While not regularly referred to in general medicine leaky gut, also called increased intestinal permeability, is often a core theme in approaches to healing from functional, integrative, holistic and naturopathic practitioners for a variety of conditions.
When Tony was diagnosed with Hashimoto’s disease in 2015 it was the first time I had heard of leaky gut and we were both suffering from its effects albeit in different ways. I spent a great deal of energy and time researching and gathering information about leaky gut symptoms, leaky gut treatments and leaky gut diet and wanted to share my understanding and personal experience of approaching an autoimmune disease, IBS, hormonal disruptions, dysbiosis and skin conditions from this perspective.
What is leaky gut?
First let me set the scene of our often overlooked, wonderfully complex digestive system.
Inside our guts we have an extensive intestinal lining covering more than 4,000 square feet of surface area. This intestinal barrier is also incredibly thin—just a single layer of epithelial cells separates the inside of your intestines lumen from the underlying tissue – so it is particularly susceptible to damage. And it is literally this single layer of cells that stands between what you put into your body and your circulatory and immune systems.
Naturally semi-permeable, our gut lining forms a tight barrier that allows small nutrient particles to cross into the bloodstream while blocking larger molecules, such as undigested food, proteins, toxins and microbes.
In an optimal situation the spaces in between the cells that line the intestines are sealed. These tight junctions are called desmosomes and play a crucial role in regulating what is allowed to cross the intestinal barrier.
When the intestinal lining becomes irritated, the junctions loosen creating ‘gaps’ or ‘leaks’ that allow unwanted larger molecules in the intestines to pass through into the blood. This is went things start to go wrong. As these large molecules enter our bloodstream, our immune system is triggered to produce antibodies and an inflammatory response which can lead to a host of health issues with far reaching consequences.
A leaky gut can have reaching consequences for our whole body
As these cells play important roles in the production of enzymes needed for proper digestion, this inflammation and cellular damage can also mean that our ability to properly digest our food, and therefore absorb essential nutrients, will be impacted. Additionally our incredible and complex microbiome or gut flora, which plays crucial roles in the production of neurotransmitters (particularly serotonin), vitamins, hormones and acts as a protector of this delicate lining, may also be affected.
What are the signs of leaky gut?
If you are experiencing and of these signs there is strong possibility that leaky gut may be a contributing factor
Bloating after meals
Altered bowel habits — like diarrhoea, constipation or Irritable Bowel Syndrome (IBS)
Inflammatory bowel conditions such as IBS, celiac disease, Crohn’s disease and ulcerative colitis
Poor immunity
Food allergies and sensitivities
Autoimmune conditions
Inflammatory joint disease/arthritis
Chronic fatigue syndrome
Skin conditions like eczema, acne or rosacea
Fatigue
Headaches, brain fog or poor concentration
Anxiety or depression
So what causes leaky gut?
There are many other contributing factors that may cause leaky gut by contributing to the weakening of the gut lining including:
· Antibiotics — can destroy the good bacteria in the gut, leading to an imbalance.
· Excess sugar — a diet high in sugar, particularly fructose, harms the intestinal wall.
· Preservatives and chemicals in processed foods.
· Food intolerances — eating foods that you have an intolerance to, like gluten and dairy, can contribute to leaky gut. Your body treats them as foreign invaders that must be fought, producing antibodies which trigger an immune response.
· Anti-inflammatories — the long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can increase intestinal permeability and contribute to leaky gut.
· Chronic stress — often a factor in gastrointestinal disorders, including leaky gut.
· Excessive alcohol — too much drinking can increase intestinal permeability.
· Dysbiosis – a unhealthy balance of different microbial strains that make up our microbiome can also cause damage to the lining of the gut as one of the roles of a healthy microbiome is to protect the integrity of the lining (many things on this list can contribute to this dysbiosis too)
· Intestinal infections such as SIBO (small intestinal bacterial overgrowth)
Leaky gut diagnosis
Thankfully, there’s an easy way to tell if you have leaky gut — there are specific tests that can indicate inflammation of the gut wall and potentially a leaky gut.
The standard test for leaky gut syndrome is the mannitol and lactulose test. Both are water-soluble molecules that the body can't use. Mannitol is easily absorbed by people with healthy intestinal linings. Lactulose is a larger molecule and is only slightly absorbed. A person drinks a solution contain both mannitol and lactulose. Urine is collected for six hours and the amount present in urine reflects how much was absorbed by the body. A healthy test shows high levels of mannitol and low levels of lactulose. If high levels of both molecules are found, it indicates a leaky gut condition. If low levels of both molecules are found, it indicates general malabsorption of all nutrients.
At this stage in our healing we worked with integrative and functional nutrition practitioners to conduct tests for both leaky gut, microbiome dysbiosis and food intolerances. While is it a great idea to be supported with these tests, the leaky gut treatments and leaky gut diet are also things that you can guide yourself through without these tests. As you begin to adopt the dietary and healing considerations, you will begin to notice improvements. I love coming back to something that our integrative practitioner always asked us – “How do you feel?” While it may seem obvious, so often we are distracted by how we feel in our body. We are not conscious of how we feel after we eat certain things or the impact they have on our digestion. So an important learning for us was to always check in with this question when including or eliminating foods and supplements.
Hope that all helped to clear up anything regarding this topic! For more information about treating leaky gut and leaky gut diet see the follow on article here.
