Leaky Gut (Intestinal Permeability)

If the small intestine becomes more permeable than it is supposed to be (i.e., “leaky”), it allows abnormally large food molecules to enter the bloodstream. These incompletely digested molecules may stimulate allergic/immune responses both in the intestinal  wall and elsewhere in the body.  In additional to gastrointestinal complaints, symptoms may be produced in the skin (hives or eczema), joints (arthritis), lungs (asthma), or almost anywhere else.

When the small intestine loses its filtration abilities (intestinal impermeability), it both absorbs what it should not and does not absorb what it should.  Vitamin B-12 and the fat soluble vitamins (A, D, E and K) pass through the leaky gut with great difficulty, often leaving the individual deficient in these vital nutrients.

The healthy intestinal wall absorbs only proteins that have been broken down into single amino acids or into tiny molecules consisting of two or three amino acids (dipeptides, tripeptides).  The small intestine is also a first line in our immune defence.  Not only does it prevent harmful microbes and toxic substances from entering the bloodstream, it also produces an antibody (secretory IgA) that neutralizes invaders and prevents them from attaching to membranes.

A leaky gut allows not only oversize protein molecules to enter the bloodstream but also bacteria, viruses, fungi and parasites. When this happens, the body reacts with alarm.  The immune system builds IgG antibodies to these “foreign” molecules that do not belong. Many diverse allergic and auto-immune reactions may follow.  Chronic fatigue is common, as it is a symptom of a body constantly struggling with a perpetual threat.    Almost every meal creates systemic stress for the body that has a leaky gut.  The longer the body is under siege in this way, the less able it is to produce the antibodies and hormones it needs to maintain normal functioning.

A laboratory test which reveals low IgG antibodies is usually indicative of leaky gut.  The presence of either parasites or candida in the bloodstream is another indicator of a leaky gut.

Symptoms of a leaky gut include:

  • constipation and/or diarrhea.
  • abdominal pain or bloating.
  • indigestion or flatulence.
  • mucus or blood in stools.
  • chronic joint or muscle pains.
  • frequent fatigue, tiredness.
  • fuzzy thinking.
  • confusion, poor memory.
  • mood swings.
  • poor exercise tolerance.
  • weak immunity.
  • shortness of breath.
  • skin rashes, hives, eczema.
  • asthma, bronchitis, respiratory infections.
  • sinus or nasal congestion.
  • food allergies/intolerances.
  • alcohol consumption makes one feel sick.

A leaky gut may be caused by gluten intolerance (celiac disease), non-steroidal anti-inflammatory drugs (NSAIDs), alcohol, intestinal parasites, food sensitivities, candidiasis, or by continually overloading a sluggish digestive system with far more food than it can handle.  All of the contributing factors need to be identified and eliminated in order to allow the intestinal wall to repair itself.

Sometimes the intestinal lining becomes so weakened that it has difficulty in handling most solid foods, especially those containing any appreciable amount of protein or starch.  In such cases it needs a complete rest in order to recover.  The medical option would be parenteral nutrition, in which all food is taken intravenously, giving the small intestine nothing to do except heal itself. Fortunately, there is a less extreme approach that can work as well.  It relies on getting one’s nutritional requirements from generous amounts of predigested (hydrolyzed) protein, fruits, non-starchy vegetables, and olive oil.

 Healing the Intestinal Wall

The surface microvilli in the small intestine are highly regenerative.  If given a total rest from everything that irritates them, individual microvilli can repair themselves within four to five days.  If damage is extensive there will be deep tears in the intestinal wall, and healing will take much longer.  And healing needs to be total in order for the body’s overall health to be restored.

A leaky gut cannot process large protein molecules, so these are to be avoided.  Starches and disaccharide sugars (sucrose, lactose) are also to be avoided because a damaged intestinal wall is unable to produce the final enzymes needed to break them down.  Incompletely digested starches and sugars remain in the gut, fermenting and feeding pathogenic bacteria, candida and other microbes that continue to attack the intestinal wall.  It is also necessary to avoid any foods to which a person has unique sensitivities.  To continue to eat these is to keep stressing the intestinal lining.

