This is the third in a three-part series. In the first installment, we took a closer look at the digestive system, its role in maintaining your health, and the importance of digestive enzymes. In the second, we examined the role of the billions of bacteria in your gut and what happens when that system gets out of balance – a condition known as dysbiosis. In this part of the series, we will examine a condition called Leaky Gut Syndrome, which is to blame for everything from skin conditions and food sensitivities to more serious degenerative diseases.
What Is Leaky Gut?
Leaky Gut Syndrome is the condition in which the mucosal lining of the intestinal tract becomes porous and irritated. As described in the previous articles in this series, the mucosal lining is an essential semi-permeable membrane that lines the digestive tract. Under normal conditions, this mucosal lining performs two vital functions. It allows essential nutrients, in the form of amino acids, fatty acids, glucose, minerals, and vitamins from small digested food particles, to pass through it and into the bloodstream. At the same time, it presents a physical and immunological barrier to the absorption of most undigested food particles, intestinal toxins, and microorganisms such as parasites and candida.
Over time, the breakdown in this intestinal mucosa can result in the passage of unwanted food particles, toxins, parasites and candida into the bloodstream. This increased intestinal permeability can lead to a weakened immune system, digestive disorders and eventually chronic disease. The unwanted substances that pass through are seen by our immune system as foreign, stimulating an antibody reaction and alarming substances called cytokines, which then alert our lymphocytes — white blood cells — to fight the foreign substances. This reaction also produces oxidants, causing irritation and inflammation far from the digestive system. At the same time, harmful bacteria that are normally kept in check in the digestive tract begin to colonize in other parts of the body. In fact, people with leaky gut have been known to develop arthritis in the knees or spine because these harmful bacteria have breached the gut lining and found their way into the synovial fluid of the joints, causing chronic inflammation and eventually breakdown of the joint structure.
Depending on an individual’s own susceptibilities, leaky gut can lead to a wide variety of symptoms and disorders, such as: asthma, celiac disease (severe gluten sensitivity), Crohn’s disease, malabsorption syndromes, attention deficit disorder and hyperactivity, colitis and irritable bowel syndrome, liver dysfunction, pancreatic insufficiency, diabetes, chronic fatigue syndrome, and even auto immune disorders such as ankylosing spondylitis, rheumatoid arthritis, eczema (dry, scaly skin), psoriasis, and Reiter’s syndrome.
What Causes Leaky Gut?
There are many factors that can lead to the development of leaky gut syndrome, such as chronic stress, dysbiosis (imbalanced gut flora which was discussed in the second part of this series), environmental contaminants, alcohol abuse, poor food choices, and prolonged use of medications such as anti-inflammatories.
Chronic stress is perhaps the leading cause of leaky gut syndrome. As we have learned from examining the link between stress and numerous other degenerative health conditions, prolonged stress has an inhibiting effect on our immune system. This result is the end stage of a natural yet paradoxical process. Initially, the body’s response to a stressful situation is a heightened immunity. In fact, sometimes the immune response can be so dramatic that it overreacts, such as in the case of an allergic reaction like hives, excess mucous production, or asthma. However, after frequent and repeated exposure to stress, the body tends to produce less immune antibodies and less anti-stress hormones like DHEA, which is released by the adrenal gland. This muted response also slows down the digestive process and peristalsis, reducing blood flow to the digestive organs, and producing toxic metabolites. This burning out effect is seen in various other bodily systems, such as in the pancreas when its overproduction of insulin in response to a high sugar diet (characterized by hypoglycemia) can eventually lead to diabetes (hyperglycemia).
In the second part of this series, we examined dysbiosis, the condition whereby there is an imbalance in the bacterial environment in the gut (e.g., candidiasis). It does not require a leap in logic to see how this condition can promote increased gut permeability. When the harmful bacteria begin to outnumber the beneficial bacteria, candida and other parasites can proliferate and irritate the gut lining leading to intestinal infection, inflammation and the erosion of the mucosa. Dysbiosis also inhibits the production of new cell growth in the intestinal tract, which is essential for the health and integrity of the cell membranes of the gut lining.
Daily exposure to hundreds of household and environmental chemicals and pollutants places stress on our immune system and the body’s ability to repair itself. This becomes a vicious cycle as these pollutants begin the build up and overburden the liver’s ability to fulfill its role of assisting the digestive system in the breaking down of fats and other food byproducts. Besides also acting as a direct irritant on the gut lining, these pollutants deplete our reserves of buffering minerals, causing an acidic environment and inflammation in the cells and tissues.
