In the world of functional medicine, it has long been known that gut health is paramount to the health of the rest of the body. For decades we didn’t fully understand why, although we knew the gut was the seat of the immune system and chronic inflammation. Now, with the gut microbiome renaissance underway, we also understand how integral gut bacteria is to health.

As such, addressing gut health has always been one and continues to be one of the first steps in managing a chronic inflammatory or autoimmune condition. However, people tend to fall into the trap of thinking everyone needs to follow the same gut healing protocol, wondering why it works for some and not others.

As it turns out, repairing gut health is not a one-size-fits-all approach. There is not just one diet, one type of probiotic, or one gut healing powder that works for everyone. Although there are some basic foundations to gut healing — remove immune reactive foods, keep blood sugar stable, and create a healthy gut microbiome — the truth is you still need to know why your gut health deteriorated in order to address the root cause.

Root Causes of Leaky Gut

While this is not an exhaustive list of the root causes of leaky gut and other gut problems, we have listed some significant ones below.

Diet

The Standard American Diet (SAD) is high in gluten, conventional dairy, sugars, industrial seed oils, food additives and other inflammatory ingredients that are not conducive to gut health. Prolonged exposure to inflammatory and immune-triggering foods such as gluten, dairy, corn, soy, eggs, lectins, food additives, and more contributes to inflammation within the gut.

When speaking of gut inflammation, it is important to draw special attention to gluten; a group of proteins found in grains such as wheat, einkorn, spelt, barley, rye, gamut, and triticale. These proteins are highly problematic for the gut lining; especially for those with celiac disease and non-celiac gluten sensitivity (NCGS). Research shows that gluten can bind to receptors in the gut and initiate intestinal hyperpermeability through the release of zonulin.

Celiac Disease

It is also clear that in genetically susceptible people, gluten binds to CXCR3 receptors which triggers an increased production of zonulin. The release of zonulin causes the enterocyte cells that line the gut to become leaky. Additionally, gluten triggers mast cells in the gut lining which release inflammatory molecules such as histamine and tryptase, which further inflame the gut.

Food Allergies & Sensitivities

As touched on above, prolonged exposure to food allergens and food sensitivities contribute to inflammation within the gut. Food sensitivities are often confused with allergies but different portions of the immune system are activated with a sensitivity (IgG/IgA instead of the IgE with allergies).

Infections

Underlying infections such as fungal overgrowth, parasitic infections, viruses, and harmful bacteria can negatively impact the microbiome and create a proinflammatory state in the gut. These infections are not just found in third world countries and are very prevalent in our culture today. Bacterial overgrowth can also be found in the wrong portions of the GI system which will create symptoms and a problem as well.

Medications

There are several medications that can initiate further inflammation and gut dysbiosis. NSAIDS, oral contraceptives, antibiotics, acid-reducing drugs, and others can alter the microbiome by reducing the abundance and diversity of beneficial organisms, allowing for pathogenic microbes to proliferate. As mentioned above, harmful bacteria and other infections can wreck havoc on the gut. This alteration of the microbiome can also cause estrogen metabolism problems and weight loss resistance, further contributing to gut problems.

Stress

When the body is under chronic stress, the stress hormone cortisol is also elevated chronically. Continuously elevated cortisol is highly inflammatory and damages the gut lining. Furthermore, when you are in a state of high stress, your parasympathetic systems and digestive system shuts down. This compromises digestion, lowers stomach acid, allows food to putrefy in the gut, and pathogens to proliferate; all of which compound gut problems.

Emotional Trauma

Emotional trauma, especially trauma at a young age, can contribute to leaky gut. PTSD is linked with many chronic conditions, including leaky gut, by contributing to immune system dysregulation, increasing proinflammatory cytokines, and altering the microbiome.

Hormone Imbalances

Proper got function depends on the proper hormone function. If there is endocrine disruption in any way- estrogen, progesterone, testosterone, thyroid hormones, cortisol, etc., the gut may become compromised.

Traumatic Brain Injury (TBI)

Brain injuries actually initiate intestinal permeability and causes the gut mucosa to atrophy and die. Traumatic brain injuries can also cause autonomic dysregulation, breakdown the blood brain barrier, impair gut motility, disrupt visceral sensing and processing, and compromise the brain’s immune function.

Environmental Toxins

Environmental toxins impact the gut in several ways. First, the microbiota impacts how the toxins and other environmental compounds are absorbed, metabolized, and excreted. Research points to the fact that gut dysbiosis can enhance the toxicity of various compounds. Oftentimes the toxins we are exposed to can become more toxic by their interaction with harmful gut microbes.

Additionally, it is well known that many environmental toxins have a detrimental impact on the gut lining. Those that have the most significant impact on the gut are heavy metals, pesticides, antibiotics, immunizations, and chlorinated water.

Lastly, the gut is involved with phase 1 and phase 2 detoxification within the body. Impaired gut function hinders the body’s ability to detoxify the toxins it comes in contact with. Therefore a leaky gut can cause the body to hold onto toxins.

