Healing A Leaky Gut Syndrome

Healing A Leahy Gut

To many people, the term ‘leaky gut’ suggests some implausible, alternative-leaning pseudo-science. Be that as it may, it is the name frequently used in place of the more technical nomenclature, ‘intestinal permeability.

‘Intestinal permeability’ may have more scientific gravitas than the slapstick ‘leaky gut’, but the latter is more visual, and the image of a colander-like gut that this term brings to mind is not entirely off the mark. Leaky gut/intestinal permeability is a common – yet, in some rare cases, deadly – condition. Your intestines are lined with a single layer of cells whose job it is to create a barrier between the outside world and your insides.

Read And Learn More: Health Problems And Dietary Solutions

• If this lining of cells becomes porous through damage, the barrier is compromised and mayhem ensues. I often liken having a leaky gut to having broken doors on the house, leaving you vulnerable to dangerous intruders.
• Whenever I mention intestinal permeability to clients, friends, or passers-by, virtually none of them has heard of it. The subject appears seldom to arise in the GP’s surgery.
• Yet the scientific literature on leaky gut/intestinal permeability is vast, and the condition is well documented as a major cause of not only gut but whole-body symptoms.

About The Gut Lining

The gut has a dual role. First, it must digest food and allow the passage of nutrients extracted from this digested matter into the blood. Secondly, the gut must act as a selective barrier, sifting out the undesirable contents of the gut and preventing them from spilling into the bloodstream. It is this second role that concerns us here.

The lining of the gut goes by a variety of names, including intestinal mucosa, the mucous membrane, and the mucosal barrier. Sometimes it is referred to as the epithelium, as it consists, extraordinarily, of just a single layer of cells.

The sheet of cells which make up the epithelium are held together by what are termed ‘tight junctions’. These tight junctions, which are made of proteins, work like intestinal ‘bouncers’, allowing in nutrients but barring harmful toxins, microorganisms, undigested food molecules, and any foreign matter that has found its way into our food and drink.

What Is Leaky Gut Syndrome

The thin layer separating your internal body from the external world can, with alarming ease, become damaged and porous. Damage leads to irritation and inflammation, and as a result, the tight junctions loosen up and microscopic holes arise, allowing larger molecules to pass through which ordinarily wouldn’t make it.

Pathogenic bacteria, toxic molecules, and undigested food can all pass unchallenged into the bloodstream. When you consider some of the rubbish you may have eaten or stuff you may even have swallowed by mistake, a leaky gut is an unnerving thought.

Symptoms Of Leaky Gut

Almost everything circulating in the blood has access to the whole body. Consequently, symptoms of leaky gut may manifest anywhere, starting in the digestive system and ending anywhere you care to mention – the brain, the joints, the skin.

Typical symptoms of a leaky gut are, therefore, manifold and affect every bodily system. They include:

• Bloating
• Abdominal Pain
• Excessive Abdominal Gas
• Constipation
• Diarrhea
• Chronic Joint Pain
• Poor Immunity
• Skin Problems – Acne, Eczema, Psoriasis, Rashes
• Fatigue
• Fuzzy Thinking
• Poor Memory And Concentration
• Mood Swings
• Anxiety
• Depression
• Recurrent thrush recurrent bladder infections.

What Happens You Have A Leaky Gut

The above symptoms are the fall-out of intestinal damage. Intestinal damage arising from a leaky gut has four main consequences: translocation of bacteria, inflammation, immune/allergic response, and liver toxicity.

Leaky Gut Translocation of Bacteria

• This means that undesirable bacteria, which should ideally stay put in the gut, are able to move through the gut lining and into the bloodstream.
• With these bacteria comes endotoxin, which is the toxic substance released by the cell walls of pathogenic bacteria when they are destroyed. When endotoxin travels from the intestine to the circulation, it can initiate injury to the liver and other organs.

Leaky Gut Inflammation: One of the major characteristics of leaky gut syndrome is inflammation. Endotoxin from pathogenic bacteria and other substances can stimulate the inflammatory response. The role of inflammation is to clear up the infection, but it can also give rise to pain and fatigue.

