Bowel and Gut Health


 

As noted by Hippocrates over 2,000 years ago - gut health is necessary for general health. Advanced research over the past several decades has clearly shown that an unhealthy gut contributes to a wide range of diseases such as diabetes, obesity, autoimmune diseases such as rheumatoid arthritis, autism, depression, chronic fatigue, skin diseases, and many others. 

While digestive health has many parts, 2 related areas are key to determining our gut health - the gut microbiota (gut flora/gut buddies) and the gut barrier. 

Gut flora and its impact on human health and disease is just now beginning to be understood. Among other things, gut flora ("gut buddies") promotes normal gut function, provides protection from infection, regulates metabolism, provides key micronutrients and vitamins, allows for proper elimination of toxins, provides nutrients for the cells lining the gut, actually communicate with mitochondria (and thus are involved with cellular energy dynamics and apoptosis), and more. The gut flora consists of about 100 TRILLION organisms (as compared to 10 trillion cells that make up our entire body). There are over 400 SPECIES of bacteria within this group of microbes. 

Dysregulated gut flora (dysbiosis) has been linked to autism, depression, autoimmune disorders like Hashimoto's, IBS, type 1 diabetes, and interference with proper detoxification mechanisms. 

Modern life can directly contribute to unhealthy gut flora - this can include antibiotics and other medications such as NSAIDs and BCP; diets with refined carbohydrates, sugars and processed foods; diets low in fermentable fibers; dietary toxins like wheat or seed oils leading to leaky gut (intestinal hyperpermeability); chronic stress and chronic infections.

The gut barrier represents the pision between the outside world (i.e. the lumen of the gut) and our inside world (i.e. our internal tissues). Remember that the contents of the gut are, in fact, outside the body (even as the intestine resides within our abdomen). In fact, one of the most important functions of the gut is to prevent foreign substances from entering the body even as it allows nutrients to pass into the body. 

The gut lining (single-cell thick) covers an area the size of a tennis court! It has many important functions - allowing for the absorption of needed nutrients at the same time keeping out everything else. These cells lining the gut obtain most of their nutrition from the gut flora. A disturbed gut flora (ie dysbiosis, parasites, H pylori) may mean poor nutrition for the cells lining the gut, which in turn means poor barrier function and poor nutrition absorption for you. NOT GOOD!

The intestinal barrier can become permeable, leading to "leaky gut". This can cause larger, inappropriate proteins, LPS, and other substances to enter the body, causing the body to mount an immune response and otherwise leading to a cascade of events that increase inflammation and poor health. Studies show that these attacks play a role in the development of autoimmune diseases like Hashimoto's and type 1 diabetes, and others. 

Experts such as Dr. Alessio Fasano now believe that leaky gut is a precondition to developing autoimmunity! Several well-designed studies show that the integrity of the intestinal barrier is a major factor in autoimmune disease. Thus the intestinal barrier determines in large part whether one develops inflammation and an immune response that affects not only the gut but other distant organs and tissues such as the skeletal system, pancreas, kidney, liver, and brain. 

Remember, you do not need to have symptomatic gut symptoms to have a leaky gut, dysbiosis and its consequences. Leaky gut can manifest as skin problems (eczema, psoriasis), heart problems, Hashimoto's or thyroid problems, joint problems (rheumatoid arthritis), mental illness, autism spectrum disorder, depression and more.

 

FoundationMED Approach

FoundationMED strives to understand the root causes of your symptoms or lack of wellness. In doing so, we are definitely concerned about the basic health of the gut, and the lifestyle choices and nutritional choices that are important to a healthy gut barrier and microbiota (the 5 boxes).

For example, one of the main reasons we are concerned about wheat and other gluten-containing grains is the protein gliadin. This protein has been shown to increase the body's production of zonulin - a protein shown to increase intestinal permeability (and measurable with proper testing). Interestingly, a medical literature search will demonstrate that many autoimmune diseases (such as celiac, type 1 diabetes, multiple sclerosis, rheumatoid arthritis, IBS) are characterized by abnormally high levels of zonulin and a leaky gut. 

Dysbiosis and leaky gut can lead to fatigue, inflammation, and depression - and is not always associated with gastrointestinal symptoms when present. Our physicians will address issues contributing to leaky gut and/or dysbiosis (gut flora imbalance) by evaluating issues such as dietary choices, medications, antibiotics, infections, stress, hormone imbalances, food sensitivities, genetic influences (with Opus 23 analysis), laboratory analysis, and others. 

To properly address these problems, we must rebuild healthy gut flora and restore gut wall integrity in all cases to restore health and wellness.

  • Eat a proper diet designed around your particular physiology and confounders
  • Avoid toxins - including food-based toxins (lectins, acrylamides, toxic chemicals, glyphosate, many others)
  • Maximize your digestive capacity (possibly using targeted supplements)
  • Incorporate fermented or live culture foods in many cases (or appropriate high-quality probiotics)
  • Incorporate increased soluble fibers "Strive for 25"
  • Identify and treat intestinal pathogens, dysbiosis, inflammation
  • Identify and enhance intestinal wall health and integrity
  • Manage stress

 

Specific Mediators of Gut Dysfunction

  • Diet and Eating Habits
  • Food Allergies
  • Hypochlorhydria
  • Bile Insufficiency
  • Leaky Gut
  • Small Bowel Bacterial Overgrowth
  • Pancreatic Insufficiency
  • Dysbiosis
  • Toxic Burden

 

Leaky gut and its association with the immune cells - as depicted in Celiac Disease.