Leaky Gut COULD IT BE TRUE? Michele L Neil Sherwood DO Internal Medicine Sports Medicine

Objectives Leaky Gut Could it be true? If so, how can we HELP? Revisiting GUT anatomy and the interrelationship of the immune system

The Intestinal Tract A Natural barrier to Toxic Substances Digestion of all micro/macro s Absorptive capacitor for fluid and nutrients Immune system surrounds the MALT and GALT GUT has its own nervous system

60%-80% of your immune system lines your GI tract Gut Associated Lymphoid (GALT) Damage lends increased permeability Poor Nutrition Bad bacteria,yeast Toxins-Inflammation Peyer s Patch, Mesocolic Lymph Nodes Antibodies line (IGA, IGG) the GI tract

GALT and MALT

Revisit Gut Anatomy

Leaky Gut What is leaky gut? The gut is naturally permeable to very small molecules to absorb these vital nutrients Cell injury disarms its regulating capacity and it becomes permeability Gut Ecology is important for IGA production and a healthy mucosal layer or biofilm and maintenance of the tight junctions. Various factors injure the gut ecology Gut cells are held tight by tight junctions Various factors break apart tight junctions in the intestinal lining

Leaky Gut Enterocyte Cells Become Permeable to large molecules Gut Ecology is disrupted causing imbalances in Secretory IGA Tight Junctions are injured allowing passage of large molecules between cells

Leaky Gut Once these factors are disrupted the gut leaks If the gut is leaky, things like toxins, microbes, undigested food particles, and more can escape from your intestines and travel throughout your body via your blood stream Your immune system marks these foreign invaders as pathogens and attacks them The immune response to these invaders appears in the form of systemic inflammation

Proper communication between GI and immune tissues is critical for good health GI Proper Poor Barrier diet, dietary toxins and MALT/GALT signals and pro-inflammatory and beneficial tissues are microflora in nutrients constant support contribute a healthy to communication immune inflammation response GI Tract MALT/GALT Toxins Dietary Signals Immune Cells Nutrients Antigen Communication T-lymphocytes Chemokines Good bacteria Probiotic Signals B Cell Antibodies

Immune cells call for reinforcements to participate in inflammation Immune cells identify antigen Immune cells produce cytokines Cytokines recruit immune cells Antigen T Helper Cell Cytokines Interleukin 1 (IL-1) Interleukin 6 (IL-6) Tumor Necrosis Factor-Alpha More cytokines produced, more inflammation

Creation of mediators (like PGE 2 ) initiates a feedforward cycle of pain Immune cells (macrophages) create COX2 PGE 2 Arachidonic Acid COX2 Prostaglandins Thromboxanes Arachidonic acid cascade creates PGE 2 Prostaglandins (PGE 2 ) tell cells to create more inflammatory compounds, recruit more immune cells and signal pain

Induced COX-2 and liberated arachidonic acid combine to create pain Cytokines Arachidonic Acid Nucleus Arachidonic Acid COX2 Inflammatory Series 2 Prostaglandins Arachidonic Acid Cell Membrane IKK Immune Cells PGE2 Arachidonic Acid

Kinase signaling plays a key role in the creation of COX-2 Kinases translate signals from cytokines to turn on the genes that create COX-2 Cytokines R R COX-2 R IKK R Immune Cells

Activation of this process in GALT / MALT tissues leads to inflammation and pain Cascade of events induces COX2 and results in inflammation Immune cells PI3K COX2 Arachidonic Acid MALT Antigen PGE 2 B Cell Antigen MALT Antigen Antigen GALT Signal pain & recruit more immune cells Bad Bacteria Antigen GALT

What causes leaky gut? Main Culprits: FOOD, infections, toxins Alcohol, caffeine Toxins: medication, Advil, Motrin, steroids, antibiotics, and acid reducing drugs Environmental toxins: herbicides, pesticides and BPA from plastics STRESS and AGE

GLUTEN

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How DO WE cause our guts to fail? Eat the wrong foods - HYDROGENATED OILS -PROCESSED OR PRESERVED FOODS -SUGAR, FAT, SALT -GM0 S -INFLAMMATORY -ALLERGENIC -INTOLERANT -EAT TO MUCH -EAT TO FAST

