Rekha Shah, MD, MD(H)
We have billions of organisms in our gut and have discovered that they
play a huge role in our health.
Our gut is essentially outside the body, and comes into contact with food
and liquids over our entire lifetime. The gut is exposed to potentially
toxic or antigenic (allergy-promoting) substances day in and day out -
wheat gluten, dairy proteins, MSG, aspartame, bisphenol A, sodium benzoate
and countless other chemicals. From the functional point of view, our
gut has to protect our internal organs from these constant insults. It
has developed very complex and multi-level mechanisms to accomplish this task.
One of the mechanisms at work is the gut mucosal lining-the epithelium
- and its lymphocytes (white blood cells). The gut is the largest immunological
organ in the body. When it is functioning at optimal levels, each cell
in the intestinal lining is healthy, connected to its neighbors by tight
junctions. This makes the lining selectively permeable to the nutrients
that our body needs, while keeping offending particles out of the bloodstream.
Exposure to a toxic or antigenic load causes the intestinal lining to
lose its integrity, loosening the tight junctions, and making epithelial
cells less functional. The protective and absorptive function of the intestinal
epithelium is affected. We call it "leaky gut". Unwanted particles
are allowed to enter the body through the no longer tight junctions, and
because of swelling of the epithelial cells, we develop malabsorption
of precious nutrients.
The breached intestinal lining mucosa (through the cell and through the
loosened tight junctions) thus allows normal beneficial bacteria and breakdown
products of dead bacterial cell walls as well as other toxic material
to pass through into the bloodstream. The immunological and chemical processors
in our body start to get rid of these unwanted particles, often by making
antibodies to tag them, so that the white cells of the immune system can
identify and eliminate them. When even helpful bacteria cross over from
the gut to the bloodstream, they are recognized as danger (foreign invader!
does not belong here!). An immune response is triggered. If the bacterium
or protein happens to look a lot like our own tissues (gluten looks very
similar to thyroid, for instance), this response may also include attack
of our own tissues. The body recognizes these tissues as "out of
place" and so "harmful". And voilà! Hashimoto's
thyroiditis, or rheumatoid arthritis, or lupus, or ulcerative colitis, or ...
This autoimmunity and inflammation is one of the causes of many chronic
illnesses that we see around us. Recent medical literature has clearly
shown the association with arthritis, rheumatoid arthritis, chronic fatigue,
fibromyalgia, multiple skin conditions like acne, psoriasis and eczema,
food allergies, multiple chemical sensitivity and practically all gastrointestinal
Multiple gastrointestinal symptoms like Irritable Bowel syndrome (IBS),
constipation, diarrhea, abdominal pain, bloating, colitis, gluten sensitivity
,celiac disease, abnormal liver function, dysbiosis, bacterial overgrowth,
are associated with gut microbes. Gut bacteria and gut integrity is right
at the center of the cause of these illnesses.
The mechanisms of leaky gut that is also implicated in cases of musculoskeletal
complaints, metabolic syndrome, diabetes, lipid problems, liver conditions,
heart failure, depression, cognitive defects, allergies, neurological
conditions and many more. Leaky gut, a compromised intestinal epithelium,
definitely needs to
be attended to first, for proper and healthy management of many of the
chronic conditions that we see around us.
Vedas, the ancient Indian scriptures, record that the first illness on earth was
indigestion and the first treatment prescribed by Lord Brahma was boiled water.
We have the choice of what to put into our bodies - healthy food or junk
food, fresh food or chemical laden food, soda pop or clean water.
We can make healthy choices. The key word is
Dr. Shah is Board Certified in Internal Medicine and Gastroenterology.
She practices Integrative Medicine with a focus on Gastroenterology at
the Arizona Center for Advanced Medicine in Scottsdale, AZ. ArizonaAdvancedMedicine.com. Tel 480-240-2600.