This is a colloquial term for increased intestinal permeability. Have you heard of it? Do you know that the following problems can arise from intestinal permeability:
Increased entry of toxins and pathogens into your bloodstream
Activation of your immune system
Dysregulation of your immune system
Disruption of your gut microbiota
And you do NOT need to have gut symptoms to have leaky gut! Brain fog, fatigue, joint pain... these are well-researched conditions connected to leaky gut and gut health.
Read on to learn more and understand how research demonstrates that leaky gut is connected to a plethora of chronic inflammatory conditions.
Intestinal permeability, also known as "leaky gut," refers to a condition in which the lining of the intestine becomes more porous or permeable than normal. The intestinal lining is responsible for selectively allowing nutrients and beneficial substances to pass through while preventing harmful substances, toxins, and large molecules from crossing into the bloodstream. In leaky gut, the tight junctions between intestinal cells become compromised, allowing larger molecules and pathogens to enter the bloodstream, which would not normally occur.
On the other side of the lining of your intestine lies your immune system. Inflammation is an immune system response, so now we can start to piece together how gut health is so connected to inflammatory conditions.
When the intestinal barrier is compromised, several problems can arise:
Increased entry of toxins and pathogens: Larger molecules, toxins, and harmful bacteria that would usually be confined to the digestive tract can now enter the bloodstream. This can trigger an immune response as the body recognises these foreign substances as potential threats.
Activation of the immune system: The presence of foreign particles and pathogens in the bloodstream can lead to chronic low-grade inflammation. The immune system becomes activated in response to these invaders, and the ongoing immune response can contribute to systemic inflammation.
Dysregulation of immune function: Leaky gut can lead to an imbalance in the immune system, potentially shifting it toward a pro-inflammatory state. This dysregulation can contribute to the development or exacerbation of various inflammatory conditions, including autoimmune disorders and allergies.
Disruption of gut microbiota: The gut microbiota, a diverse community of beneficial bacteria in the intestines, plays a crucial role in maintaining gut health and regulating immune function. Leaky gut can disrupt the balance of the gut microbiota, leading to a condition known as dysbiosis. Dysbiosis can further contribute to inflammation and immune dysfunction.
The inflammatory condition connection
Inflammatory conditions, such as inflammatory bowel disease (IBD), coeliac disease, rheumatoid arthritis, and certain skin conditions, have been associated with increased intestinal permeability. Although leaky gut is not the sole cause of these conditions, it is believed to play a role in their development and progression. In some cases, leaky gut can be both a cause and a consequence of chronic inflammation, creating a vicious cycle that perpetuates the inflammatory response.
Addressing intestinal permeability in nutritional therapy (a functional medicine approach) involves identifying and managing the underlying causes, which can include dietary factors (e.g., excessive alcohol or certain foods), stress, medications (e.g., nonsteroidal anti-inflammatory drugs), and certain medical conditions. Strategies to support gut health, such as consuming a balanced diet rich in fibre and beneficial nutrients, managing stress, avoiding potential triggers, and using probiotics or other gut-healing supplements, may be recommended to promote gut barrier integrity and reduce inflammation.
What are some of the tools I use in clinic to help intestinal permeability?
assess for food intolerances
assess for sources of toxin exposure (including mould)
review stress and introduce management techniques
introduce specific researched probiotics
review dietary amino acid intake and supplement where appropriate: Glutamine, N-Acetyl Glucosamine, Zinc Carnosine, Glycine, Proline, Arginine
Helpful further reading:
The Influence of Nutrition on Intestinal Permeability and the Microbiome in Health and Disease, Orsolya et al, Frontiers in Nutrition, 2022: DOI=10.3389/fnut.2022.718710
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