LEAKY GUT Autointoxication is the result of faulty bowel functioning The large intestine can be thought of as the body s waste disposal or sewer system Imagine what would be the result of a pump failure in a city s sewer system It would not take very long before a crisis developed

LEAKY GUT The overall major contributing factor is our straying away from a simple, natural lifestyle The further we stray from natural processes disease and illness increase in frequency and intensity Scientific research is beginning to show that our food situation is the largest contributor to the severe imbalances in peoples bodies today The way we grow, process and market our food is at the root of much disharmony in our population

LEAKY GUT Foods are hybridized to create high yields and follow specific climate conditions, to meet harvest and processing requirements Nutrient quality, freshness, taste and vitality as it becomes part of the human body is totally neglected. Processed, cooked, dried, roasted, burned, chemicalized, embalmed, preserved foods do not react well in the human body.

LEAKY GUT Food grown in poor soil does not have all the vitamins, minerals and enzymes necessary for good health. Nutritional imbalances happen earlier, body chemistries break down and illness sets in in the body and mind. Processed, devitalized foods are notoriously lacking in fiber and bulk, further slowing the bowel.

LEAKY GUT Stresses and tensions put on the members of modern society increase the need for extra nutrition to cope. Sadly the food eaten is so deficient that the body is always in a state of catching up. A vicious cycle is set up where vital tissues begin to starve and slowly disease sets in This Lends TIRED, IRRITABLE, individual who HAS NO ENDURANCE A state of chemical imbalance and OBESITY is slowly born

9 Signs You Have a Leaky Gut 1. Digestive issues such as gas, bloating, diarrhea or irritable bowel syndrome (IBS). 2. Seasonal allergies or asthma. 3. Hormonal imbalances such as PMS or PCOS. 4. Diagnosis of an auto immune disease such as rheumatoid arthritis, Hashimoto s thyroiditis, lupus, psoriasis, or celiac disease. 5. Diagnosis of chronic fatigue or fibromyalgia. 6. Mood and mind issues such as depression, anxiety, ADD or ADHD. 7. Skin issues such as acne, rosacea, or eczema. 8. Diagnosis of candida overgrowth 9. Food allergies or food intolerances.

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How Do You Heal A Leaky Gut? 4 Pillars of GI Health -look at the aspects that need healing Digestion Elimination Microflora Balance Gut Integrity

How do you heal a leaky gut? Elimination diet, which removes the toxic and inflammatory foods for a certain period of time. 4R program 1. Remove. Remove the bad. The goal is to get rid of things that negatively affect the environment of the GI tract, such as inflammatory and toxic foods, and intestinal infections. 2. Replace. Replace the good. Add back the essential ingredients for proper digestion and absorption, such as digestive enzymes, hydrochloric acid and bile acids. 3. Reinoculate. It s critical to restore beneficial bacteria to reestablish a healthy balance of good bacteria. 4. Repair. It s essential to provide the nutrients necessary to help the gut repair itself. One of my favorite supplements is L-glutamine, an amino acid that helps to rejuvenate the lining of the gut wall.

Strategies to Prevent Leaky Gut Balance microflora ( good bacteria) Limit use of NSAIDs Enlist nutritional support Minimize use of alcohol, caffeine, processed foods and additives Manage stress FMI 2015

Promote Balanced Microflora Probiotics Lactobacillus acidophilus Bifidobacterium Lactobacillus plantarum Prebiotics Fructooligosaccharides honey, onions, bananas, inulin, onions, garlic, asparagus, jicama, leeks FMI 2015

Fiber for Intestinal Health Low-fiber diets responsible for constipation and leaky gut Our fiber intakes are well below recommended levels 28-30 grams Soluble and insoluble forms Worsens diverticuli, increases diverticulitis Worsens IBS FMI 2015

Fiber Fiber I NEED more Fiber!!!

GI HEALTH EFFECTS TOTAL HEALTH

Heal your Gut, Heal Your Body

What we do not see We often do not Know!

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Questions

FMI 2015

Living Wellness, LLC 2013

FMI 2015

Living Wellness, LLC 2013