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) and the gut barrier.

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.

Gut flora and its impact on human health and disease is just now beginning to be understood. Among other things, gut flora 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 and much more.

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

All disease begins in the gut.
Hippocrates
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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 division 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 intestinal barrier can become permeable, leading to "leaky gut". This can cause larger, inappropriate proteins and other substances to enter the body, causing the body to mount an immune response. 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 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.
  • Overview

    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) and the gut barrier.

    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.

    Gut flora and its impact on human health and disease is just now beginning to be understood. Among other things, gut flora 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 and much more.

    Dysregulated gut flora 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 division 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 intestinal barrier can become permeable, leading to "leaky gut". This can cause larger, inappropriate proteins and other substances to enter the body, causing the body to mount an immune response. 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 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.
    There is growing evidence that increased intestinal permeability plays a pathogenic role in various autoimmune diseases including [celiac disease] and [type 1 diabetes]. Therefore, we hypothesize that besides genetic and environmental factors, loss of intestinal barrier function is necessary to develop autoimmunity.
    Alessio Fasano, MD
  • FoundationMED Approach
    FoundationMED strives to understand the core concepts 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.

    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! 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.

    Other issues contributing to a leaky gut are also addressed, such as dysbiosis, poor diet, medications, infections, stress, hormone imbalances, and others. Leaky gut leads to fatigue, inflammation, and depression - and is not always associated with gastrointestinal symptoms when present.

    To address these problems, we must rebuild healthy gut flora and restore gut wall integrity - particularly if you have an autoimmune disease but in fact, necessary in all cases to restore health and wellness.

    Generally speaking, to restore and maintain a health gut one must eat a proper diet designed around your particular physiology (i.e. some may have food sensitivities or other issues), avoid toxins - particularly food toxins, maximize your digestive capacity (possibly using targeted supplements), incorporate fermented or live culture foods in many cases (or appropriate high quality probiotics), identify and treat intestinal pathogens, and manage your stress.
  • Specific Mediators to Gut Dysfunction

    Diet and Eating Habits

    Food Allergies

    Hypochlorhydria

    Bile Insufficiency

    General Intestinal Hyperpermeability

    Small Bowel Bacterial Overgrowth

    Pancreatic Insufficiency

    Dysbiosis

    Toxic Burden

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