Leaky gut: is anything genuinely known about how to tackle it?

[trishrhymes]

So called fecal transplants have come a long way since the days of the home made poo in a blender treatment.

There is good evidence that if done properly it can be enormously helpful for patients with C. difficile infection.

These days I understand it's done with detailed health checks of donors, and of the poo donations and refining of the poo samples to extract the useful bacteria etc. This is frozen and stored for later use.

It's then inserted through a tube from either end of the digestive tract into the relevant area of the gut under hospital conditions. If I had C diff. I'd definitely opt to have it. I might even be interested in trying it if proven useful for ME to rebalance gut flora.

 

[arewenearlythereyet]

my thoughts on acidification is that if I can successfully get rid of a lifetime of GERD type symptoms by reducing my carb intake (100-150g per day), and I have poor absorption of vitamins and minerals (especially iron) generally, then I probably have low stomach acidity, which means that I'm not properly digesting food and microbes that are normally limited by acid environments (yeasts and mounds particularly) could be getting out of hand in my small intestine. My trial will be to look at acidification to see if this can help a little with iron absorption mainly, but also allow me to eat a more balanced diet with a bit more carbs without getting the chronic indigestion and bloating which some ascribe to a fermenting gut. I'm not convinced of this at all, but it seems like a simple thing to try that shouldn't have too many harmful consequences. I've learnt a lot from some of the guys with pernicious aneamia who also have low stomach acidity (for other reasons). I am a newcomer to this whole thing so I'm sure someone can unpick my logic. Having a Limey virgin g&t before dinner does sound quite civilised though.

 

[Hip]

I guess I'm wondering what there is that has good scientific evidence.

In this post there is a list of factors that studies have shown can cause leaky gut, and list of supplements and drugs that studies have shown can fix or reduce leaky gut.

 

[barbc56]

Here's an interesting article about leaky gut.

In some individuals, for a variety of reasons, the physical structure of their intestines is compromised. The tight junctions, which control what materials the intestine absorbs, don’t work properly, allowing larger substances (but still very small) to cross over into the bloodstream. This is known as intestinal permeability.

Physicians sometimes find increased intestinal permeability in those who have Crohn’s disease, celiac disease, in individuals receiving chemotherapy, and those who have a high intake of bowel-damaging substances such as aspirin and alcohol. However, intestinal permeability is a symptom of these ailments, not a cause; it does not lead to anything more than inflammation of the bowel walls, and it is not leaky gut syndrome. Furthermore, research shows that increased intestinal permeability sometimes has beneficial effects, such as improving water and nutrient absorption as well as activating the immune system.1

 

[Carl]

How is leaky gut diagnosed? All I can think of is cholera, etc., but that's leakage the other way .....

Lactulose/Mannitol tests are frequently used. They get people to drink Lactulose/Mannitol and then test the urine to see how much of these none metabolisable sugars show up in the urine.
https://www.gdx.net/product/intestinal-permeability-assessment-urine
https://www.gdx.net/core/interpretive-guides/Intestinal-Permeability-Interp-Guide.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4047110/

 

[TigerLilea]

and stick with the principle that if your body got rid of it ...its probably for a good reason.

What if your body didn't want to get rid of it, but the antibiotics that were prescribed to you wiped it out?

You are never going to be able to sterilise your gut flora to eliminate a particular species.

It isn't about sterilizing your gut flora, but taking in good bacteria to help keep the bad bacteria in check.

 

[TigerLilea]

I might even be interested in trying it if proven useful for ME to rebalance gut flora.

I would definitely try it if there was reason to believe that it would help with ME/CFS.

 

[arewenearlythereyet]

I understand the rebalancing argument. I did a long time ago train to be a microbiologist. The issue I have is that the advocates of the rebalancing are trying to oversimplify quite a complex thing and that's why I'm struggling to see any real science here.... Yet.

I do find it interesting and worth exploring to get the science straight though.

 

[brenda]

Many are finding that the autoimmune protocol diet heals leaky gut.

 

[ebethc]

From what I have read, most of the literature centres on L-Glutamine, which is typically an effective treatment for hyper-permeability in IBD, and in many cases can prevent relapse. I have also seen L-Glutamine studies for diarrhoea as well, and whilst it effectively reduces intestinal permeability it has no effect on symptoms in that instance.

doesn't glutamine increase glutamate?

 

[Cheesus]

doesn't glutamine increase glutamate?

Dunno. I've been taking it an I haven't had an increase in excitotoxicity, so if it does then it isn't a problem for me personally.

 

[Richard7]

@Azriel that is a good idea. I am interested in reading up on it if you get a response.

I can remember doing an internet search when I read the article and finding nothing, but I did not think to write to the author.

 

[bspg]

FWIW, my anecdotal evidence:

I've read about leaky gut being related to candida dominance/overgrowth in the intestine. I believe the theory is that once dysbiosis occurs, candida can become dominant in the intestine and if enough inflammation is present, it can "branch" into the tight junctions.

Is this a real thing? ¯\_(ツ)_/¯ I don't know. I'm not sure if and when we'll ever know. Regardless...

Years ago, I did a "yeast elimination" diet to try and dampen down the yeast and improve some of my symptoms (chronic yeast infections, brain fog, fatigue, always sick). I did it for 3 months and remember feeling the best I had in a long time. The yeast infections cleared up, I was clear headed, had more energy/felt light on my feet and I even felt happier. It was pretty incredible!

Unfortunately the diet was extremely restrictive and too stressful for me to maintain after 3 months and I fell off the bandwagon shortly after. In hindsight, I should've started adding foods back in to make it less restrictive but I wasn't the most rational or dedicated 23 year old. Also I was still functioning better than before the diet so...

There are many possible reasons why this diet helped me: maybe it eliminated foods I'm intolerant to? Maybe it calmed inflammation and allowed me to absorb nutrients better? Maybe it actually DID eliminate yeast overgrowth/leaky gut? I don't know.

Regardless of the reason, I saw significant improvement on it and it might be worth trying for those who think they are suffering from leaky gut. If anyone is interested in the protocol I used, feel free to PM or ask questions here. I'm happy to talk about my experience (at least what I remember of it! )