“All disease begins in the gut”. This quote by Hippocrates was spoken over 2000 years ago. While today we know that this is not true 100% of the time, I firmly believe that a compromised intestinal tract is one of the main causes of chronic disease in today’s world.
‘Leaky gut syndrome’ is a term used by naturopathic and alternative medical doctors to describe a dysbiotic and damaged condition of the intestinal tract. While the traditional medical community used to balk at the use and validity of this term, more and more scientific studies are confirming that a compromised intestinal tract leads to all sorts of diseases, especially things like allergies, asthma, mental illness, cancer, and autoimmunity (1).
The small intestine is not only where most of your food absorption takes place, but it also houses over two-thirds of your immune system. When the mucosal lining of the small intestine is damaged, incompletely-digested food particles and bacteria are able to slip through the intestinal lining and flow out into the bloodstream, which is a place they definitely don’t belong. When your immune system comes across these particles in the blood, it does what it is supposed to do and mounts a reaction against them. But unfortunately, the immune system was not designed to incessantly respond to food and bacteria flowing into the bloodstream every day. Constant immune stimulation causes the body to remain in a persistent state of over-responsiveness and inflammation. This creates allergies and intolerances to foods and environmental antigens that were never issues for us in the past, and if these reactions are allowed to continue unchecked, auto-immunity, which is essentially over-responsiveness to the body’s own cells and tissues, can result.
What causes a leaky gut, and why it so common these days? The answer is multifactorial, and it is likely that your gut is being affected by more than one of the following factors:
Causes of Leaky Gut:
1. Antibiotic use: Did you know that the average child today is prescribed between 10-20 courses of antibiotics by the time they are 18 years old? Additionally, a 2003 study published in the Journal of the American Medical Association showed that doctors prescribed antibiotics for more than 60% of adults with upper respiratory tract infections, even though it is a known fact that these infections are usually caused by viruses (2). On top of the fact that we are over-prescribed these drugs, we are chronically exposed to low levels of antibiotics in our food and water supply. Unfortunately, antibiotics don’t just destroy the “bad bugs”, they wipe out our beneficial bacteria as well (3). And when the surface mucosa of your gut is no longer populated by “good bugs”, pathogenic bacteria and species like Candida albicans are free to come in colonize. Candida is especially dangerous because it secretes chemicals that cause intestinal cells to shrink so that they no longer fit tightly together, creating the holes that we commonly refer to as “leaky gut” (4).
2. Stress: When you are stressed out, your body goes into “fight or flight mode”. As part of this process, your adrenal glands secrete cortisol and adrenaline, which are very beneficial substances when you are running from a bear or fighting for your life. But they both have a plethora of negative effects in the body when they are chronically elevated. High cortisol inhibits the production of digestive enzymes and slows down intestinal transit time, which then leads to fermentation and the creation of an acidic pH in the GI tract. This putrid, acidic environment is exactly what pathologic bacteria and Candida thrive in best. Additionally, cortisol decreases levels of Secretory IgA, which is your body’s first line of defense in protecting the intestinal epithelium from pathogens and toxins (5).
3. Food intolerances: This is where it can get a little tricky. First let’s be clear with our terminology. A true food allergy is an “IgE mediated” antibody reaction. This means that when you eat a food you are allergic to, your immune system produces large amounts of an antibody called immunoglobulin E, or IgE for short. These antibodies attack food allergens by releasing histamine and other chemicals which cause the typical symptoms of an allergic reaction (airway constriction, hives, itching, runny nose, anaphylaxis, etc ). In comparison, a food intolerance is a negative reaction to a food that is not IgE mediated. This could be a reaction through a different antibody system known as IgG (also known as a delayed antibody reaction), a lectin-induced reaction based on your blood type, or even something like lactose-intolerance or Celiac disease. Some intolerances we are born with, and some we actually create when we eat the same food too often. In the past, our ancestors were forced by nature to rotate their diet according to the seasons, but now we have access to the same foods all throughout the year. Additionally, today’s processed foods have a huge list of ingredients and additives, most of which originate from only a few basic food sources. The top five major food intolerances are gluten, dairy, corn, egg, and soy, and it is not a coincidence that most processed foods contain some, if not all, of these ingredients. To throw fuel on the fire, many of these foods are now genetically modified, which makes it even more likely that our bodies will mount a reaction to them.
