Tuesday, June 19, 2012

What is Leaky Gut?

A nasty-sounding problem that can undermine your health without you even knowing ...

The lining of our intestinal tract is a lot like the skin on the outside of our bodies. Although our digestive tract runs through the inside of our body, it is a closed tube and everything on the inside is actually "outside" our body. It is the lining of our digestive tract (the endothelium) that protects us from everything inside our gut. The entire endothelium is a mucous membrane (much like the inside of the mouth), which acts as a filter that only allows fully digested nutrients to pass through to our bloodstream. Each cell is tightly stitched to the one next to it by a number of attachments called "tight junctions". This lining keeps us safe from bacteria, yeast, toxins, waste products and undigested food particles that are not yet ready to be absorbed. When this lining is compromised, these foreign particles can cross the tight junctions and enter directly into the bloodstream and create problems with the immune system. 

Starting the Leak

There are a number of different things that can allow for leaking of the gut wall. Often the initial insult will come from a toxic exposure or from an infection in the gut. Toxic exposure can be accidental, like water or work-related exposure, or can be due to drugs that we ingest, like medications or alcohol. Infection can be viral, bacterial, or a Candida (yeast) infection, and it may appear as gastroenteritis (stomach flu / diarrhea) or have no symptoms at all. In each case, the resulting inflammation causes a breakdown of the proper structure of the gut lining, which can allow for the passage of debris, such as: waste, toxins, and food particles across the tight junction.

Triggering Inflammation

Once the debris is allowed to cross the tight junctions, it can be exposed to the incredible number of immune cells that lay hidden just below the lining of our gut. In fact, the vast majority, an estimated 70-80% of our immune system exists in this gut-associated lymphatic tissue (GALT). When our immune cells are exposed to foreign substances they respond as nature intended and mount an immune response. This response creates an inflammatory cascade that can begin to damage the endothelium even more, and create more leaks. Stress plays a very important role at this step in the inflammatory pathway. Cortisol is our major long-term stress hormone, and its presence alters the normal immune response throughout the body. Thus, when we are stressed, our immune response is different than when we are relaxed and happy.

Continuing the Cycle
The more the body is exposed to the triggering substance, the greater the mounted immune response, and the greater the damage to the gut lining. This is ultimately how food sensitivities become an escalating problem, and why removing the triggering food can reduce the symptoms and stop the inflammatory chain. Unfortunately, on the other hand, if the problem is caused by: toxins, yeast or bacteria that remain in the gut or that we are repeatedly exposed to, the inflammatory cycle will continue in an upward spiral.

Inflammation, Autoimmunity and Allergies
The resulting inflammatory cycle is how leaky gut can create inflammatory conditions like rheumatoid arthritis, allergies, asthma, and even autoimmune conditions like IBD (Inflammatory Bowel Disease). Studies have also shown an association between leaky gut and several conditions such as: type I ("jeuvenile onset") diabetes, lupus, MS (Multiple Sclerosis), and even autism.

Signs and Symptoms
Because the immune effects of leaky gut can enter the bloodstream and then travel anywhere in the body, there are a number of different signs and symptoms associated with this condition. Some examples include: fatigue, diarrhea, constipation, bloating, gas, reduced immunity, skin rashes, eczema, anxiety, depression, irritability and dark circles under the eyes. Because food may enter the blood before it is fully digested, it is not properly metabolized and can result in a number of nutrient deficiencies. This is called malabsorption, and can result in any number of nutritional deficiencies over time. Signs of this can appear over time as dry skin, fatigue, as well as brittle hair and nails.

Distinction from Candidiasis
Often people will attribute leaky gut symptoms to candidiasis (a yeast overgrowth in the gut), and although it is a common cause of leaky gut, treating candida alone will not fully resolve the symptoms, and can often make it worse. Anti-candida treatments can often be harsh and further damage the gut, it is important to heal any damage after clearing the cause of the inflammation.

Fixing the Root of the Problem
Curing leaky gut ends up being a two-step process. First, it is important to remove the offending agent causing the inflammation and damage in the gut. Individuals who suffer from Leaky gut may need to follow certain dietary restrictions in order to alleviate symptoms. Introducing a variety of fruits, vegetables and whole grains, as well as incorporating lean protein sources into the diet, while avoiding food sensitivities will help to alleviate symptoms.

In the case of bacteria or Candida antimicrobial herbs and supplements can be used to help remove them, for more information, please see our article on candida. If the problem is caused by a food sensitivity, the offending food(s) must be removed from the diet for at least a year and possibly permanently to prevent further inflammation. External sources of toxins should also be examined and removed to stop the ongoing inflammatory immune response. While we are removing the cause of the problem, we can help to reduce the inflammation using supplements.

Reducing Gut Inflammation
There are a number of supplements that can reduce gut inflammation, but some of the best are:

Fish Oil
This oil is rich in omega 3 fatty acids, and has been shown to reduce inflammation, improve mood, thin the blood, and reduce blood pressure. See more information on fish oil.

This herb is renowned for its ability to reduce systemic inflammation in the body. Although it has been most thoroughly researched for the treatment of arthritis, its use can be expanded to other inflammatory conditions. See more information on Boswellia.

Another herb that has been established for its anti-inflammatory properties, curcumin (tumeric) can be added to your cooking or supplemented directly as a great way to reduce any inflammation in your gut. See more information on curcumin.

Healing The Gut
Once the source of the inflammation is removed, the immune system is no longer stimulated, and the gastrointestinal lining has a chance to heal. It will, of course, heal naturally over time, but we can easily help to speed up the process. Restricting alcohol and caffeine, which are both irritating to the mucosal membrane of the gut, also helps to reduce the symptoms of leaky gut. Reducing stress levels with breathing exercises, and lifestyle changes can help to promote healthy digestion and reduce cortisol levels to allow restoration of normal immune function. See more information on stress reduction.
Supplements for Healing
Of course, there are a number of supplements that can help to reduce inflammation and speed the healing of the gut lining. Once the tight junctions are repaired, the symptoms of leaky gut will resolve.

This amino acid can be considered the single most important supplement for restoring the integrity of the gut lining. It is a major food source for the enterocytes, and providing food allows them to replicate and heal regions of damage. See more information on glutamine.
DGL (Deglycyrrhizinated Licorice)
Licorice is a soothing and healing herb that can soothe the intestinal lining directly and also acts to regulate the immune system and help calm any ongoing inflammation. See more information on DGL.

This class of herbs coat and protect the intestinal lining from any further damage. By protecting the lining, they give the enterocytes time to heal. Some examples are marshmallow, and slippery elm. See more information on marshmallow. See more information on slippery elm.

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