Leaky Gut: What’s really going on there?

My last blog post was on allergies, and delved briefly into the connection of that condition with leaky gut, and I promised to go into more detail in my next blog post. The truth is that leaky gut (in medical-ese it’s called intestinal permeability) is part of the root cause of most, if not all chronic diseases that have some component of inflammation.

So, what is happening when someone has leaky gut?  First let's start with what is supposed to be happening.

One of the many important roles of the gut

Your digestive tract is one of the most important places where your body interfaces with the outside world and develops its understanding of what is you (your cells) and what is not you (bacteria, food, pollen, etc) as well as what is safe (healthy probiotics, pollen) and what is not safe (disease-causing bacteria and viruses).

Side note: Things such as foods and healthy bacteria that your body considers safe when found in your gut are not considered safe when found in your bloodstream or elsewhere in your body.

A large portion of your immune system resides along your intestinal passageway and immune cells send out feelers to “taste” items passing through and convey to your body “this is safe” or “this is not safe”. Foods found in your gut are generally labeled as “safe”, but “not you” until they are broken down into their component parts, which are no longer recognizable as individual foods: Carbohydrates into glucose or fructose, protein into amino acids and fats into tiny fat droplets. These are absorbed through special mechanisms into the blood stream and used to build the structures in your body, burned for energy, or stored for later.

The lining of the digestive tract in an ideal state is a tightly controlled barrier that only permits fully digested nutrients though into the blood stream. This barrier is important because your immune system really doesn’t like to find unexpected things in your blood stream.

So what happens when things go awry in your digestive tract?

There are a lot of things that can cause the barrier to become leaky:

  • Stress
  • Consuming highly processed foods
  •  Food additives including added salt, refined sugar, emulsifiers, etc.
  • Consuming foods that you are allergic or intolerant to (for example: a lactose intolerant person drinking milk)
  • Excessive or chronic alcohol use
  • Maldigestion or malabsorption (pancreatic insufficiency, low stomach acid)
  • Antibiotics
  • NSAID pain medications like Ibuprofen, Motrin, Aleve
  • Parasitic infection or fungal overgrowth (candida) in the intestinal tract
  • Bacterial overgrowth in the small intestine (SIBO)
  • High intensity exercise

All of these things can wreak havoc and disrupt the intestinal barrier that keeps unwanted things out of your blood stream. And once that intestinal barrier is compromised, small particles of the foods you eat make it into your blood stream still recognizable to your immune system as foods. This is called leaky gut. Now your immune system is finding recognizable food particles in your blood and labeling them as foreign invaders. (I’m not talking about whole pieces of corn here, but for instance tiny pieces of protein from corn that haven’t been deconstructed into amino acids yet.) So now when you eat those foods in the future, your body mounts an immune attack on them. This is how food allergies happen. Along with foods, bacteria get introduced into your blood stream as well, stirring up a significant immune reaction where your body produces inflammation in response to these invaders. This whole process increases systemic inflammation and contributes to basically any chronic disease. Additionally, the liver gets the job of cleaning up the additional toxins that make it into the blood stream and rapidly becomes overloaded, potentially leading to further symptoms such as brain fog, anxiety, acne and more.

Seasonal allergies are just one manifestation of excessive inflammation. Others include asthma, heart disease, arthritis and autoimmune diseases like lupus, rheumatoid arthritis, psoriasis, Sjogren’s disease, and eczema. So why does one person develop seasonal allergies while another develops rheumatoid arthritis? We don’t know all the details yet, but it has to do with your unique genetic susceptibilities combined with your environment.

But we do know that the common factor between all these diseases is inflammation triggered by an immune reaction to leaky gut.

But there’s good news!

Your gut lining begins to heal immediately once the irritants are removed. That means that if you can give your digestive tract a break from irritants for a while, it can and will heal. The trick is to remove the irritants and support the healing process. I generally recommend spending one to three months doing a gut-healing program. Once you’re finished with the focused healing phase, it’s important to avoid falling back into bad habits. Stick to a diet of whole foods with plenty of variety, but don’t slide back into eating processed junk foods or foods you know you’re intolerant to. See my last blog post on allergies for details on the 4R gut healing protocol.

Testing

One useful test to determine if you have intestinal permeability is called the lactulose/mannitol ratio. This particular lab company has renamed it the Intestinal Permeability Assessment. Leaky gut is incredibly common due to the prevalence of highly processed diets and use of NSAID pain relievers and antibiotics. In those who have an inflammatory disease of some sort, it’s almost guaranteed that the test will come back positive. On the other hand, it can provide a great way to track whether treatment is working. It’s up to you and your doctor whether and when to test.

So there you have it. What questions do you have about leaky gut?

As always, if you feel you would like some individually tailored support, schedule a visit to work one on one with me. 

 

To your health,

Dr. Jennea

 

References:

Chen, T. (2014). Food allergens affect the intestinal tight junction permeability in inducing intestinal food allergy in rats. Asian Pac J Allergy Immunol Asian Pacific Journal of Allergy and Immunology, 32, 345-353. doi:10.12932/ap0443.32.4.2014

Fasano, A. (2012). Intestinal Permeability and Its Regulation by Zonulin: Diagnostic and Therapeutic Implications. Clinical Gastroenterology and Hepatology, 10(10), 1096-1100. doi:10.1016/j.cgh.2012.08.012

Fasano, A. (2012). Zonulin, regulation of tight junctions, and autoimmune diseases. Annals of the New York Academy of Sciences, 1258(1), 25-33. doi:10.1111/j.1749-6632.2012.06538.x

Lerner, A., & Matthias, T. (2015). Changes in intestinal tight junction permeability associated with industrial food additives explain the rising incidence of autoimmune disease. Autoimmunity Reviews, 14(6), 479-489. doi:10.1016/j.autrev.2015.01.00