‘All disease begins in the gut’…sound familiar?
Hypocrates supposedly said this thousands of years ago - and we have numbers to back it up today. Some researchers estimate that 90% of disease can be traced back to gut health.
Wait, what? How?
We’re stressing our gut more than ever before
Your small intestine is lined with a very thin barrier (1 cell thick!), which is responsible for controlling what is allowed to pass from your digestive tract into your bloodstream. This is an adaptation, which allows us to easily absorb nutrients from our small intestine to our bloodstream and eventually pass much needed supplies to every cell in our body. However, two things are putting a lot of burden on this fragile intestinal barrier now more than ever: our diet, and our digestion.
Our modern diet is taxing our digestive tract far more than it used to. We’re consuming a number of things that stress or harm the thin endothelial lining, more than we eat things to heal and repair it. Some of these dietary stressors we’ve introduced in the last several decades are:
More gluten, which is known to cause increased gut permeability, even in those that do not have celiac or non-celiac gluten sensitivity (1)
NSAIDs like Advil, Aleve or Aspirin, have been well studied in connection with increased intestinal permeability and resulting gut health conditions. (2)
Antibiotics taken orally or inadvertently in our food, conventional animal products in particular (3)
Hormonal birth control also plays a role in gut health and is linked to inflammatory bowel disease (4)
Pesticides, including glyphosate used on many GMO crops, among others (5)
It’s not only what we put in our mouths that are contributing to this added stress on our digestive tract, there’s also been a change in actual digestive function, stemming from our overstressed brains and nutrient deficiencies. We’re not chewing enough, leaving more work for the stomach and small intestine. Our stressed out eating habits cause low stomach acid, compounding the issue of improperly digested food interacting with our small intestine. And we may have insufficient bile or digestive enzymes from our low nutrient diets. Digestive juices require a number of nutrients, including B vitamins, zinc, vitamins A D E and K, fatty acids, amino acids, and more!
A stressed gut is a leaky gut
When we’re eating things that repeatedly harm our gut lining, you can imagine it as making small pin pricks in the silk chute of our GI. Over time, the number of pin pricks makes a meaningful difference in what’s escaping in the bloodstream. So now some larger particles of food, which should have continued on to the large intestine, are now slipping between these poorly controlled cell junctions. Your body doesn’t recognize them as the nutrient component part. In their less broken down form they’re treated as invaders in your bloodstream.
In addition to ‘food’ (which is really just larger-than-ideal particles), lipopolysaccharides (LPS), which are a powerful endotoxin (meaning toxin originating from inside your body, unlike pesticides for example, which come from outside) are also able to pass through the intestinal barrier and into the bloodstream. These LPS compounds can do some serious damage if given the chance.
How changes in the gut barrier lead to inflammation
Unrecognized food particles, and LPS compounds in your bloodstream activate the immune system. Your immune system creates an inflammatory response in two ways: (A) to draw additional support with increased blood flow and swelling and (B) as a by-product of the attack
it’s mounting, with release of chemicals to neutralize the threat. This inflammation can stay localized in the gut, or travel to other places in your body. This is why some people experience GI pain, gas or bloating, which we can more easily associate with food reactions, and others get brain fog, eczema, joint pain, fatigue, migraines, or a range of other unpleasant symptoms (less often recognized as being connected to what we eat).
Inflammation is a driver of disease state
Many diseases, at their most basic level, are the result of unchecked inflammation. The gut barrier can be a large, if not the largest, source of inflammation in our body. We know chronic inflammation is also a driver of heart disease, neurological degenerative diseases like Alzheimer’s and Parkinsons, metabolic dysfunction like Type 2 diabetes and insulin resistance, asthma and environmental allergies, and skin conditions like psoriasis or eczema (6). Poor gut health has also, maybe unsurprisingly, been linked to depression, anxiety, autism, Schizophrenia, among others mental health conditions (6). We know that many autoimmune diseases are linked to gut-related inflammation; as the immune system upregulates in response to increasing levels of invaders, it generates antibodies that attack the body’s own tissues, resulting in damage (7). Reducing inflammation, and healing and eliminating the source of it, is one of the best ways we can support our healthiest selves.
Gut health, and more specifically - a healthy gut barrier, is foundational to overall health. It is critical to address digestive health before all else. Without fixing the leak in the boat, we would spend a lot of time bailing and not going much of anywhere in a half sunk boat.
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Hollon, J., Puppa, E. L., Greenwald, B., Goldberg, E., Guerrerio, A., & Fasano, A. (2015). Effect of gliadin on permeability of intestinal biopsy explants from celiac disease patients and patients with non-celiac gluten sensitivity. Nutrients, 7(3), 1565–1576. https://doi.org/10.3390/nu7031565
Bjarnason, I., & Takeuchi, K. (2009). Intestinal permeability in the pathogenesis of NSAID-induced enteropathy. Journal of gastroenterology, 44 Suppl 19, 23–29. https://doi.org/10.1007/s00535-008-2266-6
Feng, Y., Huang, Y., Wang, Y., Wang, P., Song, H., & Wang, F. (2019). Antibiotics induced intestinal tight junction barrier dysfunction is associated with microbiota dysbiosis, activated NLRP3 inflammasome and autophagy. PloS one, 14(6), e0218384. https://doi.org/10.1371/journal.pone.0218384
Khalili H. (2016). Risk of Inflammatory Bowel Disease with Oral Contraceptives and Menopausal Hormone Therapy: Current Evidence and Future Directions. Drug safety, 39(3), 193–197. https://doi.org/10.1007/s40264-015-0372-y
Samsel, A., & Seneff, S. (2013). Glyphosate, pathways to modern diseases II: Celiac sprue and gluten intolerance. Interdisciplinary toxicology, 6(4), 159–184. https://doi.org/10.2478/intox-2013-0026
Fasano A. (2020). All disease begins in the (leaky) gut: role of zonulin-mediated gut permeability in the pathogenesis of some chronic inflammatory diseases. F1000Research, 9, F1000 Faculty Rev-69. https://doi.org/10.12688/f1000research.20510.1
Mu, Q., Kirby, J., Reilly, C. M., & Luo, X. M. (2017). Leaky Gut As a Danger Signal for Autoimmune Diseases. Frontiers in immunology, 8, 598. https://doi.org/10.3389/fimmu.2017.00598