4. Other medications: NSIADs, or non-steroidal anti-inflammatory drugs like Ibuprofen, work by reducing the production of pain-producing prostaglandins in your body. Unfortunately, these same prostaglandins are what stimulate the production of the protective mucous layer in the GI tract. Other common medications that damage the intestinal lining are corticosteroids, birth control pills, antacids, and methotrexate.
5. Dietary irritatants: besides specific intolerances, excess intake of sugar, processed foods, and alcohol can irritate the intestinal tract and lead to cellular breakdown.
6. Genetics: approximately 20% of people are genetically “non-secretors”. This means that these people are born without the ability to secrete their blood type antigens into the mucus later of their gastrointestinal tract. Their overall level of secretory-IgA is lower as well. So when these people are exposed to any of the above stressors, they are much more prone to the development of dysbiosis and intestinal permeability (6).
7. Other: intestinal damage can also be caused by bacterial or viral infections, low antioxidant status, environmental toxicity, aging, or physical trauma like an injury, surgery, or radiation.
Healing the GI tract:
The first step in true is healing is always to identify and treat the cause. Simply treating symptoms without knowing the cause is like throwing darts at a dartboard with a blindfold on. You might get lucky, but chances are your treatment is going to miss the mark.
For example, if a man develops leaky gut because the chronic stress of his job has created an abnormal cortisol response, going on diet that removes all food intolerances may palliate his symptoms, but he won’t actually be healed. What is the difference? Well, getting rid of the reactive foods may bring down inflammation and give his body time and energy to repair the leaky gut, but as soon as he eats one of those foods again, his symptoms will return and his gut health will quickly decline. Instead, if this same man did a food-intolerance diet combined with adrenal-specific herbs, stress-reduction techniques, and a homeopathic medicine that fit his specific state of stress, he would likely be able to eat those intolerance foods in the future with little to no negative reactions.
In contrast, if someone is born with a strong genetic food intolerance, the most important treatment would be complete and lifelong avoidance of that food. It may be challenging to discern at first, but this subtle distinction between palliation and true healing is what makes all the difference. Below is a list of the most common tests and treatment modalities that heal leaky gut:
1. Food intolerance testing/secretor status analysis: Due to our genetics, we all have different foods that are beneficial for our bodies as well as foods that cause negative reactions. When I begin treating anyone with leaky gut, I advise a 6-week ‘washout period’ where the patient only consumes foods that are beneficial for their body and strictly avoids all intolerances. This gives the body time to bring down inflammation and reactivity levels as well as heal up the gut mucosa. Once healing has occurred, most people are able to eat the foods they are intolerant to on an occasional basis without causing negative symptoms or intestinal damage. When testing reveals that someone is a “non-secretor”, stricter adherence to the diet and longer-term supportive care is necessary to maintain optimal health. For an example of the intolerance test results, please visit this link: http://www.dadamo.com/SWAMI%20GenoType%20__%20Jane%20Public.pdf
2. Adrenal testing and treatment: The most accurate way to test adrenal hormones is through the saliva. If cortisol or DHEA is found to be abnormal, treatment may be through hormone supplementation, glandular support, and/or adrenal-specific botanicals.
3. Probiotics: These are almost always necessary in the early healing stages of leaky gut. Low quality brands are often broken down too early in the acidic environment of the stomach, never making it to your intestines. Make sure to use a high quality brand with a long list of different probiotic strains.
4. Herbs and vitamins: herbs like licorice (Glycyrrhiza glabra), marshmallow (Althaea officinalis), slippery elm (Ulmus rubra), and okra (Abelmoschus esculentus), as well as the amino acid glutamine are soothing to an inflamed gut mucosa and stimulate intestinal healing. Goldenseal (Hydrastis Canadensis), geranium (Geranium maculatum), and caprylic acid can help fight the overgrowth of pathologic organisms and Candida. Rhodeola (Rhodiola rosea), Panax ginseng, and Ashwaganda (Withania somnifera) are common adrenal modifiers. Lastly, curcumin, Vitamin C, and quercitin are some supplements that have general anti-inflammatory effects in the GI tract. Keep in mind, like medications, herbs are medicinal substances and they can cause adverse reactions if misused. For this reason, they should only be used when prescribed by a licensed herbalist or physician who is monitoring your care. In my practice, I may prescribe herbs or vitamins at the beginning of treatment to speed up the healing process, but I don’t that believe most people need to live on an endless supply of supplements in order to maintain optimal health. When you remove the cause, eat healthfully, and give the body what it needs to heal, the need for supplements and pills that modify biological processes significantly decreases.
