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LeakyGut&Fatty
LiverConnection
LeakyGutoccurswhenanincreaseinharmful
bacteriaandyeast(candida)withintheintestine
reachesatippingpointandtheintestinalwallis
breached.Thesebacteriacanliterallyburrowbetweenthecellsofthe
intestinallining.Mostofthetime,wehaveasymbioticrelationshipwith
intestinalbacteriafrombirthandtheyhelpreduceharmfuleffectsoftoxins,
breakdownfoodandaidinimmunefunction.Asamatteroffactintestinal
bacteriaoutnumberthecellsinourbodytentoone.
Butharmfulbacteriacandotheoppositeandoftenthisisexactlywhattakes
placeaftera(strong)roundofantibiotics.Itcanalsooccurafterasevere
coldbutmoretypicallyAmericansgetitfromtheirdietsoverlongerperiods
oftime.
Ifyouareeatingaconsistentlypoordietwithexcessivesugarlikemostofthe300
MillionpeopleinAmerica,youmaywellbeonyourwaytohavingaLeakyGuttoo.
LeakyGutiscommonlycausedby:
Yearsofeatingdietshighinsugars,thiscanincreasecandidapopulations.
Poordietalsoincreasebacteriacoloniesthataredetrimentaltogoodgut
health.
Useofantibioticswithoutimmediategoodbacteriareintroduction.
Pesticides,GMOsandotherharmfultoxinsthatravagetheintestinewalls
andbeneficialbacteria.
Whenourintestinalwallisbreached,thisallowsfoodparticlestopass
throughandovertimetheimmunesystembecomesoverwhelmedwith
invaders.Asifthisisnotbadenough,yourimmunesystemmayalsoattack
itsowncellsneartheintestinalwallopeningsasasortofcollateraldamage.
Thisheightenedimmunestateisoftenassociatedwithchronicinflammation
ofotherpartsofthebodyliketheback.
Overtime,theincreasinginfluxoffoodparticleschargingthroughistoo
muchandtheymustbeprocessedsomeotherway.Theliver,whichreceives
70%ofitsbloodflowfromtheintestine,isthenchargedwithcapturingand
detoxifyingthebloodatthispoint.
Ifthenecessarychemicals(i.e.Glutathione,NAC,Tocotrienols)areinshort
supply,theliversimplyshuttlesthetoxinsintofatcellstokeepthemfrom
invadingtherestofthebody.Thesefatcellsarestoredintheliverand
elsewherethroughoutthebody.Thisleadstoobesity;cripplesliverfunction
andcanbeseeninhigherthannormalbloodsugarlevels,astheliveris
criticalinregulatinginsulin.
Thisisreallytheonlyoptionavailabletotheliveratthispointasitwouldbe
moredangeroustohavethesetoxinsfloatingintheblooddisruptingother
processesaroundthebody.
Thebestwaytocounterthiscycleisfindingwaystoalleviatestress,
changingyourdietandsupplementingitwithprobioticsandstrongliver
antioxidants.
SupplementsToConsider
Milkthistleisoftenused,butmanypeoplearentawarethatthe
bioavailabilityis10timeshigherwhentakingtheisolatedactiveinmilk
thistle(slybin).PeoplethathavefattylivershouldalsobetakingNAC,
SAMeandGlutathioneattheveryleast.Recently,therehasalsobeenalot
ofresearchsurroundingRedPalmOil.
AlltheseseemtoactinawaythatkickstartsphaseIIdetoxificationinthe
liver,whichchangesfatsolubletoxinstowatersolubletoenableflushing
themoutofthebody.
AgoodwaytotestforLeakyGutisifyoudetectconstantdigestive
problemssuchasgas,bloating,constipationandotherfoodallergies.Its
thissensitivitytointakethatisthesignofaproblem.
IMPORTANCE
The liver is the second largest organ in your body.
The liver performs many jobs. It processes what you
eat and drink into energy and nutrients your body
can use. The liver also removes harmful substances
from your blood.
WHAT IS NAFLD?
Non-alcoholic fatty liver disease (NAFLD) is the build up of extra fat in liver cells
that is not caused by alcohol. It is normal for the liver to contain some fat.
