Leaky gut syndrome is a disorder caused by increased intestinal permeability and inflammation.
This inflammation in the gut can eventually lead to inflammation in the bones, heart, brain, or beyond. Included in this syndrome are such diverse conditions as inflammatory and infectious bowel disorders, chronic inflammatory arthritis, chronic hepatitis, chronic pancreatitis, chronic dermatitis, chronic otitis, and allergic rhinitis and sinusitis. It may also contribute to seizure disorders, inflammatory myelitis and inflammatory myositis. It is often difficult to determine whether leaky gut plays a primary or secondary role as it seems to exacerbate any inflammatory condition.
Leaky gut syndrome causes disease in several ways. Increased permeability produces classic hypersensitivity reactions to foods. Chronic low-grade endotoxemia contributes to autoimmune disorders. It also increases the detoxification burden placed on the liver which leads to chronic hepatitis.
Leaky gut syndrome consists of four components or stages.
- Hypersensitivity (allergy) is the first and, most common, stage. It produces immediate reactions such as the classic dermatitis and otitis associated with food allergy. Is also produces delayed reactions which contribute to arthritis and other conditions not usually associated with food allergy.
- The second component is malnutrition which can range from poor hair coat to actual weight loss and vitamin/mineral deficiencies. The malnutrition will often have elements of both maldigestion and malabsorption.
- Thirdly, one may see signs of hepatic stress. This will manifest as elevated liver enzymes of two patterns. If the liver is being stressed by toxins both ALT and ALP will be elevated. If only ALP is elevated, inflammatory bowel disease may be stimulating excessive cortisol production by the adrenal glands.
- The fourth stage of leaky gut is bacterial dysbiosis (intestinal bacterial overgrowth).
It is difficult to determine the prevalence of bacterial overgrowth. Early on it is difficult to detect. Once it becomes apparent, it can be very difficult to restore intestinal balance.
Treatment of leaky gut syndrome will depend on the stage of the disease (which components are present). An attempt should be made to eliminate any factors contributing to intestinal damage- antibiotics, nsaids, parasites, toxic chemicals, etc. Most importantly, a hypoallergenic diet must be determined which will reduce the chronic intestinal inflammation which perpetuates leaky gut. Both pre and probiotics are recommended to restore bacterial balance. Glutamine supplementation is indicated to promote restoration of intestinal villi and secretory IgA levels. Glutathione and bioflavanoids such as quercetin and milk thistle are recommended to reduce tissue damage. Essential fatty acids are recommended to prostagladin synthesis in order to reduce the systemic response to endotoxins. Judicious use of fiber supplements is indicated- high doses will increase permeability. A predominance of hypoallergenic insoluble fiber is recommended.
Increased intestinal permeability is a major factor in the pathogenesis of many different diseases. It initiates a complex cycle of allergic sensitization, endotoxic immune activation, hepatic dysfunction, pancreatic insufficiency and malnutrition. Successful treatment of leaky gut syndrome requires dietary modification, avoidance of toxins, restoration of intestinal balance, and dietary supplementation of trophic nutrients.