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Healing the gut

Healing the gut

The term "leaky gut" has gained mainstream attention over the past few years. You may have heard it referred to as increased intestinal permeability.

Leaky gut syndrome is not a recognized medical diagnosis in conventional Western medicine; however, increased intestinal permeability is a known condition and what is not yet understood is whether it's a symptom or a cause of chronic disease.

What is a leaky gut?

The intestinal walls contain a tight epithelial lining that controls what passes through into your bloodstream.

Normal intestinal tight junctions are selectively permeable, meaning that digested food and nutrients can pass but pathogens and partially digested food cannot.

A leaky gut means that toxins, partially digested food, and certain bacteria can pass through, causing inflammation, disruption of a healthy gut microbiome, and of course digestive problems.

Increased intestinal permeability is associated with a variety of (mostly gut-related) disorders, from inflammatory bowel disease (IBD), celiac disease, irritable bowel syndrome (IBS), to non-gut disorders like type 1 diabetes. (1)

Leaky gut syndrome as its own independent disease is often claimed to be the root cause behind a number of symptoms from insomnia to depression, but there's no conclusive evidence in human studies to support it being its own disease.

Symptoms of leaky gut

Leaky gut symptoms can vary and depend on which condition they're associated with (as mentioned above, they're typically found with IBS, IBD, and celiac disease).

They include:

  • Abdominal pain
  • Diarrhea or constipation
  • Nausea
  • Vomiting
  • Fatigue
  • Weight loss
  • Cramping
  • Fever
  • Bloody or mucus-containing stools
  • Excess gas

What causes a leaky gut

While the exact cause of a leaky gut is still unconfirmed, there's a strong link to a protein called zonulin. 

Zonulin regulates the tight junctions of the gut, and it's been proven that those with higher zonulin levels have loosened tight junctions and increased permeability of the gut. (2)

Both gluten and bacteria have been shown to impact the level of zonulin in certain individuals. (3)

In those with celiac disease and gluten sensitivity, consumption of gluten increases intestinal permeability. (4) However, gluten has not been shown to increase intestinal permeability in other individuals.

Another factor that can cause a leaky gut is gut dysbiosis. At any given time, there are as many as 10,000 different species of bacteria living in harmony in the body. When the gut is thrown into imbalance and the harmful bacteria become more abundant than the healthy gut bacteria, this case cause intestinal permeability. (5)

Long-term use of NSAIDs (non-steroidal anti-inflammatory drugs) like aspirin and ibuprofen may increase intestinal permeability. (6)

How to heal your gut

There's no official medical treatment for leaky gut disease, because it's not a medically recognized condition by itself. On top of that, since leaky gut is usually a symptom of an underlying condition, the treatment depends heavily on the root cause.

However, there's a lot you can do to improve your gut health, digestion, and bacterial balance. Here are our top suggestions:

1. Eat probiotic foods

Fermented and cultured foods like kefir, kombucha, sauerkraut, and kimchi are rich in healthy bacteria that can help restore the balance in your gut. These good bugs are critical for your overall wellbeing. 

2. Feed the good bugs

Once you're replenishing the good bugs, you need to keep them fed so they flourish. Prebiotic fibers are what good bugs eat, and you can find a range of them in plant foods, especially bananas, broccoli, berries, and jerusalem artichokes.

3. Take a food sensitivity test

Whether you ask your doctor to perform a food sensitivity test or do one at-home (we like the test from 7drops), it's important to ensure the test you take is comprehensive and based on good science. Some tests like hair sample analyses are unfortunately not very scientific and you may end up eliminating foods for no reason (or continuing to eat ones that don't agree with you!).

Once you learn which foods cause an adverse reaction in your body, avoiding them will allow your gut to heal.

4. Avoid commonly inflammatory foods

Foods like gluten, alcohol, dairy, processed foods, and sugar often cause inflammation. If you don't know what you're sensitive to or can't take a food sensitivity test, you could start by eliminating these foods and see how it affects your digestion.

You might also want to research high FODMAP foods and try eliminating them. These are foods that can exacerbate the symptoms of IBS, and if you suspect that may the underlying cause of your leaky gut you could see how you feel without them.

5. Reduce the use of NSAIDs

The use of NSAIDs like aspirin and ibuprofen can increase intestinal permeability. Try to use them less frequently.

6. Support your immune system

An unhealthy gut can tax your immune system. (7)

It's important to give the immune system extra support while your gut is healing. You can do that by taking zinc with vitamin C, vitamin D, and a B complex, as these vitamins get depleted when your immune system is being overworked.

7. Quit Smoking

Tobacco usage can cause inflammation in the digestive tract and increase your risk of bowel disorders. (8)

8. Reduce your Stress

High stress levels can disrupt the balance of bacteria in your gut, so find healthy stress-management techniques. (9)

When to Seek Medical Help

If you suspect you have leaky gut and it's causing you discomfort or even pain, it's important to see a doctor.

A leaky gut is often a symptom of an underlying condition that will require diagnosis and intervention.

Resources

(1) Intestinal permeability defects: Is it time to treat?
Matthew A. Odenwald and Jerrold R. Turner
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3758766/

(2) Zonulin and its regulation of intestinal barrier function: the biological door to inflammation, autoimmunity, and cancer

Alessio Fasano

https://pubmed.ncbi.nlm.nih.gov/21248165/

(3) Host-dependent zonulin secretion causes the impairment of the small intestine barrier function after bacterial exposure
Ramzi El AsmarPinaki PanigrahiPenelope BamfordIrene BertiTarcisio NotGiovanni V CoppaCarlo CatassiAlessio Fasano
https://pubmed.ncbi.nlm.nih.gov/12404235/
(4) Effect of gliadin on permeability of intestinal biopsy explants from celiac disease patients and patients with non-celiac gluten sensitivity
Justin HollonElaine Leonard PuppaBruce GreenwaldEric GoldbergAnthony GuerrerioAlessio Fasano
https://pubmed.ncbi.nlm.nih.gov/25734566/
(5) Intestinal permeability, gut-bacterial dysbiosis, and behavioral markers of alcohol-dependence severity
Sophie LeclercqSébastien MatamorosPatrice D CaniAudrey M NeyrinckFrançois JamarPeter StärkelKaren WindeyValentina TremaroliFredrik Bäckhed, Kristin VerbekePhilippe de TimaryNathalie M Delzenne 
https://pubmed.ncbi.nlm.nih.gov/25288760/
(6) Intestinal permeability in the pathogenesis of NSAID-induced enteropathy
Ingvar BjarnasonKen Takeuchi
https://pubmed.ncbi.nlm.nih.gov/19148789/
(7) Secretory IgA's complex roles in immunity and mucosal homeostasis in the gut N J Mantis, N Rol & B Corthésyhttps://www.nature.com/articles/mi201141 (8) Smoking cessation induces profound changes in the composition of the intestinal microbiota in humans
Luc BiedermannJonas ZeitzJessica MwinyiEveline Sutter-MinderAteequr RehmanStephan J OttClaudia Steurer-SteyAnja FreiPascal FreiMichael ScharlMartin J LoessnerStephan R VavrickaMichael FriedStefan SchreiberMarkus SchupplerGerhard Rogler
https://pubmed.ncbi.nlm.nih.gov/23516617/(9) Stress & the gut-brain axis: Regulation by the microbiome
Jane A FosterLinda RinamanJohn F Cryan
https://pubmed.ncbi.nlm.nih.gov/29276734/

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