Leaky Gut Immune and Allergic Response

• The arrival of large molecules, endotoxin, and infection caused by bacteria, parasites, and fungi, via the gut lining, provokes the immune system into producing antibodies to fight off these foreign invaders (known as antigens).
• Partially digested food molecules are also perceived as alien, and their absorption through the gut lining can result in multiple food sensitivities. Also produced by the immune system are proteins called cytokines, secreted in response to trauma or infection and which also fight antigens.
• Unfortunately, these cytokines can also cause the gut lining to become leaky. Some cytokines are pro-inflammatory as part of an aggressive response to an antigen. Cytokines also alert white blood cells called lymphocytes to join in the fight.
• People who have a genetic tendency to develop classic allergic diseases – dermatitis (a form of eczema), asthma, and hay fever – are known as atopic. In one study of this subject, it was found that atopic people who also had irritable bowel syndrome were more likely to have increased intestinal permeability than IBS patients without atopic symptoms.
• There is certainly plenty of literature that supports the finding that a leaky gut appears to be the norm in atopic individuals. Interestingly, another study also found that not only is intestinal permeability present in all people who have adverse food reactions, there is also a statistically significant association between the severity of the symptoms of food sensitivity and the severity of the intestinal permeability.
• Inflammation is a common denominator in the many conditions caused or aggravated by leaky gut. Asthma is one such inflammatory condition. Leaky gut has already been linked to asthma in adults, and in one study of 32 asthmatic children, intestinal permeability was found to be significantly increased, compared with 32 non-asthmatic children.

Leaky Gut Liver Toxicity

• The liver is normally a fine, efficient organ of detoxification, capable of filtering out the usual everyday detritus.
• However, the stuff that arrives in the blood from a leaky gut can be a challenge too far, and this extra burden means the liver has to process a great deal more than it would under healthy circumstances Prolonged antibody response can also overwhelm the overworked liver.
• So what it can’t cope with is sent back into circulation, where it ends up in connective tissue, joints, muscles, and skin. The liver will also pass toxins to fat cells for storage.

Conditions Associated With Leaky Gut

Leaky Gut Irritable Bowel Syndrome (IBS): There is growing evidence that people with IBS also have increased intestinal permeability, and this intestinal permeability is thought to be a possible cause of IBS-associated inflammation.6 The discovery that increased gut permeability and inflammation are found in people with IBS is a recent one.7

Leaky Gut Coeliac Disease

• Coeliac disease is a severe reaction to an allergen, namely the gluten component of certain grains. The absorption sites along the intestines – hair-like protrusions called villi and microvilli – are worn smooth, so food is not properly assimilated.
• Symptoms of coeliac disease include pain, diarrhea, and weight loss. Avoidance of gluten, found in wheat, rye, oats, and barley, results in complete remission.
• Intestinal permeability is a feature of coeliac disease, and avoidance of gluten allows the permeability of the gut to return to almost normal in the majority of coeliacs.
• Although people with coeliac disease clearly have leaky gut, it is not known if leaky gut is a causal factor, a contributor to the disease, or the result of the disease.

Leaky Gut Inflammatory Bowel Disorder

• People with IBD are known to have impaired gut barrier function. Levels of inflammatory markers, cytokines, are raised in IBD, and these cytokines are known to cause the intestinal barrier to become leaky. Crohn s disease is one of the main types of IBD.
• Although the cause of Crohn s disease remains unknown, what is known (at least as found in animal subjects), is that abnormal permeability is present before the disease occurs.
• In humans, increased gut permeability is commonly observed in people considered to be at high risk of developing Crohn’s.
• Indeed, there is considerable data that support the hypothesis that there is a gut permeability abnormality in Crohn’s disease and that this abnormality plays a role in the initiation of the condition, although which comes first – intestinal permeability or Crohn’s disease – is still not fully established.

