By: Allan N. Spreen, MD, The Nutrition Physician
It is commonly said (at least I've heard it many times) that health or disease begins in the gut (the gastrointestinal, or GI, tract). I believe it. Your body is basically a long cylinder with a hole running through it lengthwise (we really are reducing this to the lowest common denominator!). Your outer surface (your skin) insulates you from the "outside world" on the outside, while your inner surface (the surface of your GI tract, or "mucosa") insulates you from the outside world on the inside.
Everything between the two surfaces is "you."
That GI mucosa is a vital link to your health. It filters toxins, blocks bacteria, viruses, parasites and other organisms from entry, assists in digestion, tries to assure that large, poorly absorbed food particles are kept out, while simultaneously attempting to assimilate vitamins, minerals, amino acids, fatty acids, and other nutrients needed within. Then, to top it all off, it tries to maintain itself through an extremely high rate of regeneration of the surface cells.
All that requires blood...lots of blood, needed for all those absorptive, blocking, and repair processes. When we eat a meal, the body tries to shunt blood to the plexus of vessels surrounding the intestines to better aid digestion. That's one reason we tend to want to rest after eating - the body is trying to remove blood volume from the muscles and temporarily utilize it doing the work of the gut.
You've heard of the "fight-or-flight" response, the amazing ability of the body to prepare to defend itself in times of stress. This process starts with an adrenalin release, such as what we experience when we're suddenly frightened by something unexpected. One aspect of this response is to shut down the gut, shunting blood instead to the muscles in preparation for immediate body defense. If you are frequently highly stressed, the constant release of adrenalin can keep the gut from doing its job properly over time.
There's a lot of that kind of situation going on today. Unfortunately, there are many other stresses that make the gut's job far tougher: refined sugars, starches and other processed foods; synthetic chemicals (artificial colors/flavors/preservatives, pesticide residues, fertilizers, herbicides); antibiotics, hormones and other drugs; alcohol; caffeine and other stimulants; chlorine; fluoride; and parasites and other invading organisms...well, you get the idea.
All these challenges help destroy the gut's ability to keep out "undesirables," and when "stuff" gets in that isn't supposed to get in, that's a "leaky gut." The "leaky gut syndrome" is a low-level inflammatory process that I believe is the genesis of many, if not most, disease processes in the body. Food particles get in that are poorly digested and too large, so they are improperly handled and can cause allergic responses that formerly weren't present. Toxins enter that would have been filtered out and previously sent on out through the end of the tube and out of the body. What's worse is that the mechanisms for absorbing "desirables" is impaired in such a situation, so nutrient deficiencies make the long-term situation worse. Undesirable microbes enter the body across the weakened defenses of the inflamed and stressed mucosa, wreaking their own varieties of havoc...the list goes on and on, and you're looking at the start of chronic disease.
Common yeast can enter the system and disrupt the "good guy" bacteria (such as acidophilus and bifidus, sometimes called "probiotics") that are supposed to be present as another line of defense. Once these helpful bugs are gone, physical problems can accelerate. This is systemic Candidiasis, a diagnosis that unfortunately has not yet entered the mainstream (but we health nuts are working on it). [If sugar cravings, yeast infections, and tons of bloating are frequent visitors, especially if you've had tons of antibiotics I'd strongly recommend Dr. Billy Crook's The Yeast Connection Handbook...I'm running out of room in this article.]
Symptoms from "leaky gut syndrome" can be far more than just digestive difficulties (though of course GI problems are usually high on the list, such as bloating, gas, cramps, "heartburn," indigestion, nausea, others). Fatigue, irritability, joint pains, fibromyalgia, concentration difficulties, headaches, and other generalized symptoms show up regularly.
Another problem with this whole situation is that the list of symptoms can be huge, and it can easily fail to fit into a specific "cookbook" disease your doc would be familiar with. Therefore, unfortunately, patients with a real problem are often told there's nothing wrong with them. Since they're physically okay, they must be "nuts," and in need of counseling, antidepressants, or similar therapies that miss the root cause. I've had more than a few patients break down in my office when I told them they weren't crazy and that I thought their symptoms were real. It's amazing what some docs will tell people when they're out of ideas.
