When bacteria and their toxins leak into the blood, it can trigger an autoimmune reaction. (Photo: Andrii Muzyka/Shutterstock)
Leaky gut syndrome (also referred to as increased intestinal permeability), is basically the result of damage to the intestinal lining. “We have to have a barrier between us and the 10 trillion to 100 trillion bacteria inside our intestines. And our barrier is just one cell layer thick,” explains Dr. Gregory Plotnikoff of the Penny George Institute for Health and Healing in Minneapolis and co-author of "Trust Your Gut."
Plotnikoff says if our skin were only one cell layer thick, we’d be a puddle of jelly on the floor, so this intestinal layer is extraordinarily smart — it knows what to let in and what to keep out. If the layer is damaged or stressed, it becomes dysfunctional — meaning the wrong stuff gets in and the right stuff stays out.
In essence, some bacteria and their toxins, incompletely digested proteins and fats, and waste not normally absorbed may "leak" out of the intestines into the blood stream. This triggers an autoimmune reaction, which can lead to gastrointestinal problems such as abdominal bloating, excessive gas and cramps, fatigue, food sensitivities, joint pain, rashes and more.
“The leaky gut was for decades not accepted by Western medicine, but recent studies are shifting that viewpoint,” says Dr. Vincent M. Pedre III, a clinical instructor at Mount Sinai School of Medicine and Medical Director of Pedre Integrative Health. “What was professed in alternative circles is now being verified, so Western doctors can no longer deny that such a thing exists.” Pedre says it may actually be the gateway to many diseases.
Plotnikoff adds that now leaky gut syndrome is written about in the finest medical journals in the world and has been linked to diseases like kidney failure, autism, migraines and others.
“It’s likely that leaky gut is the cause or a very important factor in these diseases and we haven’t had the technology to measure this. The gut wall integrity was never looked at and understood.”
Symptoms of leaky gut syndrome
Leaky gut syndrome can be an aspect of both irritable bowel syndrome (IBS) and Crohn’s disease. Essentially these conditions may be characterized by an underlying leaky gut. Symptoms may include:
Constipation or diarrhea
Fatigue (through malnutrition)
Weight gain (partly due to water retention)
Blood, stool, breath and urine tests can be used in the diagnosis. Plotnikoff finds specialized stool testing most helpful for people who have tried everything and yet their gut is just not any better.
“The gut is not a gutter. The gut is a garden and our mission is to be good gardeners. That means we need to pay attention to good seed, good soil and good support.”
When we talk about leaky gut, Plotnikoff addresses the five forms of stress that impact gut wall integrity and gut ecology:
Environmental: What is going on at home, at school, in the neighborhood, in your key relationships.
Physical: Everything from insomnia, to surgery to a chronic illness to exercise like climbing Mount Kilimanjaro.
Emotional: All of your emotions, including spiritual challenges.
Pharmaceutical: Antibiotics you take as well as steroids and chemotherapy and any medications that affect the gut.
Dietary: Including too much food, too little food, food allergies and adverse food reactivity including gluten sensitivity.
“You can argue that gut health is the foundation of all health,” says Plotnikoff.
Repairing the gut
Pedre explains the treatment for a leaky gut depends on finding the underlying causes. Often there is a microbial imbalance, low stomach acid that leads to an overgrowth of small intestinal bacteria or exposure to toxins or antibiotics needs to be reduced. Testing for food allergies or sensitivities to reveal what foods need to be avoided that are aggravating the immune reaction is also important.
Removing exposure to inciting foods, providing support for digestive enzymes may also be needed as well as improving the microbiota of the gut through both probiotics and prebiotics. “Probiotic bacteria actually help regulate our immune response and help heal the leaky gut,” Pedre says.
“Diet and gluten are just one element to dietary,” Plotnikoff says. Not everyone with leaky gut has high gluten reactivity or sensitivity, so one has to take a look all the details. There is no quick and easy answer. One thing that may help is an elimination diet. Five culprits that may play a role with their elimination are wheat, dairy, corn, nightshades and legumes.
Likewise, eating foods that help the gut is equally important. Plotnikoff says assuming there is no adverse activity, fermented foods, cruciferous vegetables and beans are prebiotic foods that are all good for the gut.
Working with a knowledgeable health professional is an important component.
“We’ve just scratched the surface of how important gut health is for our overall health in the last five years, and it’s particularly accelerated in the last 12 months,” Plotnikoff says. Restoring gut health not only will improve chronic gut problems like IBS and Crohn’s disease, but we may see continued connections being made to other diseases over time.
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