In 1822, a physician named Dr. William Beaumont treated a patient who had been wounded by a musket shot. The bullet tore a hole through Alexis St. Martin’s abdomen, straight into his stomach. The wound created a fistula – a hole that never closed – and Beaumont quickly realised that whatever St. Martin ate would eventually appear in the portal on his side. Over an 11 year period, Beaumont experimented on St. Martin. He’d tie pieces of food onto a string and pop them through the hatch into his stomach, pulling them out at various intervals to determine the degree of digestion that had taken place. Beaumont extracted the gastric juices from St. Martin’s body to attempt to digest food in beakers. He was so committed to his studies that apparently he even tasted the gastric juices by licking inside St. Martin’s fistula.
Now you might be wondering how St. Martin felt about submitting his body to medical sciences and the answer is that he didn’t seem to like it very much at all. This was not a mutually beneficial arrangement, but St. Martin was effectively Beaumont’s slave. He made several attempts to escape his master, but was ordered into a life of servitude.
Beaumont’s experiments, although disgusting and morally bankrupt, were the first to show that digestion in the stomach is mainly a chemical process, rather than mechanical as had previously been believed.
Two hundred years later and the gut is far less of a black box than it was when Beaumont experimented on St. Martin, but our preoccupation with it has reached a fever pitch. Ok, we’re not licking the insides of the stomach anymore, but we are paying venture capitalist backed technoscience companies to extract our biological data from poop and it’s a toss up as to which is worse.
It’s hard to pinpoint where the obsession with gut health first began. For a long time ‘gut health’ was synonymous with prunes and eating cardboard-y wholegrains. It wasn’t exactly sexy.
When I was an undergraduate student in the early 2000s this was beginning to shift. My honours research project involved feeding volunteers a commercial probiotic yoghurt and testing their poop to make sure the strain of bacteria in the yoghurt survived in the intestines (bacteria in yoghurts are notoriously fickle). The team I worked with had, up until quite soon before I joined, been mostly concerned with studying animals.
It had long been understood that certain animals relied on bacteria, fungus, and other microscopic organisms to help them break down food. Animal nutritionists – yes this is a thing – were interested in understanding how great big fuckoff animals like horse, sheep, and cows could subsist on salad and still get wham AF. These animals, of course, are ruminants, meaning that they don’t actually extract energy directly from the food they eat. Rather, the microbes in their guts (mostly stomach – or stomachs – in this case) ferment the grass and leaves and such, and absorb the byproducts of fermentation like short chain fatty acids, among other things.
Like Beaumont, contemporary animal nutritionists wanted to know what exactly was in those gastric juices. So, they cut holes in cows, much like the one in St. Martin. Although they do this under anaesthesia and pop a little cap in. If you’ve ever filled up a car with petrol, there's your visual. It’s called cannulation and scientists can open the hatch to sample the gastric contents whenever they like. Animals are also our slaves in this sense but that’s perhaps a different essay.
This expertise in ruminant microbiology meant that my research group could easily pivot to studying human gut microbiology - the microorganisms like bacteria and fungus living in our intestines. And, when I was there, this is exactly what was happening (yeah I was on the vanguard, no biggie).
A few key developments propelled scientific interest in the gut microbiome. Firstly, new advances in genomic sequencing technology meant that scientists no longer had to rely on culturing microorganisms in the lab – a notoriously difficult and laborious task. It's near impossible to replicate the conditions of the large intestine – dark, warm, no oxygen! - in the laboratory setting. They could now send off a sample – from poop, skin swabs, or cannulated cows – to a lab which would tell them, not just which strains were in the sample, but which genes were being activated. These new developments are known as culture-independent techniques because you don't have to grow bacteria in the lab to know what's going on.
Another important development was the Human Microbiome Project (HMP), which started in 2007, to identify and characterise all the microorganisms that lived in and on the body. In 2014, this project was extended to become the Integrative Human Microbiome Project (iHMP) with an emphasis on research projects studying potential links between human health and the microbiome – since much of the microorganisms in our bodies live in our ‘guts’, the gut microbiome became a popular area of research. Between 2007 and 2014 as much as $170 million was made available for the study of the human microbiome through the HMP and iHMP (funded by the National Institutes of Health in the USA), which is to say that’s a lot of research dollars, including part of my PhD research. Naturally, research papers followed. And university press releases. And newspaper and magazine articles. And then, of course, social media gets involved.
Somewhere around 2016, when I was practicing as a nutritionist, I was invited to speak on a panel about gut health organised by The Rooted Project; evidence-based events run by dietitians Rosie Saunt and Helen West to help combat disinformation on social media. The wellness industry was blowing up around this time, and let me tell you, there was a lot of misinformation about ‘clean eating’ and its relationship to ‘gut health’. Even back then I found it funny that this entirely unglamorous enterprise of gut microbiome research – anaerobic chambers, sterile cabinets, 96-well-plates, and literal shit – had taken on the shiny veneer of wellness.
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