Leaky Gut and Irritable Bowel Syndromes

Before we discuss leaky gut syndrome (LGS) and irritable bowel syndrome (IBS) we need to understand a little more about the small and large intestines. The primary function of the intestines is to determine which food compounds should be deemed important for absorption and which ones should be eliminated via the feces. The collective term is that the intestines should be considered a selectively permeable membrane. The example that comes to mind is a trip to our airports where the TSA determines who is eligible to board an airplane and who does not. At the airport, we have to go through several procedures to determine our ability to pass all checkpoints, baggage, ID, proper boarding pass, metal and chemical detectors and etc. You get the picture, we have all been there! Well, your intestines have several procedures or “check points” as well. Some interesting facts about the intestines also sheds more light on the importance of the intestines. The average length of the small intestines in men is 23 1/4 ft. and in women 22 1/2 feet. The large intestine is about 5 ft. in length. The lining of the small intestine is filled with velvety projections called villi (see side picture). The surface area with the villi is equivalent to the size of a tennis court! That is a huge exposure of our body to the food we eat that contains so many natural, artificial chemicals, fibers, bacteria and other microorganisms. So what exactly is leaky gut and irritable bowel syndromes? Well, LGS is a condition in which the intestines become inflamed and damaged allowing larger molecules and possibly certain microorganisms to pass through the intestines and into the blood stream. The “weakening” of the lining of the intestines can also cause the white blood cells lining the intestines to become over activated sending chemical messengers throughout the entire immune system of the body. It is estimated that about 60- 70% of the entire immune system is located in the intestinal tract alone! Irritable bowel syndrome (IBS) is confined more to the large intestine. It is estimated that 1 in 6 people in the U.S. demonstrate some symptoms of IBS. Most people develop IBS as a teenager or in early adulthood and often after an infection in the bowels or after stressful events. IBS is characterized by alternations of loose bowels and constipation. It also is accompanied by pain, bloating, mucous in stools, urgency for a bowel movement and a feeling of incomplete evacuation after a bowel movement.

MECHANISM OF LEAKY GUT SYNDROME (LGS)

The list of potential symptoms resulting from LGS is long and widespread. The reasons for this has to do with the mechanism of LGS. Many compounds cause a weakening of the protein structures that connect each cell that lines the intestines and they are referred to as tight junctions. Once these tight junctions are “broken down” this allows the compounds to interact with the white blood cells that make up the immune system called gut associated lymphoid tissue (GALT). The GALT tissue causes local inflammation of the intestines and sends chemical messengers to other remote parts of the immune system causing inflammation in areas such as the brain, bronchioles, muscles, joints and etc. Furthermore, some of these compounds pass through completely to the lymphatic and/or blood stream and are spread throughout the entire body to cause direct tissue damage/inflammation. LGS is a major contributing factor to the predisposition of inflammatory diseases of the bowels and the human body. Some in the medical community realize that intestinal permeability can be compromised, but do not accept the idea that LGS can be an important mechanism leading to inflammatory diseases. However, there is rapidly mounting scientific studies that demonstrates that such activity is taking place in the gut and is having a significant effect on health throughout the body.

SYMPTOMS OF LGS AND IBS

Many of the following symptoms are due to antigens/ proteins, poor food choices, pathogens, toxins, medications and neurotransmitter imbalances. LGS can lead to:

1. Abdominal pain, constipation, diarrhea, bloating, gas and indigestion
2. Allergies, asthma, shortness of breath, rashes, acne, eczema
3. Chronic muscle/joint pain, fibromyalgia
4. Chronic fatigue
5. Anxiety, aggressive behavior, poor memory, confusion, fuzzy or foggy thinking, nervousness, mood swings
6. Poor immunity, recurrent vaginal, bladder and other infections

  Clinically IBS is defined as having abdominal pain for more than 12 weeks within the last 12 months that is alleviated by a bowel movement and associated with a change in stool frequency and formation. The same symptoms of LGS can also occur with IBS along with bowel changes noted above. The other interesting thing to note is that there are usually no visible changes noted with a colonoscopy, so based on this one diagnostic test you may be considered normal. However, there are huge changes at a molecular level and mild changes at a microscopic level.

PATHOGENS, CANDIDA, ACETYLALDEHYDE

It is estimated there are about 1200 species of bacteria, yeast and other microorganisms numbering 100 trillion living in the human gastrointestinal tact. Most of these organisms are beneficial or of no consequence under normal circumstances. However, due to stress, poor diet, compromised immunity, medications, antibiotics, food poisoning this can all change. The World Journal of Gastroenterology, 2010 points out this connection between imbalances of bacteria and intestinal permeability (LGS). One of these organisms that will overgrow are species of a yeast called Candida. Normally candida is not a problem, but will overgrow especially after antibiotic or usage of estrogens. The yeast does invade the intestinal lining with it extensions or hypha. More importantly one of the waste products of the yeast is acetylaldehyde (AH). AH is very inflammatory to the lining, weakening the tight junctions and then enters the blood stream. AH decreases the red blood cells flexibility so it becomes more difficult to pass through the capillaries. It also decreases the oxygen delivery to the tissues. Furthermore, AH is a neurotoxin that effects all of the microtubules in your nerve/brain cells. This prevents the nerves from conducting materials to its endings called dendrites and may cause damage to the nerves.

SEROTONIN, STRESS AND IgA

Approximately 90% of all serotonin is found in the enterochromaffin cells of the intestines. Serotonin regulates the rate of movement through the digestive tract called peristalsis. Serotonin released by the intestines is absorbed by blood platelet cells and is used in regulating the clotting of blood. Excessive release can cause vomiting. Serotonin also appears to modulate the immune system as well. There is a high correlation between stress and IBS. Psychologist, Edward Blanchard PhD., at SUNY Albany suspects 60% of IBS patients suffer from general anxiety disorder (GAD) and 20% suffer from clinical depression. Many IBS medications attempt to treat both conditions by effecting neurotransmitters. Elevated stress hormone cortisol has been found to impact the immune system significantly. There is a protective protein released by the immune cells lining the gut (GALT) called secretory IgA. This protein neutralizes invading chemicals and pathogens. Stress “thins” this layer of protection and can lead to LGS and IBS symptoms.

NSAIDS, ANTIBIOTICS, FOOD CHOICES

There are numerous studies that demonstrate the potential damage that occurs with the usage of NSAIDS such as, aspirin, ibuprofen, naproxen, Celebrex, and etc. These medications have been shown to increase intestinal permeability as well. ( Journal Rheumatology, 1987,and Canadian Medical Association. Journal, 1996). Antibiotics will kill both beneficial bacteria and pathogenic bacteria in the intestines. This leads to a condition called dysbiosis. This results in abnormal growth of many other microorganism, yeast and certain bacteria that are harmful and damaging to the intestines. This can result in LGS and IBS symptoms as well. Poor food choices and food sensitivities can lead to intestinal irritation and GALT activation. Some common foods that cause these problems are: artificial sweeteners especially Splenda, alcohol, soft drinks, sugar, fructose corn syrup, chocolate, dairy, caffeine, eggs, gluten, soy, and nuts. There are specific tests to determine food sensitivities.