However, if more than 5% - 10% percent of the livers weight is fat, then it is
called a fatty liver (steatosis).
RISKS
NAFLD may cause the liver to swell (steatohepatitis). A swollen liver may cause
scarring (cirrhosis) over time and may even lead to liver cancer or liver failure.
SYMPTOMS
NAFLD often has no symptoms.
When symptoms occur, they may include fatigue, weakness, weight loss, loss of
appetite, nausea, abdominal pain, spider-like blood vessels, yellowing of the skin
and eyes (jaundice), itching, fluid build up and swelling of the legs (edema) and
abdomen (ascites), and mental confusion.
DIAGNOSIS
NAFLD is initially suspected if blood tests show high levels of liver enzymes.
However, other liver diseases are first ruled out through additional tests. Often,
an ultrasound is used to confirm the NAFLD diagnosis.
TREATMENT
There are no medical treatments yet for NAFLD. Eating a healthy diet and
exercising regularly may help prevent liver damage from starting or reverse it in
the early stages.
PREVENTION
There are ways to prevent NAFLD:
NASH
The more severe form of NAFLD is called non-alcoholic steatohepatitis (NASH).
NASH causes the liver to swell and become damaged. NASH tends to develop in
people who are overweight or obese, or have diabetes, high cholesterol or high
triglycerides. However, some people have NASH even if they do not have any
risk factors.
Most people with NASH are between the ages of 40 and 60 years. It is more
common in women than in men. NASH often has no symptoms and people can
have NASH for years before symptoms occur.
NASH is one of the leading causes of cirrhosis in adults in the United States. Up
to 25% of adults with NASH may have cirrhosis.
SignsYouHaveALeakyGut
(sndrome de intestino permeable)
http://www.mindbodygreen.com/010908/9signsyouhavealeakygut.html
Thegutisthegatewaytohealth.Ifyourgutishealthy,
chancesarethatyou'reingoodhealth.However,there'sa
conditioncalledleakygutthatcanleadtoahostofhealth
problems.
Whatisaleakygut?
Thegutisnaturally
permeabletoverysmall
moleculesinordertoabsorb
thesevitalnutrients.Infact,
regulatingintestinalpermeabilityisoneofthebasic
functionsofthecellsthatlinetheintestinalwall.In
sensitivepeople,glutencancausethegutcellstorelease
zonulin,aproteinthatcanbreakaparttightjunctionsinthe
intestinallining.Otherfactorssuchasinfections,toxins,
stressandagecanalsocausethesetightjunctionsto
breakapart.
Oncethesetightjunctionsgetbrokenapart,youhavea
leakygut.Whenyourgutisleaky,thingsliketoxins,
microbes,undigestedfoodparticles,andmorecanescape
fromyourintestinesandtravelthroughoutyourbodyvia
yourbloodstream.Yourimmunesystemmarksthese
"foreigninvaders"aspathogensandattacksthem.The
immuneresponsetotheseinvaderscanappearintheform
ofanyoftheninesignsyouhavealeakygut,whichare
listedbelow.
Leaky gut can be a difficult diagnosis to establish for a number of reasons:
It's associated with a wide range of seemingly unconnected symptoms; it
has a lot of different causes; there's no specific test to confirm it; and
evidence tying it to other conditions can be murky. As a result, theres a fair
amount of skepticism in the mainstream medical community about the
legitimacy of leaky gut as a diagnosis. But as the evidence that this is
indeed a real and recognizable condition grows, opinions are slowly
changing. That's a good thing, because leaky gut is likely to emerge as one
Whatcausesleakygut?
Themainculpritsarefoods,strongantibiotictreatment,
infections,andtoxins.Glutenisthenumberonecauseof
leakygut.Otherinflammatoryfoodslikedairyortoxic
foods,suchsugarandexcessivealcohol,aresuspectedas
well.Themostcommoninfectiouscausesarecandida
overgrowth,intestinalparasites,andsmallintestine
bacterialovergrowth(SIBO).Toxinscomeintheformof
medications,likeMotrin,Advil,steroids,antibiotics,and
acidreducingdrugs,andenvironmentaltoxinslike
mercury,pesticidesandBPAfromplastics.Stressandage
alsocontributetoaleakygut.
