When I was told I had “leaky gut” several years ago, I was aghast. It was the first time I had heard that term and it made me feel so damaged. I pictured my intestinal tract as a corroded old pipe, leaking foul-smelling, dirty liquid. Eeew! But my doctor was quick to explain what it meant and, more importantly, how we would set about restoring my intestinal health.

The digestive tract is a complicated system. It’s tough. The hydrochloric acid in a healthy stomach can destroy pathogens that slips in on your food. But it is also delicate and prone to dysregulation on a variety of levels, which I’ll point out shortly.

Leaky gut, also known as intestinal permeability, is a condition involving the lining of the small intestine. In a healthy intestinal lining, the cells are packed tightly together and transfer of food particles from the intestinal channel (called the lumen) into the blood stream is strictly regulated. When that process is compromised, leaky gut results and food particles that are not adequately broken down enter the blood stream.

Here, the immune system kicks into high gear because it views these improperly digested food particles as invaders. As the immune system would naturally attack an invading bacteria, virus or parasite, it attacks these food particles as well. Food-immune complexes form in the blood, causing inflammation and delayed reactions throughout the body.

These reactions can take many forms, including headache, sinus problems, sore throat, eczema and rashes, joint pain, bloating and diarrhea, among others. And these reactions can take up to seven days to appear, which makes it difficult to pinpoint which foods are particularly problematic.

What causes Intestinal Permeability?

There are several lifestyle factors and dietary conditions can lead to leaky gut. Here are some of the most common:
Antibiotic use
NSAID use (Advil, Motrin, etc.)
Chronic stress
Alcohol abuse
Lactose intolerance
Gluten/gliadin allergy
Abnormal gut flora (bacteria, parasites, yeasts)
Poor digestion of proteins, carbs and fats

Detecting Intestinal Permeability

The most definitive way to determine if you have intestinal permeability is for your doctor to order a food sensitivity panel. Your blood will be analyzed for antibodies to approximately 100 common foods. If multiple foods form food-antibodies complexes, intestinal permeability is indicated.

Healing Intestinal Permeability

It’s tempting to think simply removing the offending foods from the diet will fix the problem. But it’s important to understand that it is not the foods that are the issue. It is the intestinal permeability that is the underlying problem. Simply removing the items that your body is exhibiting sensitivity to will ultimately result in a different set offending foods – usually the foods eaten most often. This is because improperly digested food particles are still reaching the blood and eliciting an immune response.

The Four “R” Protocol for Intestinal Health

REMOVE – It’s important to identify any bacterial, viral, fungal or yeast infections and take steps to remove them. Natural antibiotics such as goldenseal and olive leaf extract may be appropriate interventions for moderate bacterial overgrowth while pharmaceutical antibiotics may be needed for severe bacterial overgrowth. Carbohydrate restriction is often a successful component in treating fungal infections such as overgrowth of Candida. Wormwood, black walnut, clove and oregano oil are particularly effective with parasitic infections.

Identifying food sensitivities and temporarily removing the offending foods is another important step in healing intestinal permeability. Typically, foods that elicit an immune response are avoided for 3-4 months while additional healing efforts take place.

REPLACE – Digestive factors like hydrochloric acid (HCl), pancreatic enzymes and bile may be deficient and in need of temporary support. HCl is required for the proper digestion of protein in the stomach. Pancreatic enzymes breakdown carbohydrates and bile assists in the digestion of fats. Proper digestion of food particles is critical to stopping the body’s overactive immune response.

REINOCULATE – Repopulating the gut with favorable microbes helps establish health in the intestines. Probiotics – specifically those with the beneficial lactobacillus and bifidobacterium species – are particularly useful. If antibiotics are prescribed, probiotics are definitely recommended and should be taken 3-4 hours after taking the antibiotics to avoid interference.

REPAIR – L-glutamine (an amino acid) is particularly helpful in repairing the damaged intestinal cells and supporting a healthy small intestinal lining. Herbs such as licorice (glycyrrhiza) and marshmallow can also help heal the intestinal lining by forming a protective coating.

This healing process is admittedly rather slow – often taking several months. But it’s worth the effort. Saying goodbye to chronic fatigue, sinus issues, rashes, headaches and joint pain in addition to the GI distress is definitely worth the effort. All of this also supports a healthy immune system. And in these days of the COVID-19, our bodies can use an immune system boost.

Navigating GI distress and restoring gut health can be confusing and frustrating – and needs to be individualized. It’s often helpful to work with an integrative or holistic nutritionist or a naturopathic doctor to help with the process.