Eoin Roe, Chiropractic
Call 087 958 2362
Leaky gut, or intestinal permeability as it is called in thousands of research papers, is a description of dysfunction in the gut wall, which can lead to a number of health complications and have an impact on systemic inflammation, autoimmunity, digestive health, diabetes and other health problems.
To understand intestinal permeability, it helps to understand a little about how the gut works. The wall of the gut is made up of many cells held together by proteins between the cells which are known as tight junctions. The tight junctions act as a barrier but also let selective nutrients in though the gut lining and into the blood stream. ‘Leaky Gut” or intestinal permeability is when these junctions breakdown and the gap between cells become wider and let larger inappropriate sized food proteins, pathogens and harmful by-products called LPS from gut bacteria, through the barrier. This can lead to a cascade of immune reactions, which result in systemic inflammation, pain, autoimmune reactivity and other health conditions.
What causes the gut to become leaky?
There are a lot of reasons; diet can play a part but it may surprise you to find that concussion (a brain injury) can cause leaky gut, overuse of some medications, getting a stomach bug or having diarrhoea can all cause intestinal permeability. When your body is functioning well, it will usually heal and whilst there may be a brief period of time when you have intestinal permeability, once you have got rid of the tummy bug, the gut should naturally heal.
People with autoimmune conditions such as coeliac disease, Hashimotos thyroiditis and many others are likely to be susceptible to leaky gut and ensuring good gut health will help them feel much better.
Do people with food sensitivities have leaky gut?
Not necessarily, there are a number of reasons for developing food sensitives with regard to immune function that are different from intestinal permeability. This is known as loss of oral tolerance – when you lose tolerance you can start to have immune reactions to food. Intestinal permeability can be involved, but other factors include overactive dendritic cells, dysfunctional regulatory T-cells, and over-reactive Kupffer cells in the liver.
The inverse of this is often the case: When people develop intestinal permeability they will start to develop food sensitivities that they have never had before. This is because once the gut wall has become leaky, inappropriate sized proteins are now able to enter the blood stream causing the immune system to react.
Is IBS (Irritable Bowel Syndrome) the same as leaky gut?
Again this is nuanced, food sensitivities may cause inflammation that may contribute to IBS and intestinal permeability. But It is not a given that people with IBS have intestinal permeability. Just as there are many different causes of intestinal permeability, there are many different causes of IBS and in order to get any resolution to these symptoms you have to understand what is causing them first.
Can you test for leaky gut?
Yes, intestinal permeability can be assessed using ELISA testing and looking for antibodies to the proteins that hold the tight junctions together these are called zonulin and occludin.
Food sensitivity testing which also uses ELISA testing methodology does not tell you if you have intestinal permeability.
Can you heal leaky gut?
There are supplements that help to heal the gut lining and resolve intestinal permeability. Changes to diet can reduce inflammation and also help, but the protocols for each person may be very different depending on the reason why they have developed intestinal permeability.
Whilst some mechanisms that cause leaky gut can be remedied, some cannot. Those suffering with inflammation caused by autoimmune reactivity can have repeated bouts of intestinal permeability as the condition flares up and calms down again. Another example would be someone who has chronic pre-diabetes and high levels of HbA1c, which can cause repeated breakdowns of the tight junctions causing ongoing permeability. For these people, managing leaky gut will be a life-long endeavour.
Is healing leaky gut important?
Yes, especially for those who have autoimmune conditions. The inflammation caused by flare-ups can be much worse if the person is also suffering with leaky gut and any flare-ups of the condition can be harder to manage. It is not possible to cure autoimmune conditions but it is possible to help manage the condition with a focus on lifestyle changes. It may also be important for people with other gastrointestinal problems such as IBS or multiple food reactions especially if these are accompanied with elevations in toxic LPS from gut bacteria.
Eoin Roe is a certified Functional Medicine Practitioner and Doctor of Chiropractic working in Skibbereen at Roe Health. Website www.roehealth.ie or call 0286208.