In this episode, Dr James McIlroy chats with Dr Tanya Mongan, clinical associate professor and gastroenterology consultant at the University of Nottingham. Dr Mongan specialises in gut health, particularly the gut–brain connection and faecal microbiota transplantation (FMT).

She talks us through the current state of FMT, why it works so well, and how it’s becoming an increasingly important treatment for conditions like inflammatory bowel disease. We also explore her cutting-edge research into microRNA-based medicines—a new field examining tiny molecules that can help protect the gut and may one day be used to treat conditions linked to an unhealthy microbiome, including cystic fibrosis and neurodegenerative diseases.

This episode breaks down the complexities of the microbiome in an easy-to-understand way, covering everything from the limits of current testing to the promise of personalised gut treatments. Dr Mongan also shares insights into exciting new tools such as organ-on-chip models, nano-delivery systems for microRNAs, and even zebrafish models used in gut research.

If you want to understand where gut science is heading, what’s real and what’s hype, and how future therapies may become more precise and personalised, this is a must-listen.

Chapter Markers

00:00 Introduction to Dr Tanya Mongan and gut health

Revolutionising Liver Health: The Link Between Gut Health, Genetics, and Lifestyle

In this episode, we dive deep into the intricate connections between liver health, gut health, genetic predispositions, and lifestyle factors. Our guest, Gary, a seasoned physician and entrepreneur, shares his extensive experience from pioneering liver disease research in the 90s to running a successful metabolic clinic focused on functional medicine today. Learn about the evolution of understanding fatty liver diseases like NASH and MASH, the impact of processed foods, and the groundbreaking treatments emerging, including the promising effects of GLP-1 therapies. Gary also discusses the pivotal role of a clean diet, exercise, and quality sleep in managing liver health, and the challenges of implementing these changes in a clinical setting. Don't miss this insightful conversation packed with practical advice and forward-thinking approaches to improving liver and overall metabolic health.

00:00 The State of Food Quality in America vs Scotland

Takeaways

In this episode, Dr. James McIlroy interviews Dr. Ran Blekhman, an associate professor at the University of Chicago, about the microbiome and its role as 'our second genome.'

Dr. Blekhman shares his research findings on the genetic and environmental factors that shape the microbiome, the heritability of microbial genes, and the relationship between the human genome and microbiome. They also discuss Dr. Blekhman's groundbreaking research that analysed over 168,000 samples to understand global microbiome patterns, the influence of early-life microbiome development, and the potential of microbiome-based diagnostics and therapeutics. Tune in for a comprehensive dive into one of the most promising areas of genetic and microbial research.

00:00 Introduction to Dr. R Blackman and the Microbiome

In this episode of Inside Matters, I'm joined by Dr Johan van Hylckama Vlieg, Chief Scientific Officer at Freya Biosciences. As a global leader in microbiome research, Freya is pioneering innovative approaches to women’s health through biotherapeutics that are rooted in groundbreaking microbiome science.

00:00 Introduction to Dr. Johan van Hylckama Vlieg and Freya Biosciences

Dr van Hylckama Vlieg has spent more than 20 years exploring the vast and complex world of the microbiome — the trillions of microbes that live in and on our bodies. These tiny organisms play a huge role in our health. Over time, science has moved from simply identifying these microbes to understanding how they influence our immune system, metabolism and overall wellbeing.

Yet despite this progress, turning those discoveries into real treatments remains a challenge. Dr van Hylckama Vlieg explained that while the science is compelling, the industry needs solid clinical data to bring investors and pharmaceutical companies on board. He sees microbiome-based immunotherapy as a particularly exciting area where transformative breakthroughs could lie ahead.

Freya Biosciences has chosen to focus on the female reproductive tract — a part of the body where the microbiome is less complex than in the gut but just as important. Dr van Hylckama Vlieg spoke about the key role of lactobacilli in maintaining vaginal health. When these helpful bacteria are dominant, they protect against infections and support fertility. When the balance is lost, a state known as dysbiosis, the risks rise significantly.

He also highlighted a wider issue — the historical lack of funding and focus on women’s health. This is something Freya and others in the field are determined to change, and their research is already moving things in the right direction.

One of Freya’s most innovative developments is vaginal microbiota transplantation or VMT. Inspired by the success of faecal microbiota transplants for gut health, this approach involves transferring a healthy vaginal microbiome into someone with dysbiosis. Early results are promising. Many women show a successful shift to a healthier microbial state.

Looking ahead, the goal is to leverage the successes of these natural transfers and develop targeted microbial treatments that can be scaled up. This could lead to safe and widely available therapies that restore balance and improve reproductive health.

Reflecting on his previous experience at Kaleido, another microbiome venture, Dr van Hylckama Vlieg spoke about the need for strong links between science, clinical design and commercial strategy. Though Kaleido faced setbacks, the underlying science remains solid and is being explored by others in the field.