So what causes leaky gut or increased intestinal permeability?
There's still much to be learned, but diet, chronic stress, certain
medications and bacterial imbalance seem to play important roles. Eating
a diet high in refined sugar can lead to overgrowth of yeast
species, which has been associated with leaky gut.
Preservatives and chemicals in processed foods can damage
the lining, and so can consumption of gluten a protein found
in wheat, rye and barley.
Chronic stress can lead to a weakened immune system, affecting your
ability to fight off invading bacteria and viruses and worsening the
symptoms of leaky gut. Medications like aspirin and non-steroidal anti
inflammatories (NSAIDs) that can damage the lining of your gut, as well as
antibiotics that kill off your essential good bacteria are also associated with
increased intestinal permeability. In fact, an imbalance between beneficial
and harmful species in your gut called dysbiosis is one of the leading
theories about what causes increased intestinal permeability. Excessive
alcohol consumption, infection with parasites, radiation and chemotherapy
can damage the lining of the intestine and are also risk factors.
In addition to bloating and digestive distress, a lot of the patients I see with
leaky gut have a combination of other symptoms like food allergies, chronic
sinus infections, achy joints, fatigue, brain fog or unexplained rashes.
Typically theyve been to multiple doctors trying to make sense of their
symptoms, and conventional tests and imaging studies have been
unrevealing. There can be a feeling of hopelessness and despair, because
the symptoms seem so unrelated.
When you think of leaky gut not so much as a disease, but as a mechanism
by which a number of different conditions can develop, it starts to make
sense. A leaky gut is the pathway for how toxins enter the body through the
GI tract and create all kinds of mayhem once they're in, sort of like party
crashers who slip through security and proceed to make a mess of the
venue.
What Tests Are Available for Leaky Gut?
Leaky gut is a clinical diagnosis, and while there's no specific test that can
tell you with 100% certainty that you have it, a positive Intestinal
Permeability Test is strongly associated with the condition. This
test measures the ability of two non-metabolized sugar molecules
mannitol and lactulose to get through the digestive lining.
Mannitol is a small molecule that normally passes through easily and
serves as a marker of how well nutrients are being absorbed. Lactulose is a
larger molecule that doesn't normally pass through very well and serves as
a marker for whether there are large holes in the lining. To perform the
test, the patient mixes pre-measured amounts of lactulose and mannitol
and drinks it. The test measures the amount of lactulose and mannitol
recovered in a 6-hour urine sample.
Low levels of both mannitol and lactulose indicate malabsorption. Elevated
levels of both lactulose and mannitol suggest general increased intestinal
permeability, consistent with leaky gut. Permeability to lactulose may be
increased, suggesting leaky gut, while permeability to mannitol may be
decreased, suggesting malabsorption of small molecules. The
lactulose/mannitol ratio is a useful value; an elevated ratio indicates that
the effective pore size of the gut lining has increased, allowing larger,
possibly harmful molecules to gain access to the body.
WhatIsIt?
The normal gut has a mucous lining that serves as a barrier between
the food we eat and the blood stream. Nutrients from digested food
normally and properly cross this border to enter the blood stream.
When this lining is irritated, by foods you are allergic to, or asprin and
similar non-steroidal anti-inflammatories, then undigested food
particles and other large molecules escape from the gut into the
blood stream. The immune system reacts, sending white blood cells
to attack them. This overactivity of the immune system can contribute
to ailments like joint pain, head-aches, fibromyalgia, Autism, Chrons
disease and ulcerative colitis. More Information on Leaky Gut.
WhatElseCanBeDone?
Testing in order to know if you have gluten sensitive genes. So that
you get a definitive answer so you can make a definitive decision as
to not to ingest any gluten (no grain foods) for the rest of your life, so
that you can completely repair and heal your gut lining so that
no impurities end up contaminating your precious blood stream.
Measure intestinal damage and intestinal inflammation. A simple
urine test can measure the permeability of your intestinal lining.
In addition, chew your food at least 25-50 times per bite.