Strenuous Exercise & Sedentary Lifestyle

Strenuous exercise is incredibly stressful for the body. Just like periods when individuals are under intense stress, strenuous exercise causes the body to enter into fight or flight mode. In this state, the stress hormone, cortisol is high, chronically raising inflammation levels. When cortisol is high, it allows for the normally tight cell junctions to become leaky. Another stress hormone, corticotropin-releasing hormone (CRH) is released when the body is in an exercise induced fight or flight state. CRH increases leaky gut through the activation of mast cells and the protein claudin-2 . It is also important to note that a sedentary lifestyle is associated with increased inflammation to the gut.

C-section Birth & Formula-Fed Babies

The gut is a sterile environment until the moment of birth. The baby’s gut is “seeded” with microorganisms as it travels through the vaginal canal. When babies are born via c-section, their microbiomes are formed by the microbes in their surroundings, not the beneficial organisms of the mother’s vagina.

Breastfeeding also benefits the newborn’s microbial environment by offering anti-inflammatory Lactobacillus and Bifidobacteria. When babies are formula fed, the growth of harmful gut bacteria can be promoted as well as increased intestinal permeability.

We do note that there are times when c-sections and formula feeding are necessary and life saving. There are strategies to implement to minimize the impact that these interventions can have on the gut integrity.

Sleep Disturbances

The circadian rhythm is involved with bodily processes that occur on a routine 24 hour cycle. The intestinal environment is regulated by circadian rhythm. Disrupted sleep is associated with increased gut inflammation, pathogen proliferation within the gut, and increased intestinal permeability.

Gut-Brain Axis Dysregulation

There is an intimate link between the gut and the brain via the gut-brain axis. The gut-brain axis is a bidirectional communication network that links the enteric (gut) and central nervous systems. When there is inflammation in the brain, there is inflammation in the gut, and vice vera. It has been said when the gut is on fire, the brain is on fire.

High Blood Sugar

Blood sugar dysregulation is involved in many chronic inflammatory conditions. For insight on how blood sugar impacts the gut, it is helpful to look at HbA1c, a blood marker that shows blood glucose concentrations over a 3 month time period. Research indicated that elevated HbA1c drives gut barrier dysfunction.

Alcohol & Other Substance Abuse

Chronic alcohol and substance abuse can contribute to a leaky gut because it leads to intestinal inflammation by altering the composition of the microbiome, increasing the permeability of the intestinal lining, and affecting the intestinal immune function.

Examples of Root Causes of Poor Gut Health

A number of patients can come in with a complaint of constipation. While laxatives may help the patient, it is nevertheless important to understand why they are constipated in the first place. This goes for any digestive complaint and not just constipation.

Here are some different reasons why a person can develop a digestive complaint such as constipation:

A past brain injury has dampened activity of the vagus nerve, which carries communication back and forth between the gut and the brain. This slows down motility of the intestines and causes constipation.

The gut’s nervous system, called the enteric nervous system, has degenerated significantly due to chronic gut inflammation from immune reactive foods, too many sugars and processed foods, chronic stress, gut infections, or brain degeneration. Intestinal motility depends on a healthy enteric nervous system, and constipation can develop.
Small intestinal bacterial overgrowth (SIBO) releases gases that shut down motility.
Medications impact intestinal motility and cause constipation.
Dysautonomia, a dysregulation of the central nervous system, prevents the body from getting into the “rest and digest” state that allows for healthy bowel function.

A one-size-fits-all gut protocol can completely heal one person, create improvement in another, do nothing at all for a third, and perhaps make another even worse.

It’s also important to screen for more serious conditions. These can include gastric ulcers from an H. Pylori infection, intestinal permeability — or leaky gut — from damage to the microvilli of the small intestine, inflammatory bowel disease, ulcerative colitis, or Crohn’s disease. Knowing whether these conditions are an issue also impacts how you manage gut health.

Also vital is knowing whether gut autoimmunity is the root cause of your gut issues. You can test for this through Cryex Labs. If so, this changes your expectations of your outcomes and how you evaluate your progress. Autoimmune disease occurs when the immune system erroneously attacks and destroys tissue in the body. Eventually this leads to symptoms and breakdown of function.

Although autoimmune disease cannot be cured, it often can be dampened or driven into remission for long periods of time. However, unpredictable flare ups also happen, and the person with gut autoimmunity must have realistic expectations in order not to feel demoralized if their symptoms flare and recede. Also, there is still much we don’t know about autoimmunity. For some people it’s easy to manage and for others it’s a constant battle. In these cases, the goal can be as simple as “more good days.”

This is an overview of why common gut-healing protocols work great for some people and little to not at all for others. Our digestive system is one of the most fascinating, complex, and influential systems in the body. The more scientists learn about it, the more apparent it becomes that gut health largely determines the health of the rest of the body, including the brain.

This is why we are seeing so many chronic health conditions in modernized societies that subsist largely on industrialized agriculture and food processing. The commercialization of cheap, processed, chemically laden, and highly sweetened “foods” largely void of produce has inflamed and damaged the digestive tract, decimated the gut microbiome (some researchers call it an extinction event), and ravaged the brain in today’s modern populations.

Fortunately, functional medicine excels when it comes to repairing and maintaining gut health. Ask our office how we can help you.