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What is Leaky Gut — And What Can You Do About It?

Stomach pain from IBS

Did you know that your biggest exposure to the outside world everyday is through your mouth? That’s why 70% of your immune system lives in your gut, lying in wait to protect you from anything that seems foreign (or “antigenic”) to the body. “Antigens” include bugs, like bacteria, parasites, or viruses. And believe it or not, they are  also in the food you eat – and the toxins and microbes that ride along with the food..

Your gut, which is essentially a tube starting at your esophagus and ending at your rectum,  has barrier walls separating the inside of your body and immune system from the outside world.  When you break down and digest your food into tiny particles, the intestinal lining serves to very selectively choose what can enter your body through a variety of mechanisms, including opening and closing gates called tight junctions.

Leaky Gut Syndrome

An intestinal barrier with damaged tight junctions, that isn’t succeeding in keeping those antigens out, leads to a condition known as Leaky Gut or Increased Intestinal Permeability.  The lining of the tube is damaged, and because of that, more and larger food molecules and gut bacteria are able to pass through to the other side (your bloodstream).  This leads to immune system activation as the body is overloaded with antigens, and this in turn can lead to inflammation and a variety of system-wide conditions.

Common Causes of Leaky Gut

Causes of leaky gut vary, but the most important might be dysbiosis, which is an imbalance of bacteria in the gut, also known as the gut microbiome. Dysbiosis shows up in a number of ways, for a number of reasons. It can be an overgrowth of harmful bacteria, yeast, or parasites, or simply a dearth of good bacteria, or any sort of bacteria growing in the wrong place in the gut.

Dysbiosis is caused by poor dietary choices, frequent antibiotic use, use of common over-the-counter medications (like antacids or painkillers), and can even be caused by stress, and chronic constipation.  A healthy microbiome helps you by interacting with the immune system in beneficial ways, and also by turning the food you eat into compounds that heal the tight junctions between your cells, protecting the integrity of the gut lining. Balanced gut microbiota leads to a strong barrier!

Leaky gut and the Connection to Chronic Disease

Studies have increasingly found that a leaky gut is associated with arthritis, autoimmune disease (like Hashimoto’s Thyroiditis or Rheumatoid Arthritis), allergies, and food sensitivities.  But why is it that leaky gut is associated with inflammatory diseases like arthritis? When the contents of your digestive tract, which includes gut bacteria and larger molecules of food and toxins, “leak” into your body, your immune system is activated, creating inflammatory chemicals that travel throughout your body and cause system-wide inflammation, especially in the joints. And this happens nonstop until your gut microbiome and the lining are repaired.

Leaky Gut and Nutritional Deficiencies

Leaky gut can also contribute to malabsorption of vitamins and minerals.  Ongoing inflammation can cause damage to the carrier proteins in the lining of the gut that are supposed to work to bring the good stuff into the body. The most common are iron, B12, magnesium and zinc deficiencies. These lead to all sorts of symptoms like fatigue, hair loss, rashes and muscle pains.

How to Heal Leaky Gut

The good news is that you can rebuild your microbiome and repair your gut, it just takes a little effort and sometimes some detective work. Here are five areas that deserve your attention:

  •      Food Choices: Food has the most influence on the diversity of the microbiome – and that is why we always recommend starting by changing your diet. Increasing your intake of foods high in fiber, mostly fruits and vegetables, is the simplest change we can make. These tend to increase that good bacteria that plays such a role in keeping the gut lining healthy and working. Removing foods that feed the bad bacteria is also important – so quitting – or at least decreasing the amounts of sugar, processed foods, alcohol, and bad fats will support rebalancing the microbiome.
  •      Food Sensitivities: Recognizing the foods you are sensitive to and removing those from your diet is an important way to help heal the gut lining. If the gut is constantly barraged by a particular food that is stressing the immune system, local inflammation at the gut barrier will create imbalance and lead to leaky-ness. A simple elimination diet is often the best way to determine food sensitivities. Food allergy testing can also guide us in helping you to figure out what to eat and what not to eat.
  •      Stressors: We all know that stress affects our gut. Think about it, when you don’t feel relaxed, you just don’t digest as well. Many people manifest emotional distress in their digestive tract, suffering from an uneasy stomach, loose stools or sometimes chronic constipation, bloating, cramping and food intolerance. Making sure that stress is dealt with, by looking into your habits and working to improve potential sources of stress – like lack of sleep, lack of exercise, or mood imbalance is essential. Your digestion benefits from 8+ hours of sleep nightly, a good exercise regimen that keeps you moving daily and a meditation or mindfulness practice that helps ground your mind.
  •      Toxins: Decreasing your  total body toxin exposure should be a crucial part of your gut healing strategy.  Eating well-sourced, non-gmo, organic foods as much as possible and avoiding common environmental exposures that further tax the system and damage the intestinal lining, helps decrease permeability and inflammation.
  •      Dysbiosis: Sometimes the imbalanced gut is really off.  So much so that improving diet won’t fix it completely.  In these cases, we usually use testing (stool, breath, urine) to help determine the best method of gut healing – or cleansing – with herbal preparations, medications, and probiotics.

