The small intestine is the powerhouse of the digestive\nsystem, accounting for 90% of the digestion and absorption of the food we eat,\nand is also the largest part of the gastrointestinal (GI) tract at an average\nof 20 feet long. The inside of the small intestine is made of finger-like protrusions\ncalled villi, which, in combination with overall length, give the small intestine\n2,700 square feet of absorptive area! That\u2019s the size of a tennis court. In my\nopinion, the intestines were misnamed since the \u201clarge\u201d intestine only received\nthis name due to it being a little bit bigger in diameter (4-6cm) than the\n\u201csmall\u201d intestine (3.4-4.5cm).  <\/p>\n\n\n\n

As the powerhouse of digestion, the small intestine must\nhandle many things that come through it, like gastric secretions, enzymes, food\nparticles, bacteria and other pathogens. The small intestine regulates which\nparticles stay in, and which go out, via diffusion, into the blood stream. This\nregulatory process is more complicated than originally thought and has been the\nbasis for many new health-related discoveries. Though much has been discovered,\nmuch mystery remains as to the exact mechanisms involved. <\/p>\n\n\n\n

The Gate Keeper<\/strong><\/h3>\n\n\n\n

In the walls of the small intestines are spaces between the cells that are usually closed.  These spaces are called Tight Junctions<\/strong> and are the mechanism by which selected small molecules (amino acids, electrolytes, water and other nutrients) are allowed into the bloodstream to be used by the body. Tight Junctions are like gates that open and close and the gate keeper is a protein called zonulin. As of now, zonulin has been the only identified mediator that regulates our intestinal permeability, or the opening and closing of the gates. Various things increase the release of zonulin which, then determines the amount the tight Junctions are open and for how long they remain open. <\/p>\n\n\n\n

<\/figure>\n\n\n\n

Malfunction Junction<\/strong><\/h3>\n\n\n\n

Normally, the small\nintestine works beautifully to bring only nutrients from fully digested foods\nto the body, all the while protecting the body from undigested food particles,\nbacteria and toxins. Some individuals are genetically predisposed to having tight\njunctions malfunction. In these individuals, zonulin is upregulated or \u201coverreacts\u201d\nto stimulus causing tight junctions to open at the wrong time or remain open\nfor too long. These individuals are at a higher risk for developing Celiac\nDisease, because the gluten protein is much more likely to go through the\nintestinal lining via malfunctioning tight junctions.  The immune system will then react by\nattacking the gluten protein.  With\ncontinued exposure to gluten, the immune system can get confused and begin to attack\nthe gastrointestinal tract.  <\/p>\n\n\n\n

Most often, this genetic variation\ndoes not cause any issues until an environmental factor is also involved.  Unfortunately, the number of environmental factors,\nthat stress our small intestine, have greatly increased, to the point that we\nare seeing increased incidence of Celiac Disease. Furthermore, we are even\nseeing people, without this genetic predisposition, developing issues with\ntight junctions in the small intestine. This malfunction is called increased\nluminal permeability or \u201cleaky gut syndrome\u201d and is being linked to many health\nconditions on the rise today. <\/p>\n\n\n\n

What Does Leaky Gut, Unchecked, Lead To?<\/strong><\/h3>\n\n\n\n

As mentioned in the previous\nsection, when things that don\u2019t belong, \u201cleak\u201d through the small intestine, the\nimmune system will react to the foreign invaders. Individuals may not notice,\nfor some time, that anything is awry. Overtime and left unchecked, leaky gut\nsyndrome can lead to food sensitivities, chronic inflammation and autoimmune\ndiseases like Crohn\u2019s and Ulcerative colitis (the immune system attacking the\ngut), Multiple sclerosis and Parkinson\u2019s (the immune system attacking the brain\nand nervous system), type 1 diabetes (immune system stacking the pancreas),\nHashimotos thyroiditis (the immune system attacking the thyroid causing hypothyroidism)\nand so on. <\/p>\n\n\n\n

Leaky gut can also cause a\nlot of issues with absorption of healthy nutrients, leading to deficiency and\nmalnutrition. The most common deficiencies are iron, B12, zinc and magnesium.  Deficiencies in these nutrients can lead to\nmany different symptoms to include hair loss, severe fatigue, muscle cramps and\nrashes. <\/p>\n\n\n\n

A Vicious Cycle<\/strong><\/h3>\n\n\n\n

If environmental factors causing leaky gut are not removed, and the gut healed chronic inflammation will set in. This inflammation, in and of itself, perpetuates leaky gut because the white blood cells release things called mediators (histamines, prostaglandins, leukotrienes and cytokines to name a few) to attack the foreign particles leaky through. Unfortunately, these mediators left unchecked and continuously being released, cause damage to the body\u2019s tissue, in this case, the lining of the intestine. This damage only worsens leaky gut, which then worsens inflammation which then\u2026 you get the point. <\/p>\n\n\n\n