The form of sugar that is most compatible with healing a leaky gut is fructose (fruit sugar).  Fructose is a monosaccharide, a simple sugar that is ready to be absorbed through the intestinal wall without requiring any action by digestive enzymes.  Fructose has the same chemical formula as glucose, but its molecule twists in the opposite direction.  Before the body can use fructose, the liver has to change it into glucose, a conversion that takes about 22 minutes or so.  Thus fructose is not released into the bloodstream quite as quickly as glucose.

Foods to Avoid

In order to heal the leaky gut it is necessary to eliminate all of the following:

  • milk products:  butter, buttermilk, cheese, cottage cheese, ice cream, ice milk, kefir, milk, quark, yogurt.
  • grains:  amaranth, barley, buckwheat, bulgur, corn, cous-cous, kamut, millet, oats, quinoa, rice, rye, semolina, spelt, triticale, wheat, wild rice.
  • legumes:  peas, beans, lentils, chickpeas, soy/tofu, etc.
  • starchy vegetables: beets, carrots, parsnips, potatoes, pumpkin, winter squash, sweet potatoes, turnip, yams.
  • high glycemic fruits: banana, dried fruits, fruit juices.
  • sugars: brown sugar, cane juice, corn syrup, Demerara sugar, dextri-maltose, dextrose, glucose, icing sugar, malto-dextrin, maltose, maple sugar, molasses, raw sugar, rice syrup, sucrose, table sugar, turbinado sugar, white sugar.
  • alcoholic beverages.
  • nuts and seeds.

The Diet:  Phase 1

Phase I of the diet to heal the leaky gut consists only of the following foods:

  • an elemental nutrient formula providing hydrolyzed (pre-digested) protein, fructose and gentle fibre.  This formula may be blended with water and fresh fruit (not fruit juice) to make a “smoothie.”
  • fresh, whole fruits, of as wide a variety as possible, preferably organic, and in any reasonable quantity to satisfy hunger – including apples, apricots, berries (all kinds), cantaloupe, cherries, crabapples, fresh currants, fresh figs, grapefruit, grapes, guava, honeydew melon, kiwi, lemons, limes, mangoes, nectarines, oranges, papaya, passion fruit, peaches, pears, persimmon, pineapple, plums, pomegranate, star fruit, tangerine, watermelon.
  • fresh, non-starchy vegetables, preferably organic, and in any reasonable quantity to satisfy hunger – including alfalfa sprouts, artichokes, asparagus, bamboo shoots, bean sprouts, beet greens, bell peppers, bok choi, broccoli, Brussels sprouts, cabbage, cauliflower, celery, chicory greens, chives, cilantro, clove sprouts, collard greens, crookneck squash, cucumber, daikon, dandelion greens, eggplant, endive, escarole, fennel, garlic, ginger, green beans, horseradish, iceberg lettuce, jicima, kale, kohlrabi, leeks, okra, onions, radish, romaine lettuce, mustard greens, parsley, pickles, sauerkraut, scallions, snap peas, snow peas, spaghetti squash, spinach, summer squash, swiss chard, tomatillo, tomatoes, turnip greens, watercress, wax beans, yellow beans, zucchini.
  • organic olive oil, 2 to 3 tablespoonsful per day, taken at the same time as the non-starchy vegetables (e.g., as a salad dressing).
  • honey (a source of fructose), 1 tablespoon per day, between meals or with fruits.
  • beverages:  purified water, decaffeinated teas, decaffeinated coffee.
  • condiments:  lemon juice, lime juice, vinegar.

 All of the above are to be consumed according to the following guidelines:

  • have the largest meal of the day at noon.
  • wait three hours after any meal that contains olive oil before consuming the next meal or snack.
  • wait 30 minutes after fruit or the elemental protein-fibre formula before consuming a meal that contains olive oil.
  • as long as the above timing guidelines are followed, fresh fruit or veggies (without oil) may be consumed as a separate snack as often as desired throughout the day.

 The Diet:  Phase 2

The dietary guidelines are the same as for Phase 1, except that nuts (without skins, blanched), seeds, eggs, fish and/or poultry may be consumed (again, preferably organic).  Every time animal protein is eaten however, an appropriate number of digestive enzyme tablets is to be taken.  All appropriate vitamin/mineral/herbal/glandular supplements are also to be taken during this phase.  Herbs and spices can also be added back.  Pre-digested (hydrolysed) proteins may be combined with fruits or vegetables as desired, but not with fruit juice.