Treatment options for leaky gut:

  •      Glutamine, an amino acid, has been shown to reverse intestinal mucosal damage from various insults.
  •      Marshmallow root and DGL (Deglycyrrhizinated licorice) extract are agents that stimulate protective mucus secretion in the gut.
  •      Probiotics are an essential part of healing the gut lining – a broad spectrum probiotic that contains lactobacillus and Bifidobacteria species is recommended.  Saccharomyces boulardii, a beneficial yeast, is also an important supplement to restore gut health.
  •      Fish Oil – to reduce intestinal (and systemic) inflammation.
  •      Vitamin D – at doses of 2000-5000 IU daily (get blood levels checked intermittently) supports the mucosal immune system in the gut lining.

What to do if you suspect you have Leaky Gut:

If you live in our neighborhood, make an appointment!  In my  practice at Blum Center for Health, I take a multi-pronged, holistic approach, a combination of medical and lifestyle considerations, to address, diagnose, and treat your condition.  We take your health seriously and get to the root of the problem rather than simply throwing medication at it.  For more information, please call 914-652-7800.

Don’t live nearby?  A great place to start is with our 10-Day or 30-Day HealMyGut program — it’s a total gut reset with a nutritional plan, recipes, just-right supplements, daily email support, and a private online community. Our 30-Day program includes the added bonus of a weekly chat with our Functional Nutritionist to answer all your questions. Find out which program is ideal for you: Take the Assessment

Meet Darcy McConnell, M.D.:  Dr. McConnell brings her broad expertise in prevention, mind-body medicine, and women’s health to Blum Center for Health, in Rye Brook, NY. She is board certified in Family Medicine and Integrative Medicine, with postgraduate training from the Institute for Functional Medicine. Darcy lives with her husband and three sons and enjoys the outdoors, cooking healthy meals for her family and friends and is an enthusiastic yogi.

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What is Dysbiosis – and What You Can Do About It

Dysbiosis is like having weeds in your gut garden

You have within you trillions of microbes – bacteria, fungi, viruses, even parasites – all living together in your gastrointestinal tract.  This lively bunch of microbes is known as your microflora. Often referred to as “The Garden Within,” your microbial garden can shift out of balance. Think about how a garden can become overgrown with weeds. When that happens, we say a person has dysbiosis.

Three Ways Dysbiosis Can Impact Your Gut

  1. Too much of the bad stuff overgrowing in the gut is the most basic imbalance.  An overabundance of “bad,” typically inflammatory, bacteria, or too much yeast (candida albicans is a particularly common and unwelcome yeast in large amounts), are two examples of overgrowth that cause dysbiosis.  An unwelcome virus or parasite can also cause overgrowth imbalance.

    To treat this type of dysbiosis we sometimes prescribe medications to kill unwanted bacteria, parasites, or yeast, but more often we use gentler, broad-spectrum anti-microbial herbs to weed the garden, improving the balance of good and bad bacteria. We also use probiotics and fiber-rich foods to encourage growth of the good while we get rid of the bad.
  2. Microbial undergrowth can be the culprit. It is rarer than the situation above, but sometimes a stool test result shows an under-abundance of all bacteria – good and otherwise.  An under-abundance indicates we need to work on improving the terrain (the gut lining) where the flora will take residence, as well as supporting the growth of the flora we want to encourage. We do this with probiotics, prebiotics, lining supportive supplements like glutamine, and healthy, bacteria-supportive foods.
  3. Your microbiome settles in the wrong place. Living microbes are wanted, but we need them to live where they belong, and not take up residence in places where they cause problems. Most frequently, this type of dysbiosis is SIBO (Small Intestinal Bacterial Overgrowth). SIBO occurs when the gastrointestinal microbiome has shifted from primarily growing and thriving in the large intestines (the colon) to taking up residence in the small intestine in too great a number. This tends to cause digestive problems and bloating, but can be silent as well.  Herbs and antibiotics are our go-to for treating SIBO.

Could you have dysbiosis?

In our medical practice at Blum Center for Health, we suspect an imbalance in the flora (a dysbiosis) in anyone who complains of stomach troubles. Digestive difficulty of absolutely any kind suggests there’s something wrong with the trillions of microbes inside the gut. If you have stomach upset after eating, indigestion, the extremely common GERD (reflux), heartburn, slow digestion, or bloating, we think of dysbiosis.  If you have bowel problems, like excessive gas, lower belly pains, constipation, or diarrhea – then dysbiosis is our prime suspect too.