This makes it easier for the digestive enzymes to do their job. Take
digestive enzymes 1-2 hours after meals. Get tested for food allergies
or do an allergy elimination diet, and take these food allergies
seriously. Avoid anti-inflammatory medicines like Motrin. Use instead,
natural ones like MSM, curcumin, boswellia and bromelain. For
arthritis try glucosamine, chondroitin, and niacinamide. Take friendly
bacteria and treat any infections in the gut, like candida or bacterial
overgrowth. Try L-glutamine, an amino acid that is fuel for the
intestinal cells. L-glutamine may help repair these cells and relieve
leaky gut. But if you are sensitive to MSG, then avoid this, as
glutamine converts to MSG.
ifyousufferfromanyofthefollowingconditions,its
likelythatyouhavealeakygut:
9SignsYouHaveaLeakyGut
1.Digestiveissuessuchasgas,bloating,diarrheaor
irritablebowelsyndrome(IBS).
2.Seasonalallergiesorasthma.
3.HormonalimbalancessuchasPMSorPCOS.
4.Diagnosisofanautoimmunediseasesuchasrheumatoid
arthritis,Hashimotosthyroiditis,lupus,psoriasis,orceliac
disease.
5.Diagnosisofchronicfatigueorfibromyalgia.
6.Moodandmindissuessuchasdepression,anxiety,ADD
orADHD.
7.Skinissuessuchasacne,rosacea,oreczema.
8.Diagnosisofcandidaovergrowth.
Clean the Colon to Check Candida
By Andrew Gutauskas and Monica O'Kane
The diet of the average North American consists of food that is over processed, low in fiber, and
high in refined sugar. We also consume large amounts of red meat, dairy products, and wheat.
According to a 1977 Journal of American Medical Association article, this kind of diet results in
fewer "friendly" bacteria in the intestinal tract. Furthermore, many of us eat too much, too often,
and we mix too many different kinds of food at the same meal.
These and other factors can cause a thick coat of mucus and impacted food residue, which
combines to form on the walls of the large intestine. Not only does this encrusted matter
contribute to further dysfunction of the colon, but, according to Bernard Jansen, D.C., in his boldly
illustrated book, Tissue Cleansing through Bowel Management, disease actually begins here
because toxins are absorbed to cause malnutrition of our body cells while absorption of nutrients
is prevented.
Candida albicans, a normal inhabitant of a healthy colon, prefers to live in this toxic filth where it
is warm, putrid, and lacking in oxygen. Consequently, this family of yeast does well in most
colons. In many cases, as noted by Trowbridge and Walker in The Yeast Syndrome, they become
so prolific that they escape the confines of the intestinal tract and cause havoc throughout the
rest of the body.
According to a research pioneer, C. Orian Truss, MD, in a paper published in a 1978 issue of The
Eliminate hydrogenated fats (such as that which exists in peanut butter, baked goods, margarine,
etc.);
Reduce fats (use those rich in Omega-3 --fish and olive oils);
Eat fresh and raw vegetables**** For more complete diet recommendations, see the
WholeApproach Diet Pages
Eat nothing unless it will spoil or rot, but eat it before it does so. At the grocery store, shop at the
outer fringes of the building, avoiding canned, packaged products. Exercise regularly.
Next, eliminate colon toxicity. This can be accomplished by using two natural agents, Psyllium
and Bentonite. Neither one is absorbed into the system, but rather, each absorbs and then expels
toxic materials in the feces.
Psyllium (pronounced "silly-um") is a seed, grown commercially in India. Its husk is used as a
bulk forming laxative in numerous products, and Constance Kies, PhD, in a 1982 issue of
Prevention wrote, "As it absorbs water in the digestive tract, the Psyllium expands, stimulating
and speeding up elimination." Psyllium also looks as though it is a cholesterol fighter, as Kies
found in an experiment with healthy volunteers whose cholesterol levels dropped, on average,
from 193 to 168 when they added Psyllium to their customary diets.
Gastroenterologist Jack D. Welsh, MD at the University of Oklahoma Health Sciences Center,
noted in the June, 1982 edition of the American Journal of Clinical Nutrition that Psyllium entirely
prevented the expected gas pain and nausea. If Psyllium seed powder is added to the husk
powder in the proper ratio, the preparation becomes an intestinal cleanser. The Psyllium seed
fragments are very hard; they tend to scrape away at the toxic plaguing on the walls and clean it
away over a period of months.