His outlook remains positive. With more trials underway and deeper understanding of how microbiomes influence disease, there is hope that these therapies will move from the lab into everyday medicine. Particularly in areas like immunotherapy, the potential to address root causes rather than just symptoms could be a game-changer.

Dr van Hylckama Vlieg’s insights offer a compelling look into a rapidly evolving area of science. As researchers and companies like Freya push forward, the possibilities for transforming healthcare through the microbiome are growing fast. From improving fertility to preventing infections, these tiny organisms may hold the key to better outcomes for millions — especially in areas of health that have long been underserved.

The Gut-Health Revolution | Dr Chris Damman on Nutrition, Microbiome & the Future of Wellness

Dr Chris Damman brings decades of experience from the biotech world and leading global foundations to share his vision for the future of health and nutrition. In this episode, we dive deep into the transformative power of gut health and the emerging science shaping how we eat and live.

Gut Health: Ancient Wisdom Meets Modern Science

Next-Generation Nutrition: The 4 Fs

GLP-1 Agonists: A Promising Yet Cautious Path

Weed, Seed, and Feed: A Gut Health Strategy

Fermented Foods & Probiotics

The Future: Nutrition Tech & Smarter Choices

Conclusion

Chapters:

Irritable bowel syndrome (IBS) is often brushed off as little more than an inconvenience. But in a recent conversation between Dr James McIlroy and Professor Yan Yiannakou, a consultant gastroenterologist with decades of experience, it’s clear that IBS is far more serious than many realise. Their discussion sheds light on the true impact of IBS and the exciting developments in its treatment.

IBS: A Closer Look

Affecting around 10–15% of the population, IBS can be life-altering for some. Beyond the discomfort, it can seriously disrupt work, relationships, self-confidence, and mental health. Historically, because there was little visible evidence of physical disease, IBS was wrongly considered a psychological condition. Thankfully, this outdated view is changing. New research highlights real physiological changes in the gut, such as immune activation and heightened sensitivity, helping to validate patients’ experiences.

Recognising the Symptoms

Professor Yiannakou explains that IBS typically involves abdominal pain, changes in bowel habits, bloating, and excess wind. Previously labelled a “syndrome” because its causes weren’t well understood, IBS is now recognised as a real disease linked to changes in the gut microbiome and immune system. Symptoms can vary from mild discomfort to severe, debilitating pain that significantly affects daily life.

Breaking Down Misconceptions

A key part of the conversation tackles the myth that IBS is “all in the mind.” While stress can worsen symptoms, it is not the root cause. Dismissing IBS as purely psychological can deepen patients’ distress and delay proper care. Professor Yiannakou stresses the importance of treating IBS as the genuine, physical condition it is.

What Causes IBS?

Although the exact causes are still being explored, IBS often develops after a major gut infection, which can disrupt the gut’s immune system. Treatments are now moving beyond simply managing symptoms like constipation or diarrhoea, with more focus on addressing underlying causes, particularly gut microbiome imbalances.

Hope for the Future

Research into the microbiome’s role in IBS is opening up new treatment options. Early trials of microbiome-based therapies show promising results, but more work is needed to bring these breakthroughs into everyday clinical practice.

Final Thoughts

Professor Yiannakou’s insights highlight the urgent need for better recognition and treatment of IBS. Dispelling outdated myths and focusing on the true physiological causes of the condition offers real hope for those living with IBS. As research continues, the future looks brighter for more effective, lasting treatments.

The conversation touches on everything from genetic influences on obesity and the challenges of sustained weight loss, to the exciting potential of GLP-1 drugs and next-generation probiotics. There’s also a fascinating look at how the microbiome might act as both a diagnostic and therapeutic tool in future medicine.

Finally, Max shares highlights from his book The Power of Hormones, which brings together history, science, and practical advice for anyone curious about how hormones and the microbiome shape our lives.

This episode offers an insightful look at where cutting-edge science meets real-world potential—and why the microbiome could be the key to a healthier future.

Timestamps:

00:00 Introduction to Professor Yan Yau and IBS

In this episode of Inside Matters, Dr. James McIlroy sits down with Cory Greenberg, a professional cyclist and founder of Ride4IBD.

Cory shares his inspiring journey from his initial diagnosis of inflammatory bowel disease (IBD) while training as a professional cyclist, to overcoming the challenges posed by the disease. The conversation covers his approach to gut health in the context of athletic performance, insights into training and lifestyle adjustments, and his efforts to raise awareness through Ride for IBD. Listeners will gain valuable insights into how Cory manages his condition, optimises his performance, and aims to inspire others facing similar challenges.

Through his story, Cory emphasises the importance of creating a sustainable lifestyle and offers practical advice for those living with IBD or looking to improve their gut health.

In this episode of Inside Matters, Dr James McIlroy explores the remarkable evolution of Faecal Microbiota Transplantation (FMT), from its unlikely beginnings to its promising future—and shares exciting new data from his company, EnteroBiotix.

