What is “leaky gut”?
Leaky gut, formally known as Increased Intestinal Permeability refers to a phenomenon in which the intestinal lining or gut barrier becomes compromised letting the outside world into the body which can cause many problems. The gut lining is made up of a layer of mucosal cells that should be bound close together by tight junctions. Certain molecules like nutrients (vitamins/minerals) are able to pass through between the cells or through the cells making their way into the body. An intact intestinal barrier is critical for normal physiologic function and disease prevention.
The trouble is when these cells lose the tight junctions and become more permeable to things like bacteria, food particles, toxins and inflammatory molecules from bacteria like lipopolysaccharide (LPS) which then enter the body. This causes the immune system to activate, triggering systemic inflammation and many downstream problems, like chronic disease.
What triggers leaky gut?
- Medications (antibiotics, NSAIDs, hormonal contraception)
- Food allergies/antigens (gluten)
- Infections (viral, bacterial, fungal, Small Intestinal Bacterial Overgrowth)
- Dysbiosis
- Intestinal inflammation
- Many diseases (autoimmune conditions, Irritable Bowel Syndrome and Inflammatory Bowel Disease, Alzheimer’s, Parkinson’s, metabolic disease, Sleep Apnea)
- Imapired digestion (low stomach acid)
- Toxins (pesticides, BPA, glyphosate, cadmium exposure)
- Diet/Nutritional insufficiencies (zinc deficiency, simple sugars, high fat diet)
- Stress
- Chronic alcoholism
- Strenuous exercise (HIIT)
- Increasing age
- Alcohol
- Concussions/Traumatic Brain Injury
- Sleep disruption (lack of sleep, shift work, obestructive sleep apnea)
This list may make it seem like many of us are at risk of increased intestinal permeability and the truth is we are with our modern lifestyle. The good news is, there is a lot we can do to promote gut health.
Next week we will discuss how to re-establish healthy gut barrier function when we discuss the 5R approach to gut health!
To learn more about Wild Rice Wellness and Functional Medicine, visit our ABOUT page for more details! If you are looking to improve your gut and overall health, schedule a free consultation with me to kick off the New Year!!
- References:
- Turner JR. Molecular Basis of Epithelial Barrier Regulation. The American Journal of Pathology. 2006;169(6):1901-1909. doi:10.2353/ajpath.2006.060681.
- Sartor RB. Importance of intestinal mucosal immunity and luminal bacterial cell wall polymers in the etiology of inflammatoryjoint diseases.Baillières Clinical Rheumatology. 1989;3(2):223-245. doi:10.1016/s0950-3579(89)80019-6.
- König J, Wells J, Cani PD, et al. Human Intestinal Barrier Function in Health and Disease. Clinical and Translational Gastroenterology. 2016;7(10):e196-. doi:10.1038/ctg.2016.54.
- Fasano A. Surprises from celiac disease. Sci Am. 2009 Aug;301(2):54-61.
- Valitutti F,Fasano A, Breaking Down Barriers: How Understanding Celiac Disease Pathogenesis Informed the Development of Novel Treatments.Dig Dis Sci.2019 Jul;64(7):1748-1758
- Bischoff SC, Barbara G, BuurmanW, OckhuizenT, SchulzkeJD, SerinoM, TilgH, Watson A, Wells JM. Intestinal permeability–a new target for disease prevention and therapy. BMC Gastroenterol. 2014 Nov 18;14:189. doi: 10.1186/s12876-014-0189-7. PMID: 25407511; PMCID: PMC4253991.
- Kelly JR, Kennedy PJ, Cryan JF, Dinan TG, Clarke G, Hyland NP. Breaking down the barriers: the gut microbiome, intestinal permeability and stress related psychiatric disorders. Frontiers in Cellular Neuroscience. 2015;9:392. doi:10.3389/fncel.2015.00392.
- Vanuytsel T, van Wanrooy S, Vanheel H, et al. Psychological stress and corticotropin releasing hormone increase intestinal permeability in humans by a mast cell dependent mechanism. Gut. 2014 Aug; 63(8):12939. doi: 10.1136/gutjnl 2013305690.
- Kukuruzovic R, Robins, Browne RM, Anstey NM, Brewster DR. Enteric pathogens, intestinal permeability and nitric oxide production in acute gastroenteritis. Pediatr Infect Dis J. 2002 Aug;21(8):730-9.
- Brown K, DeCoffe D, Molcan E, Gibson DL. Diet induced dysbiosis of the intestinal microbiota and the effects on immunity and disease. Nutrients. 2012;4(8):1095-1119. doi:10.3390/nu4081095
- Michielan A, D’Incà R. Intestinal Permeability in Inflammatory Bowel Disease: Pathogenesis, Clinical Evaluation, and Therapy of Leaky Gut. Mediators of Inflammation. 2015;2015:628157. doi:10.1155/2015/628157
- Arrieta MC, Bistritz L, Meddings JB. Alterations in intestinal permeability. Gut. 2006;55(10):1512-1520. doi:10.1136/gut.2005.085373.
- Centanni M, Marignani M, Gargano L, Corleto VD, Casini A, Delle Fave G,Andreoli M, Annibale B. Atrophic body gastritis in patients with autoimmune thyroid disease: an underdiagnosed association. Arch Intern Med. 1999 Aug 9-23;159(15):1726-30.
- Pinton P, Nougayrède JP, Del Rio JC, et al. The food contaminant deoxynivalenol, decreases intestinal barrier permeability andreduces claudin expression. Toxicol Appl Pharmacol. 2009 May 15;237(1):41-8. doi: 10.1016/j.taap.2009.03.003.
- Tran CD, Hawkes J, Graham RD, et al. Zinc-fortified oral rehydration solution improved intestinal permeability and small intestinal mucosal recovery. Clin Pediatr (Phila). 2015 Jun;54(7):676-82.doi: 10.1177/0009922814562665.
- Dethlefsen L, Relman DA. Incomplete recovery and individualized responses of the human distal gut microbiota to repeated antibiotic perturbation. Proc Natl Acad Sci U S A. 2011 Mar 15;108 Suppl 1:4554 61. doi: 10.107 3/pnas.1000087107.
- Järvinen KM, Konstantinou GN, et al. Intestinal permeability in children with food allergy on specific elimination diets. Pediatr Allergy Immunol. 2013 Sep;24(6):589-95. doi: 10.1111/pai.12106.
- Norman K, Pirlich M, Schulzke JD, Smoliner C, Lochs H, Valentini L, Bühner S. Increased intestinal permeability in malnourished patients with liver cirrhosis. Eur J Clin Nutr. 2012 Oct;66(10):1116-9. doi: 10.1038/ejcn.2012.104.