How to Build, Maintain & Repair Gut Health
Evidence-based insights from leading experts — and what I’ve seen work in clinic.
Over the past decade working as a nutritionist and researcher in this space, I’ve had the privilege of supporting hundreds of individuals struggling with gut issues — and one thing I can say with certainty is that no two journeys look the same.
Irritable Bowel Syndrome (IBS) is one of the most common concerns people come to clinic with — and yet, it remains one of the most confusing and, at times, isolating conditions to live with. The symptoms are unpredictable. The advice online can feel contradictory. And when you’re bloated, in pain, or constantly second-guessing your food choices, even knowing where to begin can feel overwhelming.
That’s why I’ve created this special IBS Masterclass episode — to bring together some of the most insightful, science-backed conversations I’ve had with world-leading gastroenterologists, psychologists, researchers, and clinicians.
There are no quick fixes here. No magic protocols. Just real, compassionate, evidence-informed guidance — from how you eat, to how you move, to how stress and even medication may be shaping your microbiome in ways you didn’t realise.
What we now understand more than ever is that the mind and the gut are inseparable. Your gut microbiome doesn’t just influence digestion — it plays a powerful role in your immunity, your mood, your sleep, and even your motivation. And healing the gut isn’t about chasing perfection — it’s about small, sustainable steps that respect the unique ecosystem inside you.
So, whether you’re newly diagnosed with IBS or have been living with symptoms for years, my hope is that this Masterclass provides clarity and a starting point — not just to support your digestive health, but to help you feel more in control of your body and overall well-being.
Below are the key takeaways, distilled from hours of conversations and years of clinical experience. Think of this as your roadmap — one you can return to anytime you feel overwhelmed or unsure where to turn next.
My personal insights and takeaways
1. The Gut is an Ecosystem
“Your gut is an ecosystem, just like the Amazon Rainforest, just like the Great Barrier Reef.”
Reflection: I love this image because it reminds us that our gut isn’t just a passive organ quietly doing its job — it’s a thriving ecosystem, alive and dynamic, much like a rainforest or coral reef. But here’s the key: like any ecosystem, it’s not just about what’s there — it’s about the diversity.
One of the most common misconceptions I see is people saying, “But I eat lots of fruit and veg, isn’t that enough?” And while that’s a brilliant start, the truth is that a healthy microbiome doesn’t just depend on eating plant-based foods — it depends on eating a wide variety of them. Diversity is what feeds different species of gut bacteria, helping them thrive and support various functions, including digestion, immunity, and mood.
Yes — eat the rainbow. But don’t stop at five a day. Include herbs, spices, nuts, seeds, whole grains, legumes, fermented foods, and those less familiar veggies too. Variety is the secret. The more diverse your diet, the more resilient your microbiome becomes, just like the rich, complex biodiversity of a rainforest.
This isn’t about perfection, it is about abundance, building habits that nourish the world inside you — one colourful plate at a time.
2. Diversity Means Resilience
“When they’re in balance, the good guys are outnumbering the bad guys, and there’s plenty of diversity—and because there’s plenty of diversity, it is a resilient system.”
Reflection: We often hear that gut diversity equals resilience, but why does it matter?
Around 70% of our immune cells are produced in the gut, and over 90% of our serotonin — the feel-good hormone — is also made there. That means our gut microbiome plays a central role not just in digestion, but in regulating our immune system, mood, and inflammation levels.
I often describe the microbiome like a conductor in an orchestra — coordinating signals across the immune, nervous, and digestive systems. But just like an orchestra, it only works well if there’s a wide range of players. It’s not just about eating plant-based foods — it’s about eating a diverse mix: herbs, spices, beans, lentils, whole grains, and as many different fruits and vegetables as you can manage each week.
The more diversity you feed your gut, the more resilient that internal ecosystem becomes — like a well-trained army ready to respond to whatever life throws at it.
3. Symptoms Are Only Part of the Story
“Just because you have symptoms occasionally does not mean you have a problem.”
Reflection: We’ve all been there — feeling bloated after a big meal or noticing our digestion shifts when we’re stressed. But occasional discomfort doesn’t always mean something is wrong. Our bodies ebb and flow, and no two people will experience gut health in exactly the same way. There’s no gold star for a “perfect” gut — and there’s no single definition of what a healthy gut feels like.
Everyone’s bowel habits are unique to them. That said, if you notice a significant or persistent change — especially if it involves ongoing pain, disruption to your daily life, or irregular bowel movements — that’s a good reason to tune in and seek support. Listening to your body means paying attention to patterns over time, not panicking at every gurgle. And if something feels off, don’t hesitate to speak with a GP. Sometimes the best care starts with curiosity and asking the right questions.
