Have you heard of this thing called “leaky gut”? What does it mean to have a leaky gut and what symptoms would you experience? More importantly, what can you do about it? Read further and you will have a better understanding of the primary importance of maintaining the integrity of your gut as one of the major first lines of defense for your body. You will also learn about what conditions may be associated with a breach in this protective gut barrier, and what power you have to restore this fundamental protection.
Our bodies are so beautifully and intricately designed to support our health and well-being. There is a very deliberate compartmentalization within our bodies to provide protection and division of labor. In this article, we will focus on the lining of the small intestine with our discussion of leaky gut. Know that any organ with a barrier function can be considered “leaky” (for example, leaky mouth, leaky brain, etc.).
The Digestive System
The digestive system is comprised of many parts: our mind, mouth, esophagus, stomach, small intestine, liver, gallbladder, pancreas, and large intestine (colon). The small intestine is where 90% of digestion and absorption of food occurs. The lining of the small bowel is a single cell layer thick and serves additionally as a strong barrier to toxins, pathogens (bacteria, yeast, parasites, viruses), as well as large undigested food particles. This cell layer is held together very securely with intercellular tight junctions which prevent anything from passing through other than thoroughly digested food and nutrients. Leaky gut (or increased intestinal permeability) occurs when the tight junctions between cells are compromised.
Effects of Leaky Gut
Toxins, bugs, and undigested food particles, which normally are eliminated from the body, instead come into the body. This is not a good thing and ultimately contributes to the development of autoimmune conditions, as well as a whole host of other issues.
With the disruption of this barrier, there can be a reduction of the protective mucosal layer of secretory IgA (the primary sentinel guard of the digestive tract and lungs) further diminishing the immune defense of the gut barrier.
Moreover, the digestive and absorptive capacity of the small intestine can be weakened, leading to nutrient deficiencies which can affect every part of the body, and every function of the body.
Our immune system is very well-trained to recognize things that belong to our bodies (self) and those things that don’t (non-self). As such, it will mount a defensive antibody reaction against the uninvited guests which have inappropriately crossed the gut barrier. This leads to inflammation which can affect the whole body. And over time, a continued immune response can turn into an autoimmune response against the body’s own tissues. So, leaky gut is a step in the development of autoimmune conditions.
Symptoms of Leaky Gut
Leaky gut can cause all kinds of symptoms throughout your body:
- Bloating, diarrhea, constipation, “irritable bowel syndrome”
- Food and chemical sensitivities
- Asthma
- Autoimmune conditions such as: Celiac disease, Type 1 Diabetes, Hypothyroidism (Hashimoto’s thyroiditis), Rheumatoid arthritis, Multiple sclerosis, Ankylosing spondylitis
- Joint pain, fibromyalgia
- Fatigue
- Depression, anxiety, and cognitive issues such as ADHD, brain fog
- Female and male hormonal issues
- Skin conditions such as rosacea, acne, eczema, and psoriasis
- Weight gain
If you identify many of these as issues in your body, you may have leaky gut. While testing for leaky gut is available (lactulose/mannitol test, stool zonulin and others), ultimately what leads to the diagnosis of leaky gut is having the symptoms of many of the things listed above.
What Causes Leaky Gut?
There are four primary causes of leaky gut:
- Poor diet
- Chronic stress
- Overexposure to toxins (including medications)
- Dysbiosis (low levels of good gut bacteria or overgrowth of others)
1. Poor Diet: (primary dietary offenders which can damage the lining of the gut)
- Gluten (Pro-inflammatory and causes the release of zonulin which disrupts the tight junctions between small intestinal cells. Zonulin is elevated in the tissue and blood of people affected by autoimmune conditions)
- Dairy (A1 beta Casein protein is pro-inflammatory and is very similar in structure to gluten)
- Refined sugars (Pro-inflammatory and support the growth of yeast and bad bacteria)
- Processed/packaged foods (Pro-inflammatory and foreign)
- GMO foods (Cause direct damage to gut lining. Most corn and soy in the U.S. is GMO)
- Unsprouted grains (which have phytic acid and lectins which can break down the gut lining)
2. Chronic Stress: Ultimately, chronic stress is the root cause of all illness. In the setting of gut health, chronic stress with elevated cortisol levels can lead to decreased secretory IgA levels (that primary sentinel guard of the digestive tract and lungs) and decreased defense against bad bugs. Elevated cortisol levels also lead to the breakdown of the gut lining directly. So, understand that emotional stress alone can break down the protective gut barrier!
