An Open Letter to Gastroenterologists

Dear Gastroenterologists:

I know you are smart and massively educated and experienced. I know you care. I have worked with three of you over the past seven years, and you have helped me.

Would you consider the following requests I have for you? Given my personal experiences and my desire to advocate for people with gluten-related disorders, I feel compelled to present them to you.

Gastroenterologists, Here Are My Requests

Please be willing to work with me if I have ideas of my own about what's wrong with me. Your expertise can be invaluable here.

If I arrive for my appointment with stacks of medical journals and typewritten notes and questions, don't take it personally. I don't doubt your expertise, though I don't expect you to know everything, especially natural approaches to treatment.

I want your help to determine if my current hypothesis of what's wrong with me is worth pursuing. I want your advice and supervision if I choose to undergo a natural treatment such as an autoimmune diet.

Respect my preference to use natural approaches such as magnesium supplements for constipation rather than polyethylene glycol (MiraLAX)—especially when both approaches are equally effective.

In the same breath, don't tell me: “I don't want you to stop taking any supplements that are helping you, but I want you to stop all of your supplements and see what shakes out.”

Learn functional medicine approaches and help me sort out and address the root causes of my disease.

Spend some time with me focusing on disease prevention, not just disease management. I might not yet have a diagnosable disease, but with my chronic symptoms, I am very possibly headed there.

Learn about the microbiome and how having a healthy gut ecosystem is central to all aspects of my heath—and not just my digestive system.

Please, please, please help me resolve my gut dysbiosis so that I can enjoy the benefits of a healthy microbiome.

Learn about increased intestinal permeability (leaky gut) and its role in the development of autoimmune disease.

Please, please, help me heal my leaky gut.

Research medical journals on the subject of hypochlorhydria (low stomach acid)—what it is, what causes it, its symptoms, its prevalence as compared to the opposite problem: hyperchlorhydria, and how it can be managed or resolved.

Don't omit pertinent details from my pathology report, even if a finding is inconclusive. Such details might point to new directions of inquiry, whether with you or another doctor, now or later. For example, if the pathologist notes that he or she “cannot completely exclude the possibility of Crohn's disease” from the biopsy sampled from my terminal ileum, tell me that.

Lastly, don't send me away while I still have unresolved digestive complaints. If you don't have answers for me, tell me yourself, in person or over the phone. But give me suggestions about how I might proceed, perhaps with another doctor or another approach.

Thank you for your time and consideration. May you help many people on their journey to feel good again.

Alysson Troffer, MA, Medical Writer and Editor

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