As far as the gut is concerned, alcohol could easily be considered one of the environmental pollutants discussed in the previous paragraph. Alcohol has the unique characteristic of also depleting the body of B-complex vitamins, which are essential to digestion and gut integrity. And like other toxins, alcohol places a significant strain on the liver, a key player in the digestive process, and acts as a significant source of inflammation for the gut lining. Coffee is another substance that often contains numerous toxins and, much like alcohol, contributes to inflammation and gut irritation.
As we have examined in both of the preceding parts in this series, poor food choices, has a significant and negative impact on the various components of the digestive system. Excessive consumption of refined sugars and other highly processed foods contributes to dysbiosis and insufficient enzyme production. Low-fiber diets cause an increase in bowel transit time, allowing toxic by-products of digestion to concentrate and irritate the gut mucosa. Processed foods such as breads, pastas and cereals also promote inflammation and subsequent breakdown of the digestive tract.
As also discussed briefly in the second part of this series, certain medications, such as non-steroidal anti-inflammatories (NSAIDS), can damage the gut lining if used frequently or over a prolonged period of time. Because NSAIDS work to block all prostaglandin production (including those that allow healing and tissue repair as well as those that cause inflammation), they can inhibit the cyclical repairing and replacing of the intestinal lining. The side effects of NSAIDS are well known. The gut lining becomes weak and more permeable. Although these side effects are well documented and clearly indicated on drug bottle labels, few people are aware that the use of NSAIDS, antacids, and antibiotics is one of the greatest contributors to leaky gut syndrome. Caffeine can be considered another drug that can be quite problematic for the gut lining, as well as for the endocrine system.
How Do You Know If You Have Leaky Gut?
There are a few ways to go about determining whether you have leaky gut syndrome. As described in the first and second parts of this series on enzyme insufficiency and dysbiosis/candidiasis, one way is to determine your likelihood of having the condition based on your symptoms and simply making the necessary dietary and lifestyle changes to see if they resolve the problem. If they do, then you did. In the case of leaky gut, the list of symptoms may be used as a sort of self-test to help you assess the functioning of your small intestine (your gut). Simply assign a value from 0-3 to each symptom from the following list to indicate the intensity and frequency of the symptom; “0” for those which are never or rarely present, “1” for mild/sometimes, “2” for moderate/often, and “3” for severe/almost always. This questionnaire is excerpted from Digestive Wellness, by Elizabeth Lipski, an excellent resource for digestive issues. It is not intended to provide a definitive diagnosis:
___ Constipation and/or diarrhea
___ Abdominal pain or bloating
___ Mucus or blood in stool
___ Joint pain or swelling, arthritis
___ Chronic or frequent fatigue or tiredness
___ Food allergies, sensitivities or intolerance
___ Sinus or nasal congestion
___ Chronic or frequent inflammation
___ Eczema, skin rashes or hives
___ Asthma, hayfever or airborne allergies
___ Confusion, poor memory or mood swings
___ Use of NSAID medications (aspirin, Tylenol, Motrin)
___ History of antibiotic use
___ Alcohol consumption or alcohol makes you feel sick
___ Ulcerative colitis, Crohn’s disease or celiac disease
Total of Values: _______
A score of 1-5 indicates that leaky gut is less apt to be present; 6-10 indicates it may possibly be present; 7-19 indicates probable presence; and 20+ indicates leaky gut is almost certainly present.
For a more definitive diagnosis, the recognized standard test among health professionals is the mannitol and lactulose urine test. Mannitol and lactulose are water soluble sugar molecules that our bodies cannot metabolize or use. They come in differing sizes and weights and are absorbed into the bloodstream at different rates. A qualified physician or nutritional consultant can give you a test kit to collect the urine samples. After collecting a random urine sample, you drink a mannitol/lactulose solution and collect urine for six hours. The samples are then sent to a laboratory where the levels of mannitol and lactulose present in the urine are determined. A healthy test result shows high levels of mannitol and low levels of lactulose. If large amounts of both are present, it indicates a leaky gut condition. If low levels of both are present, it indicates a malabsorption issue. Low mannitol levels with high lactulose levels have been found in people with celiac or Crohn’s disease.
What To Do About It
If you believe you suffer from leaky gut, it’s best to work with a health professional who can help you determine the underlying factors and give you guidance as to how to resolve the issue. Fortunately, there are many ways to heal your gut. The priority must always be to address the underlying factor(s) and not just to ease the uncomfortable symptoms associated with this condition. Addressing issues of chronic stress, alcohol abuse, dysbiosis, prolonged use of NSAIDS, poor diet and exposure to toxins can go a long way toward healing your gut.
