Arizona Advanced Medicine Clinic

Sick From the Inside Out?

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 (GI) conditions.

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 The Gut and Autoimmune Conditionsbe attended to first, for proper and healthy management of many of the chronic conditions that we see around us.

The 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 choice.

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.

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