You’ve probably heard the saying, “you are what you eat.”
In functional medicine, we take it a step further. You are what you eat, absorb, and do or do not eliminate.
Your gut isn’t just for digesting food, though. It performs many functions critical to your well-being. And in recent years, scientists have identified leaky gut syndrome (or increased intestinal permeability) as a possible root cause for many chronic illnesses.
Good gut health is more than simply taking a probiotic supplement. In fact, the wrong probiotics could cause more harm than good. In this article, we’ll look at what a leaky gut is, its causes, and the five steps to healing it.
What Is Leaky Gut Syndrome?
Leaky gut describes a condition in which gaps in your gut lining allow bacteria, partially digested food, and toxins to enter your bloodstream.
To understand why it’s such a big deal, let’s look at how your gut works.
Your gut, also known as the gastrointestinal tract, processes everything you consume. It acts like a conveyor belt, moving things along starting from your mouth all the way to your anus. While many people think only of the stomach and the small and large intestines as the gut, it also involves your throat, esophagus, and rectum.
A healthy gut accomplishes the following tasks:
In a way, you can think of your gastrointestinal tract as a large tube that separates the rest of your body from the external environment.
Your gut also houses over 100 trillion microorganisms, known as the gut microbiome.1 Your gut microbiome regulates a wide range of functions in your body, including how well you digest and absorb nutrients, Your microbiome even affects your emotions.
It should come as little surprise, then, that your gut is critical to your overall health.
Researchers estimate that over 70% of your immune function lies in your gut.2
Because your gut comes in contact with everything you eat, it’s exposed to more antigens – substances that can cause an immune response – than your systemic immune system is.
But your immune system doesn’t react to everything. And that’s thanks to your gut barrier, otherwise known as the intestinal lining.
The Gut Barrier
Your intestinal barrier consists of multiple elements, including:3
- The lumen, where gastric acid and bile degrade pathogens and antigens
- The mucus layer, which protects the intestinal epithelial cells from interacting with bacteria
- A single layer of epithelial cells known as enterocytes, stitched together by various proteins like tight junctions that limit the entry of pathogens and toxins
- The lamina propria, another layer beyond the epithelium that provides defense
If your gut is a castle, your gut barrier is the castle gate. Guarding the gate are protein complexes called tight junctions that open and close the gate upon learning the identities of the visitors.
Under optimal circumstances, the guards keep out anyone they deem an intruder.
But if the castle gate has holes or the guards are injured, intruders would be able to enter the castle and wreak havoc.
This is, in essence, what happens when you have a leaky gut.
When your gut lining is exposed to continuous assault from toxins, medications, and other factors, “gaps” or “holes” can form. Weakened tight junctions have a harder time being selective, giving bacteria, undigested food, and toxins unrestricted access to your bloodstream. Once they enter your bloodstream, they can travel throughout your body.
And because your immune system can detect that these substances are unwanted, it triggers an immune response. Without relief from the toxins, chronic inflammation results.
Who Is Affected by Leaky Gut?
Leaky gut may be more common than you think.
While leaky gut is not an official medical diagnosis, we only need to look at the dramatic increases in chronic illnesses in recent years to know that it is highly prevalent in our society.
But are you free from leaky gut if you don’t have any digestive issues like diarrhea or bloating?
Not necessarily. A leaky gut could also cause nutritional deficiencies, which may not be obvious. If you have the following symptoms, you may have leaky gut:
- Brain fog or memory loss
- Difficulty concentrating
- Aches and pains
- Seasonal allergies
- Food sensitivities
- Difficulty losing weight
What Causes Leaky Gut Syndrome?
So far, researchers and doctors have been unable to pinpoint a direct cause of leaky gut. But we do know that several factors play a role, including:
- Bacterial overgrowth or imbalance (dysbiosis): When the microbial population in your gut is balanced, your body functions the way it’s supposed to. But when you don’t have enough – or when you have too many – of certain microbes your health can unravel.4,5
- Food sensitivities: Consuming food you may be sensitive to can cause your immune system to react constantly, resulting in a chronic inflammatory state.6
- Food additives: Research studies have found that food additives like sugar, carrageenan, and emulsifiers can disturb the balance of the gut microbiome, leading to inflammation.7,8
- Antibiotics: Antibiotics are major disruptors of your gut microbiome. While they’re necessary in some cases, many antibiotics don’t go after only the harmful bacteria – they can eliminate the good ones, too. For this reason, inappropriate use of antibiotics can lead to the growth of antibiotic-resistant bacteria and long-term (maybe permanent) loss of some bacterial species.9,10 Antibiotics can also lead to yeast overgrowth, which can influence your gut permeability.
- Proton pump inhibitors (PPIs): This class of medications reduces the production of stomach acid. Examples of PPIs include Prevacid, Prilosec, and Nexium. Long-term use of PPIs has been associated with an increased risk of intestinal infections, most notably by a bacterial species called Clostridium difficile.11 The imbalance of your gut microbiome caused by PPIs may lead to certain gastrointestinal disorders.12
- Stress: When you experience stress, your body shunts blood and energy away from your digestive system to your muscles and brain so that they can respond to the threat. In other words, the digestion process is paused. This means toxins and pathogens can stay in your gut, triggering inflammation in your gut lining. Research studies have shown that stress can affect the composition of your gut microbiome and influence which microbes thrive independent of your diet.13
- Non-steroidal anti-inflammatory drugs (NSAIDs): A considerable amount of evidence shows that NSAIDs, often used for pain or fever relief, cause gastrointestinal or heart complications. In your gut, NSAIDs can cause bleeding, inflammation, or ulcerations. Results from research studies show NSAIDs can affect the composition and function of your gut microbiome.14
- Alcohol consumption: Excessive alcohol consumption can reduce the number and diversity in your gut microbiome, increasing the gut lining permeability. Some studies suggest that alcohol can promote bacterial overgrowth.15 Alcohol can also reduce the production of stomach acid, which in turn affects your stomach’s ability to neutralize pathogens.16
Why Does Leaky Gut Matter?