Bentonite, a volcanic ash, acts toward toxic material as fly paper does with flies when processed
into a very fine liquid suspension. The unique properties of Bentonite were reported in the
Medical Annals of the District of Columbia in June of 1961 by Frederick Damrau, MD, who
established that Bentonite adsorbs toxins, bacteria, and viruses both in laboratory dishes and in
humans. Because Bentonite, itself, is not absorbed, whatever it adsorbs is removed in the feces.
This includes miscellaneous intestinal poisons and toxins generated by Candida albicans.
The restoration of proper colon hygiene using this method takes anywhere from three to 24
months, depending on the age and condition of the individual. Caprylic acid can be added to help
reduce the Candida albicans. Its anti fungal properties were the subject of a 1961 Japanese study
at the Niigata University School of Medicine and were reported in the Japanese Journal of
Microbiology: "....the fungicidal effect of Caprylic acid on C. albicans was exceedingly powerful." It
was also noted in journal, "Caprylic acid exhibits the most remarkable fungiastatic and fungicidal
properties of all the normal saturated fatty acids with even numbered carbon atoms studied. The
fungicidal activity of Caprylic acid depends upon the concentration of the acid, the period of
contact, and the pH of the media."
Traditional Caprylic acid preparations exist as capsules or tablets, but the one we prefer is liquid
Caproyl. This was designed to take advantage of other health benefits of oleic acid from Safflower
oil and to interact with the Psyllium to amplify its fungicidal effects far beyond what Caprylic acid
has traditionally offered. We recommend that liquid Caprylic acid be mixed with the Psyllium
powder, Bentonite, and water to be taken orally once or twice daily.
As the Psyllium gel presses up against the intestinal walls, some unique and beneficial things
occur:
the liquid Caprylic acid is released into the intestinal wall at a rate determined by the gel, not by
the intestinal pH conditions, which vary widely among individuals. Consequently, results are
predictable; consistent, and favorable. Caprylic acid is slowly released through the entire length of
the intestinal tract.
As the gel rubs itself against the intestinal wall, it acts as a paint brush in delivering the liquid
Caprylic acid to the intestinal wall. Not a square millimeter of wall is missed through the entire
length of the intestines.
Because the Candida albicans micro-organisms are buried deep into the toxic accumulations on
the intestinal walls, access to them is difficult. But the bulking action of the gel forcibly rubs liquid
Caprylic acid into the filth and onto the Candida.
Liquid Caprylic acid, dispersed in a Psyllium gel, will rid most people of major yeast symptoms in
three to eight weeks. If these people really want to improve their health, however, or merely stay
well, they will need to continue to eradicate the originating site and cause of the problem. They
will need to clean up their intestinal environment.
While other colon cleansers may be touted, we know that over a period of many months, using
the Psyllium/Bentonite mixture once or twice daily and adding the liquid Caprylic acid every fourth
week for five consecutive days will clean out a colon and keep the Candida in check.
9.Foodallergiesorfoodintolerances.
Howdoyouhealaleakygut?
EliminateGrain,PastaandCerealsforthesearethemain
sourceofgluten.2nd,ifitcomeswithalabel,eliminateit.
Preparingrealfood.
Inmypractice,IhaveallofmypatientsfollowTheMyers
Waycomprehensiveeliminationdiet,whichremovesthe
toxicandinflammatoryfoodsforacertainperiodoftime.
Inaddition,Ihavethemfollowa4Rprogramtohealtheir
gut.The4Rprogramisasfollows.
1.Remove.
Removethebad.Thegoalistogetridofthingsthat
negativelyaffecttheenvironmentoftheGItract,suchas
inflammatoryandtoxicfoods,andintestinalinfections.
2.Replace.
Replacethegood.Addbacktheessentialingredientsfor
properdigestionandabsorption,suchasdigestiveenzymes,
hydrochloricacidandbileacids.
3.Reinoculate.
Itscriticaltorestorebeneficialbacteriatoreestablisha
healthybalanceofgoodbacteria.
4.Repair.
Itsessentialtoprovidethenutrientsnecessarytohelpthe
gutrepairitself.OneofmyfavoritesupplementsisL
glutamine,anaminoacidthathelpstorejuvenatethelining
ofthegutwall.