We begin with the pioneering efforts of Mr Ben Eisman in 1958, whose early use of FMT saved lives in cases of severe diarrhoea. From there, Dr McIlroy takes us through decades of progress, culminating in today's pharmaceutical-grade approaches that are changing the face of gut health treatment.

The conversation spotlights the dramatic effectiveness of FMT in tackling recurrent Clostridioides difficile (C. diff) infections and dives into the expanding potential of microbiome therapies for a range of conditions.

James also shares exclusive insights from EnteroBiotix’s recent phase 2 trial, which delivered encouraging results for a next-generation, FMT-based therapy targeting Irritable Bowel Syndrome (IBS). Designed to be scalable, consistent, and patient-friendly, this new approach marks a significant step forward in microbiome medicine.

This episode is a deep dive into one of the most fascinating areas of modern healthcare—and a look at where we're headed next.

Timestamps:

00:00 – The pioneering work of Mr Ben Eisman

In a fascinating conversation with Professor Max Nieuwdorp of the Amsterdam Medical Centre, Dr James McIlroy explores groundbreaking ideas and research surrounding the microbiome, hormones, and their profound impact on metabolic diseases. This insightful dialogue uncovers the remarkable potential of faecal microbiota transplant (FMT) and emerging pharmaceutical strategies in tackling obesity, diabetes, and even cancer.

Timestamps:

The Journey into Microbiome Research

Professor Nieuwdorp's interest in the microbiome began serendipitously during his postdoctoral studies at UCSD. There, he encountered revolutionary ideas, particularly through the work of Jeffrey Gordon, which highlighted the significance of the microbiome long before it became widely acknowledged. An unforgettable early success with FMT on a patient with Clostridium difficile infection set the foundation for his enduring commitment to this field. Over the years, Nieuwdorp has been involved in pivotal studies, evolving his understanding of how microbiome therapies could be used in metabolic diseases and beyond.

Understanding FMT and Its Role

FMT has shown remarkable efficacy, especially in treating infections like Clostridium difficile. The discussion highlights an astounding 90% cure rate demonstrated in early trials, a feat Nieuwdorp describes as "seminal". Nonetheless, expanding this success to metabolic conditions such as obesity and autoimmune diseases remains a promising, yet ongoing, challenge.

The Nexus Between Microbiome and Obesity

While the connection between the microbiome and obesity remains a complex issue, Nieuwdorp emphasises how the microbiome's role in weight control is likely more significant over the long term—akin to directing an oil tanker—than as a quick fix. The conversation delves into why the body finds it easier to gain weight than to lose it, considering genetic predispositions and evolutionary pressures. This adaptability of the microbiome, combined with dietary habits, may significantly influence how our bodies metabolise and store energy.

Revolutionary Treatments on the Horizon

Emerging pharmacological treatments such as GLP-1 agonists are causing waves in medicine. These drugs, alongside the potential of next-generation probiotics, promise to reshape how obesity and associated conditions are treated. Intriguingly, research continues to suggest the microbiome might itself produce GLP-1, hinting at a future where therapies target these microbial mechanisms directly.

The Path Forward: Microbiome as a Predictive Tool

Professor Nieuwdorp envisions a future where microbiome profiling becomes a standard diagnostic and preventative tool. It has the potential to predict disease susceptibility, allowing for earlier and more personalised interventions. In parallel, the continued development of FMT and its derivatives may revolutionise treatments for a range of conditions, from cancer to metabolic disorders.

The Educational Perspective: "The Power of Hormones"

In addition to his pioneering research, Nieuwdorp shares insights in his book, The Power of Hormones, presenting a layperson’s guide to understanding hormones across a lifespan. This book interweaves historical narratives with scientific discussion to elucidate how hormones and the microbiome intersect in influencing daily life.

This extensive dialogue with Professor Nieuwdorp is a testament to the potential of microbiome science and the exciting horizon that awaits both researchers and patients. As innovations continue, integrating microbiome knowledge with traditional medical interventions could profoundly change how we understand and treat human health.

Exploring the Human Microbiome with Dr. Joël Doré: The Future of Gut Health Science

In this episode of Inside Matters, Dr James McIlroy engages in an enlightening conversation with Dr. Joël Doré, Research Director at the French National Research Institute for Agriculture, Food and Environment (NRAE). With over 40 years of experience in microbiome research, Dr. Doré shares his extensive knowledge on probiotics, gut health protocols, at-home microbiome testing, and the gut-brain axis. The discussion delves into the intricacies of the human microbiome symbiosis, the evolutionary development of gut microbiota, and its impact on health conditions such as obesity and chronic diseases. Dr. Doré also sheds light on innovative treatments like faecal microbiota transfer and the significance of microbial diversity for a healthy gut. Tune in to discover how the future of medicine and nutrition hinges on understanding and leveraging the microbial human.

Takeaways

Timestamps

00:00 Introduction to Dr. Joël Doré and Microbiome Research