5. Digestive Enzymes: When food is not properly broken down and digested, fermentation begins in the intestinal tract and pathogenic bacteria are able to flourish. Depending on which organ is deficient, taking a supplement containing hydrochloric acid, pancreatic enzymes, or ox bile may be beneficial. Non-secretors or people under chronic stress would benefit from longer-term enzyme supplementation.
6. Liver Detoxification: Besides the fact that we live in a toxic world and almost everyone would benefit from periodic detoxification, anyone with leaky gut is in an acute state of systemic toxicity. The liver is our body’s primary detoxification organ, so supporting and stimulating its function is very helpful in lowering this toxic load. Consequently, stimulating the liver also allows for increased intestinal motility and decreased stagnation in the intestinal tract. This being said, most people don’t need to follow drastic detoxification protocols like prolonged water fasting, juice fasting, or weeks of colonics to see beneficial effects. Usually an herbal supplement combined home treatments like hot/cold bathing, dry brushing, and/or castor oil packs is sufficient. Detoxification is a vital and often-neglected component of true and lasting healing.
7. Stress Modification: If stress is the main cause of leaky gut, then treating the stress reaction is the only way for true healing to occur. If the stressor is truly a toxic situation like an abusive marriage or a job that you hate, the only answer may be to remove yourself from that situation. But often-times, stress reduction and emotional clearing techniques can help modify your reaction to stressful situations. Some therapies like EFT (Emotional Freedom Technique) can actually minimize the emotional impact of memories, thoughts, or feelings. When the ‘charge’ behind a memory or the emotional connection to a stressor is released, the body is able to let go of the negative holding patterns that often result in disease and dysfunction. I have done extensive training with EFT and have witnessed its great healing effects in both physical and mental/emotional complaints. For more information on this technique, visit the informative link (7) at the end of this article. Other great stress-modification techniques are Reiki, meditation, exercise, counseling, and spending time outdoors or with loved ones.
8. Homeopathy: I use homeopathic remedies as the backbone of almost every treatment plan regardless of the health issue. Why? Because in my clinical and personal experience, homeopathy produces the most dramatic, permanent, and profound healing in the body. While conventional medicine treats disease and all the symptoms that disease comes with, homeopathy treats the sick person individually.
What exactly does homeopathic treatment do? The short answer is this: it stimulates your body to begin healing itself. Essentially, homeopathic remedies encourage the body to “wake up” and begin moving in the direction of health instead of continuing in the direction of disease. Why don’t more naturopathic doctors practice this technique if it is so effective? One reason is this: learning how to prescribe homeopathic remedies correctly and monitor the patient’s response to treatment is a difficult and very time-intensive practice. Not every doctor has the passion needed to put that much time into training, or often they have a stronger passion for another treatment modality such as acupuncture or herbal medicine. For this reason, if you are interested in trying homeopathy, make sure that you visit a doctor who has had extensive training in this modality and lists it as one of his or her specialties; otherwise you are not likely to see positive or long-lasting results. For more information on homeopathy, please check out my last blog post cited at the end of this article (8).
If you have more questions about leaky gut, homeopathy, or would like to schedule a free 15 minute consultation to discuss how naturopathic medicine can help treat your chronic medical condition, please call Horizon Natural Medicine at 602-359-2893.
(1) http://onlinelibrary.wiley.com/doi/10.1046/j.1440-1746.2003.03032.x/full,http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3065426/, http://physrev.physiology.org/content/91/1/151#ref-83, http://iai.asm.org/content/73/1/30.abstract?sid=2a38bded-3218-43d6-99c1-483c71d5b4a0
- Posted by Dr Katie Nuckolls
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