What is Leaky gut and Why does it matter?
Leaky gut is the common term for ‘’Intestinal permeability’’. It better explains what is going on with our natural gut barrier and when unwanted visitors try to get into our bloodstream and cause problems. Before moving forward and explaining how a leaky gut can impact your health, first we must understand some of the basics of how our gut works and protects us.
The existence of an intestinal barrier
The gut is basically a hollow tube that begins in our mouth and ends in our anus. Anything that enters our mouth to digest, will need to transit through the gut. Our body chooses what is going to be absorbed, and the rest will eventually be discarded. Along this path, the body holds an intestinal barrier that is specialized in knowing what are nutrients from food that need to be absorbed, and what is foreign and cannot enter, for example: bacteria, parasites, food allergens, etc. That barrier plays a critical role in human health and disease and it is commonly overlooked. When this barrier is damaged or not working properly, it can cause allergies and autoimmune disorders. This barrier also coexists with multiple microbes that live within this hollow gut tube. They also play a critical role in our overall health.
Who do we share our gut with?
Our gut is the home of approximately 100 trillion gut microbes. (1) You might have heard them referred as the ‘’gut microbiota’’. They influence many functions within and outside the gut. For example, they protect us against infections, promote movement of food through the gut, help absorb and produce vitamins and maintain the mucosal barrier. These examples are just to name a few but many studies have shown how they also impact our health on other parts of our body like, helping us have a healthy immune system, regulate blood sugar, healthy heart, bones, skin and many other organs. (3)
This easily helps us understand that when something affects the gut microbiota and the gut barrier, it may lead to developing chronic disease. We should always start to look into our gut health, even if we do not have symptoms. Advance testing and a detailed medical history intake can help us understand the health of our gut and how to start to take care of it.
What can cause harm to my gut?
It is not easy to see right away what has been causing harm to your gut. Our modern lifestyle has a big impact on altering our gut microbiota. Since it’s the gut we are talking about, the first thing that comes to mind is food. We think about the type of diets we have tried, but it is more than just the food that we eat, our gut health is also influenced by the foods we are not eating or should be eating. Also, other factors that are not food can cause a problem with our gut health. A big example is the abuse or wrong indication of antibiotics. (4) We sometimes can kill off beneficial gut bacteria that is needed for gut health. The unnecessary use of antiacids. Stomach acid is needed for food digestion and absorb nutrients.
The quality of our sleep is commonly overlooked. We take sleep for granted and feel we can compensate by taking caffeine or make up for sleep the next day. The truth is that many studies have shown that sleeping less hours a day or just having bad quality of sleep can cause hormone imbalance and impact gut health too.
Even though we spoke about having beneficial microbes in our gut, we sometimes do not have the right balance or undetected chronic infections that have not been treated. Many of the conventional labs cannot detect these and go undiagnosed for years. Undetected chronic infections can impact gut health and be the beginning of a chronic disease.
Chronic stress goes without mentioning on how it can impact overall health. Determining what could be the cause of chronic stress and the best way to manage it might need assistance of a professional practitioner.
There are many other causes like low fiber intake, presence of inflammatory foods in our diet, not enough beneficial bacteria in our gut, etc. For this reason, it is important to have your gut checked and always remember that is where many problems begin.
But what causes a leaky gut?
We talked about how the gut has a barrier that protects us from unwanted guests, and that barrier also has an extra layer of microbes. Anything that disrupts those barriers will cause a leak of undesired substances into our bloodstream. Our immune system will fight off anything that comes in through an inflammatory response. Unfortunately, many areas of our body get caught in the crossfire and we enter a state of chronic inflammation. This plays a role in many chronic conditions when there is not a clear underlying cause but a leaky gut it’s the most likely culprit when it is commonly overlooked. This will lead to health consequences if they are not dealt with on time.
What are the health consequences from a Leaky Gut?
There can be many health consequences from a leaky gut. Many chronic conditions that we know, do not have a clear cause. Most of the time, we, as doctors, pin them to family history, genetics, age, but do not seem to link them to gut health. Even if a patient does not have gut related symptoms, they can still have a leaky gut that can be causing issues in other organs of the body. One example of this would be a patient having blood sugar problems. A high carb diet with refined sugars and processed foods with little natural fat and protein can lead to an imbalance of beneficial gut bacteria. This can lead to insulin resistance and other hormone problems (2). Other patients can have an unknown skin rash that comes and goes. Many patients with an autoimmune disease could have started because of a leaky gut. (6) We know there is a link because many studies have revealed how all these conditions benefit from an approach that focuses on gut health. In my personal experience, I’ve had had many patients achieve great improvement over their chronic conditions by treating a leaky gut and at the same time, improve overall health.
