Leaky Gut - What is it & How Do You Fix It?
What is leaky gut? (AKA ‘Intestinal hyperpermeability’)We all have 2 obvious holes in our digestive system, one at the top end (mouth) & one at the bottom end (anus). But along the way there are actually a lot more little openings, in our small intestine. These ‘tight junctions’ are teeny-tiny regulated openings designed to allow useful things from our food out of the intestines & into our bloodstream (i.e. nutrients, vitamins, minerals etc) & keep harmful things out (chemicals, microbes, & other unwanted particles like larger proteins). Leaky gut happens when your tight junctions are not working as they should, get ‘a bit too loose’ / don’t function properly, or when there’s some damage to the cells lining the gut. Damage can occur when the bad guys vs the good guys battle is favouring the baddies, also things like excess alcohol, medications (especially NSAID’S like ibuprofen), parasites, gastro bugs, stress, extremely strenuous exercise & poor sleep can cause / contribute to a leaking gut.
What happens when you have leaky gut?With all these things leaking out into your bloodstream that aren’t supposed to be getting in there, your immune system activates, as its job is to protect the body from dangerous invaders. It sees all these random things leaking out from the gut into the bloodstream as intruders & potentially dangerous, so it goes into overdrive, sometimes a bit ‘trigger happy’ & may become overwhelmed. When your immune system is freaking out, it releases inflammatory chemicals & you may notice things like food intolerances / sensitivities, hayfever, asthma, arthritis, eczema & other skin issues (like acne, rosacea, psoriasis) getting worse. Brain fog, sleep disturbances, fatigue, aches & pains, depression, weight gain, hormonal imbalances & even autoimmune diseases will be triggered or feel much worse when your gut lining isn’t working as it should. You may also notice more direct gut problems like bloating, gas, ’IBS’ type symptoms (constipation / diarrhoea / abdominal pain & discomfort). Long term, there are links between chronic leaky gut & insulin resistance, metabolic syndrome & the development of diabetes & cardiovascular disease (chronic inflammation caused by ‘endotoxins’ leaking from the gut into the blood stream).
What causes / contributes to leaky gut? (That we know of so far).We all have a degree of normal & healthy ‘gut-leakiness’. Our gut lining is supposed to allow certain things out, things that the immune system will see as normal & not react to. It’s when damage occurs to the gut lining or our tight junctions aren’t as tight as they need to be - that’s when trouble starts. Below is a list of potential triggers & things that can cause / aggravate a leaky gut.
- alcohol (small doses can be ok in healthy people, bigger doses = gut trouble, & if your gut is already damaged you'll feel much better if you abstain completely).
- NSAID’s (Ibuprofen might save you from pain in the short term, but can create a heap more in the long term!) It is not designed for & is not ‘gut-safe’ to use long term. Avoid it wherever possible.
- antibiotic use (killing your gut bugs every time you get sick = gut-immune devastation). The more often you use antibiotics, the more you'll be open to the next infection going around. Take great care to rehabilitate your gut if you do need to take a course of antibiotics.
- other medications. Ant-acids & stomach acid blockers are the biggest culprits for leaky gut, as these can lead to big changes in your gut microbial balance further down the GIT. There are numerous other pills that can also wreak digestive havoc, so ask your pharmacist which of your meds can cause gut side-effects.
- a bout of gastroenteritis (a severe infection can be very damaging to your gut lining & often leave your gut bugs seriously out of whack - think post-infectious IBS, extremely common).
- overgrowth of certain gut microbial populations or an ‘out of balance’ gut microbiome (caused by food, stress, medications etc), too many bacteria in the wrong area (i.e. SIBO / small intestinal bacterial overgrowth or SIFO / small intestinal fungal overgrowth).
- gluten in food (gluten impacts the tight junctions in sensitive people, it makes them leakier). Anyone with suspected leaky gut or the conditions commonly associated with it should experiment with a gluten-free diet for at least 6 weeks, preferably longer to observe their reaction). Our breads & pastas are not the same as they once were due to agricultural developments & food processing changes, & our guts can't cope as well as they once could (they're in pretty poor shape now).
- excess sugar & refined carbohydrates (processed food) causing poor gut microbial population. Minimise these as much as you can in your diet! For your gut as well as your blood sugar, your weight, your heart health, mental health etc etc etc - just don't have them in the house, you know you'll eat them if they're there!
- chemicals in our foods (non-organic foods esp those grown using the weed killer glyphosate aka ‘Round-up’). These chemicals can interfere with your gut bacterial activity, even if they are supposedly safe for humans, they have not been tested safe for our gut bugs (as important as any organ of our body).
