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What is leaky gut? Or… what? You can’t even eat HUMMUS?

Last Edited Feb 10, 2017 

I usually try not to talk too much about my restricted diet to family and friends because it gets some of them very upset. But I kept getting pounded with questions across a crowded dinner table about what I couldn’t and couldn’t eat. And then a relative yelled at me, disparagingly. “You mean you can’t even eat hummus?!” This particular relative is a psychologist, and convinced that I have an eating disorder. Oops! I should have changed the subject sooner!

I then politely explained that I wasn’t sure if it was the chickpeas or the sesame seeds that was causing me brain fogs and digestive distress. But I felt better when I took hummus out of my diet. And in fact, seeds and grains of all kinds bothered me. And this was after I had already taken gluten out of my diet years ago, and then dairy and soy more recently. But, this wasn’t some kind of crazy eating disorder, I explained. It was when I began reacting to hummus that I finally realized that I must have leaky gut.

Another reason I try not to talk about my diet too much, is that it doesn’t always make for polite dinner conversation. Especially when talking about symptoms. And the term “leaky gut” sounds kind of off-putting, doesn’t it? When I first heard the term, I was reminded of Olestra back in the 90s — that man-made fat-substitute that was added to potato chips to make them low-fat and low-calorie, but was known to cause “anal leakage.” Remember that? Well, leaky gut is not the same thing!

Perhaps better for dinner conversation (if one must) would be to use the more scientific term: intestinal permeability. Intestinal permeability (IP) used to be considered a fringe theory, but these days it’s being taken a lot more seriously. Just do a quick pubmed search and you’ll find over 10,000 entries!

So what is intestinal permeability?

Intestinal permeability (aka ‘leaky gut’) is the condition where the tight junctions on the lining of the intestine loosen, allowing undigested food particles, environmental toxins, foreign bacteria, and other normally restricted molecules to cross the gut barrier and migrate to other parts of the body.

Normally, our intestines push molecules through our digestive tract, using the bits our body wants and expelling the rest as waste. The intestine is selectively permeable, that is, it allows small particles that are beneficial (such as nutrients) to cross the gut barrier, and blocks those particles that it deems harmful. But certain conditions can aggravate the gut lining, causing these tight junctions to loosen too much, thereby increasing permeability. And that’s when things go bad. Depending on what’s crossing the gut barrier, and where it ends up, anything can happen.

So what exactly does happen when some of these particles leach into other aspects of our body? As it turns out, quite a bit. And while inflammation is one commonality, other effects of IP can be vastly different from one person to the next, and often very serious.

Leaky gut is associated with autoimmune disorders [1], [2], [3] including:

  • Celiac disease [4]
  • Type 1 Diabetes [5], [6]
  • Multiple sclerosis [7]
  • IBD including Crohn’s disease[8], [9] , [10] and Ulcerative Colitis [11]
  • Rheumatoid Arthritis [14]

 It has also been shown to be associated with cancers [15] such as:

  • Pancreatic cancer
  • Glioma (a brain or spine tumor that is often malignant)
  • Colon cancer [16] , [17]
  • Gastric cancer [18]

As well as diseases of the nervous system, such as:

  • Schizophrenia [19]
  • Autism [20]
  • Parkinson’s [21]

Other conditions that intestinal permeability are associated with include:

  • Migraines [22]
  • Heart failure [23]
  • Eosinophilic oesophagitis [24]
  • Cystic Fibrosis [25]
  • IBS [26]
  • HIV [12]
  • Asthma [13]
  • Type 2 Diabetes

Surely, this is not an exhaustive list, and as research continues to develop, it is highly likely that more chronic diseases will be added to those associated with leaky gut.

By now, you must agree, leaky gut is no laughing matter.

How do you know if you have leaky gut?

First, if you have recently been diagnosed with celiac disease or gluten sensitivity, you most likely have leaky gut, because we know that gluten causes leaky gut for everyone, and the more sensitive you are to it, the higher your level of permeability. This may in part help to explain why 74% to 92% of celiacs on a traditional gluten-free diet (omitting only wheat, barley and rye), actually never heal [27], [28]! Taking gluten out of your diet, may only be the first step in your healing process.

