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Leaky Gut Syndrome

You’ve heard of “Leaky Gut Syndrome”. Back in the 1980s, we used to think we had it wrapped up: we knew the story, understood the mechanics and had a good treatment modality going.

Unfortunately, we were almost totally wrong, as you will see!

It’s not like you thought! Even I didn’t realize that was coming down the turnpike! What is surprising is that in the intervening years, orthodox medicine has taken us rapidly forward on the theme of leaky gut, with the discovery of “tight junctions”

First let’s quickly re-run the “traditional” story…

Leaky Gut Syndrome

The idea was that our guts are inflamed by food allergies, dysbiosis, parasites, heavy metal poisoning etc. So they “leak’, meaning they let through molecules they shouldn’t. Instead of waiting till proteins, for example, were properly digested down to peptides or even smaller (amino acids), the much larger protein molecules appeared in the blood, not properly digested.

As a result, we got an allergic reaction to the “wheat”, or “eggs” in the blood, which shouldn’t be there. These incomplete food products were the basis of highly inflammatory reactions all over the body: antigen-antibody complexes got deposited in tissues and organs and were the focus of fiery reactions. So yet another version of “fire in the belly”!

There were two aspects to the theory:

• first, that enzyme function was somehow inadequate, to the digestive process was poor or slow and so foods remained identifiable
• Secondly, the products of digestion were leaked prematurely into the blood

The two approaches were thus to aid digestion, by the use of digestive enzyme supplements, and to quench the inflammation, by removing food allergens, parasites, heavy metals, etc. and correcting dysbiosis through the use of probiotics and then, later, pre-biotics.

I can tell you we got great results, even if the theory wasn’t exactly watertight! But in this section, you’ll learn the fuller story.

Stimulating Enzyme Function

We started by stimulating gastric and pancreatic secretions with so-called “bitters”: Dandelion, Yarrow, Mugwort, Chamomile (which are mild) and Wormwood (as in Absinthe), Barberry, Gentian, Rue and Tansy (which are very strong). Bitters are taken just before meals and stimulate the appetite, as well as the secretion of digestive “juices”!

For a discussion of enzyme supplementation therapy, I can do no better than quote the work of William H. Philpott MD, an allergy-oriented holistic doctor like myself, but who has specialty training and practice in psychiatry, neurology, electroencephalography, nutrition, environmental medicine and toxicology.

To succeed with this you will need to monitor the state of the acid-alkali process that is taking place in your body. Actually this can be quite simply done by testing the saliva. Suitable pH testing strips are available from Amazon.com Supplement as follows: Thirty minutes before your main meal take two tablets of pancreatic enzyme extract. At the commencement of the meal, test your saliva.

If the pH is higher than 6.0 (inadequate hydrochloric acid), take betaine hydrochloride or similar acidic replacement.

Start with one capsule or tablet and increase by one each day. At this time swallow the pepsin supplement, if you are using one. It is far simpler to have your HCl and pepsin combined in a single supplement.

After the meal: take two more tablets of pancreatic enzyme extract.

Thirty minutes after the end of the meal: take a further tablet of pancreatic extract, a tablet of bromelain with papain, and a half teaspoon of alkali salts mix (sodium and potassium bicarbonate).

At bedtime: take five tablets of pancreatic enzyme extract and two bromelain with papain tablets. If you have a mind to do so, Philpott recommends a further dose at 2 a.m.: take five tablets of pancreatic enzyme extract, two tablets of bromelain with papain.

I consider this redundant and stressful. Sleep is more valuable than popping supplements. It’s important to use such an enzyme supplement program short term.

If you tackle your diet problems properly, as I have outlined consistently throughout my book Diet Wise, you should not need to take enzyme supplements for more than a few months to a year.

Take a regimen of vitamin C (2000 mgm), vitamin A (10,00 IU, unless pregnant), zinc (20mgm) and pantothenic acid (500 – 1000 mgm) to improve digestive health in general.

Ready-Made Enzyme Multi-Formulas

A simpler answer may be to take a multi-enzyme preparation. There are several of these on the market. Look for the FCC activity index. These are from the Food Chemical Codex (FCC).  The FCC is published by the National Academy Press.  This system establishes activity levels and potency for enzymes. This is a far more important guide than weight alone.

Formulas should contain the enzymes required to break down and metabolize the full range of food types. Look for:

• • proteases and proteinases (which digest protein)
• • lipase (digests fats)
• • amylase (digests carbohydrates/starches)
• • cellulase, pectinase and phytase (which digest fiber)
• • lactase (milk sugar)
• • other complex sugar enzymes, such as glucoamylase, invertase, and malt diastase.
• xylanase – breaks down the xylan sugars found in most plants(works well with grains such as corn.
• actinidin – a protease from the kiwi fruit that shows significant activity on wheat products. Most products will contain bromelain – a broad spectrum enzyme that hydrolizes most soluble proteins, and papain – a proteolytic enzyme characterized by its ability to hydrolyze large proteins into smaller peptides and amino acids.
• Look out also for Alpha galactosidase, which breaks melibose, raffinose, and stachyose – sugars that are responsible for excess gas in the digestive system.

