Category 3: Need to Heal Intestinal Mucosa

If this is one of your SymptomQuiz high scores, the information in this article may help you improve your Wellness Score. This is not treatment. It is a way to improve your Wellness Score over the next 30 days.

There are many herbs and nutrients that have been shown to reduce inflammation or to improve the health of the GI lining. Presenting a complete list with the literature references may be a bit unwieldly. Several reputable companies produce combination products. First, follow the Roadmap to Health diet. Supplementation should be secondary.

Quick cookbook: Follow the Roadmap to Health diet. Take Phosphatidylcholine—one capsule 2x/day. Take Glycine, 1,3x/day.

What the Intestinal Lining Does

Food in the intestines is technically outside of your body. The intestines are like the border patrol, they keep undesirable things out of the body and let desirable things, like nutrients, into the body. The small intestine is the site where the body absorbs nutrients from food. It also produces enzymes that further break down food. It is about 20 feet long (it varies with individuals and can be as short as 10 feet and as long as 35 feet) and about an inch in diameter. Inside are projections, called villi. On each villus are more projections, called microvilli. If you were able to open and completely flatten the small intestine, it is very large. Swedish researchers found that the surface area is between 30 and 40 square meters [1].

The small intestine needs to absorb nutrients while being a kind of gatekeeper, keeping toxins, allergens, and microbes out of the body. The lymphoid tissue in the small intestine is a vital part of your body’s immune system. Around 75% of your immune system is associated with the intestines. The increased surface area created by the villi and microvilli allows the cells of the small intestine to come into direct contact with the intestinal content and absorb nutrients.

When the Barrier Breaks Down

Villous Atrophy

This is a term that means the villi and microvilli have flattened. It is a serious problem because the absorption of nutrients is drastically reduced. It can be the result of chronic inflammation (the same thing that causes leaky gut). One common cause of villous atrophy is celiac disease. There are other medically recognized causes of villous atrophy. These include HIV enteropathy, Crohn’s disease, food intolerance, autoimmune enteropathy, Whipple’s disease, tropical sprue, eosinophilic gastroenteritis, Giardiasis, and others. Certain medications can cause villous atrophy. Bacterial overgrowth in the small intestine (SIBO) can also be a cause of villous atrophy.

Leaky Gut (Intestinal Permeability)

Leaky gut is a condition where bacteria and toxins, which are normally kept out of the body, “leak” through the intestinal wall. Leaky Gut happens when the tight junctions mentioned above are loosened and larger molecules such as proteins and bacteria can “leak” across the intestinal wall. It is linked to disruptions in the microbiome. Once in the bloodstream, these particles can bind to immune cells, triggering an immune response, which can cause inflammation and tissue damage. Mainstream medicine has not recognized leaky gut as a medical condition. There are, however, several research studies that support the concept. And, as more studies are done, doctors are beginning to understand that leaky gut is linked to allergies, immune problems, and other chronic conditions, including depression and Alzheimer’s disease. Also, it is established that intestinal permeability plays a role in conditions like Crohn’s disease, celiac disease, and irritable bowel syndrome. Bacterial overgrowth in the small intestine (SIBO) is a possible cause of leaky gut.

Why This Affects the Whole Body

There are studies that support the idea that leaky gut is associated with autoimmune diseases, allergies, obesity, fibromyalgia, asthma, and other conditions, but the concept has not filtered down to most medical offices [2-7]. While the concept of leaky gut has not yet been incorporated into medical offices, researchers are extremely interested in it. While there are only a handful of studies involving the concept of leaky gut, there are many more studies that show the benefit of probiotics.

Because 75% of the immune system is associated with the digestive tract, it stands to reason that treating the digestive tract, especially the small intestine, is a good approach to treating many chronic complaints. Disease is a departure from normal physiology. One does not suddenly come down with Crohn’s disease; one day being fine and the next day having cramping and diarrhea. Normal physiology gradually unravels until finally, there is a diagnosable disease that can be recognized by the medical profession. The questionnaire is designed to help you to find these errors in normal physiology before there is a serious, diagnosable disease.

