The Conundrum of a Leaky Gut
You have probably heard the term “leaky gut”; some of you may have even received a diagnosis. Even with this term gaining mainstream attention, what we often find when working with patients is a lack of education and true understanding of this topic.
As a patient, it is important for you to be a player on your medical team, not just sitting on sidelines waiting to be called in when needed. To be a team player, you need the proper education to understand the root causes of what may be keeping you from reaching your true wellbeing. There is a saying for this that speaks volumes, “when we know, we do better”.
Here you will find everything you need to know to begin educating yourself and understanding leaky gut. What is leaky gut? How does someone develop leaky gut? What are the signs and symptoms you should be looking for and how do you treat and rid this condition.
With Ancient Greek physician Hippocrates quoting “all disease begins in the gut” over 2500 years ago, this is a topic we believe you should be well-versed in our modern day world.
What is a Leaky Gut?
The simplest way to describe it is with something that most of us do every day. We apply lotion to our skin. The lotion then gets absorbed into our system. This is because the skin is semipermeable or in simple english, slightly leaky. If I have a wound or rash that is inflamed, I will absorb a lot more of what I applied to my skin as the barrier during inflammation is breached or broken down.
This same phenomenon happens in our digestive tract lining especially in the small intestine. We have a membrane that routinely is semipermeable to the extent that foreign items stay in the gut lumen and nutrients, certain vitamins, drugs, etc. can be allowed to enter. When we get an infection, allergies or toxins enter the gut, they attack the gut lining, making it more permeable.
We call this a leaky gut or medically we use the terminology “increased gut permeability”.
What is the conundrum in this?
Simply that in conventional medicine, we do not include mechanisms of the causation of disease as a diagnosis. Harvard Health Publishing, a part of Harvard Medical School’s public outreach states the following:
“Controversy still exists on whether leaky gut causes the development of diseases outside the gastrointestinal tract in humans. However, it is always a good idea to eat a nutritious, unprocessed diet that includes foods that help quell inflammation (avoids foods known to trigger inflammation), which may, at least in theory, help to rebuild the gut lining and bring more balance to the gut flora. This recipe could make you feel better, without any side effects. It is definitely worth a try.”
So, you can read here that they do, albeit grudgingly, accept that humans need to eat an optimal diet to decrease inflammation and maintain a healthy gut lining and gut flora or microbiome. However, what most physicians take for granted is that an optimal diet to decrease inflammation is not in the thought pattern of the average person nor are the countless causes of upstream imbalances even recognized.
This is where the concept of finding the upstream imbalances in our system that lead to disease comes into play. While a diagnosis is important, it is equally important to think about what upstream imbalances in core systems in our body led to the conditions that allowed disease to happen. We call this way of thinking in any medical field, FUNCTIONAL MEDICINE. If we are able to find these imbalances and correct them gradually, it is entirely possible that we may be able to overcome our disease process. This is why it is important and it does not take away from the fact that you may use drugs short term to help your symptoms.
What Causes a Leaky Gut?
Sid Baker, M.D, the father of Functional Medicine, said to us on many occasions that if we sit on 2 tacks, taking one away will not solve the problem.
He looked at tacks by posing 2 simple questions:
What does the body need?
What does the body need to get rid of?
Using this metaphor, someone could be sitting on a whole lot of tacks that they need removed and others may simply need to tack something to their bulletin board!
Under the heading of what the body needs to get rid of or what we need, we look at the following causes and these same causes lead to a Leaky Gut:
Allergens - food, environmental agents such as food dyes, preservatives and chemicals
Toxins - drugs and countless man made chemicals that pollute us
Infections - bacterial, viral, fungal and parasitic
Stress -any event that tells our body that we have to make new adjustments to keep systems functioning is defined as stress.
Poor nutrition - in the US we refer to this as the SAD (Standard American Diet) which is actually an overabundance of major nutrients and non-nutrients in food, without the balance of phytonutrients and vitamins. In third world countries this can also be referring to malnutrition as many are starved of calories and proteins.
Under the heading of what one needs to thrive are:
Love, faith and hope
Time to heal
Proper communication
Exposure to sunlight
Movement, proper breathing and oxygenation
Sleep
Optimal nutrition
Synchronization of our bodies to the various rhythms of nature, circadian, ultradian, seasonal, etc.
When we play detective and decipher what you need and what you need to get rid of, then we have the answer to what is causing your leaky gut. Leaky gut leads to many other diseases not only in the gastrointestinal tract, but outside it as well. I see this everyday in the causation of skin rashes, migraines, allergies, anxiety and depression, poor sleep, etc.
What are some of the symtoms associated with Leaky Gut?
Within the digestive tract we can diagnose silent reflux, heartburn, ulcers, inflammatory bowel disease, irritable bowel disease and also disorders such as celiac disease and sprue.
Outside the digestive tract, every organ is subject to the intricate network between the gut, immune system and the microbiome leading to many symptoms and diseases.
In the head - headaches, eye pain and redness, allergies, recurrent sinus infections, recurrent ear infections, rashes in the face region such as rosacea, stomatitis and even burning mouth syndrome
In the heart - palpitations, shortness of breath
In the thyroid gland - autoimmunity, goiters
In the lungs - asthma, chronic cough, frequent bronchitis and even pneumonia
In the kidneys - recurrent infections, kidney stones and autoimmunity
In the limbs - muscle aches, joint aches, joint swelling, tendonitis and fasciitis
In nails, hair and skin - ridging of nails, nails lifting off the surface, dystrophy of nails, falling hair, premature graying and all kinds of rashes from hyperkeratosis-pilari to eczema.
And when looking at multiple systems strung together to cause, say, autoimmunity, we see the central role of maintaining an intact gut.
Can we test for a Leaky Gut?
Conventional testing for leaky gut does not exist but there are tests using physiology and biochemistry that test for the leak of toxins and allergens, or measure the proteins called Zonulin and Actin or antibodies that our body makes to these- the proteins that seals the gut barrier.
We can also measure LPS, lipopolysaccharides, made by bacteria that can punch holes in the gut lining. We call these tests functional tests as they truly test the functioning of our body.
Can we treat and ultimately get rid of a Leaky Gut?
Absolutely. Again, if you try simple remedies and it does not work, then think of the tacks that you are sitting on. Perhaps we have not addressed all of them.
The simple remedy is to follow the 5R’s of healing the gut:
REMOVE allergens, toxins, etc.
REPLACE acid, enzymes, bile acids
REPAIR the small intestine commonly with glutamine or zinc carnosine, and the colon with butyrate and prebiotic foods.
RE-INOCULATE with appropriate probiotics
RE-BALANCE with mindful eating, managing circadian rhythms in eating and living, getting proper sleep and sunlight, as well as down time.
Also, remember that our exposure to the environment is not static but dynamic. We will continue to come across infections, toxins, allergens etc. and may need to continually be aware of our body and its responses. When we do so, we will realize that taking care of our digestive system is central to the healing of our entire body, mind and even emotions.
The dictum in Functional Medicine is to always pay attention to the gut first. It is at the root of most disease and symptom causation.