3. Overexposure to toxins:
- Antibiotics
- Pesticides
- Tap water
- Aspirin and NSAIDs
- Excessive alcohol intake
4. Dysbiosis: Dysbiosis is an imbalance between the beneficial and harmful bacteria in your gut. When the numbers of good bacteria in the gut are reduced, this provides an opportunity for harmful bacteria, yeast, viruses, and parasites to take hold and cause infections within the gut. The key thing to understand is that when the normal defenses of the body (of which the gut is primary) are compromised, exposures which may normally not affect us can take root and cause illness. Not every exposure causes disease in every individual. When we take care to regain and maintain the natural balance within our body, we support the natural defenses of the body and prevent illness.
5 Steps to Heal Your Gut (The 5 r’s)
1. Remove what causes ongoing inflammation in the gut.
- An elimination diet to identify food sensitivities by removing the most inflammatory and commonly triggering foods such as gluten, dairy, soy, eggs. Although IgG food sensitivity testing can be useful, an elimination diet is both therapeutic and diagnostic, and likely a required step in the healing of the gut.
- Infections (identified with a comprehensive stool analysis)
- Toxins and medications
- Stress
2. Replace what the gut needs for optimal digestion.
- Digestive enzymes, liver and gallbladder support
- Stimulation of the “rest and digest” aspect of the nervous system (parasympathetic versus the “flight or fight” sympathetic nervous system) via the vagus nerve through the practice of yoga, meditation, singing, slow deep breathing, laughing, cultivating true connection with others
- Slowing down to eat and enjoy meals and snacks
3. Restore the balance of healthy gut bacteria with probiotics and prebiotics, either through food or supplementation.
- Admittedly, this is not necessarily the most straightforward recommendation. Which probiotic? What strains? How many billion colony-forming units?
- Most probiotic supplements have strains of Lactobacillus and Bifidobacterium and can be helpful for many people who are lacking those strains.
- Soil-based spore-forming probiotics survive stomach mostly intact and can work on many levels to improve gut and overall health.
- Eat fermented foods such as sauerkraut, kimchi, kefir, tempeh, miso.
- Prebiotic supplementation to feed beneficial bacteria is also very important: fiber and prebiotic foods such as raw garlic, chicory root, Jerusalem artichokes, bananas, dandelion greens, jicama.
4. Repair the gut with the nutrients it needs to heal and function properly
- Collagen and L-glutamine both found in bone broth
- Zinc, fish oil, Vitamins A, C, E
- Deglycyrrhizinated licorice (DGL)
5. Rebalance your mind, body, and spirit to rebuild the foundation for health and wellness. Ultimately, we must address the lack of balance and relaxation we so often have in our lives and that lead to poor gut health and chronic disease. We can address all of the above steps, and we may find ourselves struggling again with the same issues, or worse, not having much response at all. Being quiet and learning to relax are in the end the most balancing and healing tools we all have within us.
Know and understand that your gut health is fundamental to your overall health and well-being. When this basic compartment of our bodies is compromised, as we have seen with leaky gut, all manner of illness can result. When you embrace the power you have to heal your gut, you will find that you have all the tools you need to recover and restore your innate inner balance.
Jessica Wei, MD, FACOG is a board-certified Ob/Gyn and functional medicine practitioner, who left her private practice of thirteen years to create the women’s functional medicine practice, Women’s Holistic Health, LLC in West Hartford, Connecticut. To augment her extensive conventional training, Dr. Wei completed a fellowship in Integrative Medicine at the University of Arizona Center for Integrative Medicine founded by Dr. Andrew Weil, the internationally recognized expert in integrative medicine. She specializes in the evaluation and treatment of hormonal issues such as PMS, PCOS, fibroids, endometriosis, and menopausal issues, as well as fertility, fatigue, digestive problems, thyroid issues, and depression/anxiety.
Women’s Holistic Health, LLC is located at 18 North Main Street, 3rd floor in West Hartford. For more information, please visit: www.jessicaweimd.com; or e-mail: [email protected]; or call 860-904-9728. Dr. Wei looks forward to hearing from you! If you are interested in talking with Dr. Wei about hormonal imbalance, please schedule a free 15-minute telephone consultation at: www.calendly.com/drwei.