Ifyoustillhavesymptomsafterfollowingtheabove
recommendations,Iwouldrecommendfindinga
FunctionalMedicinephysicianinyourareatoworkwith
youandtoorderacomprehensivestooltest
Inflammation causes the spaces between the cells of the gut wall
to become larger than usual. Then protein molecules are
absorbed before they have a chance to be completely broken
down. The immune system starts making antibodies against
these larger molecules because it recognizes them as foreign,
invading substances. Antibodies are made against these proteins
derived from previously harmless foods. The immune system
becomes hyperstimulated and over-reactive to substances that
are not necessarily supposed to be dangerous.
Human tissues have proteins & antigens very similar to
those on foods, bacteria, parasites, candida or fungi. The
antibodies created by the leaky gut phenomenon against these
antigens can get into various tissues and trigger an inflammatory
reaction in that tissue when the corresponding food is consumed
or the microbe is encountered. Autoantibodies are thus created
and inflammation becomes chronic. If this inflammation occurs
in a joint, autoimmune arthritis (rheumatoid arthritis)
develops. If it occurs in the brain, myalgic encephalomyelitis
(chronic fatigue syndrome) may be the result. If it occurs in
the blood vessels, vasculitis (inflammation of the blood
vessels) is the resulting autoimmune problem... and so on.
If the antibodies end up attacking the lining of the gut itself,
the result may be colitis or Crohn's disease. If it occurs in
the lungs, asthma is triggered on a delayed basis every time
the individual consumes the food which triggered the production
of the antibodies in the first place. It is easy to see that practically
any organ or body tissue can become affected by food allergies
created by the leaky gut. Because the foods can trigger delayed
Health
Conditions
Associated
with Leaky Gut
Syndrome
The following conditions have been associated with leaky gut
syndrome:
Autoimmune disorders
Multiple food sensitivities
Multiple chemical sensitivities
Chronic fatigue syndrome
Heart failure
Depression
Chronic inflammatory conditions
Chronic pain
Inflammatory bowel
Chronic yeast overgrowth syndromes
Brain fog
Intestinal Permeability
and Autoimmune
Disease
There is a growing amount of evidence establishing the
connection between intestinal permeability and the
development of autoimmune disease. This review paper was
published in 2009 in the prestigious Annals of New York
Academy of Science. This journal is one of the top-rated
most powerful scientific journals available:
There is growing evidence that increased intestinal
permeability plays a pathogenic role in various
autoimmune diseases. Therefore, we hypothesize that loss
of intestinal barrier function is necessary to develop
autoimmunity.[276]
One of the
hallmarks of a
healthy
immune
system
is immune
tolerance to
self-tissue.
This prevents
our immune
system from
attacking ones
own tissue of
the body. We
are born with
an immune
system that is
able to differentiate self-tissue from foreign pathogens and
does not attack self-tissue under normal circumstances. One
of the things the research is showing is once these tight
junction proteins get compromised, there is such immune
zealousness and activation, this whole immune self-
Symptoms of Intestinal
Permeability
Symptoms of intestinal permeability vary significantly and
have a varied presentation. There is a spectrum of severity of
intestinal permeability from mild to severe forms. Here is a
list of the most common symptoms associated with intestinal
permeability:
Bloating
Poor Digestion
Inflammation
Food Sensitivities
Chronic Pain
Brain Fog/Poor Memory
Depression
Fatigue
Malabsorption/malnutrition
Bacterial/yeast overgrowth/dysbiosis (imbalance of
beneficial and pathogenic bacteria)
Intestinal lining degeneration/impaired intestinal immune
integrity
Immune activation/immune dysregulation/autoimmunity
Food sensitivities
Conventional
Management
of Intestinal
Permeability
There is currently no
drug available to treat
intestinal permeability
and most doctors have not even heard of it. However, this
may change in the near future because drug companies are
now working on drugs that modulate gut permeability.
There is currently a tight junction regulator being
developed, intended for the treatment of patients with celiac
disease which has just recently passed Phase IIb human drug
trial development and will start Phase III clinical trials for
the assessment of the oral drugs efficacy and safety.[287]
Once this drug is approved, doctors, or at least
gastroenterologists, will become more familiar with
intestinal permeability. However, at present, these drugs
appear to be limited to approval for the treatment of this one
particular intestinal autoimmune disorder (celiac disease).
