In the last post we explored the curious and complex world of digestion. Having completed that primer, we can discuss some common conditions that compromise gut function. Specific to the small intestine are two very insidious pathologies that can develop over the course of years but seemingly manifest with symptoms overnight. These conditions are dysbiosis and leaky gut syndrome.
A healthy small intestine is like a robust farm, full of rich soil and a diversity of crops. The cells of the small intestine form loops and trenches in the same way that loamy soil is deep but loose and aerated. This cell arrangement dramatically increases the surface area of the intestinal wall, allowing more space for nutrient absorption. The cells themselves have hair like projections (cilia) that reach out like fingers into the intestinal space (lumen) further increasing the surface area. These cilia are much like the grass growing in a vibrant pasture, holding water and fixing nutrients into the soil, maintaining its integrity. Upon these cilia reside the trillions of different species of beneficial bacteria and yeasts which provide nutrients and aid our immune system. These probiotic gut bugs are analogous to the microbial content of soil which is critical for the health of all the plants and all the animals that derive sustenance thereof. Optimal health of both your intestines and Mother Earth’s soil is completely dependent upon this microbial ecology and its diversity.
The delicate balance of this probiotic lining, however, can be easily upset. Antibiotic drugs, although necessary in some cases, lower the populations of our native microbes and allow pathogenic yeasts (unaffected by antibiotics) to take root. This is why vaginal yeasts infections are common in women taking antibiotics. The rapid overgrowth of these yeasts, particularly Candida, also accounts for the side effect of diarrhea common in those undergoing a course of antibiotics. This shifting away from healthy microbes towards pathogenic ones is generally known as dysbiosis.
Other factors contributing towards dysbiosis include a poor diet, especially one high in processed foods and lacking fiber. Fiber acts like a prebiotic, feeding your beneficial gut bugs and helping them to flourish. It is also important to have a regular source of probiotics in your diet to supplement your native population of gut bugs, collectively known as the microbiome. Traditional cultures the world over did so for generations by the inclusion of fermented foods or beverages in their diets on a regular basis. Lacto-fermented foods infuse the gut with billions of beneficial microbes, far better than the best probiotic supplement. In the absence of these foods in the diet, probiotic supplements can turn the tides on a chronic case of dysbiosis and thus have their place in a therapeutic or maintenance setting. The long-term solution, however, is to employ a threefold strategy: lower the population of pathogenic bacteria, feed our native healthy microbes, and supplement additional probiotics to outcompete any remaining pathogens.
Dysbiosis can quickly snowball into leaky gut syndrome if additional disease processes are at play. Chronic mental and emotional stress has a direct inflammatory and destructive influence on the gut. When under stress, the adrenal glands secrete cortisol, which if sustained, depress a very important component of your immune system in the gut known as secretory IgA. The absence of this immunoglobulin leaves you susceptible to a breakdown in cell integrity in a process known as catabolism.
Another very common cause of a loss of cell integrity in the gut is an intolerance to the protein gluten found in the wheat family. In those individuals sensitive to gluten, the protein activates a cascade of effects that creates gaps in the junctions between small intestine cells. The genes correlative with gluten intolerance and celiac disease are estimated to reside in 81% of the population. Couple this with the last few decades of wheat hybridization (boosting gluten levels fourfold) and you have a recipe for disaster.
As the cells of the small intestine get worn down by the collective action of these disease processes, they flatten and separate, forming gaps that reach into the vasculature feeding these tissues. Similar to compacted and eroded soil where a chemical fertilizer can more readily penetrate into the groundwater, a worn small intestine is leaky, allowing larger and larger proteins from partially digested food to enter into the bloodstream. This is leaky gut syndrome and it is a major underlying cause of malnutrition, chronic allergies, autoimmune disorders, and mental illness.
Although allopathic medicine recognizes leaky gut syndrome (caused from gluten intolerance) in its end stage (known as celiac disease and as diagnosed by a small intestine biopsy) they are seldom keen to diagnose and treat the gray area of an individual showing signs of dysbiosis and leaky gut syndrome that can exist for decades before major histological changes can be observed. Furthermore, I believe it to be medically negligent for doctors to prescribe antibiotics without taking the time to educate their patients on supplementing with probiotics to mitigate the side effects of the drug.
If you or someone you know suffers from chronic digestive problems, it is wise to pay a visit to a holistic practitioner skilled in screening for gluten intolerance and can make a clinical diagnosis, based upon history and symptoms, of dysbiosis and leaky gut syndrome. Treating these disorders on the early part of the disease continuum will save you time, money, and undue suffering.