Leaky Gut Alcoholic Liver Disease

• Alcohol can seriously damage the gut lining, and both alcoholic liver disease and fatty liver disease are associated with intestinal permeability.
• Having said that, only 30 percent of alcoholics go on to develop chronic liver disease. Increased intestinal permeability has been found in alcoholics with liver disease, but not in alcoholics without liver disease.
• There has to be a reason for this, and experimental studies ‘strongly suggest’ that endotoxin – the toxin released from bacteria that translocate from the gut to the blood – is essential to the development of alcohol-related liver injury.
• Endotoxin is also found in the blood of patients with alcoholic cirrhosis. What this also means is that the key to whether or not an alcoholic develops liver disease may lie in whether or not he or she has a leaky gut, which is a sobering thought.

Leaky Gut Depression

• Depression is a highly complex condition and its causes are known to be multifactorial, but one potential cause is inflammation in the gut. Depression has been linked to altered levels of inflammatory cytokines, those chemicals released by the immune system in response to infection.
• This fascinating association has been investigated and it has been found that the toxic by-products produced by bad bacteria in the gut – endotoxin – play a role in the development of depression where there are increased levels of inflammatory cytokines.

Leaky Gut Chronic Fatigue Syndrome: People with chronic fatigue syndrome are known to have both intestinal permeability and dysbiosis. They have also been shown to have increased levels of endotoxin. Treating both dysbiosis and intestinal permeability has been shown to improve symptoms in people with both chronic fatigue and depression.

Leaky Gut Diabetes

• There has long been a suspected link between the gut and the development of type 1 diabetes, and increased gut permeability in patients with diabetes was first reported 20 years ago. More recent studies have confirmed that leaky gut occurs frequently in type 1 diabetes patients, whereas type 2 diabetes sufferers are more likely to have normal intestinal permeability.
• One particular, recent study set out to determine whether intestinal permeability actually helped cause type 1 diabetes or was secondary to the condition.
• Eighty-one people with either pre-clinical diabetes, new-onset diabetes, or established type 1 diabetes were tested, and each one of them was found to have a leaky gut, a finding which led the researchers to conclude that leaky gut is already detectable before the clinical onset of diabetes, and the gut is in some way involved in the development of the disease.

Leaky Gut Skin Disorders

• The skin is a major organ of detoxification and a convenient dumping site for the overburdened liver dealing with the fallout of a leaky gut. So it is hardly surprising that various skin conditions, especially those which involve inflammation, are associated with gut permeability.
• In a study of 18 people with dermatitis herpetiformis (a blistering skin disease associated with coeliac disease), all participants were found to have increased intestinal permeability. It is also thought that damage to the gut lining is involved in the development of atopic dermatitis, a form of eczema.

Leaky Gut Arthritic Conditions

• Arthritis has long been associated with abnormalities of the gut and is in fact a painful manifestation of a number of digestive disorders, including inflammatory bowel disorder (arthritis occurs in up to half of patients with IBD), coeliac disease, and parasitic infestation.
• Because arthritic symptoms tend to improve when the digestive disorder is treated, it is thought that these two clinical entities are related even though the mechanism of the relationship is not fully understood.
• Three types of arthritis – ankylosing spondylitis, reactive arthritis, and psoriatic arthritis — belong to a group of arthritic conditions called the spondyloarthropathy group. Up to two-thirds of patients with spondyloarthropathies have been found to have sub-clinical gut inflammation.
• Ankylosing spondylitis is a chronic inflammatory disease characterized by back pain and spine rigidity. A leaky gut has been associated with ankylosing spondylitis for decades, though it has in the past been unclear if the leaky gut was due to the condition itself or its treatment.
• Recently, however, it has been found that patients with ankylosing spondylitis have a primary defect in intestinal permeability. Reactive arthritis may occur after contracting some kind of parasitic infection, especially salmonella, shigella, yersinia, Campylobacter, and Endolimax nana. Joint symptoms – the knee, ankle, wrist, and sacroiliac joints – arise within two to three weeks of developing diarrhoea.

