How You Can Treat Leaky Gut Syndrome

In a previous blog post, I introduced leaky gut syndrome, what it is, and how it can manifest. Today, let’s delve into how you can begin to heal your gut and finally break through the health issues you’ve been dealing with!

First things first: how do we test for leaky gut?

Small molecules, such as glucose or mannitol, are able to readily able to infiltrate cells and passively diffuse through them. Larger molecules, such as lactulose, on the other hand are normally not able to diffuse through the cell.  Consequently, if the tight junctions between the cells in our intestinal lining are functioning optimally, they will prevent lactulose from getting through.

The Intestinal Permeability Test works by directly measuring the ability of mannitol and lactulose to permeate the intestinal mucosa.¹ This test, a 6 hour urine test, compares ratios of the two substances: the ratio of the quantities of urinary lactulose and mannitol excreted during a given period.¹ Mannitol is readily absorbed and therefore serves as a marker of transcellular uptake.   Lactulose, as mentioned, is only slightly absorbed and will serve as a marker for the integrity of the mucosa.

Now for some treatment options for this leaky gut

When dealing with the gut and gut health, we often think of the 3 Rs: remove, repair and replace.

REMOVE the foods and personal triggers that injure the gut

REPAIR with appropriate foods and supplements

REPLACE with needed nutrients and probiotics (for optimal gut flora)

Where to Start?

• Begin by eliminating all foods that you are known to be sensitive to. This can be determined through an elimination diet or via IgG food sensitivity testing. Top foods that are habitually linked to leaky gut are refined sugars, certain grains², non-organic conventional dairy and meat, as well as GMO foods. In addition, it is also wise to eliminate the exposure to alcohol, pesticides, tap water with various treatment agents, non-steroidal anti-inflammatory drugs (i.e. ibuprofen, Motrin, Alleve) and antibiotics (when possible).
• The amino acid, glutamine, has been shown to reverse intestinal mucosal damage from various insults.³ Glutamine functions as a little bridge, helping repair the deficient junctions in our intestinal wall. It is principle building block which the upper intestinal tract utilizes to repair and heal.³
• In order to help heal, other agents, such as deglycyrrhizinated licorice (DGL) extract and marshmallow root extract may be employed. These botanicals stimulate secretion of a protective mucus that can be beneficial in cases of leaky gut.
• Known for it’s anti-inflammatory properties, fish oil can be very helpful in the treatment of intestinal inflammation by decreasing inflammatory prostaglandins.⁴ Supplementing with EPA and DHA can be quite beneficial and if done should be used in the range of 2-4 grams, daily. In addition, you can also add anti-inflammatory foods into the diet, such as grass-fed beef, lamb and wild-caught fish like salmon.
• A dietary flavonoid, quercetin, works by stabilizing mast cells, and thus, decreasing the release of histamine – known to contribute to inflammation.⁵ To be most effective, quercetin should be used as a powder at a dose of 3-6 grams per day.
• Both short chain fatty acids (SCFAs) and probiotics are essential!⁶
  Lactobacillus casei, bifidobacter species, and saccromyces boulardii, a beneficial type of yeast, are all important to restore gut health.⁶ Again, here you may also want to consider foods such as raw cultured dairy. These products will contain both SCFAs and probiotics that can help heal the gut. Also beneficial – fermented vegetables. These will contain organic acids that aid in balancing intestinal pH and probiotics to support the gut. Options to consider include sauerkraut and kimchi.
• Not to be forgotten, vitamins A and D are critical to supporting secretory IgA function. Both become critical to restoring the mucosal immune system and consequently, it’s optimal function.⁶

References

1. Sequeira I, Lentle R, Kruger M, Hurst R. Standardising the Lactulose Mannitol Test of Gut Permeability to Minimise Error and Promote Comparability. PLoS One. 2014; 9(6): e99256.

2. Punder K, Pruimboom L. The Dietary Intake of Wheat and other Cereal Grains and Their Role in Inflammation. 2013 Mar; 5(3): 771–787.

3. Achamrah N, Déchelotte P, Coëffier M. Glutamine and the regulation of intestinal permeability: from bench to bedside. Curr Opin Clin Nutr Metab Care. 2017 Jan;20(1):86-91.

4. Noriega B, Sanchez-Gonzalez M, Salyakina D, Coffman J. Understanding the Impact of Omega-3 Rich Diet on the Gut Microbiota. Case Rep Med. 2016; 2016: 3089303.

5. Suzuki T, Hara H. Quercetin enhances intestinal barrier function through the assembly of zonula [corrected] occludens-2, occludin, and claudin-1 and the expression of claudin-4 in Caco-2 cells. J Nutr. 2009 May;139(5):965-74.

6. Bischoff S, Barbara G, Buurman W, et al. BMC Gastroenterol. 2014; 14: 189. Intestinal permeability – a new target for disease prevention and therapy.