Exploring the Evolving World of Gut Health with Dr Tanya Monaghan
In this episode of Inside Matters, host Dr James McIlroy is joined by Dr Tanya Monaghan, clinical associate professor and consultant gastroenterologist at the University of Nottingham.
Dr Monaghan is a leading voice in gut health, especially in areas like the gut–brain axis and faecal microbiota transplantation (FMT). Together, they explore the science, the hype, and the future of the microbiome in a way that’s accessible and grounded in real clinical experience.
Chapter Markers
00:00 Introduction to Dr Tanya Mongan and gut health
01:51 Has the microbiome “bubble” burst?
03:45 The big challenges in microbiome science
06:13 What the future of microbiome testing could look like
12:45 Understanding faecal microbiota transplantation (FMT)
19:22 How FMT works and what current research shows
26:29 Why the microbiome is so complex
34:57 MicroRNAs: a new frontier in gut health
37:41 Where microRNAs come from
38:18 How microRNAs help protect the gut
39:00 Why delivering microRNAs is difficult
39:19 Nano-formulation: new ways to deliver microRNAs
40:37 The advantages of organ-on-chip models
42:02 Personalised “gut avatars”
43:58 Zebrafish and other models used in gut research
49:27 Clinical applications and future directions
53:17 Microbiome therapy and FMT in clinical practice
56:57 The future of microbiome research and treatment
01:01:23 Diet, supplements, and the microbiome
01:04:34 Weight-loss drugs and how they affect the microbiome
01:07:52 Fascinating facts about the microbiome
01:09:24 Final thoughts and wrap-up
Has the Microbiome Bubble Burst?
The conversation begins with an honest question: Has the microbiome been over-hyped?
Dr Monaghan explains the gap between public expectations and what the science currently supports. While the media often paints the microbiome as a miracle solution, the real picture is far more complex. She breaks down common misconceptions around probiotics and DIY faecal transplants, and explains why a deeper, more careful understanding of microbiome science is needed.
Understanding a Complex and Changeable System
Dr Monaghan also talks about how challenging it can be for patients to make sense of the microbiome. Factors like diet, lifestyle, stress, and medication can change the microbiome from day to day, meaning a single test rarely tells the full story. She stresses the importance of consistent, standardised testing methods and a more rigorous scientific approach in clinical settings.
The Growing Role of Faecal Microbiota Transplantation (FMT)
A key part of Dr Monaghan’s work is faecal microbiota transplantation, a treatment showing promise for conditions such as inflammatory bowel disease. She shares insights from international collaborations investigating how FMT works, including the roles of bacteria, viruses, and even fungi. Her explanations bring clarity to a treatment that is often misunderstood, highlighting why research is essential before widespread clinical use.
MicroRNA Therapies: Small Molecules with Big Potential
One of the most exciting parts of the discussion centres on Dr Monaghan’s research into microRNA-based therapies. These tiny molecules act like switches that help control how genes behave. Her team is exploring how they could be used to treat diseases linked to an unhealthy microbiome, including cystic fibrosis and inflammatory bowel disease. It’s a glimpse into a new generation of targeted, precise treatments.
A Future Built on Precision Medicine
Throughout the episode, Dr Monaghan remains optimistic about the future of gut health research. She highlights the importance of high-quality clinical trials and describes emerging tools such as organ-on-chip systems and zebrafish models, which help researchers understand the gut in far more detail. Together, these tools pave the way for precision medicine, where treatments are tailored to individual patients based on real biological understanding.
Final Thoughts: Rethinking the Story of Gut Health
This episode encourages listeners to take a fresh look at gut health and the microbiome—beyond the headlines and social media trends. Dr Monaghan blends real clinical insight with innovative research, offering a balanced and hopeful view of what the future may hold. Her message is simple but powerful:
trust your gut, stay curious, and embrace the complexity of your microbiome.
If you’d like to explore more of Dr Monaghan’s work, you can find her profile on the University of Nottingham website.
