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The Problem You Don’t Know You Have
‘After every meal, I get extremely bloated with painful abdominal distention.’
‘I can’t eat without being nauseous all the time.’
‘I only poop once every few days.’
‘It’s normal for me to have diarrhea multiple times a week.’
NONE of this is normal.
These are only the more obvious digestive indicators that your gut flora is less than optimal. I write this, as a Registered Dietitian Nutritionist, who spent too many years in school pouring over textbooks and research articles. Despite all of this, I was not immune to this cycle. When I started opening up on the SOFLETE Performance Podcast about my struggle with maintaining a healthy gut flora, I was overwhelmed by the response from men and women who could relate to this experience and were searching for the root cause instead of a band-aid for their symptoms. In a series of articles, I want to start to unravel the mystery of gut health and how to get to the root cause to repair gut flora and intestinal lining.
Let’s Start with the Basics
The gastrointestinal tract spans the mouth to the anus, with everything in between. This complex system is responsible for transporting food, absorbing nutrients and eliminating waste. The gut flora, also referred to as the gut microbiota or microbiome, is a diverse community of trillions of organisms including bacteria, fungi, and viruses that live in your gastrointestinal tract. The gut flora is its own ecosystem and works to help our bodies maintain homeostasis. When the environment, food, and stress effect the ecosystem, it can cause a cascade effect of negative or positive changes stemming from the gut flora.
The gut flora is linked to a variety of other aspects of health that have nothing to do with digestion- like immunity and mental and emotional health. Hippocrates said, “All disease begins in the gut.” Over 2,000 years later this still rings true that disease is very connected to the happenings in our gut microbiome, and the intricacy of how it works is still widely misunderstood. Numerous not-so-obvious, chronic diseases have now been linked to gut health including cancer, liver disease, obesity and type 2 diabetes. The connection for most of these disease states is still lacking research on what comes first- the chicken or the egg, but the association between gut dysbiosis (when the gut flora is out of balance) certainly exists.
Why Does it Matter?
The lining of the gastrointestinal tract, known as the gut epithelium, can either protect us from the external substances we put into our bodies, or it can allow harmful molecules to pass through into the bloodstream launching an immune response and damaging our bodies. This lining is comprised of a single layer of cells the thickness of a single human hair- that is all that separates the inside of your body from your gastrointestinal tract.
Under normal circumstances, the velcro-like tight junctions keep potentially harmful substance confined to the gut. When the barrier is comprised, ‘leaky’ or inflamed, these tight junctions open up and the body launches an immune response to protect itself against harmful substances seeping through. This immune response can end up actually damaging our other organ systems and tissues. This leaky gut syndrome, or increased intestinal permeability, is linked to many medical conditions including anxiety, depression, eczema, fatigue, fibromyalgia, inflammatory bowel disease, psoriasis, rheumatoid arthritis- the list goes on and is constantly being lengthened with new emerging research.
The Complex Web of Culprits
The term ‘leaky gut’ is despised by many, but lets look past this unfortunate term for what it is- intestinal permeability allowing things to cross the intestinal mucosal cell lining. Then trigging an immune response that can breach the blood brain barrier, causing inflammation, triggering an autoimmune response, and causing malabsorption and nutrient deficiencies. It’s worth noting that these tight junctions are incredibly dynamic and open and close frequently in response to a variety of stimuli. Think of a slinky as the lining of your gut and how different movement, large or small, can cause the gaps or openings in varying degrees of severity.
There is a variety of reasons that leaky gut and gut dysbiosis can occur, and it can even be a combination of things over time starting with the way your mother ate while you were in utero and how you were born. A mothers diet and state of gut health during pregnancy will be the first thing to start shaping your own gut microbiome. During the birthing process, whether that is a vaginal birth or C-section birth, bacterial acquisition occurs. For those born via C-section, inadequate bacterial acquisition can be a contributing factor to leaking gut later down the line. In those first months of life, the length of breast feeding and transition to eating solid foods will also play a roll.
Environmental exposures like airborne matter and other pollutants we encounter throughout life may also contribute to increased intestinal permeability and altered gut function. Other environmental exposures possibly linked to leaky gut include arsenic, BPA from plastics, herbicides, heavy metals, PCBs (polychlorinated biphenyls used in manufacturing) and pesticides. Many of this is still debated in the science community and further research is need for solid standings based in science.
It’s not secret, the majority of American’s are chronically stressed and over-medicated. Both of which play a huge roll on what’s happening inside your gut. Chronic stress can alter bacterial composition of the gut, blood flow in the body, digestive secretion and gut permeability. Medications like antibiotics, birth control and even over the counter medications like antacids and NSAID’s (non-steroidal anti-inflammatory drugs like ibuprofen) alter gut health.
Current health, body composition and eating patterns are an obvious contributor to gut health and the possibility of leaky gut occurring. Food processing and food additives have become under the microscope and although future research is needed, all signs point to negative effects on gut health. Food additives include emulsifiers, gluten (yes, they add gluten to food products during processing), and organic solvents among others.
How to Fix It
If you are looking for a quick fix and easy solution, you can go ahead and stop reading here. The gastrointestinal tract and all its glory is still largely a mystery, and getting to the bottom of what’s happening in your body is like a puzzle at a vacation house missing half the pieces.
The first step to getting your gut health back on track is to find a health care provider that you trust and feel comfortable communicating all the gory details with. The modern health care system is set up to be reactionary and treat disease, usually elevating or masking symptoms, instead of find the root cause to heal and prevent future disease progression. A good starting point is to find medical providers that believe in patient centered care with a focus on the body as a whole. Integrative and Functional Medicine is just that. Most insurance companies have strict guidelines on what they believe is an appropriate course of action once a doctor gives you a diagnosis. To take charge of your health, it might cost you- so do your research. Most insurance companies will let you submit receipts and cover some costs. Be upfront with your medical care provider and plan out testing and a course of action that fits your timeline and budget.
Once you have found a medical care provider, the real work begins. Traditional lab work only scratches the surface the complexity of human health. Extensive blood work looking at micronutrients, hormone levels and other metabolic markers will be ordered- all tailored to what is going on with your body as a whole. Additional testing like stool samples and food sensitivity testing may also be ordered to understand what’s happening with your gut microbiome. Specific test like the SIBO (small intestinal bacterial overgrowth) might be necessary. This why the guidance of a medical professional is necessary versus online mail in testing kits available to the general public. Your body and your health is crucial; pay attention to what it’s trying to tell you.
Stay tuned for the rest of this series where I deep dive into the various tests and treatments for these problems!
Additional Resources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4425030/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3637398/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5454438/
https://www.tandfonline.com/doi/full/10.4161/gmic.27251
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1856434/?escaped_fragment=po=10.9756
https://www.sciencedirect.com/science/article/pii/S1568997215000245
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4145541/
https://www.ncbi.nlm.nih.gov/pubmed/9824578
https://www.mindbodygreen.com/0-14510/10-signs-you-have-an-unhealthy-gut-how-to-heal-it.html
https://www.bepure.co.nz/blogs/news/understanding-upper-lower-digestive-systems
Brooke West, MS, RDN, LDN is the Lead Registered Dietitian Nutritionist for SOFLETE. Her areas of expertise are health and human performance, weight management, and integrative and functional nutrition.