Leaky Gut Sepsis Syndrome

1. Sepsis is an infection that has spread throughout the body, in the blood, and is often referred to as either blood poisoning or septicaemia.
2. There are around 31,000 cases of severe sepsis a year in England and Wales, and approximately 30-50 percent of those affected will die because of the infection. There is, according to research, ‘ample evidence’ linking gut barrier dysfunction to multiorgan system failure in sepsis.
3. Indeed, the scientific literature on the subject is awash with evidence pointing to a significant association between sepsis and leaky gut. It is easy to imagine how this occurs dangerous toxins enter the blood via a porous gut, and once there are free to circulate around the body, stopping off anywhere en route.

Leaky Gut Pancreatitis: People with acute pancreatitis (inflammation of the pancreas that can cause severe abdominal pain) have been found to have significantly high levels of endotoxin, the toxin secreted by pathogenic bacteria. They have also been found to have significantly higher levels of inflammatory cytokines and increased intestinal permeability, compared to people without the condition.

Leaky Gut Causes

Like most of the subjects covered in this book, the cause of a leaky gut is not a conveniently simple, readily identifiable one. Leaky gut is a complex condition with myriad possible causes. Any irritation to the gut lining can make permeability worse, and irritation arises from a number of sources, the main ones being: dysbiosis, allergens, certain medications, alcohol, and free radicals.

Dysbiosis Or Parasitic Infection

• Microscopic bugs are known to damage the gut lining and produce toxins that exacerbate irritation and increase gut permeability. Yeasts such as Candida are able to burrow their way into the intestinal lining. Other parasites also cause irritation to the gut lining, making it more permeable Blastocystis hominis, giardia, Helicobacter pylori, salmonella, and Shigella are all known intestinal offenders.
• However, one of the most significant offenders is thought to be Campylobacter. Irritable bowel syndrome develops in up to 25 percent of patients following infection with Campylobacter. In a study of one such group of patients, it was found that gut permeability was also significantly elevated.
• If you have read Solution 7 on dysbiosis you may have noticed by now that a link between parasitic infection, irritable bowel syndrome (IBS), and leaky gut is clearly emerging. Between 6 and 17 percent of IBS patients claim that their symptoms began with a gut infection. This claim is supported by clinical tests which have shown that between 4 and 31 percent of people develop IBS following bacterial gastroenteritis.
• IBS has been found to develop following infection with Campylobacter, salmonella, and Shigella. This is not a new, startling revelation the development of IBS after contracting a parasite infection is a phenomenon that was first described as long ago as 1962.

Medications: A number of drugs are known to disrupt the gut significantly. These include chemotherapy drugs, but none more notoriously so than non-steroidal anti-inflammatory drugs (NSAIDs) which are known to increase gut permeability within 24 hours of taking them. The best-known NSAIDs are probably aspirin and ibuprofen. In tests, around two-thirds of NSAID users have been shown to have intestinal inflammation and increased gut permeability.

Chronic Stress

• The brain-gut interaction is both fascinating and poorly understood. There is, however, growing scientific interest in the effects of psychological stress on the intestinal barrier. The data emerging from studies suggests that there are signaling pathways linking the central nervous system and cells of the intestinal barrier.
• It is difficult to monitor the effects of stress on the human gut lining, but animal studies have found that stress increases the passage through the intestinal barrier of small molecules produced by bacteria, as well as large molecules in the form of undigested proteins.

Alcohol: In addition to its better-known misdemeanors, alcohol can also promote the growth of pathogenic bacteria, and the result of this is endotoxin, the toxic substance created from the cell walls of bacteria that travels to the liver and elsewhere. Furthermore, when bacteria metabolize alcohol, the result is an accumulation of the chemical acetaldehyde (popularly believed to be the cause of hangovers) which increases intestinal permeability.

Free Radicals

• The oxygen used by the body to produce energy results in the production of highly reactive chemicals called free radicals. This process is called oxidative stress. Free radicals are also created by smoking, pollution, and certain cooking methods such as barbecuing.
• These free radicals can be very damaging to body cells, and unhindered free radicals are implicated in many diseases, including cancer and heart disease. Oxidative stress is a well-known cause of intestinal permeability, disrupting the tight junctions between cells and compromising the gut barrier.

