This article presents fundamental challenges in the development of a self-sustainable and biocompatible network infrastructure to interconnect the next-generation electrical and biological wearable and implantable devices, i.e., the Internet of Bio-NanoThings. The direct contact of IoBNT devices with the human body, where the cells naturally communicate and organize into networks, suggests the possibility to exploit these biological communications for the device-to-device interconnection. The aim of this work is to investigate minimally invasive, heterogeneous, and externally accessible electrical/molecular communication channels to transmit information between these devices through the Microbiome-Gut-Brain Axis (MGBA), composed of the gut microbial community, the gut tissues, the enteric nervous system. A framework to develop a network infrastructure on top of the biological processes underlying the MGBA, and the intercommunications among its components is proposed. To implement this framework, the following challenges need to be tackled. First, physical channel models should be developed to quantitatively characterize electrical and molecular communications through the MGBA. Second, novel technological solutions in information modulation, coding and routing should be developed. Third, to support these efforts with experimental data, a first-of-a-kind implantable MGBA network probe device composed of a hub connected to an ensemble of electrical and molecular stimulation and sensing modules should be designed and engineered, together with an innovative gut-on-a-chip in-vitro model system. The discussion in this paper establishes the basis for a completely novel transdisciplinary networking domain at the core of the next-generation biomedical systems for pervasive, perpetual, and remote healthcare. INDEX TERMS Molecular communication, nanonetworks, Internet of Bio-NanoThings, intra-body networks, biomedical implants, biosensors. The associate editor coordinating the review of this manuscript and approving it for publication was Resul Das. As a result, nanotechnology and biotechnology-enabled wearable and implantable devices with ever increasing biocompatibility and operational autonomy are being developed. These devices promise to pervasively, perpetually, and precisely sense, process, control, and exchange body health parameters in real time, and allow remote interrogation, which we classify under the paradigm of the Internet of Bio-NanoThings (IoBNT) [2]. This paradigm will enable accurate sensing and control of complex biological dynamics