by Marcelle Pick, OB/GYN NP
It is not uncommon in my practice to have women come in with new physical complaints after major life events like having a baby. Ellen is a perfect example of one of these cases. She was diagnosed at a young age with lactose intolerance, and managed her symptoms quite well. She even went through not one, but two pregnancies without any issues and was able to digest dairy-products. She thought she had overcome the condition, until symptoms presented again at a particularly stressful time in her life. She was a young mother of two, her newborn had difficulty nursing, she was working full time, and had many uncomfortable gastrointestinal symptoms every time she ate – gas, bloating, even diarrhea. She was exhausted, irritable, and it all impacted her daily life.
As Ellen told me her story, I thought it sounded more like leaky gut, a digestive disorder that is not always at the top of many clinicians’ diagnosis list, but more common than you think.
Our digestive system influences everything. From controlling digestion and protecting us from hostile bacteria, to communicating with the brain – sending physical signals such as gas or hunger, and emotional feelings such as anxiety, stress, and even love. This complex union moving through the gut is often referred to as our body’s second brain, affecting our health physically and psychologically.
Not a “thinking” brain, our digestive tract actually has its own reflexes and senses, working hard to move things through our body, absorbing nutrients, and removing waste. Because of this complicated system of nerves and chemicals, sometimes these exchanges of information can veer off track.
It isn’t hard to notice when our gastrointestinal tract is off, changes in digestion can impact our daily lives. Whether it’s gas and bloating, cramps and diarrhea, fatigue, or even joint pain or skin rashes, symptoms can be uncomfortable, embarrassing, even debilitating.
More than half of my patients come in with complaints relating to a digestive imbalance, and many times I can attribute it to leaky gut syndrome.
What is leaky gut?
Leaky gut is a condition affecting the lining of the intestines, creating a dysfunctional environment for proper digestion. It is also called “increased intestinal permeability”, because with leaky gut, the intestines lose some of their ability to filter nutrients and other substances. When this happens, particles of incompletely digested foods, bacteria, other waste by-products may leak through the intestines into the bloodstream. It is usually caused by some form of damage to the intestinal lining.
Our intestines are lined with cells, which are sealed together by something called “tight junctions”. In healthy intestines, these junctions work like gatekeepers, which essentially allow or prohibit particles to move through the gut and into the circulatory system. With leaky gut syndrome, particles can slip through the cells and tight junctions and literally leak into bloodstream or lymphatic system, and move freely throughout the body.
When the body recognizes these foreign substances and detects something is wrong, the immune system kicks in, and tries to fight what it perceives to be danger in the intestines. This causes inflammation and inhibits functioning. In this situation, a woman’s ability to digest food and absorb nutrients is decreased, and her immune system can become compromised. Impaired immune functioning here is extremely important, as our guts contain tissue known as gut-associated lymphatic tissue (GALT) which helps protect us from antigens causing food allergies as well as microbes carrying disease.
When the body is continually trying to repair itself from the effects of leaky gut, it can be caught in a never-ending cycle, especially when the source of the problem is not diagnosed. For example, if unrecognized food allergies are creating leaky gut, and the same foods are consumed over and over, a self- perpetuating, inflammatory cycle will be triggered, and the intestinal lining cannot heal.
Chronic inflammation in the intestines is a concern, because of the potential for its link to many serious disorders ranging from depression, osteoporosis, lupus, and multiple sclerosis to Alzheimer’s, heart failure, and more. Leaky gut may be also be linked to other gastrointestinal problems such as irritable bowel disease, Crohns disease or celiac disease, as well as immune system disorders such rheumatoid arthritis, and even asthma. That’s why I stress to my patients the importance of sharing all of their symptoms and concerns, no matter how small they may seem. As we examine each of the symptoms, we can figure out what may be causing them, and how to relieve them.
How do you get leaky gut?
Sometimes digestive problems originate early in our lives–such as lactose intolerance or food sensitivities. The problems may ebb and flow, especially during busy or stressful times. Other times we can develop issues related to taking certain medications or medical treatments that may have caused damage in our gut. Things like radiation, chemotherapy, corticosteroids, and even long term use of aspirin and antibiotics can wreak havoc with our intestinal flora, or the “good bacteria” that keep our digestive system functioning properly.
Any abundance of toxins in the system can burden our bodies. It is important to recognize imbalances and try to repair them naturally, before they lead to other disease and disorders.
How can I fix it?
In functional medicine, we look at the underlying causes of a disorder, and address it with a patient-centered focus. We evaluate lifestyle factors, environment, genetics, and history, and address individual aspects with a systems-oriented approach. The Institute of Functional Medicine developed a tool for clinicians to use when treating digestive disorders, called the Four “R” Program: remove, repair, replace, and reinoculate. I have added a fifth “R”, regulate. This method highlights effective ways to heal digestive imbalances.
1. Remove: Undertake an elimination diet
First we must stabilize and smooth the digestive tract. A 14-day detox cleanse is a gentle approach that helps eliminate common allergens, such as dairy, soy, gluten, sugar, yeast, and alcohol. It can help determine which foods may be contributing to symptoms. At Women to Women we work in partnership with our patients to help them manage and maintain an effective cleanse.
2. Replace: Investigate digestive aids
Oftentimes, using soothing digestive herbs, digestive enzymes, or other digestive supports, can help protect the lining from further damage, and coat the intestines while they heal. A functional medicine clinician can help determine which supports are best for each patient’s unique needs.
3. Reinoculate: Rebalance your gut flora
Friendly bacteria are important, and a well-colonized gut is vital to good digestive health. The good bacteria help abate the less-friendly ones, that lead to sickness and disease. Probiotics are an important way to re-introduce proper flora to the intestines. Proper diet, including fiber-rich foods also establish microfloral balance.
4. Repair: Rebuild your intestinal cells
There are many ways to repair and rebuild the intestinal cells and lining. Medical research continues to explore ways to advance this healing, naturally. Studies have shown glutamine is helpful for maintaining the structure and function of the intestine, and has been shown to improve damage from radiation and chemotherapy. Other therapies include methionine and N- acetyl cysteine, larch, kiwifruit, and zinc to aid in healing. It is important to work with a clinician to establish the best ways to treat and repair your digestive tract.
Finally, we need to pay attention to how we feel when we eat, where and how we eat, and of course what we eat. First, we should avoid anything that we know causes GI upset. We should have our meal in a relaxed setting, eat slowly, and chew our food thoroughly. Digestion begins with an antibody in our saliva called secretory IgA (sIgA), which is an indicator of digestive immune function. Found throughout the digestive tract, sIgA is our first line of defense against bacteria and along with relaxed, healthy eating, is important to our entire immune system.
With time, patience, and a little extra help, Ellen was able to heal her leaky gut. Her life turned around, and she began to enjoy eating again, as well regain confidence that she could go out without fear of running to the bathroom! Leaky gut syndrome is not yet fully understood, but is real. The symptoms may be different for everyone, but identifying and isolating the cause can help eliminate this distressing disorder. I firmly believe digestion is the foundation of our overall health, and by nurturing and improving this very important function naturally, we can open the door to better health.