Leaky gut syndrome - the leaky gut

Leaky Gut Syndrome – what is it?

»Leaky barriers« is the collective term for all partially permeable (semi-permeable) protective layers of our body to the outside world. These include the skin, lungs, mouth and the entire digestive tract. Everyone is well aware that we are protected by our skin. But the entire pathway of food and air is also equipped with protective barriers that must be partially permeable. From an anatomical point of view, the path from the mouth and nose to the exit is also part of the dangerous external world. Food is only inside the body when it is digested and absorbed in a controlled manner via the intestinal wall. These protective barriers form the immune system's first line of defense. ^[1]

How does a loose bowel form?

The intestinal wall fulfills two central tasks: Firstly, it must be permeable to the nutrients it absorbs, and secondly, it must prevent bacteria, viruses, fungi or harmful substances from entering the bloodstream through the intestinal wall. To ensure this, the permeability of the intestinal mucosa must be well regulated. In this context, we also speak of a „selective intestinal barrier“ – it must therefore be precisely regulated what is allowed to pass through the intestinal wall and what is not.

The skin is the smallest part at around 2 m². Because it is visible from the outside, it is crucial for us emotionally that its quality should be optimal. At more than 100 m², the lungs are considerably larger. However, with a surface area of well over 500 m², the digestive tract, together with the oral cavity, represents the largest protective barrier and is of central importance for health. Our intestines are eight meters long, home to 80 percent of all immune system cells and over 90 percent of the body's own »happiness hormone« serotonin.^[2] A complex, multi-layered protective barrier starting at the mouth and ending at the exit of the body protects us from pathogens and controls the absorption of food.

The inflammatory reaction in a leaky gut

Once a dysbiosis (incorrect colonization in the intestinal flora) has become established, the intestinal bacteria easily enter the body via leaky gut, our immune system is activated and triggers further inflammation. If this happens continuously, a so-called chronic, low-grade inflammation (chronic low grade inflammation) develops in the body over time. In the long term, this can lead to various health problems in the system.^[5]

“Death sits in the gut” (Chinese proverb)

The vast majority of people living in industrialized countries in the West are likely to suffer from leaky gut, especially in the mouth and intestines. The consequence of permeable parts in our protective walls is that more viruses, bacteria and stool can enter the body's circulation in an uncontrolled manner.^{[5] [6]} Meals high in fat can also transport more bacteria into the body, as they can use the fat molecules as a means of transportation through the intestinal wall. This »second wave of attack« happens at almost every meal. This attack by bacteria is called endotoxämia. Long-term endotoxemia caused by negatively supporting foods or overeating leads to chronic low-grade inflammation in the long term.^[7]

Endotoxemia is also triggered by the release of stress hormones during intensive sporting activities or other stress factors, as this also enables faster energy absorption.

With which diseases are current barriers associated?

In the last few decades, slow barriers or a leaky gut have been discovered in a large number of chronic diseases, which suggest a close connection between known diseases and the gut. These include, for example: Allergies ^[8], asthma ^[8], celiac disease ^[9], chronic fatigue syndrome ^[10], Crohn's disease ^[11], depression ^[12], diabetes mellitus type 1 ^[13], Hashimoto's, migräne ^[14], multiple sclerosis ^[15], psoriasis ^[16], rheumatoid arthritis ^[17], cardiovascular­-diseases ^[18] and Alzheimer's disease ^[19].

How do you create a transparent gut?

Globally, stress, food components, dietary habits, nutrient deficiencies, inflammatory reactions, pathogens, certain pain medications and lack of oxygen in the intestine (hypoxia) can make the barrier „l“chrig“. An overview of these factors that impair permeability can be found in Table 1.

Table 1: Release factors for loose barriers

The increased permeability of the intestinal walls (intestinal permeability) is caused by direct or indirect effects on the tight junctions, among other things. For example, pro-inflammatory messenger substances such as TNF-α or stress have a direct effect on the tight junctions.^[20] Furthermore, inflammatory processes and ulcers in the intestine can also lead to the destruction of entire epithelial cells from the intestinal barrier.^[21] On the other hand, the microbiome can produce butyric acid from indigestible carbohydrates, among other things. This fatty acid is important for the integrity of the intestinal barrier. If there is a lack of these carbohydrates, the intestinal permeability can be impaired.^[21]

How to diagnose leaky gut syndrome

In addition to the evaluation of clinical symptoms and clinical pictures, the 13C sucrose breath test is the most reliable test for the diagnosis of leaky gut.

You can have it carried out by a gastroenterologist.^[22] If you consider additional laboratory diagnostics together with your doctor or therapist, the following parameters may also indicate leaky gut syndrome:

Laboratory parameters

What can you do if you have leaky gut syndrome?

The efficient closing of our barriers and the normalization of the entire bacterial flora is the foundation for the recovery from almost all diseases and the maintenance of health. In addition to optimal nutrition and the reduction of all the negative influences mentioned above, substances such as probiotics, enzymes, the protein building block glutamine (main substance for repairing our protective barriers) and zinc (important cofactor) can also be used ^{[23] [24]}.

The most important tips for the digestive tract, from mouth to outlet:

• If possible, eliminate sugar and sweet drinks (soft drinks, fruit juices) from your daily diet. It is recommended to puree the whole fruit, as this preserves the fiber.
• Avoid or reduce cereals (whole grains), rice, potatoes and legumes because of their antinutrients, fiber and carbohydrates.
• Add L-glutamine to your meals to build up the barriers.
• Omega-3 fatty fatty fatty acids e.g. from. Fish due to their anti-inflammatory properties.
• Diet appropriate to the species and use the food list “food as medicine” for a good digestion.

Food as medicine