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.
GERD (GastroEsophageal Reflux Disease), or what most people call heart burn, ails at least 1 in 4 people in America. While it is a very uncomfortable condition with unpleasant sensations, it can have serious long lasting damage to your esophagus lining. Damage moves from irritation to scarring, constriction, ulcers, and can even lead to esophageal cancer. As a functional medicine dietitian, it is my firm belief that treating the root cause of the condition rather than taking pills forever to mask it will pay off down the road in improved health. Treatment of GERD can be achieved by proper nutrition, elimination of food agents that trigger GERD, changing lifestyle patterns, leveraging weight loss where indicated and choosing natural, healing supplements where needed.
In normal digestion, your food passes from your mouth to your esophagus ( a long thin passageway that connects from mouth to stomach) and from your esophagus to your stomach. And on down the hatch it continues. Connecting your esophagus and your stomach is a door, we call that door the lower esophageal sphincter (LES). After food passes through this door, it should close, to prevent food and stomach acid from flowing back up. Some medicines have a side effect of lowering LES function. Other than medicine, sometimes the LES just becomes weakened, or more relaxed that it should be. This can be do to chronic overeating and stretching of the stomach. And with the help of a new study, inflammation may play a major factor in this weakening, a larger role than previously imagined. Because stomach acid is so acidic, it can be painful when it climbs back up touching tissue that wasn't created to withstand exposure to acid. Helping to remove inflammatory and painful triggers and giving the body a chance to lower inflammation, it can heal itself over time.
Many medicines taken, even over the counter, block production of stomach acid. This follows the thought that less stomach acid, means less exposure when the LES is weak and opening. This can be very effective in relieving heartburn, however it just slaps a band-aid on the symptoms, and creates larger problems down the line. This is an interesting band-aid, because many sufferers of GERD have been found to create insufficient amounts of stomach acid to begin with. This leads to a theory, that less acid creates the problem of food sitting in the stomach for too long, increasing chances of back flow and heartburn. These medicines are a temporary fix for symptom management and have increased risk of conditions such as vitamin deficiencies, kidney disease, allergies, skin disorders, osteoporosis, heart attacks, GI infections and depression. I would vote we look for the cause of GERD and treat it, rather than only covering up the symptoms.
Overweight or Obesity
Consuming Large Meals
Eating Before Laying Down
High Stress Levels
SIBO - Small Intestinal Bacterial Overgrowth
Pregnancy (just due to baby pushing up on all your organs)
Some of these could be changed with simple lifestyle modifications. Treatment can include the following:
Eat foods rich in anti-inflammatory factors: Fish, Fruit, Vegetables, Healthy Fats (avocados, nuts, olives)
If you have implemented all of the above and still experience mild GERD, supplements have been known to help. These are natural supplements that can assist the body to strengthen the LES or heal the esophageal lining. Licorice, Zinc Carnosine, L-Glutamine, Magnesium.
With the above treatment options, lifestyle modifications and supplements, an individual can work towards healing their body rather than masking the symptoms with medicine that is not providing a long term solution. In time digestion can return to normal and the LES will be able to heal itself.
Caitlin Johnson is a dietitian, wife, lover of ice cream, chef wannabe, California-girl, Christian, liver eating, "food-avore."
110 N McClelland Street
Santa Maria, California 93454
Hours: Tues and Thurs 10-5 PST