The gut is often referred to as a foundation pillar of health for the body, and the digestive system as ‘the mother’ of the body, as it feeds all of the other organs and provides the first line of defence against ‘foreign’ substances.
We know that digestive health is of prime importance to overall health, and is often the first place to focus on in a functional medicine programme. When considering gut health the health of the gut lining (and repairing or preventing leaky gut) is of utmost importance.
Leaky Gut Syndrome is an extremely grey area in terms of diagnosis and cause, however it is considered by many professionals in the medical industry to be an underlying cause of a wide-range of chronic diseases.
What is a Leaky Gut?
The NHS provide a simple explanation of Leaky Gut:
“The inside of the bowel is lined by a single layer of cells that make up the mucosal barrier (the barrier between the inside of the gut and the rest of the body).
This barrier is effective at absorbing nutrients, but prevents most large molecules and germs passing from inside the bowel into the bloodstream and potentially causing widespread symptoms.
In some circumstances, this barrier can become less effective and “leaky”, although this in itself is not generally thought to be sufficient to cause serious problems.”
To elaborate upon this summary from the NHS Website, the intestinal lining acts as the first line of defence for our immune systems, and through what are known as ‘tight junctions’, molecules in our body go through a ‘screening’ process so that essential nutrients are absorbed and harmful molecules (such as toxins and unwanted food particles) are ‘turned away’.
However, in some circumstances (the reasoning behind which we will discuss later) these ‘junctions’ become too permeable, allowing un-screened molecules to move straight into the bloodstream. This is referred to as ‘leaky gut’ or ‘increased intestinal permeability’.
Obviously, when an unwanted or ‘foreign’ molecule breaches the initial defence system, your body begins to work extra hard to get rid of it. The first point of call is the liver, which provides a second screening process (much like that of the intestinal wall) to try and remove all of the ‘foreign’ particles.
However, in the vast majority of circumstances, if the intestinal wall is leaky, the flow of ‘foreign’ particles will exceed the liver’s capacity to deal with them and they will begin to accumulate in the body.
At this point, the immune system is called upon to produce antibodies to help fight the ‘foreign’ molecules. The key point to note is that your body doesn’t ‘forget’ Because of this, the next time you eat that food, your immune system is likely to have a similar reaction to it. This is the underlying mechanism behind many food sensitivities. This activation of the immune system can also result in on-going inflammation.
Signs and symptoms of Leaky Gut
The intestinal lining essentially protects substances from moving into the blood stream, so if the lining isn’t doing its job efficiently, all of these harmful substances are able to manifest and accumulate in your body. It is considered that the following conditions can potentially come about as a result of Leaky Gut:
- Seasonal allergies or asthma
- Digestive issues such as bloating, diarrhoea or irritable bowel syndrome (IBS)
- Hormonal imbalances such as PMS or PCOS
- Depression, anxiety, ADD or ADHD
- Autoimmune disease such as rheumatoid arthritis or coeliac disease
- Chronic fatigue or fibromyalgia
- Skin issues such as acne or eczema
- Food allergies or food intolerances
- Candida overgrowth
What causes Leaky Gut?
The NHS have listed the following conditions as being potential causes of Leaky Gut Syndrome:
- “Inflammatory bowel diseases – such as Crohn’s disease
- Infections of the intestines – such as salmonella, norovirus and giardiasis
- Coeliac disease
- Chemotherapy medicines
- Chronic kidney disease
- Radiotherapy to the abdomen (tummy)
- Immuno suppressants (medicines that weaken the immune system)
- Cystic fibrosis
- Type 1 diabetes
- Complicated surgery”
Other common causes are infections, toxins and foods such as sugar, dairy, alcohol and in particular gluten.
A high percentage of people are unable to digest gluten properly which causes a vast array of problems in the gut.
When a food that contains gluten reaches your intestines, enzymes produced in your intestinal wall, breaks down the gluten into its ‘active’ protein building blocks; the peptides gliadin and glutenin.
As the peptides (gliadin and glutenin) make their way through your digestive system, your immune system in your gut, the gut-associated lymphoid tissue (GALT), reviews them for potentially harmful substances.
