Counseling Sheet

Agatha M. Thrash, M.D.
Preventive Medicine

Imagine your intestinal tract as a one-way fence with small openings for particles of food to pass through into the bloodstream. In the healthy person, the holes are small enough to keep inside the intestinal tract any food particles which would cause harm if they get into the bloodstream before they are completely digested. These holes will also hold back toxic products which may be present in the food. Under certain conditions the intestinal tract fails to hold back food particles until complete digestion has occurred, or fails to prohibit certain nutrients of which the bowel has already taken up enough, from pouring into the bloodstream without a barrier.

As soon as any foodstuffs are absorbed into the bloodstream they must go promptly to the liver through a filtering and detoxifying system. Liver enzymes can transform certain partially digested food products that slip through the intestinal tract into more usable forms. This entire process, however, produces free radicals and oxidation. It is for this reason we need antioxidants in large quantities with our food and lots of fiber to hang on to toxic substances. When this intestinal barrier is damaged in any way, free radicals can increase, and the size of food particles getting into the bloodstream is larger or are less well-prepared for use in the body and can cause damage in cells and organs throughout the body. This condition is called "increased intestinal permeability" or, more commonly, "leaky gut syndrome."

Increased intestinal permeability can be associated with a variety of problems such as painful joints and muscles, arthritis-like syndrome, allergies, headaches, fevers, food intolerance, gastrointestinal problems, fatigue, not feeling well, abdominal pain or distention, diarrhea, skin rashes, toxic feelings, memory loss, inattentiveness, shortness of breath, poor exercise tolerance, asthma, and numerous other problems, many of which appear unrelated to the gastrointestinal tract.

There have been a number of conditions which have been recognized to promote increased intestinal permeability. A listing of some of these follows:

• Malnutrition, which may be associated with diarrhea or constipation. Malnutrition can be overcome by improving the diet or by overcoming the inability to absorb certain nutrients by giving a dietary supplement. Zinc in fairly large quantities, 150 milligrams a day, will sometimes stop the increased intestinal permeability caused by malnutrition. (Gut. 39:416;1996)
• The taking of nonsteroidal anti-inflammatory drugs (NSAIDs) can cause injury to the lining of the stomach and small bowel with an increase in permeability, or a leaky gut. These drugs are the most commonly prescribed medications worldwide. (Nutrition Reviews. 53(1):13)
• Overeating, drinking lots of fluids with one's meals, eating off-schedule, eating too fast, or too frequently can cause a leaky gut, as can germs of various kinds, alcohol, steroids, and too little oxygen (as from hardening of the arteries or open-heart surgery or shock).
• Beginning the eating of solid foods too early in life, or failure to breastfeed, may also cause leaky gut.
• Increased intestinal permeability commonly occurs with certain diseases including inflammatory bowel disease, rheumatoid arthritis, ankylosing spondylitis, asthma, eczema, food allergies, alcoholism, trauma, and surgery. Periods of fasting, being very careful never to overeat, and avoiding drinking large quantities of liquids with meals, or lying down afterwards can all help in correcting this abnormal permeability (Alternative Medicine Review. 2(5):330;1997).
• In 1992, it was discovered in Mexico that certain mushrooms would cause small intestinal damage characterized by flattening of the mucosa, fusing of villi, and other alterations in the cells of the absorptive surface. It is felt these evidences of injury are sufficient to cause abnormalities of absorption (leaky gut syndrome, celiac sprue, mineral or fat malabsorption, allergies, etc.).

Treatment

• A day or two of fasting per week
• Eliminate all those foods known to give you a sensitivity.
• Take one teaspoon slippery elm in water half an hour before each meal.
• Take flavonoids before eating, as they can block allergic reactions which cause, or result from, increased permeability. Very favorable flavonoids are found in catechins, milk thistle, and dandelion root. The use of foods high in flavonoids can help in correcting this abnormal permeability. (Alternative Medicine Review. 2(5):330;1997)
• Use two to four dishes of simple foods at a meal, prepared in as natural and tasty a way as possible.
• Take time to eat. Chew your food thoroughly to encourage epidermal growth factor from the saliva. Glutamine, an amino acid known to help in the maintenance of intestinal metabolism, can help to heal the intestinal tract. (Archives of Surgery. 125:1040-5;1990) The benefit (the nourishment and the enjoyment we get) from food does not depend so much on the quantity eaten as on its thorough digestion. Nor the gratification of taste so much on the amount of food eaten as on the length of time it remains in the mouth.
• Anxiety has been found to increase permeability and make it so that your intestine cannot keep partly digested nutrients out so well. Avoid anxiety with the meals. If the brain is burdened, reduce the amount of food that you take. Let food stay a long time in the mouth.
• Use no baking soda or baking powder as these upset the chemical balance.
• Essential fatty acids such as those found in walnuts and flaxseed can be most helpful to protect your body from toxins produced in the digestive tract. (American Journal of Clinical Nutrition. 54:346;1991)
• Whole grain rice with its gamma orycenin in the bran has a healing effect on the stomach and small bowel and has a very potent antioxidant activity. It should be taken at least once daily for the first six weeks after the discovery of a leaky gut. (Rephokaido Institute of Public Health. 16:111;1966)
• If abnormal bacteria are present (dysbiosis), use herbal antibacterials as indicated. Most bacteria are sensitive to gentian, and particularly to grapefruit seed extract. If a hidden infection is a probability, use goldenseal, echinacea, artemisia, and garlic as anti-germ agents.
• Glutathione (GSH) and N-acetyl cysteine are considered extremely good supplements to use in the leaky gut syndrome. Do not take these if you are taking artemisia or any other parasite medicine. Use two pills of NAG (N-acetyl glucosamine) three times a day for one year to help heal the leaky gut.
• Do not take supplemental forms of dietary fiber in large quantities, as too much may increase intestinal permeability. (Journal of Nutrition. 113:2300;1983)
• Crohn's disease patients and their relatives may have increased intestinal permeability. One study showed that about one-fourth of all first-degree healthy relatives of Crohn's patients have leaky gut. (Acta Gastroenterologica Belgica. 58(1):C61; 1995)
• Use a friendly bacteria supplement such as Symbiotic with fructo-oligosaccharide (FOS), 1/4 to 1/2 teaspoon, three times a day in water for one year.
• In addition to protein, fats and celluloses, chlorella has 3.3% glucosamine which may be helpful in the leaky gut syndrome.