Dr Debra Silberg joins Inside Matters for a deep, wide-ranging conversation on gut health, drug development, and the future of microbiome therapeutics.

Dr Silberg is the Chief Scientific Officer at Beyond Celiac, a former global clinical leader at Shire/Takeda and AstraZeneca, and one of the most respected figures in GI medicine and microbiome science.

In this episode, we explore: • How she moved from basic science to medicine to pharma leadership • Why the GI field needed so much research — and how it transformed • The real science behind ulcers, H. pylori, and the Barry Marshall story • What she teaches in her popular “Understanding Your Gut” course • Prebiotics vs probiotics — what actually matters • The truth about gluten, celiac disease, gluten sensitivity and rising incidence • The microbiome’s role in inflammation, autoimmune disease, mental health & IBS • Whether microbiome drug development is finally turning a corner • Why the gut–brain axis may be the most exciting frontier in medicine

Dr Silberg also shares insights from her work with Finch Therapeutics, her role at Beyond Celiac, and her experience advising the team at Biotics.

If you’re interested in gut science, the microbiome, diet, or how modern medicines are built from the ground up, you’ll get a huge amount from this conversation.

Be well, trust your gut — and thanks for listening.

00:00 Introduction to Dr Debra Silberg

00:54 Dr Silberg's Career Journey

02:26 Insights on Gut Health and Microbiome

04:05 Understanding GI Diseases and Treatments

07:41 The Role of Diet in Gut Health

15:59 Celiac Disease and Gluten Sensitivity

25:04 Exploring the Microbiome

27:43 Exploring Therapeutic Approaches to the Microbiota

31:36 Challenges in Microbiome Drug Development

34:22 The Gut-Brain Connection and Mental Health

39:13 Transitioning from Academia to Pharma

41:45 Insights into Drug Development and Success Stories

44:55 The Long Journey of Drug Development

52:01 The Role of AI in FDA Reviews

55:04 Quick Fire Round: Future of Microbiome Research

You must not rely on the information in this video as an alternative to medical advice from your doctor or other professional healthcare provider. If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider. If you think you may be suffering from any medical condition you should seek immediate medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of the information in this video.

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 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

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 02:39 Understanding Fatty Liver Disease: Past and Present 05:29 Genetic and Environmental Factors in Fatty Liver Disease 08:13 The Evolution of MASH: From NASH to Metabolic Health 10:46 Emerging Treatments and Medications for Liver Disease 13:35 The Role of GLP-1s in Managing Liver Health 16:18 The Gut–Liver Connection: A Historical Perspective 19:07 Building a Successful Liver Clinic: Insights and Challenges 33:52 Understanding Metabolic Health and Genetic Testing 35:13 The Importance of Gut Health 37:39 Transforming Workplace Wellness Initiatives 45:48 The Future of Functional Medicine 51:30 Addressing Liver Health and Alcohol Consumption

Takeaways

• The quality of food in America is declining, impacting health.
• Fatty liver disease is increasingly common, especially among those with higher body mass indexes.
• Genetic predisposition plays a significant role in liver disease.
• MASH is a critical condition that combines fatty liver with inflammation.
• Advancements in GLP-1 medications show promise for treating liver disease.
• Gut health is essential for overall wellness and liver health.
• Guy Neff's journey reflects a blend of medicine and business acumen.
• Building a successful liver clinic requires navigating numerous challenges.
• Functional medicine is gaining traction as a holistic approach to health.
• Routine testing for liver health is crucial for early detection and intervention.

You must not rely on the information in this video as an alternative to medical advice from your doctor or other professional healthcare provider. If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider. If you think you may be suffering from any medical condition you should seek immediate medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of the information in this podcast.