Leaky gut and immunity?

A healthy cell structure in the GI tract (gastrointestinal tract), including proper functioning of the villi (small projections that protrude from the epithelial lining of the small intestine’s walls) and tight cell junctions (the spaces between epithelial cells that are sealed tight and allow only fully digested material to be absorbed) are important for the intestinal barrier. The human intestine, while absorbing nutrients from the food we eat, also functions as a barrier that prevents harmful pathogens (microbes) from entering our body or bloodstream. If someone has a ‘leaky gut’, it means the tight junctions are compromised due to increased use of antibiotics, exposure to bad bacteria and/or certain trigger foods. The toxic stuff which actually should be eliminated will then seep through the walls of the intestine into our bloodstream. This leads to an immune system breakdown, if not corrected. This then increases the toxic burden, which leads to inflammation and disease.

Causes of leaky gut

The causes of leaky gut are inflammatory bowel disease (IBD), Crohn’s disease, NSAIDs (non-steroidal anti- inflammatory drugs or painkillers), altered flora in the gut, small intestine bacterial overgrowth (SIBO), coeliac disease (resistance to gluten), infection, food allergies, peptic ulcer disease, chronic alcoholism, diarrhoea, strenuous exercise, increasing age, nutritional depletion, poor dietary choices, stress and emotions, systemic disease, low stomach acid and exposure to toxins. 

Nearly 70 per cent of the human system’s microbiota is localized in the digestive tract. An imbalance in the gut microflora, with an overgrowth of the bad ones as opposed to the good ones, will lead to dysbiosis. Causes of dysbiosis are attributed to impaired digestion, hypochlorhydria (basically low stomach acid, leading to undigested food remaining longer in the stomach than it should), overuse of antibiotics throughout one’s life, presence of high levels of ethanol (ethyl alcohol) in the blood due to yeast overgrowth, overuse of pain- killers, decreased peristalsis (movement of food through the digestive tract), impaired immune status and dietary factors. 

Our digestive system fits inside our bodies quite neatly and compactly, but if you were to lay it out in front of you, it would cover a tennis court. The digestive tract protects you from disease and any kind of outside infections; it is your immune barrier—your gatekeeper. It works extra hard not only to extract nutrients from your food but also to sort through and deal with the stockpile of undigested food, new microorganisms and the ones already present. This gang of microorganisms are a mix of good guys, bad guys and the ones that are neutral. I can’t emphasize enough that the more diverse your gut microbes, the healthier you are. They protect you from harmful pathogens entering your gut, but only if the friendly ones outnumber the unfriendly ones. However, when this does not happen, you reach a state of dysbiosis. Over a period of time, dysbiosis will then lead to leaky gut syndrome. The overgrowth of bad microorganisms can cause your intestinal lining—which is slightly permeable and allows only nutrients and water to seep through the barrier of the gut—to become more porous, allowing toxins to escape directly into the bloodstream and cause a host of issues. In his book Eat Dirt, Josh Axe refers to a study by Alessio Fasano at the University of Maryland who brought out of the closet the protein zonulin, which causes the tight junctions of the gut wall to loosen. The three things that trigger the production of zonulin are exposure to bacteria, increased antibiotic use and exposure to gluten.

How do doctors in India test for leaky gut syndrome?

A good doctor will send you for: 

  1. An IgG (immunoglobulin G) test, which checks for food allergies in the body.
  2. Rule out parasites, generally done via a stool test, also checking for a balance of good and bad microorganisms.
  3. A breath test called the Lactulose Breath Test or LBT (lactulose is a non-absorbable sugar), which is done to rule out SIBO and diagnose Helicobacter pylori. The test will diagnose the hydrogen and methane levels in the blood (not done in India). 

Excerpt from The Detox Diet by Shonali Sabherwal (Published by Penguin Random House)

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