If you know that stress is likely a significant underlying factor, begin practicing proven stress-relieving techniques such as meditation, guided imagery, yoga, massage, and simply setting aside time on a weekly and daily basis to relax. One very effective and often overlooked stress-relieving technique is to abstain from watching, reading or listening to the news (a news fast) for a week at a time. Committing to a news fast, especially during this time of war, can be an extremely freeing and enlightening experience. If a weeklong fast is too much for you to start with, at least avoid exposure to the news during or around mealtime or bedtime.
If the underlying issue is diet or dysbiosis, then follow the recommendations laid out in the preceding two articles in this series. Generally, you want to avoid refined sugars and highly processed foods, such as breads, pastas, cereals, etc. You also want to replenish your beneficial bacteria in the gut with probiotic and support your digestive function with enzymes and/or hydrochloric acid supplements.
If you know that you have practiced an unhealthy diet for some time, this may also be a good time to consider a thorough cleanse or detoxification diet. Consult with your nutritional consultant about herbal remedies that have been found to have anti-parasitic, anti-fungal and anti-toxic properties and consider doing a two to three day vegetable juice fast. Keep in mind that fasting should always be conducted under the supervision of a qualified health professional and with the support of specific nutritional supplementation.
Certain supportive and antioxidant nutrients can help repair the mucosal lining and dampen the free radical damage caused by this condition. The following nutrients have proven to be very beneficial for leaky gut and can be found in individual supplements, as well as in combination formulas:
i. L-Glutamine (an amino acid and perhaps the most essential nutrient for repairing cells of the small intestine)
iv. Vitamin A (essential for an form of tissue damage)
v. Vitamin E
vi. Vitamin C
viii. Vitamin B5 (panthothenic acid)
ix. Deglycyrrhized licorice (DGL)
x. Folic acid
xi. N-acetyl cysteine
xii. Superoxide dismutase
xv. Glucosamine Sulfate
xvi. Coenzyme Q10
xvii. Lipoic acid
xxi. Whey protein isolates
*Remember, it is always best to consult with your physician or nutritional consultant before taking nutritional supplements.
Other lifestyle habits that have a healing effect on the gut are chewing your food more completely, limiting the amount of liquids you drink with meals, and exercising daily.
Food and Environmental Sensitivities
Since food and environmental sensitivities are often the result of leaky gut syndrome, they are often alleviated when the gut is healed. However, because consuming foods or inhaling pollutants that you are sensitive or allergic to typically exacerbates tissue inflammation and irritates the gut, it is best to avoid foods and other substances that you know cause you problems. If you don’t know what these substances are, consult with your nutritional consultant about how to identify them. Please note that food sensitivities differ from true food allergies. A food sensitivity, also called a “delayed” or “hidden” hypersensitivity, occurs when IgA, IgG, or IgM antibodies are triggered in response to foods, causing reactions that can take several hours or several days to appear. Some of the more common symptoms of food or environmental sensitivities are fatigue, water retention or stomach distension, constipation, diarrhea, joint pain, and weight gain. These sensitivities are quite common, occurring in 25-60% of people.
Allergies, on the other hand, are far more rare, affecting only 1-8% of people, and result in symptoms that are typically more immediate and dramatic. Some of the symptoms associated with allergies are sinus congestion, hyperactivity or restlessness, rapid increase in heart rate and/or blood pressure, headache, hyperventilation and, in some cases, anaphylactic shock.
The more common and reliable methods of testing for food and environmental sensitivities are the IgG blood test, the Coco Pulse Test, and the elimination/provocation diet. The patch skin tests and RAST blood tests are effective for testing for allergies, but generally ineffective for diagnosing detecting sensitivities. For those substances that you have determined are a problem, avoiding them entirely for a period of three to six months will typically eliminate the sensitivity. This is not always easy, especially if you have become addicted to the particular food or the item is mold or some other pollutant in your home. Many people find that some foods will always be a problem, no matter how long they are avoided.
I hope this information and the information presented in the first two parts of this series on digestive health has been helpful to you in your quest for optima health. Remember, attaining and maintaining good health and well-being is a process — a journey. Quick fixes and solutions that do not require attention to diet, exercise and lifestyle habits are recipes for failure and often make the problem worse. Listen to your body, trust your inner wisdom, and follow only that guidance that makes sense to you.