Have You Got A Leaky Gut

Quite simply, without testing it is impossible to know the answer to this question for sure, although it is possible to build a strong case based on symptoms and history alone. A leaky gut test will not only tell you if you have it but, if so, how badly. And if you know that much, you have an indication of just how long it will take to heal. Before you make any decisions, ask yourself the following questions

• Do you have dysbiosis, or suspect that you may have
• Have you had a parasitic infection
• Do you smoke? Smoking is free-radical hell.
• Do you drink alcohol regularly?
• Do you have a history of stress?
• Have you taken NSAIDs, such as aspirin, regularly?
• Do you eat a low-fiber, low-antioxidant diet?

Answering ‘yes’ to any of the above means that it is possible that you may have a leaky gut, and answering ‘yes’ to more than one increases that likelihood, especially if you have one or more symptoms of gut permeability.

Do Now About Leaky Gut

First, read Solution 7 on dysbiosis. If you have overgrowth of pathogenic bacteria, or a yeast or parasitic infection, you have to deal with this first, as these are a major cause of leaky gut. Next, visit your GP to ensure that you do not have an underlying intestinal disorder such as coeliac disease, ulcerative colids, and so on.

Thirdly, decide whether or not to test for leaky gut. I advise that if you feel you would like to do this you do so with the guidance of a nutritional therapist who will be able to interpret the results and devise a healing program to suit you.

Testing for Leaky Gut

• There is a very simple urine test used in medical laboratories that indicates whether or not your intestinal wall is leaky. It is sometimes known as the lactulose/mannitol test. To do the test, you drink a solution containing lactulose and mannitol.
• These are harmless water-soluble sugar molecules that the body does not metabolize so they pass easily through the body. Mannitol is a small molecule, readily absorbed by the healthy digestion system, so serves as a good indicator of healthy absorption.
• Lactulose, however, is a larger molecule, and because less than 1 percent of the dose taken should pass through the gut lining, it serves as a good marker of permeability. After drinking the solution you collect your urine over a period of 6 hours and draw off a sample. Low levels of mannitol indicate malabsorption.
• Elevated levels of both lactulose and mannitol are indicative of increased permeability, or leaky gut. The ratio between the two sugars is also significant. A normal lactulose/ mannitol ratio in urine should be less than 0.03. Anything higher than this suggests excessive permeability.

Healing The Leaky Gut

How long it takes to heal a leaky gut depends on the severity of the damage. From experience I would say that the process takes at least 2 months and may take up to a year. There are various approaches, which are all helpful and which I have outlined below. There are no pharmaceutical medicines available to heal intestinal permeability, which may explain why GPs do not as a rule treat this condition.

Probiotics

• The friendly bacteria in your gut, with which you are now familiar, are key not just to healthy intestines but also to a healthy gut lining. Probiotics, when used therapeutically, appear to work in several ways. They compete with pathogens for adhesion to the intestinal lining and at the same time stimulate the gut’s immune system to produce anti-inflammatory substances.
• Lactic acid bacteria have been shown to prevent free-radical disruption of tight junctions and to preserve barrier function.
• In children with atopic dermatitis, lactic acid bacteria have been found to significantly decrease the frequency of gastrointestinal symptoms. The children who were studied were also shown, through lactulose/mannitol testing, to have improved intestinal permeability after taking probiotics.
• Skin symptoms also improved from taking lactic acid bacteria, leading the researchers to conclude that impairment of the intestinal barrier may in some way be involved in the development of atopic dermatitis. It is important to establish a healthy gut lining as early as possible. Children are much more prone to allergies, possibly because their guts have not fully matured.
• Children with cow’s milk allergy have been found to have increased permeability. Breastfeeding is important in establishing a healthy gut lining, as it increases levels of infection-fighting antibodies and levels of beneficial flora.
• Adults, on the other hand, are more prone to various forms of inflammatory bowel disorder. In a study of 34 patients with Crohn’s disease who were given either probiotics (Saccharomyces boulardii) or placebo, intestinal permeability was measured before, during, and at the end of 3 months of treatment.
• At the end of the study, the Crohn’s patients taking a placebo were found to have increased gut permeability, whereas those taking the probiotics showed the opposite – that is, an improvement in gut integrity. Gut integrity was not fully restored, however, suggesting that in cases of Crohn’s, at least, the healing process may take longer than 3 months.