How do you treat a Leaky Gut?
To treat a leaky gut, you must first remove what could be causing harm. A known cause is being on a standard American diet. It has many harmful, inflammatory foods that could be harming your gut. The approach we would take is a combination of focusing on a whole food, nutrient dense diet. There can still be foods that can cause inflammation so it would be best to identify them with advanced testing for food sensitivity and start with an autoimmune elimination diet. The advance testing is also helpful for finding any untreated infections that could be causing Leaky Gut. An example of these could be harmful bacteria, fungi and parasites. (5) These pathogens many times are imbalanced and even though, most of the time their presence is harmless, the high amount could be causing harm to your gut.
Managing these findings in your gut and knowing how to individually per patient takes time but it is worth the effort. Slowly, patients start noticing improvement overall and lets them proceed with working on other areas that are also affected. For example, beginning to exercise. Not just physical and strenuous exercise in a gym but improve overall movement throughout the day. Sometimes, moving and standing overall throughout the day has better results than going to the gym.
Focusing on sleep habits is highly overlooked. Working on getting a good quality 8 hours of sleep is crucial for improving overall health. Practicing on developing a sleep schedule is a good way to start and reducing blue light exposure before going to bed. That might have you turn off your TV or phone at least 2 hours before going to bed. You can start by avoiding these devices from entering your room, that will help avoid temptations.
Avoiding stress from work or at home might not be easy. If the environments are highly toxic and you have the option to change them it is best to do so. If that cannot be avoided, participating in reduction stress activities in your free time can help. Many patients participate in activities like meditation, yoga, reading and anything that brings you a calming effect. Try to do these constantly during the week if possible.
Where can I find help if I think I have leaky gut?
The best place to start would be by finding a doctor that is familiar with the term ‘’Leaky Gut’’ or intestinal permeability. Most practitioners that practice an integrative approach, like Functional Medicine, are more familiar on using advanced testing and working with patients to help them prevent disease. We will investigate the whole body, try to find the underlying cause, and reverse a condition as much as possible. The goal is to achieve overall health and not be dependent of any unnecessary drugs. You will feel healthy and stay healthy.
Investing on lab testing and on the right practitioner at the beginning may be the best option, to avoid a long life of complications. Many chronic illnesses take a toll on your body and may not allow you to live a good quality life.
1. Host-Bacterial Mutualism in the Human Intestine. Fredrik Bäckhed*, Ruth E. Ley*, Justin L. Sonnenburg, Daniel A. Peterson, Jeffrey I. Gordon. Science 25 Mar 2005: Vol. 307, Issue 5717, pp. 1915-1920.DOI: 10.1126/science.1104816. https://science.sciencemag.org/content/307/5717/1915.abstract.
2. Gut Microbiota in Cardiovascular Health and Disease. W.H. Wilson Tang, MD, Takeshi Kitai, MD, PhD, and Stanley L Hazen, MD, PhD. Circ Res. Author manuscript; available in PMC 2018 Mar 31. Published in final edited form as: Circ Res. 2017 Mar 31; 120(7): 1183–1196. doi: 10.1161/CIRCRESAHA.117.309715.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5390330/
3. Antibiotics and the Human Gut Microbiome: Dysbioses and Accumulation of Resistances. M. P. Francino. Front Microbiol. 2015; 6: 1543. Published online 2016 Jan 12. doi: 10.3389/fmicb.2015.01543.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4709861/
4. Allergy and the gastrointestinal system. G Vighi, F Marcucci, L Sensi, G Di Cara, and F Frati. Clin Exp Immunol. 2008 Sep; 153(Suppl 1): 3–6.doi: 10.1111/j.1365-2249.2008.03713.x.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2515351/
5. Tight Junctions, Intestinal Permeability, and Autoimmunity Celiac Disease and Type 1 Diabetes Paradigms. Ann N Y Acad Sci. 2009 May; 1165: 195–205. doi: 10.1111/j.1749-6632.2009.04037.x
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2886850/
6. Mathew, S., Smatti, M.K., Al Ansari, K. et al. Mixed Viral-Bacterial Infections and Their Effects on Gut Microbiota and Clinical Illnesses in Children. Sci Rep 9, 865 (2019). https://doi.org/10.1038/s41598-018-37162-w [ES1]
