Leaky gut syndrome . . .something the docs don’t teach you

Hi All!
In an effort to pass on some great pearls of wellness advise and information, I’m sharing an article that I believe everyone should read.  Whether or not it applies to you, it offers wonderful insight into just how integrated our bodily systems are.
The article is about “Leaky Gut Syndrome” and the connections between inflammation in the body and a healthy (or unhealthy) intestinal system.  It’s great information for anyone (not just women) and shows so much about how important digestion is to overall health.
I will be adding articles like this from time to time, and would love to know your thoughts.  The purpose is not to preach or annoy (  ; but to educate and give you the power to make conscious and informed decisions regarding your personal health.
You matter to me, and I want you to live a long and vital life!
With gratitude and a true passion for you to BE WELL,

Leaky gut syndrome — how healing your digestive tract promotes total wellness

by Marcelle Pick, OB/GYN NP

The sheer number of digestive complaints I hear from women is astounding, but I always listen carefully for any clues that can help me isolate the causes of my patients’ symptoms. Clearing up digestive problems is a high priority for me as a practitioner because you simply cannot regain, or maintain, physical health without good digestive function. Often, what seems like just a minor (if embarrassing) digestive inconvenience is instead a waving red flag, telling me that something much bigger is occurring, with potentially wide-ranging health consequences. This is definitely the case with “leaky gut” syndrome.

During a recent appointment, a patient said jokingly, “I can’t wait to get home at night so I can change out of my work clothes and get into my baggy sweatpants!” We had a laugh, but I continued to press her about why she was so uncomfortable during the day. It turns out that her clothes felt too tight due to chronic bloating.

Do you have any of these signs and symptoms of leaky gut (LG)?

  • flatulence
  • bloating
  • cramping
  • diarrhea
  • food sensitivity
  • joint pain
  • muscle pains
  • fatigue
  • unexplained fevers
  • cognitive and memory defects
  • shortness of breath
  • low tolerance for exercise
  • skin outbreaks/rashes
  • urticaria (hives)
  • bone loss

In fact, a lot of my patients say they have “everyday” gas and bloating. But chronic gas and bloating are not normal sensations! They may even be important indicators of intestinal hyperpermeability, or as it is commonly called, “leaky gut syndrome.”

The term “leaky gut” has been around for a while, but in my opinion, the condition itself is still not very well understood, especially in the world of conventional medicine. A leaky gut not only can lead to disruptive symptoms, it has also been connected to other sorts of medical issues, including diabetes, chronic fatigue syndrome, and heart failure, and may even contribute to certain kinds of depression and psychiatric disorders.

Thankfully, leaky gut is something you can heal with the right support. And once we’ve made the connection between a patient’s symptoms and leaky gut, I can tell her with confidence just how much better she will feel as healing progresses. So let’s take a closer look at what’s going on inside a leaky gut, how you can heal it, and what it takes to maintain healthy digestion.

Inflammation and more — what happens when the intestinal barrier is “leaky”

A healthy intestine is lined with permeable mucosal tissues that carefully regulate the passage of nutrient particles from the gut lumen (the space inside the tube of your intestine) into circulation. This “intelligent” lining acts as a kind of safety net that selectively determines which particles are safe and which ones should be barred from crossing and removed from the system altogether. When everything is working correctly, molecules that are too big — or those that could cause other kinds of trouble — are not allowed to cross through the intestinal wall.

When your intestinal lining is unhealthy or compromised, it can “leak” because it is too permeable, or hyperpermeable. This allows larger-than-normal “macro” particles — such as undigested food molecules, microbes, wastes, toxins, and even antigens and pathogens that piggyback onto proteins and amino acids — to push through into the lymphatic system or bloodstream. The escape of these rogue particles alerts your body that something is wrong, and so the immune system tries to come to the rescue by responding with inflammation.

