Tuesday, June 26, 2012

Is a Leaky Gut only Found in Those with Celiac Disease?


If you follow the literature at all on celiac disease or gluten sensitivity, then you have likely heard much about ‘leaky gut’.

What is it?

The small intestine, 23 feet in length and responsible for turning food into fuel, is a permeable organ. This means that it allows digested food to leave its confines in order to feed all the cells of the body but it also has an intelligent ‘gate keeper’ system that prevents toxins or dangerous organisms from escaping.

When it is functioning normally, the small intestine performs these two, but opposite, functions superbly.
A leaky gut it defined as a small intestine that no longer is guarding the gates well. As a result, partially digested food, toxins and disease-causing organisms gain access to the bloodstream where they can be responsible for a host of ills including many autoimmune diseases – the third leading cause of death in this country.

When testing for the presence of a leaky gut most research has employed the use of a test called the lactulose mannitol test. Lactulose and mannitol are both sugar molecules that are water soluble but not metabolized by the body. Mannitol is the smaller of the two and should be easily absorbed by cells, while lactulose has larger molecules and should be only partially absorbed.

When evaluating those with celiac disease vs. gluten sensitivity, many researchers have cited a positive lactulose mannitol test in those with celiac disease, while consistently showing a negative test in a gluten sensitive population. Their conclusions were, therefore, that only those suffering with celiac disease suffered from leaky gut and those with gluten sensitivity did not.

I have been perplexed by this for quite some time because I see many gluten sensitive patients that respond very favorably to a program that heals a leaky gut.

My clinical knowledge, meaning what I learn from working with my patients, rarely steers me wrong. It was due to my patients that I even discovered gluten sensitivity 20 years ago and I recently saw a quote from Alessio Fasano that cited very much the same thing. He commented that people who were ‘convinced’ that they were celiac and came to his center only to be tested and discover they were not, went home and tried a gluten-free diet anyway and reported miraculous improvement from having done so. Fortunately he listened and from these individuals he began to research what we now know is a very legitimate and common condition, gluten sensitivity.

A couple of years ago I heard research presented by a doctor who was discussing a new permeability test. This doctor contended that the lactulose mannitol test was too gross a test and by the time it showed positive there was extremely severe damage done to the lining of the gut. This makes sense because the test is typically found positive only in celiac and we know that disease causes catastrophic damage to the lining of the small intestine – it is in no way a subtle degree of destruction.

The new test claimed to be more sensitive to subtle changes in permeability of the small intestine, thus making early diagnosis available (always a good thing) plus it frequently proves to be positive in those with gluten sensitivity, not just celiac.

This got my attention because it aligned with what I saw with my patients.
Do understand that I have no personal vested interest in the laboratory offering this test, I’m simply trying to make the point that I believe two things to be true:

1.       The lactulose mannitol test is potentially outdated because it isn’t sensitive to early and subtle changes in gut permeability
2.       Gluten sensitive patients suffer from leaky gut in much the same way as do those with celiac disease. The damage is not as severe, but it doesn’t preclude the negative effects that a leaky gut will create.

Why is this important?

If you have a leaky gut and it isn’t treated properly and early on, you will not regain optimal health, despite a gluten-free diet) and you will be more likely to develop other diseases involving the immune system and nervous system, whether it’s a poor balance of good bacteria in the gut, chronic food reactions, depression, chronic fatigue or autoimmune disease.

The more sensitive test, a blood test, is offered by Cyrex Labs and it measures the body’s immune response to the passage of a lipopolysaccharide (LPS), a substance that is released once a bacterial cell has died. It is felt that the passage of LPS is a more sensitive marker than the previous lactulose mannitol that has been likened to a ‘Mack truck’ passing through the small intestine. And as we all know, a Mack truck is not subtle. The LPS molecule is more like tracking the passage of a ‘Mini cooper’ making its way through the intestinal barrier. Both are a problem and therefore both must be identified.

Much like our poor diagnosis rate – on 5% of all celiac ever get diagnosed in this country and that is typically after a decade of seeking out help – it seems that our ability to diagnose leaky gut is also in need of some assistance.

If you suspect leaky gut you should try to find a clinician to test you. If you need help in this department, always feel free to contact me. I can offer you a free health analysis if you call the clinic at 408-733-0400.
I feel that we will soon appreciate the fact that leaky gut is prevalent in those with gluten sensitivity as well as celiac. This knowledge plus the implementation of an effective treatment plan will go a long way towards dramatic health improvement.

My treatment for a leaky gut involves identifying any and all inhospitable organisms (this would include bacteria, parasites, amoeba, etc) and eradicating them. It further entails evaluating the balance of the good organisms or probiotics in the gut and balancing them as needed. Looking for any nutritional deficiencies, toxicities, hormonal imbalance and other food reactions is all part of this comprehensive program.

Do you know anyone who is wondering if leaky gut is a problem for them? If so, please send them this post.
I am here to help and my commitment is to dramatically increase the awareness of celiac disease and gluten sensitivity, while developing effective treatment strategies that work. We have a strong, effective program for normalizing gut permeability. It is tailored to each individual because we are not all the same, but the above description is the foundation upon which it is based.

I hope this was informative. Do you have any questions? Please send them to me.
We are happy to offer a free health analysis to you, your family and friends – we are here to help!


To your good health,
Dr Vikki Petersen, DC, CCN
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect”
Author of the eBook: “Gluten Intolerance – What you don’t know may be killing you!”

2 comments:

Amy said...

Dear Dr Petersen,

I am 25 years old and have been diagnosed with hashimoto's thyroiditis and I have eczema on my left hand. I realize that both of these conditions are autoimmune. Over the past year I have developed a lot of stomach problems. I had a food sensitivity test and am now avoiding beans and gluten due to results of this test, as well as dairy since I feel it causes some problems for me. I take probiotics and digestive enzymes along with a multi-vitamin and some other supplements. I eat as organic and hormone-free as I can afford. My extreme menstrual symptoms have lessened, which seems to indicate that my hormonal imbalances are improving. The information I have read here and other places about leaky gut is so eye-opening. Thank you! What I need to know is whether or not what I am doing is enough to cure my leaky gut and autoimmune responses? I still suffer from (more mild now, but still regular) anxiety, depression, nausea, constipation, fatigue, etc. What should my next step be in order to find health?

The HealthNOW Doctors said...

Hello Amy,
You are definitely doing some good things for yourself but there is more that should be addressed.

I call these issues the secondary effects of gluten and they include such things as discovering if there are any intestinal infections, poor probiotic populations, cross-reactive foods, etc. All of these things, plus a few more, can cause and cause to persist, a leaky gut.

If you'd like we can speak further. We are a destination clinic and we treat people from across the country and internationally.

If you'd like a free health analysis you can call us at 408-733-0400.

We'd be delighted to try and help you. At 25 you have a lot of healing capability that could potentially reverse if not at least stabilize your autoimmune diseases.

Best,
Dr Vikki