Dysbiosis as the Root Cause of Seemingly Unrelated Disorders

It surprises many patients that other symptoms, including those that on the surface seem to have nothing to do with the gut, also make me suspect dysbiosis.  We are becoming more and more aware the impact our microbiome has on our whole being – our whole health – and our disease processes.

When I see someone whose health concerns are not primarily digestive in nature – even those who report having a perfect digestive system – I usually investigate their microbiome, and will almost always prescribe a probiotic. Why? Because sometimes dysbiosis is silent gut-wise, while still causing trouble in other areas of your body.

Here are a few examples:

  • Hormonal imbalance – we know that certain bacteria encourage an imbalance in hormones.  
  • Autoimmune diseases show clear links to overgrowth of some bacteria.  
  • Joint aches and pains can be caused by leaky gut, which is usually a consequence of some kind of imbalance in the gastrointestinal microbiome.  
  • Neurological and psychiatric disease is being traced back to problems with our microbes.  
  • Weight loss resistance is often a consequence of over (or under) growth of the bacterial flora.  

Basically, any inflammatory process can be traced back to the gut.  

How do you know if you have dysbiosis?

How does your internal garden grow?  The tests we most often request are simple:  Stool, breath, and urine testing – all of which give us a picture of what your personal microbiome looks like.  We learn from the test results how many beneficial bacteria are growing, and how many malicious bacteria have taken up residence in your gut. We use that information to create your personalized treatment plan.

With some patients we assume dysbiosis without testing – and just get you started on the good stuff  – probiotics and healthy, fiber-rich foods.

Not sure if you have dysbiosis? Take our Assessment and find out!

How did you get this dysbiosis?

There are many reasons we harbor the microbes we do. Our developing microbiome begins at birth – it is different if we are vaginally delivered or born via c-section, for instance. Our food choices (throughout our lives) affect our microbiome, as does any antibiotics we might have taken.  Other medications, both prescription and over the counter, also affect the microbiome.

What to do if you suspect you have dysbiosis:

If you live in our neighborhood, make an appointment! In our practice at Blum Center for Health we take a multi-pronged, holistic approach, a combination of medical and lifestyle considerations, to address, diagnosis and treat your condition. We take your health seriously and get to the root of the problem rather than simply throwing medication at it. For more information, call 914-652-7800.

Don’t live nearby?  A great place to start is with our 10-Day or 30-Day HealMyGut program — it’s a total gut reset with a nutritional plan, recipes, just-right supplements, daily email support, and a private online community. Our 30-Day program includes the added bonus of a weekly chat with our Functional Nutritionist to answer all your questions. Find out which program is ideal for you: Take the Assessment

 

Meet Darcy McConnell, M.D.:  Dr. McConnell brings her broad expertise in prevention, mind-body medicine, and women’s health to Blum Center for Health, in Rye Brook, NY. She is board certified in Family Medicine and Integrative Medicine, with postgraduate training from the Institute for Functional Medicine. Darcy lives with her husband and three sons and enjoys the outdoors, cooking healthy meals for her family and friends and is an enthusiastic yogi.

 

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3 Simple Steps To Great Gut Health

By Susan Blum, MD

If you have gas or bloating after you eat, or if you experience constipation and/or loose stools, or any type of intestinal discomfort, you have a problem with how your gut is functioning. While this is commonly labeled irritable bowel syndrome, or IBS, the diagnosis doesn’t tell you why you’re having this problem.

Usually, the issue is something called dysbiosis, which means your gut flora isn’t healthy. You might have an overgrowth of harmful bacteria, yeast or parasites, or you might not have enough of the good stuff: those probiotics you find in yogurt and cultured foods.

But who cares about a little gas or bloating?

You should! Your gut flora needs to be fixed, because the symptoms you’re having could just be the tip of the iceberg. A whopping 70% of your immune system is located in your gut and if the flora are out of balance, you have an increased risk of something called Leaky Gut Syndrome, and this can lead to autoimmune disease.

Here are my tips to heal your gut, which will treat your symptoms and keep your immune system happy, too.

  1. For your digestive symptoms, find out whether or not you’ve got food sensitivities, which could be causing the problem. Check yourself for gluten and dairy by removing them both from your diet at the same time for three weeks, and then reintroduce each one at a time, four days apart and monitor how you feel.
  2. For your flora, eat cultured food every day, like coconut or almond milk yogurt and kefir, sauerkraut or kimchee, and consider taking a probiotic supplement.
  3. If the above doesn’t do the trick, consider a gut-cleansing program using herbs like berberine or oregano to remove the harmful microbes. Our new HealMyGut program will help you do just that!