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Intestinal Permeability (AKA “Leaky Gut”)

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Last month I was chatting about the value of exposure to a wide variety of bacteria: from your first journey down the birth canal, to childhood proximity to animals—family pet or time on a farm, to some good adult exposure to dirt: gardening? Soccer? We also of course need exposure to bacteria in our food. No, I’m not talking about rotten deviled eggs or botulism-infested vegetables, but rather about probiotics, the food and supplement sources of beneficial bacteria that become part of our healthy intestinal microbiome.

Resident bugs live in many parts of our bodies, but mostly in our large intestine, where they essentially help keep us alive. Researchers have recently dubbed it “our forgotten organ” since we could no more survive without our gut microbiome than we could survive without our heart or lungs. The microbiome’s first job happens right where they are: they help us digest food so we can absorb its nutrients, but its chore list also includes:

  • Develop and maintain the immune system
  • Respond in the moment to acute infections
  • Produce vitamins
  • Communicate with the brain and nervous system, and even more.

Co-habiting with our cherished microbiome is of course our not-so-cherished excrement. I remember learning in medical school that our stool was 90% dead bacteria, but that was an overstatement! Current thinking is about 30% and the remainder is what’s left over after our microbiome has sorted through our food: indigestible fiber and unabsorbed nutrients.

There is one more very important function of the microbiome and that is to help maintain the lining of the gut. The lining is a single layer of cells with a huge responsibility. The lining forms a complex barrier functioning to protect the inner spaces of our body (sterile circulating blood and lymph) from the bacteria and waste materials in the intestines, while simultaneously allowing the absorption of the nutrient we want from our food, into that same blood and lymph.  A physiological “bouncer” if you will: “You’re good, vitamins, c’mon in, but hey, wait a minute: not you dirt guys!”

The door that the bouncer regulates is designated a “tight junction”, the semi-permeable passageway between cells. Healthy bacteria keep the tight junctions functioning well, thankfully. When the bouncer fails, we are at risk for a number of conditions associated with “leaky gut” (LG) or “intestinal permeability” (IP). They mean the same thing, but IP is the term used by physicians and researchers who tend to disparage the LG concept.

Conditions associated with leaky gut include inflammatory bowel disease and other auto-immune diseases—in itself a formidable list—as well as infertility, mental illness, certain cancers (non-Hodgkin’s lymphoma) and degenerative diseases (Huntington’s disease.)

Regulation of tight junctions allows a proper balance between open and closed. Some factors cause our tight junctions to get open or leaky: strenuous exercise and gluten are two. Open is one thing, it happens to all of us: stuck open is another. Healthy folks endure the transient open junctions, closing them up in a timely manner. On the other hand, anyone with a chronic illness might consider that their “tight junctions” could be stuck in the “open” position and attend to getting them closed. Most health care practitioners with some focus on nutrition can help you test for that condition.

For the “mostly healthy” folks, however, it’s good to keep in mind what keeps our own “bouncers” happy and strong.

  • Say yes to: whole foods, prepared gently, restful sleep, regular exercise and recovery times, good stress management, and a diet that includes probiotics in some form, either fermented foods or supplements.
  • Say no to: processed and sugary foods, vegetable oils (canola, safflower, sunflower may be fine if processed cold and eaten cold and balanced with adequate fish oil), non-steroidal anti-inflammatories (ibuprofen or naproxen) and any unnecessary prescriptions, and skip those hand sanitizers: soap and water when it’s time to get clean! Use moderation with alcohol, caffeine and chocolate.

Read more of Dr. Deborah’s healthy insights at www.DrDeborahMD.com.




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