Leaky Gut Syndrome: How to Achieve Gut Health

by Millie Ruth Lytle, ND, CNS, MPH, is a naturopathic doctor and works as part of the Live Well / Stay Well Program at Tournesol Wellness

Your gastroenterologist doesn’t know what your naturopathic doctor does. For instance, your gastroenterologist likely doesn’t know what leaky gut syndrome is because he was not taught it in medical school. He doesn’t how to treat it and therefore doesn’t believe it exists at all. But, it does exist, even though some would rather deny it happens than face a new paradigm. Check out this “hilarious” conversation WebMD has published between two integrative gastroenterologists and how they very hesitantly “explain” leaky gut syndrome:

“Leaky gut syndrome” is said to have symptoms including bloating, gas, cramps, food sensitivities, and aches, and pains. But it’s something of a medical mystery.

“From an MD’s standpoint, it’s a very gray area,” says gastroenterologist Donald Kirby, MD, director of the Center for Human Nutrition at the Cleveland Clinic. “Physicians don’t know enough about the gut, which is our biggest immune system organ.”

“Leaky gut syndrome” isn’t a diagnosis taught in medical school. Instead, “leaky gut really means you’ve got a diagnosis that still needs to be made,” Kirby says. “You hope that your doctor is a good-enough Sherlock Holmes, but sometimes it is very hard to make a diagnosis.”

“We don’t know a lot, but we know that it exists,” says Linda A. Lee, MD, a gastroenterologist and director of the Johns Hopkins Integrative Medicine and Digestive Center. “In the absence of evidence, we don’t know what it means or what therapies can directly address it.”

When I say “hilarious”, I mean disturbing. It’s certainly not hilarious to the patient. The fact that many doctors aren’t trained properly in physiology, pathology, and nutritional biochemistry is not a good excuse for leaving millions of patients misdiagnosed and maltreated.

Leaky gut syndrome is not a disease, it’s a functional and structural disorder that requires nutritional repair, not “treatment.” It’s a stage in the manifestation or development of other diseases, gastrointestinal and otherwise. Why would an expert wait until an actual disease presents before promoting healing? I love science, but research also shows medicine is 17 years behind the evidence so do you really want to wait until your medical doctor catches on? If the gut is not repaired, systemic disease like autoimmune conditions, psoriasis, eczema, allergies, migraine headaches, depression, and asthma can ensue. Perhaps you already have one! Each of these disorders requires gut maintenance, and most patients I see with these conditions have preceding digestive issues that were mistreated or ignored. The body repairs itself everyday, but if there are more agents damaging the cells than means to repair them then this healing deficit will cause leaky gut. What agents damage the gut? Antacids, NSAIDs/Aleve/Ibuprofen, gluten, food sensitivities, pesticides/glyphosates/Roundup, to name only a few.

What is leaky gut? It’s intestinal permeability. It may be caused by damage to intestinal cells from eating the wrong foods, constipation and diarrhea, allergies, medications like Ibuprofen, Aleve, Ranitidine, Prilosec, Nexium, and other antibiotics. It means that the gap junctions between the intestinal cells are not glued shut, they are torn open by a protein called zonulin, allowing proteins, drug, and food metabolites, pesticide residues, hormones, and other toxins to enter the blood stream. Whereas, epidermal growth factor (EGF) is a protein that stimulates growth and repair of epithelial tissue. Though it is widely distributed in the body, high concentrations are detectable in saliva. In order to increase salivary EGF, sit down for 20 minutes while you eat and chew your food thoroughly. EGF has also been shown to heal ulcers of the small intestine (Lancet, 1993; 341: 843-8).

Saccharomyces boulardii is a “yeast against yeast,” meaning it’s safe for candida and SIBO. It’s a non pathogenic yeast, originally isolated from the surface of lychee nuts. It has been widely used in Europe to treat diarrhea. Clinical trials have demonstrated the effectiveness of Saccharomyces boulardii in the treatment or prevention of diarrhea (Am J Gastroenterol, 1989; 84: 1285-7; Gastroenterol, 1989; 96; 981-8). Usually it is not found in most probiotic supplements.

Probiotics such as Lactobacillus caseii var GG, or Culturelle, isolated and purified in Finland, have been shown effective in the prevention of diarrhea and in the treatment of colitis (inflammation of the colon). This strain also reduces the gut permeability (leaky gut) associated with rotavirus infection (Ann Med, 1990; 22: 57-9). Live cultures of Lactobacillus acidophilus significantly reduced diarrhea when given to patients during radiation to the pelvis (Marteau, de Vrese, Cellier, & Schrezenmeir, 2001). Another strain of Lactobacillus, given two weeks after radiation therapy, known as Lactobacillus rhamnosus reduced the need for diarrhea medication and the number of daily bowel movements among patients who had been experiencing diarrhea for more than two weeks (Urbancsek, Kazar, Mezes, & Neumann, 2001). Radiation, whether therapeutic, accidental, or diagnostic, induces diarrhea, which directly produces the loss of mucosal integrity.

Glutamine is the most widely available free amino acid needed for the repair of enterocytes (intestinal cells), maintenance of intestinal metabolism, structure, and function. It has been shown to reverse all the gut abnormalities in patients when given intravenously. Oral L-Glutamine also repairs gut lining damage caused by chemotherapy or radiation (Arch Surg, 1990; 125: 1040-5). While cabbage and potato juice contain quite a bit of L-Glutamine that can heal the gut, you might prefer to take it in supplement powder.

Glutathione (GSH) is the mother of all antioxidants and responsible for repairing liver cells. Low levels of liver glutathione is a common occurrence in leaky gut syndrome, contributing to liver dysfunction and liver cirrhosis and necrosis among alcoholics and immune impairment in patients with HIV/AIDS. The most effective way to raise liver glutathione is to take its dietary precursors such as NAC (N-acetyl-cysteine), ALA (alpha-lipoic acid), and MSM or (methionine); the best supplements for leaky gut are GSH and N-acetyl cysteine.

Because leaky gut can be caused by too much histamine build-up that damages enterocytes, taking natural anti-histamines such as vitamin C and Bio-flavonoids before eating can reduce immediate inflammation. They may block allergic reactions which increase permeability. Catechins, such as those from green tea have been used in Europe to treat gastric ulcerations; the flavonoids in milk thistle (silymarin) and in dandelion root (taraxacum) protect the liver as well by reducing inflammation and repairing damaged cells.

If you are supplementing with dietary fiber, make sure you are taking hypoallergenic insoluble fiber and watch the amount. Too much insoluble fiber from psyllium, whole wheat, or flax seeds may increase gut permeability (J Nutr, 1983; 113: 2300-7) when taken during a flare up. Choose cooked foods over raw, as well as soluble fibers from stewed blueberries, apples, cooked greens, and cooked squashes.  Apple pectin, arabinogalactan from latch and FOS help ease bowel movements, heal the intestine, and feed good bacteria. But be careful because quality and type matters, especially in those with food sensitivities, SIBO, and Candida.

I hope you learned some good stuff about the gut. Just because your body repairs itself under normal circumstances, doesn’t mean your body is repairing itself fast enough. If you have the risk factors and symptoms discussed above see a Naturopathic Doctor.