Leaky Gut Syndrome: Using Probiotics and Digestive Enzymes in Autoimmune Disorders

Leaky gut syndrome or intestinal permeability are terms used to describe an inability of the stomach lining to absorb protein molecules. Instead of being absorbed and digested, these protein molecules circulate throughout the blood stream. Here, they stimulate the immune system, and, in turn, immune system cells react to their presence as they would to any foreign protein by initiating an inflammatory reaction that leads to autoantibody production and autoimmune disease development. Evidence for this theory includes the presence of gastrointestinal tissue damage seen in patients with a number of different autoimmune diseases including ankylosing spondylitis, irritable bowel syndrome, rheumatoid arthritis, Crohn's disease, multiple sclerosis, vasculitis, thryroiditis, and dermatitis herpetiformis. In many of these conditions, a reduction of digestive inflammation correlates with a reduction or remission of autoimmune symptoms.

In Ayurvedic medicine, the presence of ama, which is a toxic byproduct of digestion, is responsible for most treatable conditions. Ama impairs nutrient absorption and tends to accumulate in tissues that are weak, causing congestion, inflammation, and degenerative changes. Among medical practitioners today, intestinal permeability is thought to be caused by a substance or combination of substances, such as allergens or toxins, which initiate inflammation in the digestive tract. This inflammation allows for large molecules to pass across the intestinal barrier, including molecules from proteins, fats, parasites, bacteria, ad fungi. Because human tissues have protein antigens similar in structure to these other proteins, the scene is set for autoimmune disease development.

Common causes of leaky gut syndrome include antibiotics, alcohol, caffeine, parasites, bacteria, some food preservatives and additives, allergic states such as gluten sensitivity and lactose intolerance, corticosteroids, non-steroidal anti-inflammatory drugs, refined carbohydrates, oral contraceptives, and fungi. Chronic inflammation from these sources damages the protective coat of immunoglobulin (antibody) A, which interferes with the body's normal ability to inhibit these substances. The resulting toxins then interfere with the liver's ability to detoxify these substances. One result is increased sensitivity to environmental agents such as cigarette smoke, chemical cleaning agents and strong perfumes. Early symptoms include a tendency toward hayfever.

Other symptoms include nutrient deficiencies, acne, headaches, poor concentration, fatigue, and irritability, With aging and exposure to stress, a gradual loss of stomach acid occurs, which can aggravate the problem and contribute to vitamin B12 deficiency and deficiencies of minerals such as chromium, copper, iron, magnesium, manganese, selenium, and zinc.

Oral supplementation with friendly bacteria and digestive enzymes help restore intestinal permeability. Substances known as probiotics supply these friendly bacteria. Probiotics include tablets containing Lactobacillus acidophilus, Propionibacterium freudenreichii, shermanii, and Bifidobacterium bifidum. The recommended dosage is 6-18 billion bacteria used three times daily. Added polysaccharides in these preparations also offer benefits.

Gentian, barberry and other bitter herbs as well as the digestive enzymes papain, bromelain, and pancreatin are used to restore stomach acid. Clinical research shows that oral supplementation of probiotics enhances the immune system's ability to fight foreign organisms (phagocytic property).

Herbs and botanicals with anti-inflammatory properties include black cohosh, turmeric, wild yam, licorice root, devil's claw, willow, and ashwaganda. Demulcents are used to establish integrity of the stomach lining and include, aloe vera, marshmallow root, slippery elm, and licorice root. Herbs used to help relieve musculoskeletal pain include arnica, wild lettuce, Jamaican dogwood, nutmeg, and California poppy. Herbs used to reduce congestion and eliminate wastes include red clover, celery seed, burdock, dandelion root, and stinging nettle.

Immunomodulators offer benefits, whereas immunostimulants such as Echinacea should be used with caution. Ayurvedic therapies such as massage and herbal mixtures are based on the body's primary imbalance or tendency toward kapha, pitta, or vata predominance.

Eliminating or reducing substances that promote intestinal permeability also promotes intestinal healing. This includes avoiding antibiotics, nonsteroidal anti-inflammatory drugs, pesticides, herbicides, and meat contaminated with hormones. Substances that promote healing include high fiber foods rich in antioxidants such as cabbage, cauliflower, beets, and onions; omega-3 fatty acids found in salmon and flaxseed, multi-mineral supplements, and digestive enzymes such as bromelain and pancreatin.

Kajander K, Hatakka K, Poussa T, Farkkila M, Korpela, R, A probiotic mixture alleviates symptoms in irritable bowel syndrome patients: a controlled 6-month intervention, Aliment Pharmacol Ther 2005 Sep 1;22(5):387-394.

Hussain Z, Quigley EM, Systematic review: Complementary and alternative medicine in the irritable bowel syndrome, Aliment Pharmacol Ther, 2006 Feb 15;23(4): 465-471.

Verdu EF, Collins SM, Irritable bowel syndrome and probiotics: from rationale to clinical use, Current Opinions in Gastroenterology, 2005 Nov;21(6): 697-701.

Apr 8, 2009 1:02 AM

Guest :

I would just like to point out that gluten intolerance and lactose intolerance are NOT 'allergic states'. This is a common misconception. Celiac Disease (a form of 'gluten intolerance') is an autoimmune reaction. Autoimmune diseases are caused by a different arm of the immune system from allergies. Non-Celiac gluten 'intolerance' can be unknown in origin. Some of these people have antibodies but no intestinal damage (autoimmune pre-clinical Celiac), but others have absolutely no medical tests that display a reaction to gluten, even though they claim that gluten makes them sick. Lactose intolerance is the lacking of an enzyme needed to break down milk sugar (lactose). It has nothing to do with the immune system. This is NOT AN ALLERGY IN ANY WAY.

A true allergy to milk protein (or wheat protein)is IgE mediated. This would be like a peanut allergy (which can be fatal) to milk or wheat. In an allergic person, milk or wheat can cause breathing difficulty, a drop in blood pressure and heart function, swelling, hives, vomiting, and death. These problems do not occur in 'intolerances', because they are not the same thing as an allergy. Gluten intolerance is not even the same concept as lactose intolerance. All 3 are different. The main message is that gluten intolerance and lactose intolerance are NOT 'allergic states'. However, it is true that a damaged intestinal barrier may contribute to intolerance AND allergic states. But the reaction depends on genetic disposition and other yet unknown factors. But they are not all the same, and it's important for people to know that. Someone with lactose intolerance may get stomach cramps from milk, but a person with Celiac could get intestinal damage from gluten, and a milk protein allergic person could DIE from milk. People need to know the difference.