leaky gut

What is leaky gut syndrome?

Your digestive tract consists of a long tube which runs from the mouth to the anus. After food is swallowed it passes through the oesophagus to the stomach, where it is churned up with acid and stomach enzymes into small particles. This then passes into the small intestine. One of the functions of the small intestine is to digest and absorb nutrients from the food particles that arrive from the stomach. Secretions from the liver and gallbladder (bile) and the pancreas (enzymes) pass through a duct into the upper portion of the small intestines. A healthy intestinal lining allows only properly digested fats, proteins and starches to pass through so that they can be assimilated by the body. An important function of the small intestine is to prevent passage of large undigested foods, foreign substances and the re-absorption of toxins and molecules.

Leaky gut (intestinal permeability) is a name used to describe intestinal hyper-permeability, when this important function isn’t working, as it should. The space between the epithelial cells in the digestive tract, are called tight junctions. Tight junctions represent the major barrier within the pathway between intestinal epithelial cells that line the digestion tract. Tight junctions are multi-protein complexes that mediate cell-to-cell adhesion and regulate transportation through the extra-cellular matrix. Tight junctions are only found between epithelial cells.

Because tight junctions encircle the cell and attach it tightly to its neighbour, these junctions act as a barrier preventing molecules from diffusing across an epithelial sheet between adjacent cells. In some situations when molecules need pass through the layer of cells, their transport is a multi-step process, involving several signal pathways, regulation of junction proteins, and alternations in cytoskeletal organisation. Tight junctions are a major regulator of permeability, expressing different levels of tightness based on location and chemical stimuli. The looser this connection between cells, the greater the variety of molecules that can get across the epithelial sheet, causing intestinal permeability or leaky gut.

When the digestive tract becomes inflamed, leaky gut can develop. When this happens, large molecules, endotoxins, xenobiotics can pass through into the bloodstream to the liver for detoxification. The problem is that these substances should not be in the bloodstream, so the immune system reacts attacking the substances, releasing immune complexes, which also need to be broken down by the liver. All this extra work for the liver can cause an accumulation of toxins that need to be stored in adipose (fat) tissue where they can be nullified.

When the liver detoxification process becomes overloaded or inadequate, there will be an accumulation of dead blood cells, toxins and microorganisms in the blood stream. Naturally this will have a knock on effect on the immune system. The immune system will then produce excessive inflammatory chemicals, and in some cases, auto antibodies, because it is in a hyperstimulated state. This may lead to symptoms of immune dysfunction such as allergies, inflammatory states, swollen glands, recurrent infections, chronic fatigue syndrome, fibromyalgia or autoimmune diseases. Some of the more common autoimmune diseases are systemic lupus erythematosus (SLE), sclerosing cholangitis, primary biliary cirrhosis, Hashimoto’s thyroiditis, vasculitis and rheumatoid arthritis.

Research in recent years has shown an important connection between the health of the human body and the integrity of the gut wall. It is now well established that inflammation of the intestines and a resultant increased permeability of the intestinal mucosal wall has a connection with conditions such as infection, food allergy, Crohn’s disease, coeliac disease, dermatological conditions, colitis, or auto-immune diseases (such as rheumatoid arthritis, ankylosing spondylitis, Reiter’s syndrome, eczema and other ‘allergic’ disorders).

What are the causes?

Improper digestion can be a major factor in leaky gut syndrome. To prevent large molecules from entering the system and triggering the immune response, it is essential for complete digestion to occur.  Hydrochloric acid in the stomach and enzymes in the digestive tract break down foods so they can be absorbed. Hydrochloric acid breaks down proteins and is also our first line of defence against disease-causing microbes. If such microbes are allowed to proliferate, they can open up the tight junctions of the gut lining and cause leaky gut syndrome. As we age, less hydrochloric acid is produced, causing symptoms of indigestion. Deficiency in pancreatic enzymes also prevents the complete breakdown of foods and can lead to problems such as bloating, gas and indigestion.

Sometimes an imbalance of bacteria (dysbiosis) can cause problems in the gastrointestinal tract.  Dysbiosis occurs when levels of beneficial gut bacteria become too low, allowing the proliferation of harmful bacteria and yeasts. The yeasts are thought to have fungus like properties and attach themselves to the intestines by roots. This also causes damage to the wall of the intestines again making it leaky. Causes of dysbiosis can include: a diet high in fat, meat, sugars and refined carbohydrates and low in vegetables and fibre, antibiotic use, stress, lack of digestive enzymes and stomach acid and overuse of laxatives.