Repairing The Damaged Gut

Logically, the reader will understand that this whole Academy is about damping down inflammation in the guts. Avoiding high impact foods (allergy and intolerance foods), cleaning up parasites (the section in Diet Wise on Dr. William Stuppy and his work is highly useful in that respect), altering the microbiome with probiotics and pre-biotics is all good measure for this aspect of therapy.

The degree to which the gut was damaged could be measured using a test like the Mannitol absorption test could be useful, as a before and after. Mannitol is a large sugar molecule that ideally should not be absorbed.  So the person fasts, swallows a test dose and blood and urine samples are taken. If mannitol appears in the blood and urine in significant quantities, when the gut leaks.

Similarly, tests for pancreatic enzyme sufficiency, such as the bentiromide test, involves ingestion of a chemical called bentiromide. This is broken down by pancreatic enzymes and one constituent (para-aminobenzoic acid, PABA) is absorbed and excreted in the urine. Pancreatic insufficiency is suspected when urinary PABA levels are low.

Another more advanced pancreatic function test is available but could add value in difficult cases. A tube is placed through the nose or mouth so that its tip is lying next to the opening of the pancreatic duct into the duodenum. Secretions are collected and the content of bicarbonate and enzymes are measured after the pancreas has been stimulated with a hormone called secretin or with a test meal. Pancreatic insufficiency is indicated if the bicarbonate and enzyme concentrations are very low.

Finally, it’s worth mentioning a fancy new electronic test: the TEER (trans-epithelial electrical resistance test). It’s a fancy small electronic gadget that passes a current through tissues. If too much current flows, the tissues are leaking.

Again, we have our orthodox colleagues to thank for this extra insight…

Now The New Sensation

OK, well I am not going deeper into the old story…. Because it’s history! (well, almost, just joking). But things have changed very majorly, as you will see, starting with the involvement of orthodox doctors and scientists. Things always get moving quicker when they get on the case, because they have the money and resources and skills not possessed by the average struggling clinical ecology doctor.

They fight new ideas for decades and then, when it’s safe to join in, they get involved as if it was always an orthodox point of view. You have probably heard of the standing joke, about the various stages of “discovery” in medicine:

1. “You are mad.”
2. “There might be something in it.”
3. “There might be something in it, but where is the proof?”
4. “Of course, we knew all along.”

We seem to have reached stage 4 in this matter!

Tight Junctions

It’s all about the discovery of so-called “tight junctions”. Like the name implies, these are supposed to be sealed joins in the gut. Tight junctions exist between individual cells of the intestinal mucosa; good job, special proteins which bind a bit like glue, no leaks.

But these tight junctions can spring open, in just minutes, in response to neurological reflexes in what we have called “the second brain”; that is the vast network or neural tissues which exists in the gut. This is a doors-open effect; it’s got very little to do with the wear-and-tear idea of former decades. Leaky gut truly exists but not so much as a result of long-term inflammation and breakdown, much more to do with instant reactions.

That changes everything.

Our second brain is a very crucial organ. There are plenty of nerve cells and nerve fibers down there in the bowel. But more to the point, all the neurotransmitters found in the brain are also found in the gut. In fact more so! Over 90% or our serotonin, the so-called “happy” neurotransmitter, is found in the gut, not the brain.

This means, among other things… (are you sitting down?)… that our thoughts and moods when you eat add to the “fire in the belly” or the systemic inflammation effect I have been writing about through this entire book.

That means a good bottle of wine, a loving conversation and delicious slow-food could do a lot to calm and soothe the fiery belly. It’s a whole new ballgame!

However I am not going along with that one… at least not here. Let’s just concentrate of the mechanics of those “tight junctions”.

Zonulin

We’ve now got a new hormone to worry about; it’s called zonulin. Zonulin is a signalling molecule that blows tight junctions wide open. It appears to be triggered by gluten and is raised in celiacs. That’s all that orthodox doctors are seeing at the moment; they haven’t heard of other cyclical food allergies, so tight junctions couldn’t be affected by anything other than gluten, right?

Well, the mechanism is clear; the fact that they haven’t yet seen it will apply to all causes of bowel irritation, not just gluten, doesn’t alter the mechanics of this. Eventually, they will catch up in their slow, dull way…

Thing is, Dr. Alesso Fasano, in a 2006 study showed that celiac patients who had been off gluten for a number of years, still had high zonulin levels (up to 30 times the amount of controls). Moreover, the leakiness factor was up by a factor of 3 in celiacs, again even if he or she had been of all gluten for 2 years or more.

What does this tell us? That zonulin isn’t the only control mechanism, or that zonulin is controlled by a number of unknown epigenetic factors. Guess what those are? Food allergies (other than gluten), dysbiosis, heavy metal poisoning, parasites, and all the things I’ve been telling you here.

Fire in the belly! Ya!