I felt an interesting dissonance in the framing of this article, which reports the latest in a wave of studies showing gut biome differences in people with MS.
MS UK: MS linked to gut microbiome changes, study finds
I don’t think it’s just a matter of avoiding specialist language when reporting for a wider audience - agency is attributed differently in the popular article vs. the study. MS UK seem to position the gut microbiome as a source of evidence regarding the role played by diet in this immune disorder:
"While the exact cause of MS remains unknown, growing evidence points to environmental risk factors like poor diet and smoking playing a role in the disease’s development. This makes the gut microbiome a promising area for further research into how MS may begin and progress."
Despite the use of the word “environment”, the examples given seem to focus on the patient’s own individual behaviour. Although I’m very interested in improving my gut health as part of how I manage MS, I don’t think of it strictly as a diet and lifestyle thing, maybe because the relationship is reciprocal?
In contrast, the study authors conclude their overview by positioning the immune system as the driver of change in the gut microbiome: “This analysis of gut microbial ASVs reveals shifts in taxonomic strains induced by immune modulation in MS.” I don’t think it’s better to attribute agency to the immune system itself rather than to diet, I think both are probably true and I like to imagine that one day we’ll figure out how to intervene on both sides of the system.
I’m personally doing a lot to try to improve my gut health, and I’m just about knowledgeable enough on the topic to feel overwhelmed and confused on a regular basis. My gut frequently, and quite rudely, reminds me that this isn’t a system that responds in a direct, linear, and consistent way to given inputs. MS and IBS both challenge the border between self and world: MS symptoms cause sensory changes that I experience as though it were the world itself that changed; meanwhile, IBS reminds me that there is a complex living ecosystem inside of me that nobody really understands.
