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Gastroenvironmental distress: metaphorical antecedents of the gut microbiome
  1. Nitin K Ahuja1,
  2. Amisha Ahuja2
  1. 1Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  2. 2Cooper Medical School of Rowan University, Camden, New Jersey, USA
  1. Correspondence to Dr Nitin K Ahuja, 600 North Wolfe Street, Blalock Suite 412, Baltimore, MD 21287, USA; nahuja4{at}


The human gut has been viewed for centuries as a potential mediator of systemic disease. The theory of autointoxication, which found its clearest articulation in the late nineteenth and early twentieth centuries, focused on altered bowel habits as the cause of widespread physical decay and advocated for the pursuit of health through regular defecation. More recently, under the banner of the microbiome, research on commensal bacteria makes a similar case for associations between alimentary dynamics and illness manifestations far outside the gastrointestinal tract. Surface distinctions between these two conceptual frameworks are apparently antipodal, the former championing emptiness and sterility, the latter abundance and restoration. Within both models, however, persists a common anxiety about the detrimental effects of civilisation on the body in relation to the natural world. As scientific understanding of the microbiome continues to mature, acknowledging the historical and moral parameters of its borrowed ecological idiom may facilitate critical distinctions between what is true and what feels like it should be.

  • Gastroenterology
  • Nutrition and metabolism

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