Other contributory factors may be non-steroidal anti-inflammatory drugs (NSAID) usage, intestinal infection, parasites, deficient immunoglobulins, ingestion of allergenic foods, alcoholism, ingestion of toxic chemicals, trauma, chemotherapy, IBS, ulcerative colitis and gastroenteritis. 

Frequent signs and symptoms

Bloating Inflammatory skin diseases, e.g. psoriasis, eczema, acne
Diarrhoea Auto-immune diseases
Gas Arthritis
Frequent indigestion Asthma
Belching Rectal itching
Constipation Undigested food in stools
Food allergies or intolerances Foul-smelling stools
Irritable bowl syndrome Weight loss, poor absorption of nutrients resulting in malnutrition
Crohn's disease Chronic joint/muscle pain
Coeliac disease Gastritis
Recurrent vaginal infections Fatigue

Things to try to help with leaky gut

  • Drink more water (aim for 2 litres per day).
  • Increase your intake of fibre (30-38g for men/ 25g for woman per day). Stagnation of food in the digestive tract can cause a build up of toxins, leading to inflammation (read more in our fibre article).
  • Reduce sugar, refined carbohydrates meat and excessive dairy.
  • Alcohol causes inflammation in the intestines, so is best avoided.
  • Avoid gut irritants such as caffeine and gluten containing foods (oats, wheat, rye and barley).
  • Avoid smoking.
  • 30-40% of your diet should come from raw fruit and vegetables at a ratio of 4:1 vegetables to fruit. Raw foods contain living enzymes, antibiotics and phytonutrients that improve digestion, fight unfriendly microorganisms and reduce inflammation of the bowel wall.

How to improve digestion and absorption of nutrients from food

  • Chew food thoroughly and have teeth and jaw problems checked out early.
  • Do not eat very much if you are angry or stressed and do not over eat.
  • Drink only small amounts with meals because fluids will dilute the gastric juices needed for digestion.

The lining of the stomach produces hydrochloric acid, which provides the correct acidity for the digestive enzymes, pepsin and rennin, as well as those secreted in the small intestines to break down food. Hydrochloric acid is also required for efficient liberation of the important nutrient vitamin B12.

Deficiency of stomach hydrochloric acid is common in those over 60 years of age, and can lead to weakened digestion and deficiency of vitamin B12. In these cases it is desirable to increase stomach hydrochloric acid, and this can be done with tablets of Betaine Hydrochloride.

Another useful technique to increase stomach acidity during a meal is to sip a glass of water containing 2 to 3 tablespoons of good quality organic apple cider vinegar with the juice of half a lemon added. Some people find that this practice really improves their digestion and reduces flatulence and abdominal bloating.

If you find that you feel uncomfortable after eating a regular or large sized meal it is worthwhile to try a supplement containing digestive enzymes. The pancreas produces vital enzymes called proteases, lipase and amylase, without which it is impossible to breakdown proteins, fats and carbohydrates. It is not uncommon for a slight to moderate deficiency of these pancreatic enzymes to occur, especially in those over 50 years of age. Lack of these enzymes will result in poor breakdown of proteins, fats and carbohydrates, leaving only partially digested food to pass through the bowel. This reduces absorption of vital nutrients from the lining of the gut and malnutrition of some degree will result. Furthermore only partially digested proteins will be absorbed from the gut, which will overload the liver and may cause allergies. The growth of unfriendly microorganisms is more common inside intestines containing only partially digested foods.

Natural remedies to help the bowels

The following can be used to increase fibre bulk, soothe irritated mucous linings and reduce muscular spasm in the bowels:

  • Aloe Vera juice - can soothe the lining of the stomach and intestines and is useful for those with stomach ulcers, colitis and irritable bowel syndrome. Occasionally people became allergic to it, so do not use it continually.
  • Psyllium husks (or powder) - are often used as a bowel cleansing fibre and help to remove stagnant waste material from bowel pockets. Like Aloe Vera, some people become allergic to it, so that it causes rashes and itching, so watch out for allergy symptoms if you use it long term.
  • Antacids are often used by those with excess gastric acidity and/or reflux. Avoid the long-term use of antacids. Alfalfa juice or alfalfa tablets are alkaline and can soothe gastritis and/or reflux.
  • Soothing and anti-spasm herbs - such as golden seal, marshmallow, meadowsweet, valerian, chamomile, peppermint, arrowroot, slippery elm powder will reduce colic and mild bowel inflammation, and benefit those with gastritis.
  • Digestive herbs - such as dandelion, fennel, dill, aniseed, parsley, ginger root and catnip can reduce burping and flatulence. Condiments that aid digestion and reduce flatulence are caraway, cardamom, coriander, cumin, cloves, ginger root and turmeric (turmeric is also a liver tonic).

This article has
been written by
Terry Fairclough