- Food allergies or sensitivities
- Irritable bowel syndrome
- Polycystic ovary syndrome
- Non-alcoholic fatty liver disease
- Liver cirrhosis (late-stage liver disease)
- Autoimmune diseases
- Eczema and other rashes
- Environmental allergies
- Mood disorders
- Chronic fatigue
…and much, much more.
The 5 Rs to Start Healing a Leaky Gut
Healing your leaky gut is more than taking a probiotic supplement or drinking kombucha and kefir. Too much bacteria in your gut can also be problematic, leading to a condition called small intestinal bacterial overgrowth (SIBO).
Gut healing also does not equate to going gluten-free. Many gluten-free products are heavily processed foods, which can cause inflammation.
So how do you start to heal a leaky gut?
As a functional medicine clinic, MaxWell Clinic uses the 5R framework to restore balance to an unhealthy gut: remove, replace, repair, reinoculate, and rebalance.
Let’s discuss each of the 5 Rs.
Remove stressors that damage the environment of your gastrointestinal tract, including emotional stress and foods to which you may be sensitive or allergic.
For many of our patients with a leaky gut, we recommend undergoing an elimination diet. Doing so will remove most inflammatory foods, such as dairy, peanuts, soy, etc. By decreasing the inflammatory load, an elimination diet gives your gut a chance to heal.
A stool test can also provide valuable information about the composition and number of beneficial bacteria in your gut. If we determine that your gut would benefit from a probiotic supplement, we can use your stool test results to find the right probiotic for you rather than handing you a generic probiotic supplement.
We may also find that your symptoms may be caused by harmful bacteria, parasites, or yeast. In such cases, we use targeted therapy that will help eradicate the particular microbe, including (but not limited to) antibiotics, antifungals, antiparasitics, dietary interventions, or herbs.
Replace digestive secretions by adding supplements that promote proper digestion, including digestive enzymes, hydrochloric acid, and bile acids. These secretions allow your body to break down and absorb nutrients from the food you eat while further reducing the inflammation in your gut. They can be affected by factors like aging, medications, diet, and illnesses.
In this step, we reinoculate your digestive tract with prebiotics and probiotics to push out bad bacteria and restore balance.
Whenever possible, we encourage consuming whole foods like kimchi, sauerkraut, yogurt, and other fermented foods as sources of probiotics. Depending on your condition, you may need to take probiotic supplements, which are a much more concentrated source and can speed up your healing.
Prebiotics are food for your probiotics. Help your good gut bacteria flourish by eating foods high in fiber, like artichokes, garlic, chicory, tofu, leeks, grains, etc.
The next step in the framework is to support the repair of the gut lining. This is done by supplying key nutrients that are often diminished in a disease state. Such nutrients include:
- Antioxidants (ex: vitamins A, C, and E)
- Omega-3 fatty acids
- L-glutamine, an amino acid that helps seal the gut
- 5-hydroxytryptophan (5-HTP), which regulates the formation of microvilli, microscopic protrusions that assist with absorption
Your lifestyle choices can have profound effects on your gut health. Your gut-brain connection means that any alterations to your biological clock (circadian rhythm) can disrupt your gut microbiome. Pay attention to your sleep, and your gut will thank you.
Exercise also influences your gut health. But more isn’t always better. Too much intense exercise can increase inflammation in your body.19 We will work with you to find the right amount and intensity of exercise for you. Research studies show exercise can promote beneficial bacteria regardless of your diet.20
As discussed above, stress can increase your gut inflammation and promote dysbiosis. If your body is under chronic stress, it can’t focus on healing. Instead, it’s diverting all its energy and focus to simply surviving, further impairing digestion.
Prioritize stress relief to help your gut heal.
How Long Does the 5R Program Take?
This is a question we frequently get asked. And our answer is: It depends.
Because we believe in personalized systems medicine, your treatment should be tailored to your unique symptoms and needs.
Your body can’t move from a state of poor health to stellar health overnight. Your treatment timeline will be influenced by various factors, including:
- Your age
- Your health
- How long you’ve had your health issues
- Your medications
- Your lifestyle
- Your diet
It’s also important to note that the 5R program isn’t necessarily meant to be sequential. Some phases, such as remove and replace, can occur simultaneously. We may also determine that you can jump between phases if your lab test results show that doing so would benefit your health.
With all things considered, a young, healthy individual can expect to heal their leaky gut in approximately six months. An individual with more severe or chronic issues may take up to 12 months to heal.
A Healthy Gut Is a Happy Gut.
Health begins in the gut. If gut dysfunction exists, improving your health can be challenging no matter how many expensive supplements you take.
But here’s the truth: Healing leaky gut syndrome is complex and can take time. And without the right tools and proper guidance, you could end up right back where you started.
We believe your health is worth the effort.
If you’re in the Nashville area, schedule a free 20-minute discovery call with our New Patient Coordinator to see how we can help restore your gut health. Your gut health matters, and more importantly, you matter.
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