The defense wall which has been breached
Leaky gut or increased intestinal permeability is a new concept which has been linked to many autoimmune diseases.
I see a lot of patients with leaky gut and what I find is that they have heard of the term but have no idea what it actually means and what they should do to help with it.
So, here I will try to explain the leaky gut or intestinal permeability issue in a simple language so you can understand what it means and also how to take care of Leaky Gut issue.
So imagine your gut is like a defence wall which is supposed to only allow few things to cross the wall and everything else is forced to exit your body through a bowel movement.
In the leaky gut issue, this defence wall is damaged and so the things which were not allowed to pass through the wall now start passing through and begin to enter your bloodstream.
These unwanted elements which are now getting in your bloodstream, causes your body’s security system to gets activated and your body starts firing bullets at these unwanted things.
These bullets are antibodies. And while these antibodies are generated to work against the newly entering foreign particles in bloodstream, they also start damaging your own bodies cells in friendly fire.
When this damage goes on for a long time, it ultimately causes inflammation and autoimmunity in people.
This autoimmunity can present itself differently in different people. Some will have thyroid problems, others will have gut problems, other joint problems, skin issues, neurological issues, mood changes etc.
Now the simplest way to take care of inflammation and leaky gut problem will be to remove the thing which is damaging your gut wall and then we should also start working on repairing this damaged wall so that the barrier is restored and the unwanted elements do not enter the body anymore and our body’s defence mechanism which has gone all crazy comes back to rest.
What Causes Leaky Gut Damage?
Now the question is what causes the initial damage we talked about. So this initial damage can be things which we all feel are “ not such a big deal” but in reality, they are a BIG for our certain bodies.
The initial damage to the gut can be caused by certain foods like gluten, dairy etc. or they can be medicines like NSAIDs, steroids, stress of any kind – physical, emotional or mental stress can also do this damage.
Infections of any kind – It can be a one-time Infection or an ongoing infectious attack that we a person might be going through.
Different people based on their genetic makeup are susceptible to different kinds of threats. Sometimes there can be more than one threat which is causing the leaky gut issue, so it’s always wise to tackle this problem in a comprehensive manner.
Is leaky gut real?
I have been asked this question multiple times. People are not sure if this a real condition or just made up concept.
Leaky gut or increased intestinal permeability is a real condition and we know this from the work of Dr.Fasano. He is a researcher who has been instrumental in discovering zonulin molecule which is involved in controlling the intestinal permeability. He has shown that zonulin is an important marker for intestinal permeability and now there are tests available to actually measure this marker to evaluate for leaky gut. Further, it has been shown that leaky gut is linked to various chronic disease including autoimmune, neoplastic and inflammatory conditions. It has been hypothesised that because of increased intestinal permeability, the influx of dietary and microbial antigens in our body increases which ultimately leads to dysregulated immune response. This altered immune activation further contributes to the development of various autoimmune diseases in our body.
Leaky gut test
The zonulin molecule that Dr.Fasano discovered is now available through commercial labs, and people who have symptoms concerning for leaky gut can get this test done.
The zonulin levels can be checked in serum and in stools also. There are some other labs which offer a comprehensive intestinal permeability panel which also checks for tight junction proteins, and LPS.
But I always caution my patients that if the test results are negative they don’t always mean that they don’t have issues with intestinal permeability.
Leaky gut is a diagnosis which includes lab test but also clinical signs and symptoms, so it is very important to discuss this problem with a provider who has experience tackling patients with leaky gut.
Leaky Gut Treatment
Leaky Gut treatment is a two step process, where we first need to get rid of the trigger that is causing leaky gut, and then we need to repair the wall.
Step 1 of Leaky Gut Treatment —
Remove the triggers that might have caused the leaky gut in the first place. Often times it can be food related. For this doing an elimination diet is the best way to treat the leaky gut issue. To do the elimination diet as a treatment for leaky gut, you need to eliminate gluten, dairy, soy, corn, caffeine, alcohol, processed sugar. Other triggers could be medicines like NSAIDs.
Step 2 of Leaky Gut Treatment —
Repair: Now we also would like to heal the damaged gut and for that, there are some supplements which could be useful, the most important being
- L glutamine 2-3 grams daily.
- Fish oil in the dosage of 2-3 gram of combined EPA/DHA.
- Good quality probiotic
This is How I Treat Leaky Gut in My Clinic –
First, we take a comprehensive history of the person and try to identify various things which could be causing the problem. Sometimes the initial damage and the subsequent development of symptoms can happen so far off that to put the two together is not easy. But with careful history taking, it is possible.
Often times I will not order the zonulin test as it might not be covered by the insurance. And I start the protocol for people based on clinical suspicion. If sometimes I am not sure of the symptoms as leaky gut than I do order the test.
These are the steps I follow to treat leaky gut
- We start with a comprehensive elimination diet. The elimination diet takes care of all the food triggers which most people will have one or the other. An additional benefit of the elimination diet is it also helps to restore gut balance.
- We make a stress management plan. Whether it is deep breathing, relaxation sounds, meditation etc.
- If they are on long term NSAIDs or pain medicines. Will try to stop them or wean them off and sometimes if needed address their pain through supplements.
- Along with addressing the things which are damaging the gut, I also start the healing process. The supplement that has worked for my patients is L glutamine. The dosage that I generally use is upwards Of 3-5 gram a day. Make sure you are getting it from a reputable company as you don’t want any fillers in this supplement.
- A good quality probiotics to support the gut. And I also recommend turmeric supplement or just adding turmeric in their diet.
Most people will heal their gut in 6-8 weeks on this protocol. If you are not seeing a difference within this time frame then there may be something else which is preventing the gut from being healed. I will recommend working with a trained Functional Medicine professional, to get to the root cause of Leaky Gut.
Is Leaky Gut real? Hope after reading this post you will be convinced that research does support leaky gut or increased intestinal permeability as a real diagnosis. We also discuss here the tests for leaky gut and what are the treatment options for leaky gut.