Leaky Gut and IBS - warning signsfood allergies RAST test IgE antibodies Grains IBS-D intestinal permeability Diet remedies inflammation Alcohol abuse Dysbiosis
Posted 13 April 2014 - 06:47 AM
(This is a very shortened summary of information I found on the web. Leaky Gut is serious if left untreated.)
Normally food is digested in the small intestine and passes through the colon. Leaky Gut is another term for intestinal permeability, which means that food particles travel through the tight junctions of the villi of the short intestine and into the blood stream. Leaky Gut is the process that underlies Celiac Disease. The immune system sees these food particles as foreign invaders and creates antibodies against these foods. The longer you eat allergenic food, the more pronounced the leaky gut symptoms will become. If untreated, you may develop sensitivities to many other foods and eventually Leaky Gut could evolve into inflammatory bowel disease.
Common initial causes are considered to be substances that damage the intestinal lining, such as abnormal flora i.e. Candida, NSAIDs and Aspirin, food poisoning and viral infections and alcohol abuse. Generally, those with eczema or food allergy have higher permeability scores than healthy people. Many studies indicate that IBS is a low level inflammatory disease. There is a very strong link between Leaky Gut and IBS (particularly IBS-D).
Leaky Gut can precede autoimmune disease, however this may be preventable if Leaky Gut is healed, as is with successful treatment of Celiac Disease (i.e. a gluten-free diet).
The most common food allergies are gluten grains (wheat barley oats), corn, legumes, nuts, nightshades, dairy and eggs. Celiac Disease permeability is caused by gluten however other wheat proteins can also damage the intestine by other methods. An allergic reaction to these foods involves an IgE antibody and histamines. On the other hand a simple food intolerance is rarely damaging and is often due to enzyme deficiency or other factors. Testing can easily determine genuine food allergy.
How Leaky Gut is tested:
Suspected food allergy is urine tested after ingesting harmless sugars lactulose and mannitol.
Lactulose is a larger molecule disaccharide and is usually only partially absorbed. The unabsorbed part is excreted through faeces and the absorbed part through urine. Mannitol, a monosaccharide, is easily absorbed. Ideally the test should indicate high levels of lactulose (as you shouldn’t be able to absorb it) and low levels of mannitol (as you should easily absorb it). High levels of mannitol and lactulose indicate Leaky Gut. Low levels of both indicate malabsorption of nutrients. High levels of lactulose and low levels of mannitol indicate healthy digestion.
A blood RAST test screens for IgE which indicates food allergies.
Healing nutrients to repair the intestinal lining:
A low fibre diet increases permeability therefore a high insoluble fibre diet is recommended. However most IBS patients can’t tolerate too much fibre and insoluble fibre in particular. Also, high FODMAPs (fermentable complex carbohydrates that resist digestion) are generally healthy for the colon as they produce short chain fatty acids that feed bacteria. Again, most of us find our IBS symptoms are much improved by excluding high FODMAPs.
One solution might be to exclude the most common food allergy types, grains and dairy for instance, for a few days. Along with this eat mainly gentle, soluble fibre (mashed or pureed if necessary) along with protein and some healthy omega 3 fats, e.g. salmon. If you notice definite reduction of IBS symptoms, then gradually increase the low FODMAP salads, fruit and vegetables. If symptoms are further reduced, add a few high FODMAPs. Certain high FODMAPs are beneficial but it could be argued that others, oligosaccharides like raffinose (baked beans) for instance, weren't meant to be eaten by humans at all. Legumes can also be highly allergenic. On the other hand small portions of mushrooms, apple or peas could be gradually introduced.
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Posted 13 April 2014 - 02:02 PM
I had read about leaky gut syndrome many years ago but didn't really hear much about it until recently. Apparently it is only considered as a possibilty by alternative, functional or integrated medical practitioners- not yet accepted by allopathic doctors who of course always seem so slow and stubborn to accept new ideas (like when H Pylori was discovered to cause ulcers as opposed to purely stress- they didn't want to believe they could have been so wrong!)
But, just like maybe with SIBO, leaky gut could explain some of the other symptoms that seemed to start for many of us at the same time as IBS- like water-weight gain, acne, other aches and pains, fibromyalgia. I was always told that my other symptoms were not related but I always felt like they were, like I was being poisoned by my own body.
So far I have read that things to try if you suspect you have leaky gut syndrome is something like a FODMAPS or Specific Carbohydrate diet, maybe herbal antibiotics for dysbiosis and yeast, and zinc or L Glutamine to help with healing the gut. For some reason L Glutamine didn't agree with me so I take zinc.
I have read about the urine test for it but am not fortunate enough to have an alternative practitioner in my area. And if it is anything like the SIBO test it might not always be able to rule it out anyway so maybe it is best to go on suspicion based on symptoms. The hardest thing for me is keeping my sugar consumption down which I hear is a must!
Posted 14 April 2014 - 03:40 AM
Yes, I've got other issues too but mine are fairly new - eczema, gout like twinges, leg cramps - and zinc is supposed to be good for cramps. Seafood has a lot of natural zinc. The new symptoms are worrying because they fit the allergy pattern. It seems as though you're right about testing being on the fringe. The urine test is available over here, but only from a naturopath.
It's best to just exclude one suspect food at a time, which is what you'd have to do anyway. Sugar is OK I think, just not too much. I think the specific carbohydrate diet has a lot going for it but I'd be too hungry. I love the foods that don't love my colon.
I found quite a few studies linking intestinal permeability and IBS so I think the theory is accepted mainstream, it's just that the testing isn't for some reason.
Intestinal Permeability and Irritable Bowel Syndrome
The immune system in Irritable Bowel Syndrome
Abnormal Intestinal Permeability in Subgroups of Diarrhea-Predominant Irritable Bowel Syndromes
Leaky Gut in Patients with Diarrhea-Predominant Irritable Bowel Syndrome and Inactive Ulcerative Colitis
Leaky Gut Syndrome
Intestinal membrane permeability and hypersensitivity in the irritable bowel syndrome
Irritable Bowel Syndrome: Methods, Mechanisms, and Pathophysiology. The confluence of increased permeability, inflammation, and pain in irritable bowel syndrome
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