When one doesn’t have an issue with gluten, then the proteins are efficiently absorbed. However in those that do have a sensitivity or intolerance, the GALT identifies gluten peptides as potentially harmful substances and therefore antibodies are produced by the body to attack it.
When your body produces antibodies to defend itself against gluten peptides, the intestinal barrier may also become compromised decreasing your ability to absorb nutrients and making the walls of your intestine ‘leaky’ allowing more substances through. This can manifest itself in digestive symptoms, including bloating, constipation, diarrhoea, weight loss, fat malabsorption and malnutrition.
Gluten also causes the gut cells to release a protein called zonulin. Zonulin’s role is to open up the spaces between the cells of the intestinal lining and this is a process that is essential for the efficient absorption of nutrients. However, in those with gluten sensitivity the gut cells remain open allowing much larger protein molecules (that are potentially harmful) to be absorbed into the bloodstream.
When these tight junctions remain open, you have a leaky gut. When your gut is leaky, harmful things like bacteria, toxins, heavy metals and undigested food particles can leak through your intestines into your bloodstream. Once they get into your bloodstream, they are transported to the liver. This puts a strain on your liver function and most people who have had a leaky gut for some time eventually go on to develop poor liver health.
Leaky Gut is known to have a strong association with Candida overgrowth. The Candida cells begin to cause problems when they adopt their fungal form and begin to grow hyphae – the long branches that grow out of the fungus. These branches invade the cells in your intestinal lining, creating inflammation and permeating the membrane that prevents substances from leaking out.
The overuse of antibiotics is of grave concern on a Worldwide basis. Antibiotics reduce the friendly gut bacteria that provide protection against infections all around the body. The friendly bacteria in the gut also produce substances that are protective for for a healthy gut. A reduction in friendly bacteria can allow undesirable bacteria to overgrow -this potentially causes inflammation which can lead to a Leaky Gut.
The 4-Step Plan to Healing a Leaky Gut
Functional medicine practitioners use a 4 step plan to heal a leaky gut called the 4-R programme. This programme involves identifying and removing dietary and lifestyle factors that may be damaging the gut, replacing missing factors and adding in gut healing nutrients for repair.
Remove – all gluten containing foods, sugar, alcohol, conventional dairy products and any other known food sensitivities; stress; and non-steroidal anti-inflammatories (unless these have been prescribed by a medical practitioner). If there is an overgrowth of undesirable bacteria or yeast this will also need to be addressed using appropriate anti-microbials.
Replace – use digestive enzymes (and betaine hydrochloride if indicated) as natural production of digestive enzymes and stomach acid may be compromised in a leaky gut. Ensuring adequate digestion of food will help with absorption and prevent undesirable bacteria from using the food. Choose healing foods such as bone broths, probiotic rich foods (eg fermented vegetables), prebiotic rich foods (such as vegetables), chia seeds and good quality proteins.
Repair – with digestive tract healing nutrients such as l-glutamine, aloe vera, curcumin, essential fatty acids and vitamins A and D. It is important this step is not overlooked – if the gut is not healed then further food sensitivities may develop and you may not see a full resolution of symptoms.
Rebalance – with probiotics and additional nutritional support. Probiotics are needed to rebalance the gut flora. In addition there may be a need for additional nutritional support – if digestion and absorption have been compromised for some time short-term additional nutrients will be needed to address any specific needs identified, along with a good quality multivitamin and mineral in both the short-term and for long-term maintenance.
In conclusion, the gut is key to overall health and a leaky gut is the start of many health conditions and disease processes. Hippocrates summed it up 2000 years ago when he said “All disease begins in the gut” and “Death sits in the bowel”.
A health improvement programme should start with an evaluation of symptoms that might be related to gut health. If needed a 4-R programme can then be used to repair the gut and start the return to health.
If you have any questions regarding the health topics that have been raised, or any other health matters please do contact me (Amanda) by phone or email at any time.
firstname.lastname@example.org, 01684 310099
Amanda Williams and the Cytoplan Editorial Team: Joseph Forsyth & Simon Holdcroft