This response is a natural, normal protective mechanism, but if this inflammation continues, it can become chronic, generating a wide array of symptoms throughout your body. Digestive symptoms like gas and bloating can be signs of leaky gut, but many other possible symptoms may be difficult to trace back to the scene of the crime — the intestine — because they don’t seem related to digestion. Women might never imagine that joint and muscle pain, cognition problems, unexplained fevers, poor coordination, and even shortness of breath could be signs and symptoms of leaky gut syndrome. And if there is any type of chronic inflammation, I always look to the digestive system for the source of the problem.

These microscopic intestinal “leaks” occur where two adjacent cells are joined together by tiny strands into what’s called a “tight junction” (zonula occludens). Rows of tight junctions are “stitched” together to form a membrane that is coated with a layer of mucous gel.

In a healthy intestine, the tight junctions prevent certain inappropriate fluid molecules from moving out of the intestine and into circulation. They also control how molecules and substances travel, forcing them through the cells — rather than between them — into the underlying tissues. But an intestinal barrier with faulty tight junctions can allow undigested food particles, bits of waste, excess ions (electrically charged atoms or molecules), and toxins through the safety net and into your body’s circulation.

Beneath the tip of the iceberg

Leaky gut can cause or lead to many health issues, but there are two major effects of intestinal permeability that can cascade rapidly into other problems. First, leaky gut disturbs one of your most fundamental needs — the ability to properly digest and absorb nutrients and electrolytes (substances required to maintain cellular balance) so your body has the required nutrition for optimal function.

Second, a faulty intestinal barrier disrupts healthy immune system function, which is the actual source of most of the symptoms women can feel. Special areas in your intestinal lining called gut-associated lymphatic tissue (GALT) work to protect you from allergy-causing food antigens and disease-carrying microbes. When you have a leaky gut, these harmful entities can elude the GALT and instead are routed through the hepatic portal vein or the lymph system to gain access to your bloodstream, where they can travel far and wide throughout your body.

Is leaky gut the origin of food allergy and intolerance?

Wherever the undesirable particles go, they stimulate the release of cytokines (special immune-signaling substances) and stir up further trouble in the form of symptoms. When the cytokines cycle back to the gut for processing, they cause even more proinflammatory problems in the gut. A true vicious cycle!

In leaky gut syndrome, your body is caught in a self-perpetuating loop of leaky gut, semi-infectious states, and inflammation. As a practitioner of functional medicine, I believe this pattern of digestive disruption lies at the very root of most, if not all, food allergies. If your immune system is continually stimulated by specific food antigens that are leaking into circulation, and you continue to consume those foods, you could easily develop allergic reactions or sensitivities to those foods. Your immune system remembers those foods as triggers and calls up the same inflammatory reaction upon each re-encounter.

Leaky gut has effects on liver function and vice versa

As your liver helps digest and process foods, it’s called upon to handle toxins and other unfriendly particles in a two-stage detoxification process. But leaky gut can cause stress along the liver’s detox pathways, especially during phase II of the process, when highly reactive, intermediate substances left over from phase I are neutralized.

“Things sweet to taste prove in digestion sour.”
— William Shakespeare

When the liver is overloaded with poisons, it experiences oxidative stress (from free radicals), which generates even more inflammation. This specific reaction may be a kind of “double whammy” that leads to more serious forms of non-alcoholic fatty liver disease, an increasingly common inflammatory disorder linked to insulin resistance and metabolic syndrome. It’s also part of the link between leaky gut and the progression and symptoms of joint pain and arthritis.

Causes of leaky gut

Now that you know what leaky gut is, it’s equally helpful to know what causes it. Essentially, anything that alters or damages the mucosal lining of your GI tract can contribute to leaky gut — and the list is long. Certainly, the food you eat matters. Consuming lots of refined carbs and sugars, along with highly processed foods, may lead to leaky gut. Exposure to heavy metals and toxins, as well as long-term alcohol use, are also thought to be connected.