Testing for Leaky Gut 

Blood or stool tests for zonulin can indicate the presence of leaky gut, but they are not entirely reliable. Other blood tests can also show potential causes of leaky gut: high histamine, low DAO, antibodies to intestinal cells, and immune activation to bacteria.

Perhaps the most reliable test is the lactulose/mannitol test. It measures how well the intestinal barrier functions by comparing the absorption of a small sugar (mannitol) to a larger one (lactulose); an increased ratio suggests a “leaky” gut.

Supporting the Intestinal Lining

The Roadmap to Health Diet features a diet that is high in antioxidants and will help protect the GI lining. It is also high in polyphenols and fiber; both of which help ensure a good balance of the bowel flora and health of the GI lining. It is a good place to start. This diet is designed to reduce inflammation and to balance the GI tract. AVOID GMOS, THEY DISRUPT THE MICROBIOME! The diet is also similar to the specific carbohydrate diet, which will help keep inappropriate bowel flora from growing. The basic supplementation recommended is as follows:

  • Phosphatidylcholine (PC) 1, 3x/day When you think of phosphatidylcholine, think of cellular repair. It will help heal damage to the cells lining the intestine. Studies have shown that PC supplementation is extremely helpful to patients with ulcerative colitis8,9,10. Phosphatidylcholine can also mitigate the damage done to the GI tract by NSAIDs11,12.
  • L-Glycine: Glycine is a simple amino acid that supports tissue repair and the integrity of the intestinal lining.

The combination of diet and these two supplements should be adequate to help heal the intestinal lining.  There are other substances that can help (this is not a complete list):

  • Bone broth: Helps heal intestinal permeability. It contains collagen, which nourishes the intestinal lining and reduces inflammation. It is also easy for a damaged gut to digest and reap the benefits of its protein and minerals. It is what used to be called stock. You boil meat, bones, and vegetables, then simmer for 9-15 hours. There are many recipes online.
  • Folate: Folate is necessary for all rapidly growing cells, like those lining the small intestine.
  • Curcumin: Inflammation can damage the GI lining. Curcumin is a natural anti-inflammatory.
  • Aloe Vera can soothe the inflamed lining of the GI tract.
  • Quercetin and other bioflavonoids can reduce inflammation and promote tissue healing.

In general, it is a good idea to address other aspects of digestion, like HCl & enzymes, and the microbiome. You could keep adding substances to heal the gut, but it is better to add upper GI support and to address the microbiome. The microbes growing in the intestines have a lot to do with the health of the mucosa (see next category).

References

  1. Scand J Gastroenterol. 2014 Jun;49(6):681-9. doi: 10.3109/00365521.2014.898326. Epub 2014 Apr 2).
  2. 2018 Aug 3;10(8). pii: E1016. doi: 10.3390/nu10081016
  3. Neuro Endocrinol Lett. 2008 Dec;29(6):902-10.
  4. Immunol., 23 May 2017 https://doi.org/10.3389/fimmu.2017.00598
  5. J Ren Nutr. 2017 Nov;27(6):458-461. doi: 10.1053/j.jrn.2017.02.010.
  6. Psychoneuroendocrinology 2018 Aug 4;98:52-60. doi: 10.1016/j.psyneuen.2018.08.007. epub ahead of print
  7. Front Immunol. 2017 May 23;8:598. doi: 10.3389/fimmu.2017.00598. eCollection 2017
  8. Ann Intern Med. 2007 Nov 6;147(9):603-10
  9. 2005 Jul;54(7):966-71; Dig Dis. 2021 Jan 13
  10. Am J Gastroenterol. 2014 Jul;109(7):1041-51
  11. Am J Gastroenterol. 2011 Feb;106(2):272-7
  12. Aliment Pharmacol Ther. 2008 Aug 15;28(4):431-42
  13. Journal of Epithelial Biology and Pharmacology, 2012, 5, (Suppl 1-M7) 47-54)