According to many alternative health care practitioners, a ‘leaky gut’ may be the culprit for a wide range of disorders. Leaky Gut Syndrome (LGS) seems to be implicated in everything from anxiety to abdominal pain, migraines, chronic pain, autoimmune disease and lowered immunity.
Whether LGS is an ‘actual thing’ remains a point of contention between holistic practitioners and mainstream medicos. Here is my take on the topic.
What Exactly is Leaky Gut Syndrome (LGS)?
Our gut lining is made up of epithelial cells, which are held together with ‘tight cell junctions’ (like a zipper). These junctions essentially control what passes through the lining of the small intestine. The theory behind LGS is that damaged junctions, or a broken zipper, results in substances ‘leaking’ into circulation that wouldn’t (and shouldn’t) ordinarily be able to enter.
Proposed Causes of LGS:
- Overeating
- Binge drinking
- A ‘Western’ style diet – low fiber intake, high intake of trans-fats, refined carbohydrates, artificial sweeteners, processed foods, GM wheat (glyphosate exposure), etc.
- Smoking
- Certain medications – Antibiotics, NSAIDs, corticosteroids.
- Chronic stress (linked to cortisol)
- Pathogens and chronic parasitic infections
- SIBO – Small intestinal bacterial overgrowth
What’s Wrong With Having a Gut That’s Leaky?
Well, when your gut barrier is impaired a few things happen. Firstly, you get bacterial translocation to the blood stream and peripheral tissues. Secondly, as a result of low-grade metabolic endotoxemia, your immune system goes into overdrive. Over time, this can result in a confused immune response and systemic inflammation (Burcelin et al, 2011). Increased intestinal permeability has been associated with several autoimmune diseases. It has been observed prior to disease and appears to be involved in disease pathogenesis (Arrieta et al, 2006).
A study published this month in Nutrition Reviews discussed how leaky gut-derived low-grade systemic inflammation in early life can have profound consequences on the gut-liver-brain axis, compromising normal growth, metabolism, and cognitive development (Oria et al, 2016). Another review suggested that both intestinal permeability and gut microbiota changes can modulate brain development, function and behavior by immune, endocrine and neural pathways of the brain-gut-microbiota axis (Kelly et al, 2015). This is just a small insight into the relationship between our gut and our nervous system.
The Lipopolysaccharide Link
Another study published in the Journal of Infection this month (Cangemi et al, 2016) showed that enhanced gut permeability is implicated in higher circulating levels of lipopolysaccharides (LPS). Other research supports these findings. This is a REAL concern because LPS are powerful endotoxins which result in a worsening of intestinal permeability, inflammation, immune dysfunction and small intestinal bacterial overgrowth (SIBO).
Can You Test For a Leaky Gut?
Yes. An intestinal permeability test measures your urinary output of lactulose and mannitol (two non-toxic sugars) over a 6 hour period after ingestion. If both are high, this would indicate increased intestinal permeability. Many functional medicine practitioners and Naturopaths order this test regularly. One area of contention with this test is that it doesn’t differentiate between more acute versus chronic absorption fluctuations, and factors such as alcohol and medications can irritate the gut lining.
Bottom Line
There IS evidence to verify the relationship between intestinal permeability (aka LGS) and ill-health. Dysbiosis can induce intestinal inflammation and result in intestinal permeability and bacterial translocation. Fact. Given that chronic inflammation and microbiota imbalances are linked such a wide range of disease states, I can see how having LGS could be under the spotlight as one causative factor.
Personally, I feel that the term “Leaky Gut” is part of the problem with the whole debate. By definition, the small intestine IS “leaky”, but selectively so! Where would we get our nutrients from if it was impenetrable? It’s only when the permeability is increased that a problem arises. I also believe that increased intestinal permeability is a causative factor, not a disease state (which the word ‘syndrome’ in LGS implies).
Although we know LGS causes systemic inflammation and immune dysfunction, the clinical impact LGS is having on those affected is obviously difficult to quantify. We must also remember that the pathophysiology of the gut barrier is highly complex, as is our microbiota, and intestinal permeability reflects only one aspect of our health (albeit an important aspect!).
As the cause of LGS is often multi-factorial, so is the treatment. Zinc, butyrate, prebiotics, gelatin, glutamine, fermented foods, resistant starch, slippery elm, curcumin and probiotics have all shown promise in treating LGS; however diet and lifestyle (stress, environment, etc.) matters enormously, and the treatment should always be unique to you and your health circumstance.
Until next time,
Stacey.
PS – On another note… I’ve got an exciting new website which is under construction, can’t wait to share it with you all soon!