Leaky Gut

“Leaky Gut” Syndrome

You may have heard the phrase “leaky gut” or increased intestinal permeability as it has been a hot topic in the health world recently. But what does it really mean and what are some of the potential consequences of having a “leaky gut”?

GI Basics

First of all let’s start with a little anatomy and physiology. The GI tract is technically not “inside” your body but rather a hollow tube that goes from one end to the other. It is made up of several different distinct sections: the mouth, esophagus, stomach, small intestine (consisting of the duodenum, jejunum, and ileum), the colon, and the rectum.

Most people assume that digestion starts in the stomach, but it actually begins in the brain. When we are hungry and begin to think about food our digestive juices begin flowing to get ready for the meal. Then there is chewing, swallowing, and passage of food into the stomach. From here it goes to the small intestine where most of the nutrients are absorbed. It’s only through this process involving specialized cells that the nutrients from food actually enter the body. Any disruption in the health, function, or interaction of these cells with each other or their environment can significantly compromise the absorption of nutrients. These cells also protect us from unwanted foreign invaders such as bacteria, viruses, and other potentially harmful particles.

What problems can “Leaky Gut” cause?

Ideally this system works flawlessly and we are healthy, vibrant, and have no problems. But when these cells become damaged undigested food particles, bacteria, and debris that are normally excreted pass into the bloodstream. These are recognized by the immune system as foreign invaders and an immune response is initiated. After years of this recurring problem the immune system begins to see cells and molecules in our own body as foreign. This initiates an autoimmune process (meaning the body is attacking itself) that if left unchecked can result in multiple GI symptoms as well as systemic illness–think Hashimoto’s thyroidits, rheumatoid arthritis, multiple sclerosis, Chron’s disease, lupus. In addition, the ongoing inflammation associated with leaky gut damages the protective coating of the intestines making us more susceptible to infections and increases our sensitivity to environmental chemicals that we ingest. The presence of undigested food particles that have made it into our bloodstream creates food allergies and microbes in the gut can cross over causing a toxic burden that overwhelms our liver’s ability to detoxify.

Common Causes of Leaky Gut

  • food sensitivity
  • poor dietary choices
  • intestinal infections
  • damage from non-steroidal anti-inflammatory drugs (NSAIDS)
  • cytotoxic drugs and radiation
  • certain antibiotics
  • excessive alcohol consumption
  • compromised immunity
  • stress and emotions
  • toxic exposure

What can we do about it?

There is a test available to assess for leaky gut and thankfully there are options available for treatment. Most treatment recommendations consist of lifestyle and dietary changes such as avoidance of anything that can damage the gut lining like inflammatory foods, NSAIDS, and alcohol. There are also a few nutritional supplements that are beneficial. I typically recommend starting with a comprehensive elimination diet to identify any food sensitivities followed by a good anti-inflammatory diet. Fish oil, vitamin D, probiotics, and glutamine can also be helpful in healing the gut lining. Fiber is very important and I recommend 30-50 grams per day of mixed fiber. If digestion problems are suspected you may need a digestive enzyme as well. Stool studies are very helpful in identifying underlying infections or imbalance of bacteria that normally live in the gut.

There are mixed opinions on leaky gut, and the conventional medical community typically does not recognize it as a real phenomenon, however the evidence is growing that this is not only a real condition but may actually be contributing to many of the health problems plaguing our country. Hippocrates stated over 2000 years ago that “all disease begins in the gut,” and the more we learn, the more we realize he may have been right.