What is Leaky Gut (and why Should I care)?
Our intestines, and really our GI tracts in their entirety, are fascinating. Our entire digestive tract works tirelessly to break down, digest, assimilate, and absorb food we eat, to be used as energy, building blocks, etc. - and rids of the rest. The digestive tract, often referred to as being the "exterior" of the body, it's actually open to the external environment at each end. Only under very particular circumstances are substances able to pass through the digestive tract and into the body's general circulation.
When "leaky gut" is present - this may not necessarily be the case.
What is Leaky Gut?
Leaky gut, otherwise known as "intestinal hyperpermeability" - is where the tight junctions holding the cells of the intestinal wall together, become loosened. The intestines act as a barrier that only allows properly digested nutrients pass through to be assimilated and utilized by the body, and keeps all bacteria, foreign substances, and larger undigested molecules within the GI tract.
The gastrointestinal mucousal lining in the small intestine is just one cell thick. One cell! These cells are normally connected by tight junctions that don't allow larger, undesirable molecules to travel through. It's when these tight junctions become loosened (as a result of irritation or inflammation), that these larger molecules can then pass through and become problematic - the gut therefore becomes "leaky."
When this happens, things like pathogenic bacteria, fungi, toxic molecules, and undigested food particles can pass through, and into the bloodstream - this activates antibodies and cytokines to alert the lymphocytes (white blood cells), our immune system, to handle these unwanted substances in the blood stream. Oxidants are produced as a result, which can cause systemic irritation and inflammation.
Leaky gut (AKA intestinal hyperpermeability) can lead to many signs, symptoms, and potential health implications.
It's been associated with the following:
abdominal pain
anxiety
asthma
chronic joint pain
bloating
chronic muscle pain
constipation
diarrhea
fatigue & malaise
brain fog
gas
nervousness
mood swings
poor memory
poor immunity
poor exercise tolerance
recurrent UTI's
recurrent vaginal infections
Some common clinical conditions associated with leaky gut may be:
acne
arthritis
celiac disease
chronic fatigue syndrome
eczema
food allergy and food sensitivity
gives
intestinal infections
irritable bowel syndrome
liver dysfunction
malnutrition
pancreatic insufficiency
psoriasis
trauma
ulcerative colitis
What Causes Leaky Gut?
There could be many contributing factors that can cause the gut to be leaky. Some of these might include:
stress
When the body goes through the stress response, it produces less secretory IgA as a result. This secretory IgA is one of the body's first lines of defense in intestinal immunity. It protects the intestinal epithelial lining from pathogens and harmful toxins.
The stress response (the sympathetic nervous system, or "fight-or-flight" mode), causes digestion and peristalsis to slow down. Prolonged periods of stress can lead to constipation, and purification within the gut - which can contribute to inflammation, and the production of toxic metabolites that can irritate the gut lining, and promote inflammation within the GI tract.
2. dysbiosis
Dysbiosis - which is an imbalance in the gut microbiome, often where there is an overgrowth of pathogenic bacteria - can lead to intestinal permeability. These pathogenic bacteria have the ability to alter the actual protein structures of the tight junctions, which increases the "leakiness" of the gut.
Some pathogens may actually "degrade the intestinal mucosal layer, and/or inhibit the normal commensal triggers for mucous production.” This mucosal layer is super important, as it protects the intestinal epithelium from these harmful bacteria. The breakdown or degradation of this mucosal layer can lead to leaky gut, inflammation, and infection.
3. environmental toxins
Household chemicals, environmental chemicals, and toxins, pollutants, etc. stress the body's immune system & the ability of the body to heal - if intestinal healing is required, these resources may not be as available to the gut.
4. over-consumption of alcohol
Alcohol has been known to irritate the intestinal lining. Alcohol consumption taxes the liver - it requires a lot of energy and resources (nutrients), to metabolize. This added stress on the liver consequently affects the competency of the digestive system.
5. foods (inflammatory, low in fiber, etc.)
Inflammatory foods - such as processed foods, refined sugars, refined oils (like vegetable, canola, soy), restructured fats, etc. - irritate the gut lining, and can contribute to intestinal permeability.
Foods low in fiber (a lack of nutrient-dense, whole foods), can contribute to constipation, or slowed transit time. This can contribute to a concentration of toxic metabolites in the gut, which can lead to inflammation and irritation to the intestinal lining.
6. antibiotic & NSAID use
Antibiotic usage is known for its impact on the balance of the gut microbiome, but it may also degrade the intestinal mucosal layer
The use/overuse of medications and NSAIDS may damage the intestinal brush border - which is the epithelial lining of the small intestine, covered in villi and microvilli (tiny finger-like protrusions), that enable us to absorb nutrients into the bloodstream
What to do about Leaky Gut:
Glad you asked. While working with a practitioner who can help you dig deep and uncover the root cause of your intestinal permeability (which is the most important means to successfully healing your gut), there are things you can do to get started from home:
*I always always always advise consulting a trusted practitioner prior to starting any sort of supplementation or regimen*
1. Lifestyle practices
Stress management practices can help support the body's nervous system(s). This is especially important for gut health, as stress has a profound impact on the gut, and discussed earlier - on intestinal permeability. Practices like breathwork, journaling, meditation, walking, a creative hobby, yoga - can all help to calm the nervous system, and reduce feelings of stress.
