Gut: The Inside Story of Our Body's Most Under-rated Organ
from the Sydney Morning Herald
Continued Enders was provoked into her search, she tells us, by a question about toileting
put to her by a flatmate. The studious Enders hit the textbooks, lost herself in
study of the "masterly performance" of our inbuilt disposal factory and emerged
with a gleam in her eye: she would answer the simple question at book length
and in language that would not cause her flatmate's eyes, along with the rest of
us who are not gastroenterologists, to glaze over.
To sell her vision of the wonders of our gut, our "least understood organ", she
employs a writing style that showcases the same disarming panache that won
her the 2012 Berlin Science Slam. I wondered initially if there wasn't an
element of youthful overreach in her approach to hooking the reader. In the
first 50 or so pages, under headings such as "How does pooing work?" we meet
phrases such as "our kinky rectal-closure mechanism" and a description of the
biofeedback therapy for chronic constipators likened to the experience of being a
contestant on a TV show with "a sensor up their bum".
Once Enders has stormed the taboo "poo" barriers a sort of liberating permission
to abandon conventionality flows across to the reading audience. We follow her
from the gateway to the gut (the inside of our mouths), down the oesophagus,
into the stomach, the small and large intestines (with an interesting detour to
the appendix) to the final exit through synchronised sphincters that assess the
load and decide when it's the appropriate time for "full steam" ahead.
Not everyone trained in the sciences may appreciate the quirky appeal of
reading a sentence that goes: "If we vomit the raw egg back up after the right
amount of time, the results would look like almost perfect scrambled eggs —
without any cooking!" For this scientifically trained reader coming upon the
phrase "the sophistication of our sphincters" made me break into an appreciative
smile.
Her exponentially growing number of fans seems happy to be swept into an
engagement with her larger thesis after a warm-up on poo stories. "My
flatmates have learned to recognise the familiar look on my face when I rush
into the kitchen bursting to tell them my latest gut anecdote," she writes, "Like
the one about the tiny squat toilets and luminous stools. "Whereupon, the
flatmates and the reader are drawn on to the next heading, "Are you
sitting properly?"
In well-ordered chapters, illustrated with whimsical line drawings by her sister
Jill, Enders scatters little pause-for-thinking notes. Observe the three-day rule
with laxatives (don't take another one yet — monitoring for a normal stool
should begin on the third day); don't fry in olive oil, dip your baguette in it
instead; food intolerance is not the same as allergy (useful when hosting an
over-anxious dinner guest); make your own salad dressing; limit the amount of
sweetened yoghurt, canned soup and tomato sauce you consume (and therefore
the negative effects of too much fructose). Each note reinforces her message
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that feeling miserable can be just as much about how the gut is performing as
the state of our neurotransmitters.
In the harder science chapters, Enders is particularly good at explaining why the
gut is the body's largest sensory organ and how it works co-operatively with the
brain to stabilise our emotional lives.
She describes new research on the "discussions" between head and stomach
during periods of stress, "such as time pressure or anger". The brain, a problem
solver, borrows energy from the gut by retarding the flow of mucous and blood
needed for digestion. Problems arise when the stressed brain keeps draining
energy from the gut, causing weakening of the gut walls and a knock-on effect
on the immune cells that dwell in the walls.
In a recent interview, Enders expands on the high correlation between certain
types of brain and intestinal disorders: "The information exchange, we've
learned, is 90 per cent gut to brain, but only 10 per cent the other way; the
brain doesn't have much to tell the gut. But the other way around? If we
change the gut flora in animals, we see changes in their immune systems and
then in their behaviour …"
In humans, this brain-gut balance plays a role in antidepressant pharmaceuticals
that target serotonin levels. It is well known that mood-stabilising drugs cause
nausea in the uptake phase and constipation in the long term, side effects that
make sense once we know that 95 per cent of the serotonin our bodies produce
is manufactured in the cells of the gut. She notes the work of an American
researcher, Dr Michael Gershon, who is considering the viability of an
antidepressant that targets the gut and bypasses the brain.
Apart from a lack of footnotes (such as a link to Gershon's work) and an index —
no doubt in keeping with the author's stated intent of being entertaining while
communicating "the information that scientists bury in their academic
publications or discuss behind closed doors" — this is a book well worth owning.
If you want a taste of the Enders treatment, watch her on YouTube, winning the
Science Slam. Three quarters of a million viewers have already had the pleasure.
Or flip to page 63 and "take a closer look at the mysteries of number twos!"
Gail Bell has worked as a pharmacist, educator and writer. Her books
include The Poison Principle and Shot (Picador).
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