Carolina Holistic Medicine | Functional & Alternative Medicine | Charleston, SC

What is Leaky Gut?

What is leaky gut?

A: Leaky Gut or Gastric Permeability is a medical condition where the intestinal lining in our villi is more porous than it should be. The barrier between the outside world and our inside selves is disrupted. This barrier is made up of tight-junctions of cells. Think of it as a protective brick wall around a city. When something disrupts this protective layer (an invading army breaches the wall of a fortified city) then things leak through. When things leak through (foreign material, proteins and other molecules) then the body’s immune system ramps up to protect us against these invaders (in war we call them invading soldiers, in medicine we call them antigens). This normal innate immune response can cause inflammation. Prolonged inflammation is not good. Because of something called molecular mimicry at times our own body’s immune system will attack our own tissue/organs believing they are invading antigens. When this happens, it is called autoimmunity.


What can cause Leaky Gut?

A: Several things can lead up to or predispose a person to leaky gut. One is genetic predisposition. Some folks are more susceptible to leaky gut than others. Second, there may be an important trigger or aggravating factor and that can be food sensitivity or food allergy. Third, it could be a disrupted gastric microbiome (the balance of bacteria in the gut that if out of balance or encumbered with pathogenic microbes causing dysbiosis or SIBO). If the two modifiable reasons are not fixed, the leaky gut situation continues to build upon itself and becomes worse and worse eventually resulting in a disability or chronic illness. Everyone’s tipping point is different. Some folks can go years before a leaky gut manifests as a major medical problem. Putting out a big fire of runaway leaky gut after years of neglect can be a daunting task and frustrating. Fixing the leaky gut at that point and any collateral damage can take years.


How is leak gut related to Autoimmune Disorders?

A: There are somewhere in the neighborhood of one-hundred different autoimmune disorders that the medical community has named. They essentially attack different organs and tissues is different ways to manifest themselves by organ involvement. For example, when autoimmune attacks the brain tissues of the myelin sheath it breaks down this protective nerve covering and causes ‘’plaques’’ seen in multiple sclerosis (MS). Another example is where autoimmune attacks the skin, one of our largest organs and causes a particular dermatitis known as psoriasis. So, you can call different organ or tissue involvement by the autoimmune hyperactive and confused immune system by what ever name you wish, but essentially the basic tenet is that it involves a dysfunctional innate immune system. The immune system becomes dysfunctional by having a leaky gut. One of the main causes of autoimmune is having a leaky gut caused by an altered immune system.


How is SIBO connected to Leaky Gut?

A: SIBO or Small Intestinal Bacterial Overgrowth (and also referred to by another term Dysbiosis) can come in a couple of types. These subtypes of SIBO have to do with the production of gasses (exhaust from the abnormal microbes in the gut flora). Hydrogen-predominant SIBO and methane-predominant SIBO are the two basic types and methane-predominant is a bit more difficult to treat. However, one can get distracted with differentiating the two, so let’s just say in the grand scheme of things that does not really matter. What matters is that we must regain the proper balance of good microbes in the gut to cure SIBO. Curing SIBO will eventually take one of the biggest offenders out of the picture of leaky gut. Fixing SIBO/Dysbiosis and eliminating the agitating foods that cause leaky gut can restore the whole body to health and eliminate or reverse autoimmune disorders.


How long does it take to fix Leaky Gut?

A: The fix for leaky gut depends on identifying the causative factors (is it a bad food allergy?) Also correcting dysbiosis if that is identified. Sometimes dysbiosis (SIBO) can be resistant to therapy and can reoccur. One must follow very carefully the recommendations of a functional medicine physician to completely heal the gut. This may involve strict dietary restrictions such as the elimination diet or even in worse cases the elemental diet. Healing the gut may also involve recolonization of the gut with proper microbes and the use of agents (natural or antibiotics) to remove the bad microbes. Also, a healing or patching up of the tight-junctions has to occur once the inflammation has settled down. Finally, when the leaky gut stops leaking one may notice a return to health. This does not happen overnight. Healing can take months to even years for gut health to return, so a patient must have patience with the process.

Since Leaky Gut and Autoimmune are linked, how long will it take me to correct an autoimmune disorder?
A: The process of healing leaky gut can be lengthy, but the process of correcting an autoimmune disorder is even more tricky and can take quite a while. Because the first step is to avoid re-kindling the fire of autoimmune, leaky gut and other factors need to be fixed completely. Second, the way our immune system works with the T-cells and B-cells there is ‘’memory’’ associated with certain antigens. That is how our body continues to protect ourselves aggressively against foreign invaders such as viruses, parasites and microbes. B-cells that produce antibodies generate daughter cells that carry the same ‘’memory’’ and those cell lines can propagate for many years. Throw in an antigen after a few years of not having it around and presto … the immune system wakes up and starts a heightened response. This is good if you are invaded by a nasty virus, it is bad when the antigen is a gluten molecule, and this sparks your autoimmune disorder with a flare up.


How do you fix leaky gut?

A: There is a process or protocol in functional medicine and the oversimplified answer is to:

  • Eliminate the offending foods identified as a food allergy or sensitivity
  • Use of probiotics to recolonize the gut to a more normal microbiome
  • Use of higher doses of vitamin D3 as an immune modulator
  • Adding in glutamine to repair the tight junctions
  • Use of EPA/DHA as an anti-inflammatory agent
  • Use of curcumin or other natural anti-inflammatory agents to quell the fire of inflammation
  • Use of colostrum as a healing agent when indicated
  • Potentially the use of Low Dose Naltrexone (LDN) as an agent to suppress autoimmune and fix the dysfunctional immune system. LDN has also been shown to help heal leaky gut and mucosal lining directly
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