"Eating hygiene" - refers to practices that support the system whilst eating. A few deep belly breaths before a meal, helps to direct the body back into the parasympathetic nervous system (our rest-and-digest system), which is where the body can best digest. Thoroughly chewing your food (ideally until it's essentially liquefied in your mouth before swallowing), helps to reduce the energy required to break-down food further along the digestive tract. Eating mindfully, which means removing any distractions while eating, and focusing on the food and the process of enjoying a meal (yes, this means taking a break from work, and putting your phone away) - aids in the digestive process.
Movement/exercise is known to reduce stress, and encourages a good mood, through the release of endorphins and dopamine (which has a trickle effect on our digestive processes!!). Exercise has also been known to increase the robustness of our gut microbiome, and encourage the production of short-chain fatty acids (all supporting a healthy GI tract!).
2. removing/minimizing exposure to chemical stressors
While this might not be 100% possible for everybody, removing (or at least minimizing exposure to) chemical stressors like highly- processed foods, alcohol, and environmental chemicals will support the healing of the gut lining, and remove additional irritation, and inflammation.
With regards to food - maximizing the amount of whole foods, especially plant-based whole foods, will help to minimize your exposure to highly-processed foods. Start slow with this if it doesn't come as naturally to you. Try to incorporate a wide variety of fruits and vegetables, nuts and seeds, whole grains, healthy fats (like olives and avocados, and their oils), and quality meats. Even starting slow and swapping some of the highly processed foods you're consuming now, for lesser-processed alternatives will be beneficial: ie. swap canola or vegetable oils, for olive or avocado, swap highly refined sugars for natural alternatives like maple syrup or honey.
With regards to environmental chemicals/toxins - look into what's within your control. Household and skincare products? Opt for those that are made with naturally found ingredients instead of conventional products. The earth and your body will be better for it. Your produce? Shop at least the dirty-dozen organically. These are the 12 most highly sprayed conventionally farmed crops. Your drinking water? Look into a water filter, if possible, to rid of chemical residues.
3. support the health of the gut mucousal lining through foods and targeted nutrients
Soothing foods line bone broths, mushroom broths, and herbs like slippery elm, marshmallow root, aloe vera, turmeric and ginger can help sooth and nourish the GI tract.
Glutamine - specifically l-glutamine - is a highly regarded nutrient for gut healing, especially intestinal permeability. Glutamine is the preferred energy-source of choice for the cells of the small intestine, and aid in maintenance and repair.
Zinc (especially zinc l-carnosine), is renowned for it's gut-healing properties. It helps to maintain integrity of the intestinal lining, as well as provide antioxidant support against free-radicals.
DGL (aka deglycyrrhizinated licorice), is an herb that's known to support a healthy mucousal lining in the GI tract
4. support digestive function through: bitters, digestive
enzymes, HCl, etc.
Supporting your digestive process through the use of bitters before a meal (this can be found in the form of a tincture), can help to stimulate the release of gastric juices (which include things like our stomach acid (hydrochloric acid), bile, and digestive enzymes), which aids in the digestion of our foods
In some instances, the utilization of HCl through supplementation can be beneficial in increasing stomach-acid levels, which is a key aspect of the digestive processes, and is important in ridding of any potentially harmful substances in our food prior to it’s release into our intestines.
The used of digestive enzymes (through supplementation) can be helpful to support a compromised system, and leaky gut, in the digestive processes as well (also reducing the burden on the GI tract)
5. Antioxidant support
Antioxidant support should also be considered when healing intestinal permeability. With a leaky gut, there is often an increase in the production of free-radicals. This can cause more inflammation and irritation, which perpetuates the cycle. Increase your antioxidant intake through foods like berries, beans, dark leafy greens, fruits, and vegetables. For additional support - antioxidant nutrients such as zinc l-carnosine, vitamin E, coenzyme Q10 (coQ10), vitamin C, etc. might be considered.
Intestinal permeability - "leaky gut" - can have a profound impact on overall health; it's systemic effects reach far and wide throughout the body. It can be an underlying cause for many seemingly unrelated symptoms and illnesses. Taking a look at your gut health is a great place to start when looking to renew and support your health and vitality.
References:
Bischoff, Stephan C, et al. “Intestinal Permeability--a New Target for Disease Prevention and Therapy.” BMC Gastroenterology, BioMed Central, 18 Nov. 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4253991/
Lipski, Elizabeth. Digestive Wellness: Strengthen the Immune System and Prevent Disease through Healthy Digestion. McGraw-Hill, 2020.
Plöger, Svenja et al. “Microbial butyrate and its role for barrier function in the gastrointestinal tract.” Annals of the New York Academy of Sciences vol. 1258 (2012): 52-9. doi:10.1111/j.1749-6632.2012.06553. May 24, 2020
