or cook bacon, if using raw, until slightly crisp.
  3. Wrap pineapple pieces with bacon and secure with toothpick and place on cookie sheet.
  4. Drizzle pineapple pieces evenly with pure maple syrup.
  5. Bake for 5-10 minutes just to warm.

Russ and I are hosting  a little ‘ugly sweater’ party this weekend! :) …So the appetizer planning is fully underway.  I like to have fun, easy but creative appetizers that everyone can enjoy.  Even though bacon isn’t the healthiest of foods, it makes a nice treat at a party.  Hopefully these will be a hit!  Have a great rest of the week!


Getting the Most Out of your Visit with the Gastroenterologist

It takes two. In every relationship, there is a little give and a little take, right? This is true for your patient-doctor relationships too!UntitledMy message to you today:  Be an active partner in this relationship! You and your doctor should work collaboratively together in an effort to help you feel your very best. Your relationship with your doctor should feel like a partnership…not a dictatorship! Mutual collaboration and respect is key! If you can’t work together with your doctor, it just might be time to find a new one. Just sayin’!

Last summer, in June 2014, I had the pleasure of meeting Dr. Doug Drossman at the University of North Carolina Patient Care Day: An Expert Update on Treatments for Functional Gastrointestinal Disorders. We both spoke at this event that featured interactive workshops. My talk, of course, was on diet, particularly the low FODMAP diet. Dr. Drossman’s talk focused on how to make the most of your doctor’s visit. As a world renowned leader in functional gut disorders and the President of the Rome Foundation, Dr. Drossman specializes in both biopsychosocial medicine and gastroenterology.

In 2012, Dr. Drossman founded the Drossman Center for the Education and Practice of Biopsychosocial Care (DrossmanCare) which focuses on improving healthcare by improving doctor-patient communications. Improving patient-doctor communications is shown to improve healthcare outcomes for both patient and doctor! No surprise there!

In my opinion, given the sensitive nature of taking about GI symptoms, your relationship and comfort level with your gastroenterologist is particularly important! During your meeting with the doctor, you should feel you are being heard. Unfortunately, in this technology focused world we live in, doctors are sometimes buried behind their computer! This does not help the patient-provider relationship one bit! Try to get your provider to talk to you face to face to get their undivided attention!

Here are a few resources to help you make the most of your doctor’s visit:

For starters, Dr. Drossman shared this great video with me…to share with you. I suggest you take a look at the video with Dr. Drossman and Dr. Chey titled:  Health Body, Healthy Mind, Talking about your GI health found in this link. I think this video shows the reality of  the impact IBS has on real people! YOU are not alone. IBS impacts up to 1 in 5 Americans! It’s easy to feel you are all alone when you have a  functional gut disorder. Most people keep their symptoms to themselves, right? But… providing honest and open dialogue is SO important at your doctor’s visit. Even if you feel embarrassed to discuss your bathroom habits, be rest assured your gastroenterologist has heard it all! The more accurately you tell your story, the more helpful your doctor can be in helping you manage your symptoms or identify a treatable condition.

Prior to your first appointment, write a few notes including the following:

  • Create a timeline:  when did your symptoms start and did they accompany a trip out of the country, with an episode of gastroenteritis or food poisoning? Or have you had them most of your life? Did they worsen or occur after a stressful event?
  • Do you have a family history of GI issues? Do you have any  family members that have Celiac disease, inflammatory bowel disease or perhaps a relative with chronic belly aches or IBS?
  • How often are your GI symptoms impacting your quality of life? Are you able to work outside the home? Do you travel without worry? Can you eat at restaurants? Are you in pain daily?
  • If you had to rate how you feel on a scale of 1-100% (100% being the very best), what number best represents how you feel on a general basis?
  • Do your symptoms wax and wane or do you have symptoms daily?
  • What symptom or symptoms do you find the most problematic?
  • Have you found any tricks to help manage your symptoms?
  • List all the medications and supplements (including herbs!) and dosages you are currently taking.
  • Be prepared to talk about your poop! Yes, this can provide key information about what is happening in your body!

For additional hints on how to talk to your doctor, check out two more resources that Dr. Drossman generously shared:  How to Talk to Doctor handout from UNC’s Functional Gut and Motility Center and this blog post provides even more tips on preparing and making the most of your doctor’s visit.

After you visit with your gastroenterologist, ask them what is the best way to get hold of them if you have a question. Not all doctor’s keep an active email thread going and would prefer you called their office. Knowing what is the preferential way of communicating for your doctor and utilizing this way of contacting him or her is a way to show your respect and enhance communication.

I hope this post helps you make the best of your time with your gastroenterologist.  If you can’t work respectively and collaboratively together, you may need to part ways and find a new doctor.  Remember though, it takes two.  Do your part to help create a healthy and successful relationship… to ultimately guide your treatment and better your health!