Leaky Gut – Finding the Cause

Leaky gut syndrome results from the irritation and inflammation of the lining of the intestines. Tests can be done to determine the causes which are commonly diet related.

How do you define what leaky gut syndrome is?

Dr. Greg Olsen: When we look at the term leaky gut, leaky gut means that the gut has an integrity to it. It’s like a filter. You can imagine, when you’ve eaten some food, it’s digesting, it passes through the intestines. The intestines are going to let certain things in for absorption for you to use nutrient wise, for your body to run, and the rest of it is going to pass through.

What leaky gut syndrome basically means is that mucosal lining, or the lining of the intestines, rather than being normal and intact in what we’ll call the selective membrane, it gets irritated, gets inflamed, and begins to open up to the point where it starts letting some of the products of digestion to be absorbed, that shouldn’t be.

These basically then are looked at by your body as foreign substances. They’re going, “What the heck is this?” So leaky gut is, ultimately, that compromised or that poor functioning gut lining allowing substances to pass through that shouldn’t be, which then leads to symptoms people often times experience.

Just sitting down with a patient yesterday, going over her discussion with it, bloating, sometimes feeling after eating that she’s pregnant, and experiencing sometimes rashes around the body because of different types of immune responses that are going on. That is part of basically the identification of a leaky gut, and some of what is experienced by people when they’re experiencing leaky gut.

You just touched on this a little bit, but what are the symptoms of leaky gut and how is it diagnosed?

Dr. Greg Olsen: All right. Yes. I got ahead of myself a little bit here.

RC: That’s okay.

Dr. Greg Olsen: When we talk about symptoms of leaky gut, again, looking at some of the relationships there, that can be everything from just what I was mentioning, somebody who basically always feels like, men and women experience this, but it’s one of those things it’s more often reported with women who might come in and say, “I’m always bloated,” or “I eat these particular foods or eating these and I feel like I’m pregnant.” That can be part of it sometimes.

Also, people with leaky gut may alternate between diarrhea and constipation. The bloated feeling because of the compromise in that gut, you can have poor energy, your bowel movements might be off, decreased frequency. So, those are some of the symptoms.

How is it diagnosed? There are a couple ways of looking at this. There are different ways of testing for it. There are also, in office, there’s a series of questions that we ask because people who often times experience leaky gut, often times experience certain symptoms.

So the first step is screening questions. The second step is, I will do abdominal or stomach palpation or feeling around the stomach. Because leaky guy is an inflamed, compromised intestinal lining, it’s almost always associated with firm palpation through the small and large intestine with tenderness and pain. So, in office questionnaire, examining or palpating large and small intestine.

There are connections that then move it into looking at the laboratory testing. So, laboratory testing can go a couple of different directions. The first one, there are measurements where you can do testing, particularly a sugar substance and then measuring how it passes through. Larger chain sugars should pass through the intestines, and if they get absorbed, then that would be an indication of it.

There’s a lab I use called Cyrex Labs that actually does an evaluation of that intestinal lining, the mucosal lining through what is called the “tight junctions.” That evaluation tells us if that tight junction is intact or if it is being attacked and compromised. That is for me the best diagnosis for it.

I will also look on a stool test. On a stool test, looking for signs of inflammation. If the gut is inflamed, then that’s going to be a key problem associated with the leaky gut. That also looks for other organisms and compromised digestion. It’ll look for a relationship to, for example, pancreatic enzymes, and the ability to digest food once it’s in taken.

It’s also going to look for those other organisms that can be present. There can be different things that cause inflammation of the intestinal lining leading to leaky gut. That can be stress. It can be the food relationship, such as gluten, and cross-reactive foods. It can also be the presence of chronic intestinal infections from things like parasites, fungus, bacteria.

An example, the first patient that comes to mind, there was a patient who had been on a mission to Russia and chronically looking at gut issues, inflammation. We were looking at leaky gut issues. We evaluated and we found that he likely picked up a parasite on a missionary trip to Russia 15 years prior and it was chronically infecting his gut, contributing to a leaky gut, and to other musculoskeletal and digestive issues.

So those are the key steps that I look at in diagnosing leaky gut.

You did touch on this a little bit, but my question is, are there any known causes of leaky gut syndrome and if not have researchers found any triggers?

