What is leaky gut?
It is a condition where the tight junctions in your mucosal layer let bigger molecules through than it normally does (this is called increased gastrointestinal permeability), this can lead to increased inflammation, allergy, and immune responses and gastrointestinal upset (Mu et al., 2017).
How does your gastrointestinal tract protect you from bacteria, toxins, food antigens, and pathogens while helping you absorb nutrients?
Well, it’s all in the mucosal layer. This single later of epithelial cells are held together by tight junction proteins that dictate what can pass through into the blood circulation. The mucosal layer is supported by the immune system including immunoglobulins, cytokines, mucins, and other antimicrobial molecules. The intestinal barrier helps to stop these toxins and pathogens from penetrating through and entering into the blood circulation and causing a systemic immune response (Mu et al., 2017).
Most epithelial cells renew every 3-5 days and host a variety of functionalities including enterocytes (absorption), goblet cells (production of mucus – this helps to protect the epithelial cells), Paneth cells, microfold cells, enteroendocrine cells, cup cells, and tuft cells (Mu et al., 2017).
The microbiota in your gastrointestinal system also helps to protect the epithelial cells, they do this by using up nutrients and attachment sites that pathogenic bacteria may use. They are also known to produce antimicrobial substances so that pathogenic bacteria can not colonize – this means the levels of “bad” bacteria stay low. The microbiota is involved in the absorption and digestion of nutrients needed by the epithelial cells (Mu et al., 2017), meaning that they are able to supply nutrients directly to the cell that needs it.
Intestinal permeability is also influenced by your circadian cycle and stress (Camilleri, 2019). More about this in another blog coming out soon!
Does having a leaky gut mean anything?
Yes, those who have a “leaky gut” are more susceptible to autoimmune disease and if you already have an autoimmune disease, this condition can make your symptoms worse. When a thin mucus layer is penetrated by bacteria it can initiate local and systemic inflammation and inflammatory diseases such as colitis (Mu et al., 2017).
What conditions can be linked to a leaky gut?
IBD such as celiac disease, systemic lupus erythematosus, multiple sclerosis, type 1 diabetes, and autoimmune hepatitis, Alzheimer’s disease, alcoholic liver disease, cancer, and more. Autoimmune conditions are those conditions where the body produces autoantibodies that attack the self, resulting in tissue damage and inflammation (Mu et al., 2017). Leaky gut has been shown to cause cramping, bloating, gas, fatigue, food allergies and sensitivities, headaches, and depression, and Crohn’s disease (Camilleri, 2019).
What can cause leaky gut?
Diet: The role of vitamin D in protecting the epithelial cells have been shown, while you can get vitamin D from food, most of your RDI comes from the sun. The intestinal barrier is protected, and enhanced by microbiota in the gut, foods that feed pathogenic bacteria help to break down the barrier, while high fiber foods help to feed the “good” bacteria and keep colonization of pathogenic bacteria low. Consumption of saturated fat has been shown to decrease “good bacteria” and increase “bad” bacteria, especially in the proximal colon, and can lead to increased permeability (Mu et al., 2017).
Synthetic surfactant food additives: these include esters of fatty acids that have been shown to increase intestinal permeability, including inhibiting p-glycoprotein and decreasing the mucosal layer (Camilleri, 2019).
Alcohol consumption: AMP has been shown to be suppressed in alcoholic clients – this is the molecule needed to physically separate the bad bacteria from the intestinal epithelium. However prebiotic supplementation, or supplementing with lactobacilli and bifidobacterial probiotics have been shown to store the properties of AMP and help control pathogenic bacteria overgrowth (Mu et al., 2017).
Stress disorders: such as pregnancy, endurance exercise, surfactants, and nonsteroidal anti-inflammatory drug use, chronic constipation, exposure to environmental toxins, and antibiotic use have been shown to increase intestinal permeability (Camilleri, 2019).
Hyperglycaemia: increased glucose has been shown to alter the intestinal barrier and increase intestinal permeability (Camilleri, 2019).
Is there a test for it?
No, unfortunately, research has not been able to set a gold standard test for barrier function yet (Camilleri, 2019). However, there is a test that involves drinking a substance (usually a saccharide such as lactulose/sucralose with mannitol/rhamnose) and testing the urine at different times to see how much crossed the intestinal epithelium and the potential site of entry/leaky gut (Camilleri, 2019).
Can you fix a leaky gut?
There are lots of potential therapies, with leaky gut being a condition newer to the research sector, many more long-term studies are needed to show the true potential of these therapies. However, as noted above in what can cause a leaky gut, a good start is to try to reverse these actions (Mu et al., 2017). It should be noted that even if you can normalize the intestinal barrier function, this may not completely reduce all the symptoms of the gastrointestinal or systemic disease (Camilleri, 2019).
- Increase pre and probiotics (reduces intestinal permeability). One such strain is Bacteroides fragilis (this particular strain has also been used in autism spectrum disorder mouse models to reduce behavioural defects (Mu et al., 2017). Increase fermented food intake such as sauerkraut, yogurt, kefir, and kimchi (Camilleri, 2019).
- Remove “problem” foods such as gluten, sugar, and dairy (Camilleri, 2019).
- Some research suggests taking supplements can help repair the intestinal lining such as l-glutamine, vitamin D, zinc, and omega-3 fatty acids (Camilleri, 2019). However, this will depend on your current diet, sun exposure, and level of disease deterioration – your registered naturopath should be able to recommend high-quality supplements tailored to you (Camilleri, 2019).
If you have the symptoms of an increased intestinal permeability click HERE to book in with me now for your comprehensive check-up and personalised treatment plan.
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Camilleri, M. (2019). Leaky gut: mechanisms, measurement and clinical implications in humans. In Gut (Vol. 68, Issue 8, pp. 1516–1526). BMJ Publishing Group. https://doi.org/10.1136/gutjnl-2019-318427
Mu, Q., Kirby, J., Reilly, C. M., & Luo, X. M. (2017). Leaky gut as a danger signal for autoimmune diseases. In Frontiers in Immunology (Vol. 8, Issue MAY, p. 598). Frontiers Research Foundation. https://doi.org/10.3389/fimmu.2017.00598