What do you need to know about the digestive system and leaky gut? Part 2: How to heal.
In my previous article I talked about the importance of digestion, and what may cause leaky gut. The walls of the intestine serve as a physical barrier, separating food and the bacterial populations of the intestine from the rest of the body. Intestinal permeability, or “leaky gut,” occurs when antigens that normally can not go through the intestinal tract are able to make their way through and enter into the bloodstream.
There are numerous things that can alter the permeability of the intestine, including stress, medication, alcohol, rheumatoid arthritis, Crohn’s disease and cystic fibrosis, celiac disease, and food allergies. Leaky gut can lead to systemic inflammation, and can also cause autoimmune disorders and many other complications. Hormone imbalance and estrogen dominance are also often associated with leaky gut. Signs and symptoms include digestive issues, bad breath, body odor, bloating, gas, nausea, and constipation.
Diet/bacteria relationships lead to two types of unwanted antigen exposure. First, the body may be directly exposed to unwanted food antigens consumed in the diet via disrupted permeability. Second, the body may experience indirect exposure in which the disrupted microfloral balance may produce unwanted endogenous toxins and antigens. And for the bacterial balance and imbalance in the gut, there’s a strong connection between what we eat, and how we eat (such as when and where). Consuming difficult to digest foods, such as a meal with both high fat and high carb content, or highly processed foods, can delay intestinal food transit. This, combined with poorly timed intestinal muscle activity, can lead to excessive permeability and can result in abnormal bacterial balance and the absorption of antigenic or toxic substances into the bloodstream.
So can leaky gut be “cured”? The answer is definitely yes.
Relatively short periods of fluid/nutrient-supplemented fasting have been shown to improve the microfloral balance in the intestine. Gluten, found in wheat and other grains (barley and rye), also plays a huge role in inflammation and leaky gut. Dr. Alessio Fasano, head of research at the University of Harvard Celiac Research Centre, has shown that there is at least some increased gut permeability induced in all people when exposed to gluten. And now, Dr. Fasano has actually demonstrated what’s being called “leaky brain,” when similar changes in the blood-brain barrier permeability are brought on by similar influences.
A very effective way of treating intestinal dysbiosis and leaky gut is the 4-R program, developed by Dr. Jeffrey Bland. The four Rs are Remove, Replace, Reinoculate and Repair.
In the Remove phase, the patient removes the common allergy-producing foods, including grains containing gluten and dairy products, and switches to a low allergy potential diet utilizing rice-based products, legumes, fruits, vegetables, fish and poultry. If the patient is suffering from chronic infections of the sinus, oral cavity or intestinal tract, then these are treated. The exposure to toxic chemicals and toxic metals such as mercury is also eliminated.
The second clinical step in the 4R program, Replace, removes the substances that might disrupt the function of the immune system, and evaluates the patient for their sufficiency of digestive enzymes and proper stomach acid. The best “test” here is whether the person can properly digest a normal meal without complaints of bloating, gas formation, or reflux. If this is a problem then digestive aids can be used, such as digestive enzymes that are taken along with meals.
Reinoculate is the third 4R step, and refers to the reintroduction of desirable bacteria into the intestine to establish microfloral balance via a therapeutic dose of a well researched and medically documented probiotic, along with a prebiotic supplement.
Prebiotics are specific food fibers that are used by the friendly probiotic organisms as their “food” in the intestinal tract to improve their therapeutic value. In other words, prebiotics are there to support our good bacteria.
A variety of supplemental sources can be helpful in this phase, including cultured and fermented foods containing live bacteria, refrigerated liquid supplements containing live bacteria, or freeze-dried bacteria packaged in powder, tablet, or capsule form. In addition to directly reintroducing bacteria, this step may also involve indirectly bolstering the reinoculation process through foods or food products that enhance lactobacilli or bifidobacteria growth without simultaneously enhancing pathogenic bacteria growth.
After a couple of weeks in the Reinoculate phase, the fourth and final step in a 4R approach, Repair, involves providing the nutrients that the membranes need to regenerate via direct nutritional support of the intestinal cells through the use of supplements containing nutrients known to be critical in intestinal wall structure and function. In this group of nutrients are many of the antioxidants, including vitamins C, E, and A/betacarotene, the minerals zinc and manganese, the amino acids cysteine, N-acetylcysteine, and glutamine, the tripeptide glutathione, and the carbohydrates inulin and/or FOS. Also included are other nutrients closely involved with collagen formation, such as the vitamin pantothenic acid (vitamin B5), as well as licorice root, and curcumin.
If you feel that you might be suffering from leaky gut, then some food recommendations include lightly steamed, organically grown fresh vegetables. You can add mustard seed, which is an active enzyme that helps ease digestion, as well as herbs such as parsley, cilantro, and basil. Wild-caught fish, including sardines and salmon, can be helpful, as can raw nuts and seeds, almonds, sprouts, and organic eggs. You can switch to almond, coconut and hazelnut flour instead of gluten, and to almond, cashew and coconut milk instead of dairy. And you can add superfoods to your diet, such as maca, chlorella, blue-green algae, cacao, mulberries, and hemp seeds. Also beneficial are sweet potatoes, asparagus, dandelion greens and Jerusalem artichoke, spinach, organic kefir and organic beef liver. Fruit, of course, is great but try to go for lower sugar fruits, such as berries.
And finally, choose organic as much as possible for all of your shopping. Yes, some people do believe that it does not make much difference, however in my own life and practice I am seeing so many positive effects, especially in helping improve digestion. So I personally believe it is still our best choice.
Merry Christmas, and a Happy Healthy New Year!!
Ayda Ersoy is a nutrition and fitness director at The Diet Doc Hawaii. She can be reached at DietDocHawaii.com, Ayda@DietDocHawaii.com or (808) 276-6892.