For me, the telltale sign that I had leaky gut was multiple food reactions, including pretty severe brain fogs. I knew it just couldn’t be possible to go from being able to eat most things (except gluten), to not being able to eat anything! But leaky gut symptoms don’t end at digestive distress and brain fogs. I also had Candidiasis and Vitamin D deficiency, both of which can be associated with gut permeability as well. If you have any kind of chronic disorder that doctors haven’t been able to cure yet, then there is a good chance that you have leaky gut.

Have a chronic disorder that doctors haven’t cured yet? There's a good chance you have #leakygut Click To Tweet

Aside from having any of the disorders listed above, symptoms of leaky gut can include:

  • Seasonal allergies [29]
  • Chronic fatigue [30], [31]
  • Multiple food allergies/sensitivities [32]
  • Digestive distress (such as constipation, diarrhea, heartburn, gas, bloating)
  • Skin disorders (such as itchy skin, rashes, eczema[33], hives [34] or psoriasis[35] )
  • “Brain fogs” or cognitive impairment [36]
  • Nutrient and mineral deficiency [37], most notably, Vitamin D [38]
  • Chronic Depression [39] , [40]
  • Anxiety [41]
  • ADHD [42]

So what causes leaky gut?

Gluten has been found to cause leaky gut in everyone, regardless of whether or not they have celiac disease, although the level of permeability is not as high in non-celiac patients. [43] Still, as Dr. Alessio Fasano is often paraphrased: no one is able to digest wheat! Also, have you ever noticed how the rise of genetically engineered crops coincides with a rise in allergies, celiac disease and autism? Coincidence or not? Either way, avoiding GMO foods and gluten, will help to prevent leaky gut.

Some people also surmise that the excessive use of antibiotics can lead to gut dysbiosis, including Candida overgrowth and/or Small Intestine Bacterial Overgrowth (SIBO), which can in turn lead to intestinal permeability. And sadly, for many people who are in pain and resort to NSAIDs (e.g. Advil, Motrin (ibuprofin), aspirin, Aleve) to alleviate that pain, they may be making matters worse. NSAIDs are known to cause intestinal distress, including inflammation and increased permeability.

Among the worst offenders for intestinal permeability (including those already mentioned are):

  • Gluten [44]
  • High Fructose Corn Syrup [45]
  • GMO corn, soy and other genetically modified foods
  • excessive use of antibiotics
  • Stress [46], [47]
  • Non-Steroidal Anti-inflammatory drugs (NSAIDs) [48], [49]
  • Excessive exercise [50], [51]
  • Alcoholism [52], [53]
  • Candida [54], [55]
  • General gut dysbiosis [56]

Can you test for intestinal permeability?

Currently the only test that exists for IP is the lactulose-mannitol test, which is only being done in a scientific setting, and is not yet validated for clinical diagnosis. However, in recent years, more understanding of how IP manifests, is helping scientists to identify markers of IP. The exact mechanisms involved in intestinal permeability are still not entirely understood, but we do now know that that the enterotoxin named “zonulin” by Dr. Alessio Fasano [57] is often secreted around the same time that gut permeability increases. So now there is an ELISA test for zonulin currently in the works. The lactulose-mannitol test is also being refined for clinical use, while the alpha 1-antitrypsin test is also in the works. [58]

In the meantime, you can still test for Candidiasis, SIBO, pathogens in the stool, food allergies, and Vitamin D deficiency, all of which can be signs of leaky gut, although not necessarily definitive of it.

How do you heal leaky gut?

That’s the million dollar question! I will tell you that there is currently no special little colored pill that you can take. But now that much attention is being put into the research of leaky gut, and the mechanisms that cause it, scientists like Dr. Alessio Fasano believe we may be able to start reversing some of these diseases. In fact, a zonulin inhibitor, called AT1001 or Larazotide (Larazotide acetate), has been tested on rats with “encouraging results.” [59] Inhibit the production of zonulin, and you decrease the level of intestinal permeability. And if we can heal leaky gut, we can begin to reverse some of these life-threatening diseases. Its actually kind of exciting! Remember what Hippocrates said?

