Total pain and human gut microbiota

Addressing total pain through a holistic approach is a central philosophy in caring for those with life-limiting illnesses. There continues, however, to be an entrenched divide in care treatments that either privilege a biomedical or a psychosocial aetiology of suffering. The result is that an individual's experiences of severe distress at the end of life may be situated predominantly within the mind or body, even within a multidisciplinary team setting. This chapter considers one innovative approach to this issue by exploring possible relationships between human gastrointestinal microbiota, the brain–gut–microbiome axis, and experiences of suffering in advanced life-limiting illness. It employs a transdisciplinary approach that is informed by literature across life, medical, and social sciences to provide a concrete example of how our biological and social selves are intertwined, and to offer a radically new way of thinking about total pain in life-limiting illness.