What Environmental Factors Cause Leaky Gut? <\/strong><\/h3>\n\n\n\n

• Undiagnosed food sensitivities \u2013 this perpetuates chronic inflammation, which increases leaky gut. <\/li>
• Gliadin \u2013 a component of gluten, naturally increases zonulin in everyone. For many people this doesn\u2019t cause issues because, even though their tight junctions open, the junctions then close much more quickly than those who are genetically predisposed to malfunctioning of the tight junctions. <\/li>
• Alcohol \u2013 generates nitric oxide and promotes the growth of bacteria in the intestine, that do not belong there. <\/li>
• Food additives \u2013 microbial transglutaminase\/TG enzyme or \u201cmeat glue\u201d, sugars, sodium, emulsifiers (Polysorbates, cellulose\/guar\/zanthum gum, carrageenan, lecithin and polyglycerols), organic solvents and food dyes.<\/li>
• Medications \u2013 non-steroidal anti-inflammatory (NSAIDs), vaccinations (particularly HPV and flu vaccines), antibiotics, proton-pump inhibitor (antacids)<\/li>
• Stressful lifestyle left unchecked \u2013 due to chronically elevated levels of cortisol<\/li>
• Systemic inflammation \u2013 the vicious cycle mentioned above<\/li>
• Parasitic, bacterial or viral infections<\/li>
• Radiation and Chemotherapy<\/li><\/ul>\n\n\n\n

  Health Conditions Associated with Leaky Gut<\/strong><\/h3>\n\n\n\n

  <\/figure>

  \n

  • Celiac Disease<\/li>
  • Type 1 diabetes<\/li>
  • Crohn\u2019s disease<\/li>
  • Other autoimmune diseases: ankylosing spondylitis, multiple sclerosis, rheumatoid arthritis, lupus, Hashimotos Thyroiditis<\/li>
  • Asthma<\/li>
  • Irritable bowel syndrome (IBS)<\/li>
  • Food allergies and intolerance<\/li>
  • Cancer \u2013 particularly brain, breast, lung, ovarian and pancreatic<\/li>
  • Obesity due to insulin resistance<\/li><\/ul>\n<\/div><\/div>\n\n\n\n

    How Do You Know If You Have Leaky Gut?<\/strong><\/h3>\n\n\n\n

    There are a\nfew diagnostic tests available, but they are mostly used in well-controlled\nresearch labs due to difficulty in interpreting results because of so many\nvariables that occur outside of a controlled laboratory. <\/p>\n\n\n\n

    The symptoms\nbelow are a good indicator but it is best to meet with a healthcare professional\nwho can help guide you.<\/p>\n\n\n\n

    • Chronic diarrhea, constipation, gas\nor bloating (usually labeled as IBS)<\/li>
    • Fibromyalgia<\/li>
    • Vitamin and mineral deficiencies<\/li>
    • Poor immune system<\/li>
    • Headaches, migraines, brain fog,\nmemory loss<\/li>
    • Excessive fatigue<\/li>
    • Skin rashes and problems such as\nacne, eczema or rosacea<\/li>
    • Cravings for sugar or carbs<\/li>
    • Arthritis or join pain<\/li>
    • Depression, anxiety, ADD, ADHD<\/li>
    • Autoimmune diseases<\/li>
    • Food sensitivities<\/li><\/ul>\n\n\n\n

      How to Heal<\/strong><\/h3>\n\n\n\n

      \n

      \n

      • Eliminate processed foods and turn to whole foods. This will involve more cooking from scratch and meal prep.  We should all do this. <\/li>
      • See a healthcare professional (yours truly) to see if you have a food sensitivity.  If you do not eliminate foods causing inflammation your gut cannot heal (remember the vicious cycle). Eventually, under the care of said healthcare practitioner, you may be able to incorporate foods back into your diet.<\/li>
      • Find alternatives to NSAIDs and antacids <\/li><\/ul>\n\n\n\n

        <\/figure>\n<\/div>\n\n\n\n

        \n

        <\/figure>\n\n\n\n

        • Stress management, stress management, stress management! <\/li>
        • Some supplements that may help (again, it is best to start these with the guidance of a professional)
          • Digestive enzymes<\/li>
          • Betaine hydrochloric acid (HCL)<\/li>
          • Fiber<\/li>
          • Collagen<\/li>
          • L-Glutamine<\/li>
          • Probiotics<\/li>
          • Zinc and B12 <\/li><\/ul><\/li><\/ul>\n\n\n\n

            <\/p>\n<\/div>\n<\/div>\n\n\n\n

            References<\/h6>\n\n\n\n

            1. Balda M. Fallon M, Van Italie C,\nAnderson J. Structure, regulation and pathophysiology of tight junction in the gastrointestinal\ntract. Yale Journal of Biology and\nMedicine<\/strong>. 1992; 65(6): 725-740<\/li>
            2. Fasano A. Zonulin and its regulation\nof intestinal barrier function: the biological door to inflammation, autoimmunity,\nand cancer. Physiol Rev. <\/strong>2011;\n91(1): 151-175<\/li>
            3. Stewart E. Leaky gut syndrome \u2013 Learn\nabout the causes associated conditions and treatments under research. Today\u2019s Dietitian<\/strong>. 2016 18(1): 46<\/li>
            4. Lionetti E, Catassi C. The role of\nenvironmental factors in the development of celiac disease: what is new? Diseases<\/strong>. 2015 3: 282-283.<\/li>
            5. Torsten M, Aaron L. Microbial\ntransglutaminase is immunogenic and potentially pathogenic in pediatric celiac\ndisease. Front Pediatr. 2019.<\/li>
            6. Fasano A. Intestinal zonulin: open\nsesame! Gut<\/strong>. 2001; 49: 159-162<\/li>
            7. Sapone A, Lammers K, Casolaro V, Cammarota\nM, et al. Divergence of gut permeability and mucosal immune gene expression in\ntwo gluten-associated conditions: celiac disease and gluten sensitivity. BMC\nMedicine. 2011; 9:23.<\/li><\/ol>\n","protected":false},"excerpt":{"rendered":"

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