All disease begins in the gut.

But bringing a drug from clinical trial to market is a long and costly process, and so we probably won’t be seeing this little pill anytime soon. And since you and I don’t want to wait around for 15 years or so before we can start to see improvement in our bodies, we have to take matters into our own hands.

Knowing the causes and mechanisms of leaky gut, means we can cure it. But its not always easy to do. Often a three-pronged approach is recommended, but I believe a three-step approach instead may be better, which I will explain shortly.

Step 1): Identify foreign invaders such as excess candida, SIBO, or other bacteria that can cause a gut infection, and take steps to eradicate them. This may include the use of anti-fungals, as well as changing your diet to starve the intruders. This should always be done under supervision of qualified health-care practitioner. You can’t start your healing process, if your gut is still invaded by unwelcome intruders.

Step 2): Eliminate all offending foods and other gut-harming factors from your diet and your routine. That is why I usually recommend a paleo diet when first going gluten-free. It automatically eliminates the majority of foods that cause digestive distress. Of course if you have leaky gut, you could be reacting to all kinds of foods, beyond the worst offenders that many of us share. So you may have to take some time in determining what other foods might also be causing you problems, and remove them from your diet, too, until you begin to heal.

As an example, in my case going gluten-free, then dairy-free and soy-free was not enough. I had to go grain and legume-free, too (hence the paleo diet). Still, this was not enough. I finally learned that I also had to eliminate fructose (even the tiniest amounts) and (believe it or not) coconut oil (blasphemous, I know!) for some time.

In addition you should probably eliminate alcohol and NSAIDs for at least two weeks from your diet, and probably longer, depending on where you are in your healing process. And if you do re-introduce either, be sure not to become dependent on either, or to ever use them in excess.

You should also reduce stress and you need to be gentle in your exercise regime while you are healing. Yoga is a great way to get gentle exercise and reduce stress at the same time! Try these 9 simple yoga poses for digestion and relaxation.

Step 3): Begin healing the gut. Actually, steps 1 and 2 have already started healing your gut. But now you need to identify any nutritional deficiencies, and supplement where needed. Celiac disease and gluten intolerance usually have several deficiencies associated with them, most notably Vitamin D. Plus, you want to repair actual damage caused to the intestines. There are several supplements that are used for this, most especially glutamine (the prefix glut has nothing to do with gluten, here!) and glucosamine. Probiotics are also important in helping to restore gut balance. But with any supplements that you take, I believe you should start off slowly. Its also best to work with a trusted naturopath or other alternative health care practitioner, who can help you gauge your body’s reactions to new supplements.

It’s always best to get your nutrition from real food when you can, as the body assimilates nutrients from food much better than from isolated components. So I advise getting your probiotics from fermented foods, including yogurt (you may need to do lactose-free for a while, if you can handle it). Be sure the foods are fermented and not pickled as the use of vinegar or other acids will kill the beneficial bacteria.

Turmeric is a rhizome that is used in Indian cooking. It looks like ginger but is smaller and bright orange on the inside. It is known for its anti-inflammatory properties, as well as so many other health benefits. It has even been shown to help heal leaky gut. I eat it often! I’ll post some recipes using it, soon.

Also homemade bone broth, is one of the healthiest foods we can eat. This is because as the bones cook they release essential vitamins, minerals and amino acids, such as proline and glycine, creating gelatin, which has shown to help protect gastric mucosal integrity. [60] By that same vein, gelatin is also good to eat. You can make your own very easily (recipe coming soon). In addition, organ meats (as “offal” as it sounds) are the most nutrients dense foods we can eat. You must try this liver pâté recipe. I promise, it does not taste the way you think liver tastes. J

Herbs, supplements and foods that show promise in helping to heal leaky gut (including some already mentioned) are:

  • Melatonin [61], [62]
  • Zinc [63]
  • MicroRNAs [64], [65]
  • Turmeric (curcumin) [66]
  • e.coli Nisile 1917 [67]
  • L-arginine [68]
  • glutamine [69], [70]
  • Cannabinoids [71]
  • Barbirine (a flavanoid from the barberry plant) [72]
  • Colostrum/colostro [73]
  • Bone broth [74]
  • Gelatin
  • Organ meats [75]

Many health practitioners try to do all 3 “prongs” at one time. From my own personal experience, I don’t recommend this. I prefer a “3-step approach.”