4. Low and Slow is the Tempo
“Low and slow is the tempo.”
Reflection: This might be one of my favourite mantras — and one of the most important! When it comes to changing your diet or introducing more fibre, slow and steady really does win the race. Why? Because fibre pulls more water into the bowel, which means if you increase it too quickly — without also upping your hydration — you can end up with bloating, cramping, or discomfort.
This is why it is key to build fibre up slowly to avoid any gut discomfort, because fibre is one of the best long-term allies for your gut. Give your gut time to adapt and support it with plenty of fluids along the way.
Just like any meaningful lifestyle shift, the goal isn’t to achieve overnight success — it’s building something sustainable, kind, and consistent.
5. Your Microbiome Mirrors Your Diet
“Your gut microbiome has been trained to whatever you’ve been eating in the last two months.”
Reflection: This is both humbling and incredibly hopeful. Changes in the gut microbiome can begin within just 24 hours of consuming fibre nourishing foods, which means every meal is a new opportunity. One bad day doesn’t undo everything, and it certainly doesn’t define your long-term health.
Reminding yourself that you quite literally have the power to shift your gut microbiome through the food you eat can be a powerful daily mantra.
6. Medication and the Microbiome
“Many of these medicines that we take, that we don’t think about as being antibiotics, are in fact antibiotics.”
Reflection: This shifted my perspective. It’s not just antibiotics — everyday medications like SSRIs or common painkillers can also impact our gut microbiome, especially when taken over a prolonged period of time.
While these medications can be essential, it’s helpful to build an awareness of how they might be affecting our internal ecosystem. As Dr James Kinross mentioned in LWBW to me, the average person takes multiple pharmaceutical drugs a year, and many of them, even those not labelled as antibiotics, can have antimicrobial effects.
That doesn’t mean we stop taking what we need. It does mean, however, that we can support our gut more consciously during these times — with things like prebiotic and postbiotic foods, fibre diversity, and staying hydrated — to help strengthen and restore microbial balance.
7. Beware of Quick-Fix Tests
“Most of the direct-to-consumer tests that you buy are not very helpful.”
Reflection: We all want answers — especially when we’re struggling with gut issues — but no magic test can sum up your gut health in one go. Our gut story is written over time, shaped by what we eat, how we feel, and how and where we live.
It’s worth noting that the only scientifically validated tests currently available are endoscopies for coeliac disease and colonoscopies to diagnose inflammatory bowel diseases like Crohn’s or ulcerative colitis.
Many of the direct-to-consumer gut tests on the market aren’t considered gold standard methods, so it’s important to approach them with caution. Clever marketing can be convincing, but it doesn’t always mean evidence-based.
If you’re concerned about your gut health, always seek support from a qualified healthcare professional who can guide you with proper diagnostics and care.
8. Healing the Gut is Like Building Muscle
“Conceptually, the gut is like a muscle. It can be trained. It can be made stronger.”
Reflection: I find this so encouraging. Our gut’s strength isn’t fixed — it can grow, adapt and become more resilient, just like a muscle. We just have to give it the right fuel, challenges and rest, and not expect miracles overnight.
9. The Brain and Gut Are Inseparable
“Anytime you have a chronic disturbance of your bowel function... You almost have to have some sort of associated brain component.”
Reflection: One thing that’s often overlooked is just how many people with IBS also experience anxiety and depression, and we’re still not entirely sure which comes first. What we do know is that the connection between our gut and brain is bi-directional. They’re constantly communicating - like two best friends.
Given that a large percentage of our neurotransmitters, including up to 90% of our serotonin, are produced in the gut, it makes sense that our mental health is so intertwined with our digestive health. When we’re stressed or overwhelmed, that emotional state can directly impact our gut microbiome — and in turn, gut imbalances can worsen mood symptoms.
What I found particularly powerful is how much research over the past decade has pointed to the benefits of mindfulness-based therapies in supporting IBS. Practices like meditation, breathwork, and even gut-directed hypnotherapy are now being prescribed on the NHS because of their proven ability to calm symptoms.
So, when we talk about gut health, it’s not just about what we eat. We need to take a two-pronged approach: nourishing the gut physically, but also supporting it emotionally. Because ultimately, our gut and brain are never not in conversation.
I’d love to know what resonated with you most from this Masterclass. Was there a particular insight or quote that made you think differently about your gut? Or perhaps something you’re now inspired to try?
As always, your feedback means the world — not just to me, but to the way we shape future episodes. If this conversation helped you feel seen, informed, or simply less alone in your IBS journey, I’d love to hear about it.
Love,
Sarah Ann x