But factors that contribute to leaky gut may also originate from within your own body. If your system doesn’t produce adequate amounts of the right digestive enzymes, you won’t be able to break down certain foods that you eat. Lactose intolerance is a prime example. Many people have genetic lactase deficiencies that prevent their bodies from being able to break down lactose, the primary sugar in milk products. And if those folks keep consuming dairy foods, the integrity of the mucosal layer becomes compromised, generating inflammation and widening the tight-junction gates.

Medical treatments that can increase intestinal permeability

  • Radiation therapy
  • Chemotherapy
  • Steroid drugs (corticosteroids)
  • NSAID use (aspirin, ibuprofen, naproxen)
  • Antibiotic use

Bacterial overgrowth in the gut is another well-known risk factor for intestinal hyperpermeability. An imbalance in gut flora can be caused by chronic infections — as well as by the antibiotics used to treat them! Similarly, systemic yeast (Candida) creates conditions that increase intestinal permeability, and when present in a pregnant woman’s system, may influence the baby’s developing immune “profile” and intestinal function. Supplemental probiotics can rebalance this overgrowth and help regulate digestion.

Many practitioners have suspicions about other factors that may be associated with leaky gut. These include excessive caffeine use, food additives, and chronic stress. We also see certain other digestive conditions occur in conjunction with leaky gut: parasites, Crohn’s disease, celiac disease, inflammatory bowel disease (IBD), and irritable bowel syndrome (IBS) that is traceable to food intolerance. What we can’t always tell is which comes first — the condition, or the leakiness.

But that’s not all: complications of leaky gut

Is there a test for leaky gut?

The most common test is an intestinal permeability test. Also known as the “lactulose-mannitol challenge,” it measures the degree to which these two sugar molecules are able to permeate your intestinal barrier. This helps establish whether there is hyperpermeability or nutrient malabsorption.

If you think you have leaky gut, you may not need to confirm it with a test. The important element is healing your digestion. Try following our leaky gut recommendations for two weeks, and see if that helps you feel better. Visit a practitioner of functional medicine for more in-depth guidance.

Leaky gut isn’t always obvious, and we may not see digestive trouble as the first sign that it’s occurring. Often, another condition or an unpleasant non-digestive symptom brings a patient to the Women to Women Clinic for help. It usually takes some detective work to make the connection between the patient’s complaint and leaky gut. This has been the case with chronic fatigue syndrome (CFS). Currently, researchers are studying whether leaky gut is a starting point for CFS. But there’s good news: we already know that resolving leaky gut can lead to remission of CFS.

The chronic inflammation that is the cornerstone of the leaky gut cycle may lead to heart failure, and scientists think that leaky gut may contribute to certain types of depression. Leaky gut may also be a factor in the development of multiple sclerosis, lupus, vasculitis, and Addison’s disease, as well as these other conditions and illnesses:

  • Type 1 diabetes
  • Asthma
  • Autism
  • Rheumatoid arthritis
  • Acne, eczema, and psoriasis
  • HIV
  • Osteoporosis

What’s really important: you can heal leaky gut

My patients are always relieved to hear that it is entirely possible to heal the gut using nutritional measures and other aids that restore the integrity of the intestinal barrier. I have seen this happen time and again.

But the path to healing may not always be a straight one, and it’s likely you will need to consider other factors that could be integral to healing your damaged intestinal lining and prevent recurrences. In other words, the leaky-gut puzzle may have many pieces that you and your practitioner must fit together to improve the situation.