- artificial sweeteners (these can cause imbalances to your gut ecosystem, & they still lead to obesity - don't eat / drink them).
- extremely intense or prolonged exercise. If you are a serious athlete, you need to be aware that this will put you at risk for developing leaky gut (even if it's just post competition / hard training). L-glutamine is a great supplement to support athletes with gut issues.
How Do I Test For Leaky Gut?Your doctor, specialist or naturopath should be able to organise some tests to see if your body is showing signs of gut leakage.
- urine test. This is the easiest & most common way to test - you’ll be given something sugary to drink & they’ll check if large sugar molecules are leaking through the gut lining later on (your pee will provide the answers).
- SIBO breath test (not strictly a test for leaky gut, but chances are very high that your gut is leaking if you have SIBO - small intestinal overgrowth).
- LPS & actomyosin antibodies tests (blood testing to see what level of immune reactivity is going on to 'lipopolysaccharide' - something found in higher levels in the blood when gut bacteria are leaking out in the bloodstream, & actomyosin - exposed to the blood & immune system when the tight junctions get leaky).
How Do I Fix Leaky Gut?If you think you may have leaky gut, you should get everything looked into & be tested to exclude other causes (like Coeliac disease for example). An integrative GP or naturopath who specialises in gut health will be the best person to book an appointment with, they can recommend what needs to be checked & also arrange some 'leak detection' testing if leaky gut seems likely.
- avoid the main triggers / aggravators mentioned above
- make sure your upper GIT function is good as this is crucial for the function & microbial balance further down. You may benefit from apple cider vinegar, digestive enzymes, chewing your food more, taking a bitter liver-stimulating herbal formula.
- exercise is essential for a healthy digestive system. If you’re an athlete or go to extremes - be aware this can compromise your gut lining as blood flow is directed away from the digestive system in favour of your muscles, causing damage to the cells lining the gut. If you’re sedentary, you need to start moving to fix your gut as a stagnating gut will breed lots of nasty bugs, that will stay lurking long enough to damage your gut lining. If you are not currently exercising due to pain / injury - you need to start moving the non-painful parts at least, this will help.
- sleep. If sleep is a problem for you, it will be messing with your gut (it may also be caused by your gut microbes). Eating more fibre & less sugar = great for the gut, & can also help with sleep too.
- stress management (regular massage, holidays, time off, counselling, meditation, laughing lots, spending time with people who relax you - not the stress heads…make time to do the things that you love). Do not underestimate the ability of stress to make you sick, or the ability to manage your stress better to get you well again.
- sunshine (vitamin D is very important for your immune system & also your gut lining). Get yours tested.
- eat lots of polyphenols & practice some intermittent fasting (increase your population of the 'akkermansia' gut bugs, these gut guys help maintain & strengthen your gut lining).
- pre & probiotics (try eating a fibre rich diet that also includes fermented foods, or use a probiotic supplement regularly). Get guidance with these if you think you may have SIBO, often found with leaky gut).
- kill off your gut bug nasties (decrease sugar & carb consumption, eat your prebiotic fibre, use antimicrobial herbs & probiotics when you know you’ve overindulged & have overfed your bad guys - seek help with this to get started).
- L-glutamine, zinc, N-acetyl glucosamine are nutrients that you’ll find in most ‘gut repair’ type products in the health food store & are very useful in healing the gut lining.
- licorice (the plant, not the lollies - you can try liquorice tea or a herbal tincture / capsules)
- greens - your gut bugs LOVE their greens, even if you don’t! If you hate eating greens, drink them in a green smoothie instead. They can be sooo yummy this way. Greens+Aloe - our supergreens powder is a '2-in-1' gut tonic (organic grass & algae plus a good therapeutic dose of aloe vera inner leaf gel, perfect for adding into green smoothies).
- collagen is great to help heal leaky gut. It is found in meat, skin, gristle & cooked bones. Sip on bone broth, chicken soup, or add collagen powder to a smoothie regularly.
- aloe vera, slippery elm, okra, oats, oysters = rich in mucopolysaccharides (good gut-healing foods)....some great vegan bone broth alternatives (except the oysters obviously!)
- resistant starch. This is easily found in cooked & cooled rice & potatoes, potato starch & green banana flour (& in smaller doses in many other foods).
- calm the immune system response. Eat oily fish, turmeric, ginger, flaxseed - include lots of the natural anti-inflammatories in your diet (or take these in supplement form).