My ideas might not always be right, either, but treating such patients "as if" they were victims of leaky gut syndrome is a harmless (and often highly rewarding) enterprise. The first thing I do is stop all refined sugar and white flour products (which is free). Such foods are low-fiber, high-carb junk, pure and simple. All breads, pastas and cereals should be 100 percent whole grain and sweetened without artificial sweeteners or sugar. Craved foods should be avoided for at least seven days (21 for dairy, sorry).
That has to be first. I'm a supplement nut (I don't think optimal health can be remotely approached anymore without them), but without junking the junk they have little chance to get you much better. You need whole, fresh foods- fresh fruits, vegetables, whole grains, untreated organic meats, deep-well spring water and the time while eating to chew thoroughly and swallow everything in the consistency of soup.
That being said, diet alone is probably not enough once leaky gut is a problem. For serious candidates I've used high-dose vitamin C intake, enough to cause temporary diarrhea. This can require many grams per hour to help detoxify and clean out the gut. A knowledgeable health care practitioner in this area would be most helpful in such an effort. For some, fresh juice fasting can also be very helpful (there's even a place for water fasting in such situations under the watchful eye of someone who knows what he's doing). There are also several good books on detoxifying for those who want a more comprehensive approach.
Once the gut has had a chance to cleanse and rest somewhat there are helpful supplements for further improvement. The first is acidophilus, or probiotic, supplementation. Powdered probiotics (maybe a billion cfu, or colony-forming units) should be taken before meals and bedtime. Capsule-form is okay but it's better to open the capsule and let the powder work its way down with the least water possible (this is also useful for heartburn symptoms, though the stuff is not an antacid).
In most cases, I use full-spectrum digestive enzymes, such as Super Enzyme by NOW. They are one of the few to include betaine hydrochloride in the mix which augments stomach acid and which I've found helps the vast majority of victims (though not all). Two capsules right after meals can do a remarkable job on the digestive complaints that may be involved.
If loads of antibiotics have been involved, agents to kill yeast may be needed along with efforts to kill invading parasites and other organisms. Serious efforts should have an "enlightened" doc for guidance. Olive leaf extract, grapefruit seed extract (not grape seed, though I like the stuff), caprylic acid, taheebo tea, and other efforts, even including anti-yeast medication like Diflucan (fluconazole) may be indicated.
A last idea worth considering, believe it or not, is bovine colostrum. This is a concentrated source of antibodies and nutrients that cows produce for their calves immediately after birth (I figure human would be better but the source seems to be limited). I wasn't originally sold on the colostrum idea, but I've run into too many people who've benefited from its use.
Usually leaky gut syndrome depresses the immune system. Icing the cake in an attempt to ward off more trouble while healing what's gone before would, in my opinion, be a substance from sugar cane (yep, there's even a use for sugar cane!) called beta 1,3 glucan. This is a newer agent that is receiving rave reviews as a strong immune stimulant.
There are more things you can do if you think leaky gut syndrome may be involved in any symptoms you have. Seek literature on it at your health food store, and see what you think. I believe that it's highly prevalent and that treatment "as if" most people actually had the problem would show impressive results...
but that's just me.
Allan Spreen, MD
"The Nutrition Physician"
Dr. Spreen is a nutritionally-oriented medical doctor in practice for over a decade before concentrating on nutritional writing. He is known for his original "Nutrition Physician" on-line sites for both America Online and iVillage's 'The Women's Network', offering nutrition information directly to the public.
His authored works include Nutritionally Incorrect-Why the American Diet is Dangerous amp; How to Defend Yourself (Woodland); Smart Medicine for Healthier Living (Avery), co-authored with Janet Zand and James LaValle: and The Menopause Diet(Woodland). A graduate of both the Georgia Institute of Technology and the University of Tennessee before obtaining his M.D. from East Tennessee State University, Dr. Spreen wears a second hat as a coach of competitive divers at the national and Olympic levels.