So patients with intestinal permeability with diagnoses of
other autoimmune conditions (or any other condition) will
not be able to get drug treatments for the foreseeable future.
HowtoFindOutForSureIfYouHave
LeakyGut
There are several tests that have been developed, and more on the
way, that can tell you if you have some degree of leaky gut.
1. There is a urine test that involves first swallowing a
carbohydrate that will only make it across your intestinal lining
and into your blood and urine if your gut is leaky.
2. It is also possible to identify leaky gut by checking for IgG and IgA
antibodies to food in a blood test and this test is often preferable
because it gives us two pieces of information:
Whether or not there is leaky gut; and
Which foods you can avoid to help heal the leaky gut (if its there).
You can order a food sensitivity test here and complete it at home.
3. A blood test that measures zonulin as well as a substance called
actomyosin which is released when intestinal cells are damaged.
4. A breath test which, like the lactulose-mannitol test, involves first
swallowing sugar mixed in water, and then breathing into tubes which
will identify a gas (carbon dioxide) that is only produced if your gut is
healthy.
I can help you with determining which test is best for you:
please make an appointment!
Note: Leaky gut cannot be found with an endoscopy or colonoscopy,
and does not show on standard bloodwork, so it is missed by most
practitioners.
Nutritional
Compounds Shown
to Repair the
Intestinal Lining
There are various plant compounds, vitamins and minerals
that have been shown in the literature to have a restorative
effect on a damaged intestinal barrier. These include the
following: L-glutamine [288-292], deglycyrrhinized licorice
[293-303], N-acetyl glucosamine [304-307], aloe leaf extract
[308-312], spanish moss [313-317], marshmallow extract
NSAID-Induced
Enteropathy
NSAID-induced enteropathy refers to intestinal damage that
occurs from the use of non-steroidal anti-inflammatory
drugs (NSAIDs). Examples of NSAIDs are ibuprofen
(Advil, Motrin), naproxen (Aleve, Naprosyn),
Celebrex and aspirin. The use of NSAIDs, including
aspirin, is common in the treatment of pain, inflammation,
and fever. Additionally, low-dose aspirin is used routinely in
the prevention of heart attack and stroke. These drugs, both
through prescription and over-the-counter (OTC) use, are
the most widely used class of medications in the United
States.[352] Not surprisingly, NSAID use increases among
the elderly. In a survey of people 65 years of age and older,
70% used NSAIDs at least once weekly, and 34% used them
at least daily! The prevalence of at least weekly aspirin usage
was 60%![353] More than 111 million NSAID prescriptions
were written in 2004.[354]
Injury
Lining
Mechanism of
of NSAIDs to Gut
How do NSAIDs
cause damage to
the gut? Lets take
a more in-depth look at how NSAIDs injure the gut lining.
This may be a bit technical for some readers but others will
find this informative. NSAIDs cause topical injury to the
mucosal lining of the GI tract and systemic effects
(throughout the body) by inhibiting the COX enzymes
resulting in prostaglandin depletion. COX (cyclooxygenase)
is an enzyme that is responsible for the production of
prostaglandins and thromboxane. Prostaglandins are lipid
compounds that have a wide range of hormone-like effects in
the body. Tissue prostaglandins are produced via two
distinct enzyme-dependent pathways: a COX-1 and a COX-2
pathway.
Conventional
Management of NSAIDInduced Enteropathy
There is no known drug treatment for NSAID-induced
enteropathy, other than the withdrawal of use of NSAIDs.
Some doctors may still recommend the use of PPIs in these
cases, however, as we have seen, recent literature has shown
that the use of PPIs increases intestinal damage, rather than
alleviates it.
Moreover, recent studies suggest that commonly used
drugs for protecting the upper gastrointestinal tract (i.e.,
proton pump inhibitors) can significantly worsen NSAIDinduced damage in the small intestine.[357]
proposes that the cause of IBS is an altered NES of the gut, which accounts for
abnormal GI motility, secretions and sensations.[360] All of these abnormalities are
characteristic of IBS. The researchers propose that alterations in the NES could be the
result of one or more of the following causative factors of IBS: genetic factors, diet,
intestinal flora, or low-grade inflammation.[360] Lets take a look at each of factors
that are believed to contribute to the development of IBS.