Targeted nutritional solutions for leaky gut

Ongoing research continues to unveil more useful information about which nutrients support and encourage healing in the gut. These include:

  • Glutamine. This is an amino acid important for maintaining structure and function of the intestine, as well as metabolism. Glutamine has been shown to improve mucosal damage from radiation and chemotherapy, for example.
  • Methionine and N-acetyl cysteine. These are sulfur-containing amino acid precursors to glutathione (GSH), a key antioxidant for protecting cells from free-radical damage.
  • Larch. Derivative nutrients from this conifer have immunologic, metabolic, and growth-factor benefits for healing leaky gut.
  • Kiwifruit. This edible berry encourages the epithelial cells in the mucosal barrier to proliferate, and for this reason helps heal existing damage from leaky gut.
  • Zinc. Research suggests supplementation with this metallic element “tightens up” the leakiness of a hyperpermeable intestine — and helps prevent its recurrence.

Clearly, the goal is to reduce the permeability of your intestine, which will quiet the immune response to any particles that slip through your gut’s safety net. Subsequently, chronic inflammation will diminish, both locally in the GI tract and elsewhere in the body. Reducing gut leakiness also rebalances special immune cells, such as T-helpers, and helps reset and normalize your immune response.

Where do you start?

For patients with leaky gut, we need to both calm the gut environment and repair existing damage to the mucosal lining of the intestine. This dual approach is remarkably effective, and has the welcome side benefit of reducing — or eliminating — the symptoms that brought the patient to our clinic in the first place! Our goals are to eliminate common allergens, reduce inflammation, restore microbial balance throughout the GI tract, and restore optimal nutrition.

Slow down and chew your food well. Take the time to sit down to your meals, and don’t rush through them. Digestive enzyme supplements help, but there’s nothing better than the habit of chewing food slowly and completely, because digestion starts with enzymes in your saliva. Wolfing down meals and swallowing unchewed food makes your digestive system work much harder than necessary.

Undertake an elimination diet. To stabilize and soothe the digestive tract, I recommend a 14-day Quick-Cleanse. The foods in this gentle approach are free of common allergens, such as gluten, dairy and yeast, as well as sugar, and give the gut a break from the major trigger foods that exacerbate leaky gut. By the end of the two-week cleanse, you will find that your whole digestive process runs more smoothly, and there should be a noticeable reduction in symptoms.

Rebalance your gut flora. Reestablishing microfloral balance throughout the GI tract is crucial, and it’s important to maintain that healthy balance. A well-formulated probiotic supplement such as Women to Women’s Balanced Biotic is indispensable for treatment of leaky gut, and can help stabilize your overall digestive environment. While fiber intake is a major ingredient for good microbial balance, some women with leaky gut cannot tolerate additional fiber at first. You can gradually increase dietary fiber by eating more “tender” fruits and vegetables (bananas, pears, applesauce, well-cooked squash, and the like). Once healing is well under way, you can add in more fiber.

Investigate digestive aids. Functional medical providers have been at the forefront of developing methods for healing the gut, based on identifying the true origins of this condition. In my practice, I use a cutting-edge medical food that coats the intestines and protects the lining from further damage. This gives your body’s innate healing powers the opportunity to go to work and recover the integrity that your intestinal mucosal barrier needs to be fully functional.

Understanding leaky gut is the first step toward healing

I’ve found that one of the biggest challenges with leaky gut is just being able to understand what it is. Women are often confounded by the possibility that a digestive problem could be causing symptoms like joint pain or fuzzy thinking. But the digestive system is the foundation for your whole body’s health, so it’s important to resolve digestive issues before other problems arise. Take a step back to look at the big picture of your health, and work with your practitioner to map out possible connections between your symptoms and their sources, no matter how unrelated they might seem.

For many women, putting a name to the problem is the first step in healing, and we’re learning more about leaky gut — or intestinal hyperpermeability — every year. Once you identify the potential causes of your leaky gut, which are unique to each woman, it’s much easier to chart a course for both digestive healing and total wellness.

Marcelle Pick, OB/GYN NP is the co-founder of the Women to Women Clinic in Yarmouth, Maine, as well as the Women to Women Personal Program.  She is a regular contributor to Women to Women.com.  Her first book, The Core Balance Diet, has recently been released (2009), and she has a weekly call-in show on Women’s Health for Hay House Radio


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