Leaky gut caused by low gut blood flow, an explanation for our PEM?

[Emootje]

During maximal exercise in healthy humans, blood flow to the gut is reduced by about 80%. This reduction in blood flow could cause an increase in gut permeability whereby endotoxins leaks into the systemic circulation leading to various symptoms, such as fever,shivering, dizziness, nausea, vomiting and diarrhoea. In ME/CFS the gut blood flow is already challenged by low blood volume and sympathetic over-activation. If we exercise this gut blood flow is challenged even further. Now I was wondering whether this gut hypoperfusion is responsible for our PEM symptoms.

"Prolonged exercise at high intensity leads to a quantitative
redistribution of blood flow, i.e. flow to the exercising
muscles is increased in order to supply oxygen and
substrates. In addition, during intense exercise the blood
flow to the skin is increased to facilitate heat dissipation.
As a consequence, blood flow to central tissues (gut and
liver) is reduced during exercise [1,2]. During maximal
exercise in humans, blood flow to the gut is reduced by
about 80% [3]. Exercise in the heat leads to an extra loss
of total body water and a greater decrease in plasma
volume, with further reduction in blood flow to the gut
[4,5]. A similar redistribution of blood flow is seen in
patients with major trauma and/or sepsis and various
forms of shock [6]. In this situation, a serious underperfusion
of the gut often leads to shock-induced mucosal
damage and invasion of Gram-negative intestinal bacteria
and/or their toxic constituents (endotoxins) into the
blood circulation [7]. Endotoxins are highly toxic lipopolysaccharides
(LPS) of the outer cell wall of Gramnegative
bacteria. Increased circulating LPS levels in
patients lead to various symptoms, such as fever,
shivering, dizziness, nausea, various gastro-intestinal
(GI) complaints such as vomiting and diarrhoea, and
ultimately sepsis [8]"
"Not only might decreased splanchnic blood flow lead
to ischaemic damage to the intestinal wall, but there may
also be thermal and mechanical damage to the mucosal
layer of the gut. Gram-negative bacteria, present in the
gut, may then penetrate the mucosal layer and enter
the lymph nodes in the submucosal tissues. This may lead
to the entry of LPS into the portal vein and, under extreme
conditions, even into the main circulation"
http://www.clinsci.org/cs/098/0047/0980047.pdf

 

[natasa778]

Very interesting, thanks.

 

[xchocoholic]

Wow. Great find. I don't get the symptoms mentioned other than dizziness but I get petite mals and sob on standing.

I always feel better if lay down after eating. It feels like my abdomen finally relaxes so it can digest my food. I get the same feeling in my other organs when I lay down too. It typically takes me an
hour for these organs to fully relax.

I don't know if it's because I'm a celiac with gut damage, low blood flow, lack of digestive enzymes or bad gut bacteria or all the above.

This seems like an easy enough avenue for further research tho. Thanks .. X

 

[alex3619]

I always feel better if lay down after eating. It feels like my abdomen finally relaxes so it can digest my food. I get the same feeling in my other organs when I lay down too. It typically takes me an hour for these organs to fully relax.

When you eat a whole lot of blood rushes to the gut. It stays there for up to an hour or two. So blood flow to the brain would be compromised. Lying down would help to compensate for this but not fully. This is independent of other factors like insulin or chemical sensitivities.

 

[xchocoholic]

When you eat a whole lot of blood rushes to the gut. It stays there for up to an hour or two. So blood flow to the brain would be compromised. Lying down would help to compensate for this but not fully. This is independent of other factors like insulin or chemical sensitivities.

I only eat small meals but this still happens. Eating too much meat at one sitting made it much worse tho. That's why I cut back to 1/4 lb of meat a day divided into 3 - 4 servings as opposed to 1/4 lb at each meal. Beef or other tough meats are harder on me than a light weight fish.

I agree with you on insulin and chemical sensitivities being independent of this. I have insulin and chemical sensitivity problems too but I don't notice the need to lay down with these problems like I do after eating.

I just wonder how many of us do this. BTW. I can feel the blood going back into my upper body after I've layed down. My muscles / organs relax from being in spasm. This lack of blood can't be good for any of our organs.

tc ... x

 

[Enid]

Interesting find - thanks Emootje. (though never was a serious exerciser).

 

[nanonug]

During maximal exercise in healthy humans, blood flow to the gut is reduced by about 80%. http://www.clinsci.org/cs/098/0047/0980047.pdf

This is a great find. Thank you for this!

I am of the opinion, as many know already, that CFS has its root cause in some kind of gut dysfunction eventually leading to intestinal hyperpermeability. It is then intestinal hyperpermeability that leads to all the systemic effects felt as CFS symptoms. For this reason, I have recently done testing (still waiting for results) to assess intestinal permeability. I recommend this same kind of testing to everybody. Meanwhile, here is a nice summary on Leaky Gut. Also, there is a recent book entitled "Increased Intestinal Permeability aka Leaky Gut Syndrome: The Science of Achieving Digestive Health".

 

[mellster]

It is important for those who exercise to do this on a mostly empty stomach. This also explains why people complain that exercise does not increase their gut well being as claimed by the docs. It may do so in the long term by supporting circulation, but it increases gut permeability in the short term and that's not good if you already have an issue with this.

 

[Enid]

Thanks for the links nanonug - much inclined to agree too. And entero "infection" initially which if found early enough might have solved a lot of problems.

 

[nanonug]

It is important for those who exercise to do this on a mostly empty stomach.

Agreed! This is something I found out about myself a long time ago.

 

[Ai-Yai]

Not bad work, but as i undestand they are considering mainly acute condtions, I'm curious why they didn't analyse possibility of so-called negative reverse connection.
It migh be just the case when the GIT already chronicaly afected.
i.e. because of activity ischemic tissue parts and hypoxemic locuses are starting to get more microvascular flow which results to lysis of dead tissues microparts, new microvascular formations and possible local pre-stored toxins removal (through the mainstream finaly) what leads to symptomatic flares in cases of pre-existed chronic tissue pathology.

It is important for those who exercise to do this on a mostly empty stomach. This also explains why people complain that exercise does not increase their gut well being as claimed by the docs. It may do so in the long term by supporting circulation, but it increases gut permeability in the short term and that's not good if you already have an issue with this.

That is why not hard\"gentle", but dynamic aerobic activity is best one. (when oxygen consuption is low, but blood circulation is high).
But it also leads flares esp. in the beginning of trainings.