IBS: Diet
Most patients with IBS believe that their diet has a
significant influence on their symptoms and they are
interested in finding out which foods they should avoid.[374377] There is some evidence supporting dietary influence on
IBS symptoms. In one study, about 60% of IBS patients
reported a worsening of symptoms following specific food
ingestion: 28% within 15 min after eating and 93% within 3
hrs.[377] Many IBS patients report specific foods as triggers,
most commonly implicating dairy and wheat products, but
other foods as well such as onion, peas and beans, hot spices,
cabbage, certain meats, smoked products, fried food and
caffeine.[378]
IBS: FODMAPs
FODMAPs include fructose, lactose, fructans, galactans and
sugar alcohols, such as sorbitol, maltitol, mannitol, xylitol
and ismalt. Fructose and lactose are present in apples, pears,
watermelon, honey, fruit juices, dried fruits, milk and dairy
products. Polyols are used in low calorie food products.
Galactans and fructans are present in common dietary food,
such as wheat, rye, garlic, onions, legumes, cabbage,
artichokes, leeks, asparagus, lentils, inulin, soy, brussel
sprouts and broccoli.[379]
IBS: Fiber
A deficiency in dietary fiber was once widely believed to be
the primary cause of IBS.[380] Although increasing the
amount of dietary fiber continues to be a standard
recommendation for patients with IBS, clinical practice has
shown that increased fiber intake in these patients increases
abdominal pain, bloating and distension.[380] In one study,
IBS patients assigned to fiber treatment showed persistent
symptoms or no improvement in symptoms after treatment
compared to patients taking the placebo or a low-fiber diet
but these patients were using common bran types of fiber.
[380] It is noteworthy that the role of FODMAPs and fiber
on IBS symptoms is associated with the intestinal flora. The
presence of gut bacteria that break down FODMAPs and
fiber and produce gas, such as Clostridia spp., can cause
distension of the small and large intestine with abdominal
discomfort or pain and lead to small intestinal bacterial
overgrowth (SIBO).[381,382]
Prevalence of SIBO
Only limited data are available regarding the prevalence of
SIBO in healthy populations but age appears to be an
important risk factor. In a study of 294 non-hospitalized
older adults in which 34 younger adults (mean age 33.6
years) served as healthy controls, the prevalence of SIBO, as
determined by glucose breath test, was 5.9% in the control
group versus 15.6% in the older group.[505] Healthy elderly
volunteers from the United Kingdom had a 14.5% prevalence
rate for SIBO based on a positive glucose breath test.[505]
Causes of SIBO
SIBO can result from failure of the gastric
acid barrier, failure of small intestinal
motility, anatomic alterations or
impairment of systemic and local
immunity[511]
In the intact intestine, small intestinal
bacterial overgrowth is prevented by the
actions of gastric acid, pancreatic enzyme
activity, small intestinal motility, and the
ileocecal valve[512]
Production
As discussed in Common Stomach Disorders:
Hypochlorhydria, gastric acid suppresses the growth of
ingested bacteria, thereby limiting bacterial counts in the
stomach and upper small intestine. Diminished acid
production (hypochlorhydria) is a risk factor for bacterial
overgrowth simply because there is less acid available to
prevent bacteria from growing. As discussed in the
hypochlorhydria section, there are a number of factors that
can lead to this condition, including colonization with H.
pylori, stress and as a consequence of aging.[505] SIBO can
also result from PPI use in the treatment of GERD.
intestine
Decreased vagal activation of HCl release leading to inability
to suppress bacterial growth
All of these dysfunctions lead to SIBO as well as the following
conditions:
Bacterial disruption in the small intestinal lumen
Interference with thyroid medication absorption
Decreased thyroid response on receptor sites
Summary of Disruptions to
Normal Physiology Caused by
SIBO
Assessment of SIBO
The diagnosis of SIBO is controversial.
There is substantial disagreement in the
literature regarding which test is the most
appropriate in either the clinical or
research setting. Two tests are commonly
employed: bacterial culture and breath
tests.[505]
[520]