According to the National Institute of Health, 60-70 million people in the United States are affected by digestive diseases. This includes irritable bowel syndrome (IBS), constipation, inflammatory bowel disease (IBD), gallstones, and reflux, among others. The condition and function of the GI tract is important for our overall health and well-being. Research shows that stress, lack of physical activity, processed foods, and chemicals affect the gastrointestinal tract (GI tract) and contribute to an increased incidence of disease.
The food we ingest gets broken down, and the nutrients are absorbed in the small intestines before entering the bloodstream. The balance of gut micro-organisms, the mucosal lining, and the integrity of the tight junctions, which are located in the epithelial lining of the small intestines, all contribute to the proper digestion and absorption of food. The lining of the small intestines is semi-permeable and normally allows nutrients to be absorbed, while also acting as a barrier to prevent toxins, microbes, and large food particles from entering our internal system. Additionally, the lining contains a substance called secretory IgA (SIgA), which is an immunoglobulin that binds to bacteria, toxins, viruses, fungal spores and antigens, and it prevents them from crossing the epithelial barrier and entering the bloodstream. Next, the lining is made up of tiny openings called tight junctions, which are responsible for determining what is allowed to pass from the intestine into the bloodstream. They allow vital nutrients into the blood stream while keeping large undigested food particles and disease causing compounds out of the systemic circulation.
Leaky gut, also known as intestinal hyperpermeability, occurs when the toxic byproducts and undigested proteins in the GI tract are absorbed into the bloodstream and cause inflammation. When SIgA is decreased, fewer pathogens are eliminated, and the altered microbiota in the small intestine leads to dysbiosis, which is a change in the balance of the microorganisms. Other causes of dysbiosis are physical stress, mental stress, infections, chemicals, alcohol, antibiotics, corticosteroids, birth control pills, and dietary factors, such as gluten. Additionally, an overgrowth of yeast can also damage the mucosal barrier and increase the permeability of the intestine so that undigested particles are absorbed. Yeast also releases toxins and enzymes which can further increase intestinal permeability. In summary, any condition that may cause inflammation, such as medications, infections, trauma, or a range of diseases including cancer, may result in hyperpermeability.
As a result of this dysbiosis, there is a malfunction of the tight junctions and a breakdown of the gut barrier. The tight junctions open too wide and become more permeable, allowing unwanted toxins and other particles to “leak” into the bloodstream overwhelming the liver and causing potential allergies. There is an inflammatory response with toxins moving from inside the gut to outside the gut due to lipopolysaccharides (LPS), which are molecules on the surface of gram negative bacteria. These molecules cause inflammation outside the gut by activating the cytokines, which are substances that signal the activation of the immune system.
Some of the symptoms of leaky gut include fatigue, fevers, poor tolerance to exercise, memory issues, food sensitivities, thyroid dysfunction, inflammatory skin conditions, nutrient malabsorption, bloating, abdominal issues, fevers of unknown origin, and issues with concentration. Very often, leaky gut can lead to diseases and conditions and can be underlying factors in ADD, psoriasis, irritable bowel syndrome, malnutrition, food allergies and intolerances, autism, celiac disease, depression, inflammatory bowel disease, eczema, acne, dermatitis, rheumatoid arthritis, and chronic fatigue syndrome.
In order to repair leaky gut. A “6R” approach is often used: 1. Remove 2. Reduce 3. Restore 4. Replace 5. Reinoculate 6. Repair. First, it is important to remove whatever is irritating and damaging the GI tract, such as NSAIDS, alcohol, allergenic foods, and pathogens. After removing these irritants, proper motility needs to be restored. Insoluble fiber can be used to restore the appropriate bowel transit time to make sure food is moving through the GI tract at an acceptable rate. Next, digestive enzymes need to be replaced to aid in digestion and stimulate the body’s own enzyme production. Afterwards, the GI tract needs to be reinoculated with friendly bacteria by taking probiotics to rebalance the microflora. Lastly, the mucosal lining should be repaired with specific supplements, such as L-glutamine, zinc, essential fatty acids, N-acetyl glucosamine, aloe vera, glycerrhiza, beta carotene, vitamins A, C, an E, and others.
Leaky gut is not a disease, but it is a real condition that needs to be addressed. It is a gray area in the medical field because it is result of some other condition rather than a diagnosis by itself. If you are experiencing GI symptoms without an etiology, it is certainly worth investigating. The gut could be your answer to a healthier, happier existence.
by Denise Groothuis MS RD CPT