Glutamine

• Glutamine is a non-essential amino acid, meaning that the body is able to make it. It is in fact the most abundant amino acid in the body. It is mainly obtained from the diet, meat being one of the best sources. It provides energy to muscle and helps build tissue.
• In large doses it has been shown to have remarkable therapeutic properties. Glutamine is the primary fuel used by the cells of the intestine to repair itself. Along with probiotics, it is the most effective product available for mending a leaky gut.
• Its therapeutic benefits have been well documented and it has been shown to improve and protect intestinal barrier function. In practice, many of my clients have commented on how much better they feel soon after starting to take glutamine.
• Many studies have been carried out on the therapeutic use of glutamine in people who have developed intestinal permeability due to different causes. Glutamine is effective in people whose gut permeability has been induced by taking NSAIDs.
• It is also useful in the treatment of people with infections in parts of the body other than the digestive system, as it is thought that it may help prevent pathogenic bacteria and their toxic by-products from moving from the gut to the blood. Patients who are critically ill with an infection often have increased intestinal permeability, and glutamine has been shown to improve gut integrity in those patients.

Aloe Vera Juice: Probiotics and glutamine appear to actively heal the gut. Other substances work by reducing inflammation. One such substance is aloe vera juice. Aloe is both an antioxidant and anti-inflammatory agent and for this reason, is thought to be therapeutic in the treatment of inflammatory bowel disorder. It has also been found to improve the symptoms of ulcerative colitis significantly, compared to a placebo.

Zinc

• Zinc is a trace element widely found in meat, fish, and seafood and also in wholegrains, nuts, and seeds. It plays many roles in the body and is involved in all protein structures.
• It is crucial for wound healing, so it is not surprising that it is important in maintaining and healing the intestinal lining. In animal studies, zinc has been shown to enhance the function of tight junctions, and in humans, zinc supplementation has been shown to preserve intestinal permeability in patients with Crohn’s disease.

What to Eat

• First, consider how you eat. One unfortunate consequence of a leaky gut is the passage of undigested food through the gut barrier. Therefore, the more you chew your food before swallowing, the better digested it will be by the time it reaches your small intestine, and the less likely therefore to cause a reaction.
• Avoid foods to which you have a sensitivity. If you suspect that something you are eating is causing a reaction, but have not yet identified the offender(s), read the Solution 1 chapter, which discusses food intolerances.
• Follow a diet that favours the friendly bacteria in your gut and therefore reduces your risk of developing intestinal permeability. In addition to foods that feed friendly bacteria, you need to incorporate foods high in antioxidants and phytonutrients and low in free radicals.

Antioxidants are natural plant chemicals that disarm those dangerous free radicals, which, as previously mentioned, are one of the main causes of intestinal permeability.