Elemental Nutrient Formula

This powdered protein-fibre formula was developed for the main purpose of helping to heal the leaky gut:  Hydrolyzed Lactalbumin (40%), Vegetable Fibre/Psyllium  (40%), Fructose  (20%).

Because this formula provides only hydrolyzed (predigested) amino acids and fructose (a monosaccharide), its elemental nutrients are ready to be pass directly through the intestinal wall without requiring any action by digestive enzymes.  The fibre in this formula prevents the constipation that accompanies low residue diets.  Blend it with water.  Add fresh berries or fruits to make a “smoothie.”  May also be used as an “instant breakfast” or as a protein supplement for athletes and bodybuilders.  (Because this formula does not provide any essential fatty acids, vitamins or minerals, it is not to be used as a sole source of nutrition.)

The fibre in this formula is highly absorptive and requires a high water intake to be effective.  For that reason, it is best to drink one 10 oz. (300 mL) glass of water immediately before consuming this protein-fibre blend and another similar sized glass shortly afterward.  It is also advisable to drink several smaller sized glasses of water (4 – 6 oz./120 – 180 mL) at various times throughout the day.  Those with sluggish metabolisms may at first become constipated if they do not take sufficient water with this formula.  If PRO-FIBE produces intestinal gas, it means that beneficial intestinal flora need to be replenished.  To correct this imbalance, take 12 capsules daily of dairy-free Lactobacillus acidophilus and and spread this intake throughout the day.  Over the next several weeks, gradually reduce the number of acidophilus capsules to a maintenance level at which no more intestinal gas is produced.

 Length of Treatment

The intestinal healing program consists of two parts, each of which lasts for three weeks.  Phase 1 includes only those foods on the above “acceptable” list.  Homeopathic remedies may also be taken, but no vitamin, mineral, glandular or herbal supplements of any kind — also no spices and no herbal teas

In Phase 2 the dietary guidelines are the same, except that protein foods may be added, such as eggs, fish, poultry, fermented soy (miso, tempeh, or tofu only) may be consumed (preferably organic).  Every time protein is eaten, an appropriate amount of a digestive enzyme formula is to be taken.  All vitamin/mineral/herbal/glandular supplements appropriate to the individual’s needs are also to be taken during this phase.  Proteins may be combined with the non-starchy vegetables and with the olive oil, but not with fruits and not with the elemental meal replacement formula.

The complete program consists of three weeks on Phase 1, followed by 3 weeks on Phase 2, followed by three weeks on Phase 1 … and so on  … for up to six months to heal the most stubborn cases.  It is a strict and challenging program to follow, but it is what the small intestine needs in order to do its own healing in the shortest possible time.  If at any time the program should cause undue hardship, then modify it – either by adding particular supplements to Phase 1, or by shortening the time spent on Part 1 and lengthening the time spent on Phase 2.  Dairy products, grains, legumes, starches and di-saccharide sugars are the enemies of intestinal healing.  If you must consume any of them during the program, do so infrequently.  Your body can more easily handle a large quantity consumed once in awhile than it can small amounts eaten every day.

The leaky gut both absorbs what it should not and does not absorb what it should.  Its ability to absorb essential fatty acids, certain vitamins (e.g., A, D, E, B-12, folic acid) and certain minerals (e.g., copper, iron, magnesium, selenium, zinc) is greatly impaired.  Thus, a person with this syndrome may have significant deficiencies of several key nutrients in spite of an adequate intake of them.  Supplementing with generous amounts of these factors can both compensate for their poor absorption and speed the healing process.

See also the chapter, “Leaky Gut”, in NUTRITIONAL SOLUTIONS FOR 88 CONDITIONS  (available at Amazon.com)

 

This entry was posted in Condition, Digestion by David W. Rowland. Bookmark the permalink.

About David W. Rowland

David W. Rowland, PhD is a leading edge innovator in the field of natural nutrition, and the creator of the Nutri-Body(R) method of nutritional assessment favored by practitioners. Dr. Rowland is available for telephone consultations. To set up an appointment email: david222@hush.com.

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