Intestinal Permeability aka ‘Leaky Gut’
‘Leaky gut’ is a term thrown around in the wellness space but the correct term is intestinal permeability. From our mouth through to our anus we have what is known as the intestinal lining which is a single layer of cells that holds a really important role as an immune barrier.
It’s the barrier between us and the outside world - technically our whole intestinal tract is still the ‘outside world’. This layer has many turns and folds and collectively covers 400 metres squared.
We want this to be a well controlled barrier ! We want our body to selectively choose what enters into our blood system - nutrients and water - and what doesn’t - toxins, bacteria, medications, digestive enzymes etc. Tight junctions are what hold the cells together.
Under various circumstances, that I’ll explain in a second, this barrier can be damaged resulting in increased permeability - uncontrolled permeability. Essentially the tight junctions are broken down so that molecules can ‘leak’ through the lining.
Signs and symptoms
It’s a hard condition to identify as many of the symptoms could be attributed to something else but any of the following could occur when you have increased intestinal permeability:
Loose bowels
Feel like you react to everything that you eat / lots of food intolerances
Bloating
Irregular bowel movements
Gut discomfort/pain
Most cases of irritable bowel disease - Crohn’s and Ulcerative Colitis will have a degree of intestinal permeability, especially when not managed well
Undiagnosed coeliacs disease
Over time, if not addressed, it can lead to systemic inflammation whereby the inflammation can present in other areas such as in joints or as migraines. It can also contribute to the development of autoimmunity as the immune system becomes so overactive from foreign particles being in the blood system that it eventually attacks your own body = autoimmune.
Tests to identify?
There are a couple of tests that can indicate increased permeability:
Zonulin is a protein that breaks down tight junctions in the intestinal wall. If this is raised there is a high chance of intestinal permeability. Zonulin can be tested in the blood and stool.
Confocal endomicroscopy: an endoscope is used to look at the gut lining and a fluorescent liquid is used to identify any areas of increased permeability
Clinically I use a comprehensive stool test to get a complete picture of what is going on in the gut. One of the markers tested here is zonulin.
I also use an IgG/IgA food intolerance testing as an indication. If the individual is reacting to everything then it’s likely they have a leaky gut as opposed to true food intolerances.
Key causative factors would include:
Excessive alcohol consumption
Excessive gluten consumption, especially when there is an undiagnosed sensitivity to gluten. Gluten increases the protein zonulin which breaks down the tight junctions.
Unidentified food sensitivities
A low quality western diet that is low in fiber and high in refined sugars
Overuse of non-steroidal anti-inflammatories like ibuprofen and aspirin
Inflammatory gut diseases
Chemotherapy and radiation that can degrade the intestinal mucosa
Obesity
Antibiotics
Diabetes
Gut dysbiosis
High stress levels for long periods of time - coritosl can thin the mucosal lining of the gut which is important for protecting the intestinal cell
How to heal a leaky gut:
Our gut cells turn over every 3-5 days so if we give the gut the right environment it shouldn’t take too long to repair. To address leaky gut you need to first understand what is driving it - identifying one or more things from the list above.
Remove the culprits! Take out processed foods and potential aggravators of the gut. There is no point supplementing or adding in loads of healing foods until these culprits are gone.
This would look like eating a whole foods diet, with minimal/no sugar, alcohol and gluten.
Addressing/identifying any food intolerances
Managing stress levels
Addressing gut dysbiosis
Only taking medications when necessary e.g. antibiotics
2. Add in healing foods
Bone broth
Add in fiber rich produce/prebiotics which works to feed beneficial bacteria in the gut
Add in fermented foods
Gelatin gummies
Collagen
3. Add in gut healing supplements
L-glutamine - fuels the growth of intestinal cells
Colostrum - babies are born with a ‘leaky gut’ and colostrum is key to healing this as soon as they’re born!
Zinc
Vitamin D
Herbs:
Slippery elm
Aloe vera
Marshmallow root
Get in touch if you’d like to explore this more!
