The Puzzle of Leaky Gut Syndrome: Understanding the Pieces

Do gastrointestinal symptoms and a lack of diagnosis have your stomach in knots?

The answer may be a leaky gut.

What exactly is leaky gut syndrome?

Spanning the space between your mouth and anus, the human gastrointestinal tract (GIT), or gut, is an extraordinary system that absorbs and digests nutrients, and eliminates waste. The GIT is the biggest mucosal organ in your body, routinely exposed and responding to foreign matter passing through.

The gut does not stand alone, but is home to trillions of microorganisms called microbiota. The number of microbiota in the gut is far greater than the number of cells that compose our bodies. While there are commonalities across the microbiome (another word for the rich ecosystem of microorganisms), each of us harbors microbiota as unique as our fingerprints.

The small intestine is located in the lower gastrointestinal tract. As food passes from the stomach to the small intestine, consumable nutrients, like proteins, carbohydrates and lipids, are broken down by microbiota, enzymes, hormones, and other chemicals.

When decomposed, nutrients are absorbed through the surface area of the small intestine. Once absorbed, nutrients are transported by blood vessels throughout the body. Undigested material passes into the large intestine.

At least, that is how it is supposed to work.

Leaky gut syndrome is a broad term that describes the theory that the small intestine, under certain conditions, becomes inflamed and allows undigested matter, allergens, and potential toxins to leak into the bloodstream.

The mechanism of the leak is increased permeability of the surface area of the small intestine, allowing larger, undigested particles or materials to pass into the bloodstream that otherwise would have been excreted.

Ailments linked to leaky gut syndrome include:

• Asthma
• Autoimmune disorders — like rheumatoid arthritis, Hashimoto's Thyroiditis, Graves’ disease, and others
• Crohn’s disease
• Chronic fatigue syndrome
• Depression
• Eczema and other skin conditions
• Fibromyalgia
• Food allergies
• Irritahble bowel syndrome
• Immune system disorder and dysfunction
• Kidney dysfunction

How do you know if you have leaky gut syndrome?

While we know that the small intestine is permeable, how that affects disease and physical disorder is still being explored.

There is also a gap between the mainstream medical approach, and integrative medicine’s ideas about and acceptance of leaky gut. Factors known to damage the lining, and affect permeability, include:

• Alcohol
• Aspirin
• Celiac disease
• Cystic fibrosis
• Diabetes
• Heart disease
• Inflammatory bowel diseases
• Intestinal infections
• Non-steroidal anti-inflammatory drugs (NSAIDS)
• Scleroderma
• Food sensitivities and allergens

Research into intestinal permeability is ongoing. Here are a few interesting studies :

• Newly discovered protein could increase permeability: In 2012, research published in the Journal of Gastroenterology and Hepatology describes a protein that regulates intercellular junctions and permeability in the lining of the GIT. Study authors theorize dysfunction of the protein in susceptible individuals may lead to “immune-mediated diseases.”
• MS may cause intestinal permeability: A study published in PLOS ONE in 2014 suggests Multiple Sclerosis (MS) disrupts the permeability of the intestinal lining. While leaky gut syndrome is linked to MS, the study is one of the first to propose increased intestinal porosity is a result of the immune-mediated event of MS.
• Diet affects intestinal inflammation: Attention to diet and nutrition has long been advocated by physicians who believe their patients suffer from leaky gut syndrome. In a 2014 study published in Gastroenterology, researchers note modification of diet and nutrients can reduce intestinal inflammation—a trigger of increased intestinal permeability.

What are your options if you suspect leaky gut syndrome?

My clinical practice is focused on integrative medicine. We look at causes and all potential treatments of digestive related issues, and often look for and correct underlying digestive and leaky gut-related issues as a core of other conditions.

Options include:

• Resolution of underlying infections, i.e., yeast overgrowth/candidiasis
• Change of diet, elimination of food allergens
• Gluten-free diet
• Supplements, including probiotics and digestive enzymes, among others

In working with my patients, I know the importance of understanding the underlying cause of their disease and symptoms. If you are concerned about digestive issues, and live in New York City, contact my office.