• Antioxidants and Phytonutrients
  • Oxygen is a highly reactive chemical in the body, and free oxidizing radicals attack the DNA of the cells, causing damage and affecting cell replication.
  • To the rescue come antioxidants, the best known of which are perhaps the vitamins C and E, the mineral selenium, and the vitamin A precursor, beta carotene. However there are hundreds if not thousands of antioxidant chemicals in foods, and these are also known as phytochemicals.
  • The best sources of antioxidant nutrients and phytochemicals are plant foods, namely fruits, vegetables, legumes, nuts, seeds, and whole grains. The best sources of vitamin C are berry fruits (blueberries, strawberries, and other berries), kiwi fruit, citrus fruits, and potatoes.
  • Vitamin E is often found together with selenium in nuts and seeds, especially pumpkin seeds, cashew nuts, walnuts, and Brazil nuts. Nuts are also an especially good source of the antioxidant enzyme glutathione. Phytochemicals are broadly categorized into two groups: carotenoids and polyphenols. The best-known carotenoid is beta carotene, as found in carrots.
  • Other excellent sources of carotenoids include sweet potato, pumpkin, squash, yellow poppers, and other orange or red plant foods, such as tomatoes.
  • Dark leafy greens such as spinach and kale are rich sources of carotenoids, too, as are the famous cruciferous vegetables (which I can barely stop myself from evangelizing about at every opportunity): cabbage, cauliflower, broccoli, Brussels sprouts, curly kale, spinach.
  • The best-known polyphenols are flavonoids, powerful antioxidants which are also potent anti-inflammatory agents. They are found in a wide variety of plant foods, and some are easily identifiable by their colour – deep reds, purples, and blues are the mark of a flavonoid.
  • These include those vitamin C-rich berries (especially blueberries and blackberries), plums, grapes, and red onion.
  • Other flavonoids are found in soya beans, soya products and citrus fruits, pulses, and cocoa. Other polyphenol-rich sources worthy of mention are green tea, certain herbs (especially rosemary and thyme), turmeric, and mushrooms – in particular shiitake, maitake, and reishi.
• Essential Fats: Include plenty of essential fats in your diet. Essential fats are powerfully anti-inflammatory and are required to help repair damage to the gut lining.
• Anti-inflammatory Foods
  • Consume plenty of foods that are known to have anti-inflammatory properties, including oily fish (those good fats again), ginger, fennel seeds, garlic, slippery elm tea, oregano, oats.
  • Although these foods are known for their anti-inflammatory properties, the only one which has been shown to affect intestinal permeability directly is, to my knowledge, oats – giving oats to rats has been shown to reverse induced gut leakiness, though it is not known how.
• Proteins: Ensure adequate protein, especially zinc-rich foods. Oily fish is ideal because it contains zinc, protein and anti-inflammatory fatty acids.

Leaky Gut Case History

For my final case I thought I’d describe my own health issues, which I eventually came to clear up through nutritional therapy after a history of totally ineffectual medical treatments. Throughout my teens and twenties, I was plagued with digestive symptoms – at times quite severe irritable bowel accompanied by some extraordinary bloating. The internal chaos I endured was reflected in my skin – itchy rashes and spots were the bane of my life.

Of course, at that stage, I was a nutritional philistine and had no idea that there was an association between my bowel disorder and my skin problems. What shocks me now is that neither did any of the doctors or specialists I consulted for both conditions.

• I took lots of medications for IBS, which had no effect at all. I saw a skin specialist in Harley Street who gave me antibiotics for my acne, which were also ineffective. I also visited a Chinese herbalist, on whose advice I brewed up various foul-tasting concoctions, which had a sum effect of zero.
• To cut a long story short, once I started studying nutrition it became clear to me that diet was almost certainly key to restoring my overall health. I arranged for a laboratory to carry out a comprehensive parasitology test, and sure enough, this revealed I had dysbiosis and the parasite B. hominis.
• I followed the appropriate diet and took probiotics and herbal medicine. My symptoms improved enormously – but not completely, so I knew I had to go a step further and do the intestinal permeability test. The results were as I’d suspected. Lactulose levels were virtually off the page, mannitol was only just within the normal range, and the lactulose/mannitol ratio was also in the red. I had a very leaky gut.
• One thing I have always observed with my clients who choose to undergo tests is that, no matter how bad the results, they are always relieved finally to know what it is that is causing their symptoms. That is exactly how I felt.
• All those years of pain, embarrassment, and elasticated waistbands were coming to an end. I followed the appropriate dietary steps to heal a leaky gut and took a level teaspoon of glutamine powder, twice a day. The glutamine was effective from the start – I felt as if a wild beast within had been tamed. My skin cleared up.
• I concentrated on anti-inflammatory foods, took aloe vera, made lemon and ginger teas every day, and avoided alcohol most of the time. Nearly 20 years later I still feel utterly relieved that I no longer endure the daily torment of IBS.