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Guts by Raina Telgemeier is the third in the Smile graphic novel memoir series. In Quebecois, the title is Courage and that's an important insight for the themes of the book.
On the one hand, Guts is a straight up account of a time in Raina's life when she was grossed out by illness, especially vomit and diarrhea. It begins the night after the family has eaten artichokes and wake up with the stomach flu.
Fear of going through that again manifests as anxiety and IBS. She's teased at school and ends up missing a bunch of days. Ultimately she ends up needing therapy.
That's where the courage connotation of guts comes in. Through therapy, Raina has to learn how to handle her anxiety. She has to conquer her fear of public speaking (something needed for her class that year and of course now as an author).