This is because I had a wagon-load of supplements to take, while following a diet that was pretty restrictive, yet I still hadn’t identified a couple of major problem foods for me. I would run to the bathroom after ingesting probiotics (including fermented foods), and I experienced painful bouts of inflammation from coconut oil for days on end. Large doses of Vitamin C caused me intense bloating, as did supplements with all kinds of extracts from fructose- and fructan- containing plants. Inundating my body with all these supplements and live biological agents, while I still hadn’t figured out what my trigger foods were, just confused things and didn’t allow the real healing to begin. Not to mention the pain and discomfort I felt, as well as the frustration of feeling like I was getting nowhere in the healing process. In fact, I was bordering on depression.

I recommend, instead, taking each step slowly. You can of course, start a healthy diet at any time. The sooner you do so, the sooner you start healing. But keep your diet simple and don’t overload yourself with too many “beneficial” things all at once. What may be beneficial to me, may actually be harmful to you, and this is a process that takes some time to figure out.

Start with an elimination diet and find out just what foods affect you. If this means you have to take it all the way down to a diet of just salad greens and lean proteins topped with olive oil for a few days, at least you can start to find out what foods upset you. Then you can slowly introduce foods one by one and note reactions. Finally, you can add supplements one by one and note any reactions, too.

I was happy when I finally got to “ground zero” in my gut. That is, bloating, distention and inflammation finally ceased. And that happened solely from taking out the problem foods. From there, I could start the next steps of healing and restoration. Now live cultures do not affect me adversely, I have no more brain fogs, and I’m feeling better than I have felt in years. And all because of the foods I put (or don’t put) into my body. Just as the father of medicine himself said:

Let food be thy medicine and medicine be thy food.

How long does it take to heal a leaky gut?

Good question! Restoration (restitution) of the cells lining the small intestine have been shown to occur in as little as 4 to 7 days [76], [77], and the intestinal lining is fully replaced in 2 to 3 weeks [78]. So if you can keep offending foods out of your system for that long, you should be well on your way to healing in less than a month.

However, if you need to eradicate invaders of your gut, that will take more time. In fact, both Candidiasis and SIBO are notoriously difficult to cure. Plus, if you have multiple food reactions and are having difficulty pinning down all the culprits, that will take even more time.

Furthermore, if you have celiac disease, the duration of intestinal permeability after eating is gluten is known to be longer for celiacs than for non-celiacs. And there may be other damage done to the digestive tract beyond the loosening of the tight junctions, which will need to be healed, too.

So the answer to this question really depends on the duration and extent of damage that was done to your gut, as well as what stage you are currently in your healing process. I had to resolve each of my gut-damaging issues one by one, and mostly on my own through research and perseverance. It has actually taken me many years to get to a point where I finally feel like I am healing.

But please don’t lose heart! I am sharing my experiences and results of my research with you, because I want to save you years of healing time. I truly hope this blog post does.

So if you’ve found that you have a chronic disease that hasn’t been cured yet, or you are experiencing too many food reactions, debilitating brain fogs, or other strange reactions, especially after eating certain trigger foods, please know that its not all in your head. Your body is trying to tell you something. Listen to it!

You can fix leaky gut. But it takes determination, patience and perseverance. And as Andrew Carnegie said:

Anything in life worth having is worth working for

Given all the complications that intestinal permeability can cause, is there anything worth more than a healthy gut?

Is there anything worth more than a healthy #gut? How to heal intestinal permeability: Click To Tweet

Have you ever been diagnosed (by self or by a doctor) with leaky gut? If so, what steps have you taken to fix it or are you still struggling with it? I’d love to hear from you!

 

 

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Author, diet & nutrition researcher, photographer. Founder of Stuffed Pepper. Using my MSc to unravel the health & science behind grains, gluten & the gluten-free/paleo lifestyle. Loves finding order in chaos.

