Leaky gut syndrome is gaining attention in both conventional medicine and alternative treatment modalities as more and more chronic inflammatory illnesses are plaguing Americans. I know that cooky aunt of yours or the self proclaimed health nut down the street have been talking about it for years, but what does the research, the current evidence have to say about the process? First of all, what is leaky gut syndrome? Is it as gross as it sounds? Yes! Most of us can’t stand the sight or smell of our own gut contents when they move from us to the toilet, can you imagine what these contents are doing as they leak out of your GI tract and into your body?
The lining of the GI tract, like our skin, is a barrier to the outside world, and it is one layer of cells thick. Thankfully, this lining is extremely good at blocking the bad and letting in the good. These cells sit very closely to one another and transport nutrients into the cells to be absorbed into the blood or lymph stream and distributed throughout the body. However, when contents of the GI tract can get IN BETWEEN the cells and access our blood and lymph systems, it can create havoc. You immune system at first will respond with local inflammation and mount a defense against the invaders, but after long term exposure your immune system can become “confused” and start mounting a defense against you and your body, your organ systems.
Physicians and the general public have long been resistant to the idea of leaky gut as an alternative medicine quack diagnosis, but if you take a search among medical research databases for the words “intestinal permeability” or “intestinal hyperpermeability” you will find hundreds upon hundreds of studies looking at just this: leaky guts.
The symptoms leaky gut can cause include: fatigue, gas, bloating, joint and muscle aches and pains, skin rashes and confusion. The difficulty with these symptoms is that they can occur in many different diseases, making leaky gut syndrome all the more difficult to correctly diagnose. Among the published evidence the following specific medical conditions are associated with leaky gut syndrome: celiac disease, IBS, asthma, Crohn’s disease, Type 1 diabetes (late onset), rheumatoid arthritis, obesity-associated insulin resistance, migraines, food allergies/sensitivities, even cancer. In some of these conditions we have a chicken and egg scenario and we need more research to determine causality or just merely association. In others, we understand the increased gut permeability, or leaky gut starts an immune system cascade that affects very distant parts of the body, including the brain, joints as far away as hands and feet.
If you or a loved one experiences any of the above medical conditions, I know you are thinking: Is there a way to be tested for leaky gut syndrome? Yes, labs have the ability to do three different tests that assist in identifying how permeable our intestines are. They are all based upon ingestion of certain foods and then measuring ratios of these food contents in the urine. The idea is your body takes in the food, it makes it to the part of the GI tract that is compromised, then it will either pass between cells, into your blood, to your kidneys to be filtered and out through urine, OR your gut is okay, and it makes it out as a part of your stool.
Conventional and Alternative Treatments
There is absolutely no doubt in my mind about it, we need more research in this area. Many doctors will just slap your gut with a healthy dose of anti-inflammatory drugs, with no regard to the fact that NSAIDs have been implicated in causing increased intestinal permeability. However, working with a Dietitian (especially and functional and integrative medicine dietitian) provides a unique advantage to adjust diet to try and lessen symptoms, remove underlying roots of the problems, clear infections (Small Intestine Bacterial Overgrowth or SIBO) and institute patient specific interventions to heal the gut.
If you feel that you may have leaky gut the first recommendations I make are the following: Stop taking NSAIDs, decrease alcohol intake significantly, consider removing gluten from your diet for a time. The next step (though it can be expensive) is test for food immune reactions, so offending foods can be eliminated and your body can be given a chance to heal. As a specific elimination diet is implemented, then considering glutamine, zinc, gelatin, and probiotic supplementation and other gut healing protocols that are appropriate for the individual and their condition.
Making the paradigm switch to eating whole foods and removing processed foods from the diet will give your body an extreme advantage in avoiding a leaky gut. Why? Because all of the processed chemicals and highly refined foods can be inflammatory to the gut and soon when the gut is compromised when these foods make it to the blood before your body has a chance to rid them or break them down into smaller particles, it is likely your body will mount an extreme response to the chemicals contained in these foods. Whole foods taste good and are good for you. What do I mean when I talk about whole foods? Fruits, vegetables, whole grains, beans, nuts, seeds, choosing meat that has not been treated with hormones, responsibly sourced fish.
Thanks for reading, please let me know if you feel you need assistance with this, I would be glad to set up an appointment with you.
Caitlin Johnson is a dietitian, wife, lover of ice cream, chef wannabe, California-girl, Christian, liver eating, "food-avore."
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