Dr. Greg Olsen: Looking into the known causes of leaky gut, I did go into that a little bit. Elaborating on that, when looking at leaky gut and the causes I’m going to relay two different sides to this. If we have a compromised gut and there’s the tight junctions are off and the mucosal integrity is off, from a medical standpoint, you go, “Okay. Well, how do we treat that junction?”

More importantly from a functional standpoint, is what’s the cause of that? Don’t just treat the symptom, treat the cause. Where is the cause of this coming from? That cause could be different. Again, different organisms that might be present, chronic parasite, chronic organism, chronic fungus, bacteria, chronic stress, chronic exposure to foods that are irritating to the gut lining.

Also, we look at function with the intestines, just throwing it in there, there’s something called ileocecal valve, which is the junction between the large and small intestine. That can, at times, mechanically be compromised allowing bacteria from one area to the other contributing to an irritated state in the intestines.

Most commonly, when we’re looking at that, we’re going to be looking at organisms. We’re going to be looking at that food connection. We’re going to be looking at that gluten and cross reactivity connection related to leaky gut syndrome.

Directly with that research and associated triggers with it, probably the first one that jumps into that is that connection to foods. As far as researchers go, looking at the gliadin and the gluten connection, cross reactive foods. So, every time that food is eaten and is passing through the intestines, it’s basically irritating, inflaming that intestinal lining, ultimately, leading to a compromise of those junctions and that leaky gut connection.

Clinically, would be identification of the triggers that we were looking at before. That is chronic stress leading to inflammatory response, as well as looking at the presence of other organisms that might be present.

What type of tests or evaluations are available to try to determine these causes of leaky gut syndrome?

Dr. Greg Olsen: The best testing done to evaluate leaky gut syndrome for the ultimate or gold standard diagnosis is the test from Cyrex Labs where we look at the integrity of that intestinal tight junction, where that final step of absorption takes place, that final gateway for absorption. If that is compromised, and it’s found to be off from that testing, it is finding that there’s leaky gut present and ultimately, where that cause is at in that junction there.

There’s also evaluation through intake of different substances.  And if they are absorbed, then we know that there is a compromise in that gut because those tight junctions are off so it’s absorbed rather than being passed through or eliminated.

The last one that I look at, for me, is very important from a causative standpoint, is looking at intestinal inflammation. Every time there’s a situation with leaky gut, there’s always going to be inflammation in the intestines. They go hand-in-hand. Knowing about the presence of and the amount of inflammation happening in the intestines is extremely valuable to determining the cause and also what is going to likely be the course of action and how long that might take.

If someone suspects that they have leaky gut syndrome, what should they do?

Dr. Greg Olsen: If somebody thinks they have leaky gut syndrome, then the best step is to find somebody who knows what they’re doing related to evaluating leaky gut. There are times when people will think, “Oh, I have leaky gut,” and look up things, and say, “Okay. Well, this is what I do for leaky gut.”

There are times where people might have hit the right target with that and get going, but the gut is so important to overall health. It’s not just hanging out there digesting and absorbing food. It’s important in that digestion and absorption process, but it also has an incredible, what we call enteric nervous system that ties in with brain health, ties in with overall well-being, neurotransmitter function.

The multitude of connections with gut function, really if you’re having issues that you’re concerned about, and leaky gut syndrome, or other things that you’re concerned about, is finding somebody who can properly evaluate you and get you on the right path, rather than leaving it and guessing.  Part of that process is getting evaluated, but also doing the follow-up testing because there are many times where you might be feeling better, but not be better.

One of the things we want to make sure of is that you’re not just 50% better in your gut function, but you go, “Wow, I feel so much better.” We want you to be 100% better with regard to how your guts working.

Many times, because leaky gut may have been developing over 5, 10, 15, 20 years or happening to some small degree, by the time people start feeling better they go, “I haven’t felt this good in years,” but they’re not back to where they’re 100%, which is to just basically not only give them that short term of being better, but we want that long term. We want that gut to be in good shape. We want it to be healed. We want you to know what caused it and how to take care of it and prevent it in the future.

Learn More

To speak with Dr. Greg Olsen, visit www.askdrolsen.com or call (949) 859-5192 to schedule an appointment.

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