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12 comments
  1. IBS Treatment Center

    We have worked with many patients with these kinds of issues. There are so many interconnected conditions that it can be very challenging for the patient to make progress without expert guidance. If you are having these problems be sure to work with a doctor who has lots of experience with these issues specifically and has a demonstrated track record of solving them.

  2. Heather Jacobsen

    Ann,

    Thank you for taking the time to comment.

    You are correct that intestinal permeability can change in a variety of diseases. The gut wall is already selectively permeable, and with many diseases, permeability is shown to increase. This increased permeability is where the problem lies.

    While IP may not be the first and only cause, there IS some evidence that “by simply abrogating epithelial barrier function, inflammatory disease can be induced” (reference [26] above). Additionally, Dr. Fasano cites several other studies that propose IP in the “pathogenesis of these diseases” ([reference [3] above).

    The study that you reference did not actually refute that “leaky gut syndrome” exists. It just says that there is still more to learn about it. But you are right that chiropractors and alternative medicine practitioners are more likely to diagnose this syndrome than conventional doctors. Yet, just because conventional doctors don’t recognize this disorder, does not mean it doesn’t exist. Many conventional doctors also tend not to believe in Gluten Sensitivity beyond Celiac Disease, nor do they believe in Candidiasis, or SIBO, or even that diet could ever have any impact on health except for a very small percentage of the population.

  3. Fernanda

    My son did a Breath test using lactulose when he was 2 years old and the results were really bad, he was diagnosed with SIBO after at least 1,5 years of struggling not knowing why he will get such high fevers in the 40s every week! plus soft stools, iron deficiency, etc

    The doctor only told us to give the antibiotic treatment, give probiotics and little fruit, that’s it! He got a little better but his iron levels were still on the floor, so we did the test again after one year and again was positive for SIBO not as bad as before but still positive, so antibiotics again.

    After a few months we found out about a blood test of food intolerance IgG, and we did it, well he was intolerant to pretty much everything. I change his diet completely, no dairy, no gluten, no eggs (he was already allergic to them anyways), minimized sugars and got a new iron supplement from Kirkman laboratories and his levels of Iron went from 1 to 11! The normal range my lab uses is 20 – 45!

    I don’t know what could have cause this on my child but we have struggle so much trying to understand it and how to treat it, because doctors usually say: Oh yeah small kids get sick often as they get older they outgrowth it. That is nonsense! Kids should be help to be able to growth with optimal health.

    I hope just hope to be helpful to someone out there trying to help her/his child.

    1. Heather Jacobsen

      That’s great news, Fernanda! Its always great to hear success stories with patients, whether they did it with their doctor, or (unfortunately, in some cases) in spite of their doctor! And how is your son doing today?

  4. Peggy G.

    It’s good you are able to remain polite when people are drilling you about your restricted diet. I am getting more of that happening. Why do people get so knotted up over other’s diets? I never put it upon anyone else to feed me special foods and never dictate what restaurant to go to, so why should anyone care? Venting…..

    Meanwhile, I really appreciate all the references you gave. Knowledge is power and also a way to help others understand that limitations are real.

    1. Heather Jacobsen

      Well, it is hard to remain polite, but I just try to put on my Zen attitude, and remember that this is about what’s right for me, and if others don’t understand it…. well that’s their problem, not mine. 🙂 Which is also why I arm myself with as much fact as I can, too.

      I really don’t know why people get so upset about others’ diets. Does it make them feel insecure about their own diet? Psychology is at the root of so much of this.

  5. Amanda Paa

    this is so comprehensive and informative heather. it sounds like we have similar stories, where all of a sudden more and more reactions start coming and you know something isn’t right. it’s difficult trying to explain to people as well, and not having them think you are crazy or doing this for attention. that’s one piece i really struggle with. if only they knew how terrible it feels. i hope you are doing well now, and i’d love to talk more to see how everything has gone for you. lots of love, amanda

  6. Heather Jacobsen

    Yes, it is difficult for others to understand. But you are strong, so I know you will get through this! And luckily you are friends with Stephanie Meyer. 🙂 I saw on Facebook that she made you dinner? I’m jealous! 😉 We can chat more about it anytime you want.

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