Connecting Large & Microscopic Environments

A Q&A session with Dr. Zach Bush reveals the truth about current health concerns at the intersections of human biome, microbiota, food, and farming.

Dr. Zach Hil

What follows is an interview with Dr. Zach Bush, a physician and internationally recognized educator working at the intersection of the microbiome, human health and disease, and our food production systems. We asked for his insight into the root causes of today’s gut health concerns, and his responses indicate the need for major changes in the sectors of corporate agriculture, Big Pharma, and Western medicine. Dr. Bush’s research and businesses suggest a future based in regenerative health for the planet, and the humans who live here, is possible.

Fermentation: Conditions such as irritable bowel syndrome (IBS), small intestinal bacterial overgrowth (SIBO), and leaky gut seem to be the maladies of the moment. They also seem to be a stopping point in conversation or diagnosis for the allopathic community, but a starting point in conversation for naturopathic and integrative medical communities. Why is this?

Zach Bush: I don’t know that I have the entire answer, but the underpinnings of it, I believe, come down to the segmented nature of education at the allopathic level. You have gastroenterologists, cardiologists, pulmonologists, oncologists, rheumatologists; all of these areas of expertise are trained away from understanding the whole picture of health. None of the conditions you described fall into the above specialties. There’s never been a microbiome specialty to coordinate the education or expertise in this area of medicine; even our lauded federal agencies of the NIH (National Institutes of Health) and FDA (Food and Drug Administration) don’t yet recognize the microbiome as a source of disorder or disease at this point. The traditional segmentation of an allopathic medical education has failed to find a home for microbiome expertise.

You would guess the gastroenterologist to be an obvious champion in this field, yet we find this subspecialty often the most resistant to this information. I think this has to do with education. They’re really trained as optical technicians, spending much of their time looking through scopes at the colon, at the stomach, at the small intestine via cameras, and so they have a very gross anatomical look at the body.  They’re not molecular biologists by and large, and learning isn’t cross-pollinated with gastroenterology, for example. When you learn gastroenterology without studying the microbiome (which seems hard to believe for the consumer at this point), you’re taught to believe the GI tract is a simple anatomical tube, and not a complex ecosystem that maintains optimal metabolism, immunity, and nutrient delivery via an intricate matrix of epithelial barrier cells, endocrine cells, nerves, immune cells, and beyond.  This educational limitation not only excludes the microbiome, but also the more intricate reality of the microscopic function of the gut lining. As such, there’s been huge pushback, even categorical denial, from allopathic gastroenterology about pathologic gut permeability or “leaky gut” as a disorder that’s emerged as an epidemic underlying the chronic disease explosion in recent decades.

The technology-driven specialties can maximize billing through imaging technology: Radiology, interventional radiology, interventional cardiology, and gastroenterology are the last bastion of economic profitability in hospital systems.  The industry rewards practitioners in these fields with the highest salaries in the physician world.  If gastroenterologists make their money understanding the GI tract as a tube, there’s no incentive to study or to teach nutrition, microbiome, or microbiologic physiology as a focus for clinical training. Interestingly, despite global recognition over a few thousand years that food is our medicine (tracking back to ancient Chinese medicine teachings and Hippocrates of ancient Greece), nutrition has been completely left out of medical education at large, which is where we meet the microbiome at the largest level, through food and the water systems that populate our guts. Education is the short answer to why it is that allopathic medicine is so far behind the science that even the general consumer has come to understand.



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