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‘Leaky gut’ (also known as increased intestinal permeability) is a term used primarily by alternative medicine practitioners to describe a condition of altered or damaged intestinal lining. Proponents of the condition argue ‘leaky gut’ arises as a result of damage to the intestinal lining that is thought to be caused by chronic inflammation, poor diet, damage from taking large amounts of non-steroidal anti-inflammatory drugs (NSAIDS), cytotoxic drugs and radiation, antibiotics, excessive alcohol consumption, or compromised immunity.
Allow me to illustrate: the lining of the gut is made up of mucous membrane that maintain the barrier between the inside of the intestines and the bloodstream. It is similar to a row of guards protecting the wall between the castle and the moat. Now when the guards become tired or decide to take a break the integrity of the wall becomes compromised and invaders may enter the castle. This is exactly what happens in the gut - increased permeability of the mucosal membrane means that some bacteria, incompletely digested proteins and fats and waste not normally absorbed may “leak” out of the intestines and into the blood stream: a compromised wall ripe for invaders to enter. This ‘leaking’ from the intestines into systemic circulation causes the immune system to go haywire: our immune system is designed to stay on the lookout for any intruders or unidentified matter and therefore responds immediately to any partially digested food particles, antigens, toxins, and pathogens entering the bloodstream (imagine unauthorised personnel entering a building and the alarm signal sounding). In response to the infiltration of particles through the intestinal wall, an immune response is initiated and the body manufactures specific antibodies to these antigens. In some people, their own tissues are mistaken to be an exogenous antigen and the tissue is attacked. This autoimmune response can lead to a host of gastrointestinal disturbances such as abdominal bloating, gut inflammation (often manifested as a belly ‘pooch’) excessive gas and cramps, fatigue, food sensitivities, joint pain, skin rashes, and autoimmunity. Other conditions that have been clinically associated with increased intestinal permeability or “leaky gut” include inflammatory bowel disease, autism (ASD), inflammatory joint disease, dermatological disorders such as eczema, dermatitis and acne, and mood disorders such as depression and anxiety. There is also increasing evidence that damage to the intestinal wall plays an important role in autoimmune diseases such as multiple sclerosis, celiac disease, crohn’s disease, psoriasis, ankylosing spondylitis, Behcet’s syndrome, type 1 diabetes and rheumatoid arthritis.
While some medical practitioners dispute the term ‘leaky gut’ few dispute that the intestinal wall can become ‘leaky’. They argue however, that the ‘leakiness’ is the cause of another disease and not the cause of the disease itself. However, with growing evidence to demonstrate the effectiveness in treating the gut lining to eliminate symptoms of disease, it would seem that treating the gut as the first priority is a no brainer. For this reason, most alternative medicine practices will test the intestinal permeability of patients in the initial consultation. Given that poor gut health is often at the root of illness and that the intestines are the primary site for nutrient absorption, prescribing dietary strategies or supplements without addressing intestinal dysbiosis or leaky gut is pointless in alleviating symptoms and/or disease in the long term.
Thanks for the diagnosis but now what do I do?
In patients who are diagnosed with a high level of intestinal impermeability in clinic, the first line of treatment is to remove the foods and irritants that are causing gut inflammation. If we compare this to a leaking tap in the bathroom what we are doing by removing the inflammatory foods and other materials such as alcohol, antibiotics, aspirin, drugs, processed foods, tobacco, extreme stress is turning the tap off. It is much easier to fix a leak while the water is not running continuously and the same concept can be applied to the gut. While I am not an advocate of removing foods from the diet unnecessarily this is one instance where it is absolutely fundamental to effectively minimize inflammation and allow the gut to heal.
Following an anti-inflammatory and/or detoxification diet will help restore balance and function to the digestive tract while removing the excessive toxic load off of the liver. Supplements are also used to improve the function of the digestive system and sometimes for hormonal support and regulation. This helps to get the body out of constant stress and back to proper function and balance. Quality practitioner only powdered and activated supplements are preferred to ensure optimal uptake and prevent further stress on the digestive system. Specific nutrients are often prescribed to protect, soothe and support the colon, probiotics are prescribed to restore balance to the gut flora, aid in the digestion and absorption of food, ensure proper bowel function and act to police the digestive tract to keep the harmful parasites and bacteria. Supplements may also be prescribed to accelerate the healing process by stimulating the natural cell repair process.
As a result of this treatment plan the mucosal barrier of the intestinal lining becomes restored and the wall is once again protected by efficient and capable guards.
A Note on Children
Children are particularly susceptible to gut dysfunction as their gut and immune systems are not fully developed for the first few years of life meaning that their intestinal lining is already somewhat leaky’.
It is imperative that children who are given antibiotics or who suffer with acute or chronic allergies, eczema, asthma, or recurring colds and flus are replenished with quality supplementation and that their diet is kept free of antigenic foods such as gluten and dairy along with other mucous forming foods (such as citrus and bananas) to minimise the inflammatory response so that their gut lining (and with it, their digestive and immune systems) can heal.
Attempting to heal the gut by simply administering probiotics or digestive enzymes is akin to attempting to fix a leaking tap with the water gushing out. The allergenic and trigger foods need to be removed completely during the treatment process so that the gut can heal.
Take Home Point
Healthy gut function is foundational to all other health pursuits. In treating gut function as the first priority, we are confident that we are treating the underlying cause of most symptoms presented in clinic.
Healthy gut = healthy body.
Karen Meier is a Nutritionist with FoodBodyMind, http://www.foodbodymind.com.au/. Karen is a dedicated Schkinny convert and helps us with making sure our juices, and programs are nuritionally balanced, and also keeps us up to date with the latest research!