Leaky Gut Syndrome—Sick from the Inside-Out: This condition may be the hidden culprit in affecting one's wellness,says Dr. Rekha Shah

We have billions of organisms in our gut and have discovered that they play a huge role in our health. Ironically, our gut could be considered essentially outside the body, coming into contact with food and liquids over our entire lifetime. The gut is exposed to potentially toxic or antigenic (allergy-promoting) substances day in and day out, such as wheat gluten, dairy proteins, MSG, aspartame, bisphenol A, sodium benzoate and countless other chemicals. From the functional point of view, our gut has to protect our internal organs from these constant insults, and it has developed very complex and multilevel mechanisms to accomplish this task.

One of the mechanisms at work is the gut mucosal lining—the epithelium—and its lymphocytes (white blood cells). The gut is the largest immunological organ in the body, and when it is functioning at optimal levels, each cell in the intestinal lining is healthy, connected to its neighbors by tight junctions. This makes the lining allow passage of the nutrients that our body needs while keeping larger particles out of the bloodstream.

Exposure to a toxic or antigenic load causes the intestinal lining to lose its tight junctions, making epithelial cells less functional. The protective and absorptive function of the intestinal epithelium is affected, and we call that “leaky gut”. Unwanted particles are allowed to enter the body through the no-longer-tight junctions, and because of swelling of the epithelial cells, we develop malabsorption of precious nutrients.

The swollen and leaky intestinal lining thus allows normal beneficial bacteria and breakdown products of dead bacterial cell walls, as well as other toxic material to pass through into the bloodstream. The immunological and chemical processors in our body start to get rid of these unwanted particles, often by making antibodies to tag them so that the white cells of the immune system can identify and eliminate them. When even helpful bacteria cross over from the gut to the bloodstream, they are recognized as danger (Foreign invader! Does not belong here!) and an immune response is triggered.

If the bacterium or protein happens to look a lot like our own tissues (gluten looks very similar to thyroid, for instance), this response may also include attack of our own body. It recognizes these tissues as “out of place” and thus “harmful”. Voilà! We get Hashimoto’s thyroiditis or rheumatoid arthritis or lupus or ulcerative colitis, and so on.

This autoimmunity and inflammation is one of the causes of many chronic illnesses that we see around us. Recent medical literature has clearly shown the association with arthritis, rheumatoid arthritis, chronic fatigue, fibromyalgia, multiple skin conditions like acne, psoriasis and eczema, food allergies, multiple chemical sensitivity and practically all gastrointestinal (GI) conditions. Multiple gastrointestinal symptoms like irritable bowel syndrome (IBS), constipation, diarrhea, abdominal pain, bloating, colitis, gluten sensitivity, celiac disease, abnormal liver function, dysbiosis and bacterial overgrowth are associated with gut microbes. Gut bacteria and gut integrity is right at the center of the cause of these illnesses.

The mechanisms of leaky gut are also responsible for many cases of musculoskeletal complaints, metabolic syndrome, diabetes, lipid problems, liver conditions, heart failure, depression, cognitive defects, allergies, neurological conditions and much more. Leaky gut, a compromised intestinal epithelium, definitely needs to be attended to first for proper and healthy management of many of the chronic conditions that we see around us.

The Vedas, ancient Indian scriptures, record that the first illness on Earth was indigestion, and the first treatment prescribed by Lord Brahma was boiled water. We have the choice of what to put into our bodies—healthy food or junk food, fresh food or chemically laden food, soda pop or clean water. We can make healthy choices. The key word is choice.

Dr. Shah is board certified in internal medicine and gastroenterology. She practices integrative medicine with a focus on gastroenterology at the Arizona Center for Advanced Medicine, in Scottsdale. Contact her at 480-240-2600 or ArizonaAdvancedMedicine.com.