My gut is leaking? Understanding intestinal hyperpemeability

What? My gut is leaking? Shall I find some gut putty? Call a gut plumber? What does this even mean?

Leaky gut is a term utilised by natural health practitioners for many years, and more recently come to the attention of the mainstream and under significant investigation in research labs.

The term preferred in the medical community for leaky gut is intestinal hyperpermeability (IHP), meaning:

1. intestinal – the part of our gastrointestinal tract fondly referred to as the gut
2. hyper – abnormally increased
3. permeability – ability for fluid to flow through porous material.

Basically, it is the increased ability for stuff from your gut to move through the intestinal wall and into the blood stream. Cool. So, is this a good or bad thing?

What is normal, what is not

Our intestinal gut lining is a barrier designed to facilitate the passage of certain molecules into the blood stream, such as water, phytochemicals, vitamins and minerals, to be sent on their merry way to various parts of the body to work their nutritional magic.

The endothelial cells of the barrier are thought to be like tiles sealed by grout –bumped up against each other permanently. In the last 20 years, however, there has been much research into tight junctions, the space between the cells. It turns out to be an incredibly complex world.

Through the groundbreaking research over the past 2 decades by gastroenterologist Dr Alessio Fasano and co., we have learned that the protein zonulin moderates the tight junction function as a gatekeeper for molecules to move from the intestine to the bloodstream.

And to our current knowledge two things trigger zonulin release – health of the microbiome, and presence of gliadin – a protein within gluten.¹

When zonulin is activated, gut barrier function is compromised as the space between the ‘tiles’ open wider or for longer than they should. Material normally unable to pass moves freely between the intestine, blood vessels and the brain.^1;2

The body then loses its overprotective mind!

The immune system thinks it is under attack by the influx of foreign molecules, so in your defense there is a cascade of events, leading to systemic repercussions of inflammation, oxidative stress, and eventually immune dysfunction.

Excess of these three bodily responses underlie all ill health. All of it.

Zonulin is only one component in gut barrier function that we are aware of, and there are likely many, many more. As mentioned, science in this area is in its infancy.

However, there are there a plenty of other things that compromise barrier function with regard to the health and solidity of the microbiome.

Love your gut bugs

The health, complexity and diversity of the bacterial populations residing in our gut is heavily influenced by environment from birth. How we are born, if we were breast-fed, our diet, presence of inflammation, drugs, infection, toxin exposure and stress are some of the elements that influence the health of the intestinal microbiome – and consequently impact the gut barrier function.

So we can make the assumption then, that good health begins in the gut, right?

And my oh my, what science is finding in support of this is far-reaching, and somewhat surprising.

We are a whole human, not just a sum of many parts

The persistent and compelling body of evidence around the influence that leaky gut and the health of our microbiome have on most body systems is growing.

In casual, witty Italian fashion, Fasano states, “the gut is not like Vegas: what happens in the gut does not stay in the gut”. The consequences are far reaching, with implications manifesting in rashes, depression, thyroid disorder, aches, joint pain, behavioural disorders, autoimmune dysfunction, cardiovascular disease, cancer and more.

Feed the gut

Nourishing and supporting intestinal happiness is critical to good health. Living symbiotically with our microbes (of which there are 10x more than cells in our body) will enable us to flourish.

Think of it as tending to a garden. We must create good soil and feed the plants in order for them to produce food and flowers for us to enjoy. The beneficial microbes are on our side, so let’s give the bacterial dudes a helping hand!

We discuss implications of inclusions and exclusion in diet and lifestyle in more detail here. But here is a brief overview on how you can help your gut help you:

Include:

• Prebiotic and probiotic foods
• Good fats such as coconut oil, extra virgin coconut oil, cold pressed nut oils
• Bone broth
• Herbs such as slippery elm and liquorice (no, not the all sorts variety)
• Sunshine for Vitamin D

Avoid

• Limit intake of sugar
• Limit intake of processed and artificial food and beverage
• Avoid genetically modified foods
• Avoid antibiotic treated foods

By Angela Johnson

References:

1. Fasano, A 2011, Zonulin and its regulation of intestinal barrier function: the biological door to inflammation, autoimmunity, and cancer, Physiological reviews, vol. 91, no. 1, pp. 151–75, viewed 25 April 2016.
2. Fasano, A 2001, Intestinal zonulin: open sesame!, Gut, vol. 49, no. 2, pp. 159-162