Authors: Elizabeth Lipski
HIV-positive status
Intestinal infections
Irritable bowel syndrome
Liver dysfunction
Malnutrition
Multiple chemical sensitivities
NSAIDs enteropathy
Pancreatic insufficiency
Psoriasis
Schizophrenia
Trauma
Ulcerative colitis
Typically, I don’t recommend lactolose, mannitol testing for leaky gut. Rather, I use the clinical observations to determine the likelihood. Leaky gut is a symptom not a cause, so I look deeper. Does the client have food allergies or intolerances? Does he or she have parasites, yeast infections, or bacterial infections? Could high stress levels or medications be the cause of the leaky gut? Typically I will recommend a comprehensive stool analysis and/or look for food sensitivities. But for those of you who want something on paper proving that you have leaky gut, the lactulosemannitol test is the gold standard. (See
Chapter 11
, “Functional Medicine/Functional Testing.”)
Leaky gut syndrome has no single cause, but some of the most common are chronic stress, dysbiosis, environmental contaminants, gastrointestinal disease, immune overload, overuse of alcoholic beverages, poor food choices, presence of pathogenic bacteria, parasites and yeasts, and prolonged use of NSAIDs. Let’s discuss some of these one at a time.
Prolonged stress changes the immune system’s ability to respond quickly and affects our ability to heal. It’s like the story of the boy who cried wolf. If we keep hollering that there’s a wolf every time we’re late for an appointment or we need to finish a project by a deadline, our bodies can’t tell the difference between this type of stress and real stress—like meeting a vicious dog in the woods or a death in the family. Our body reacts to these stressors by producing less secretory IgA (sIgA) (one of the first lines of immune defense) and less DHEA (an antiaging, antistress adrenal hormone) and by slowing down digestion and peristalsis, reducing blood flow to digestive organs, and producing toxic metabolites. Meditation, guided imagery, relaxation, and a good sense of humor can help us deal with daily stresses. We can learn to let small problems and traumas wash over us, not taking them too seriously.