Increased intestinal permeability, hyperpermeable gut and leaky gut syndrome are terms used to describe gastrointestinal barrier breakdown. Normally the lining of the small intestine allows absorption of nutrients while providing a barrier to keep out undesirable molecules. When that barrier breaks down it  becomes "leaky".  Larger molecules and a greater number of pathogens and antigens seep through into systemic circulation.

The increase of foreign substances allowed into the system places an additional burden on the detoxification pathways of the liver. When the body is overwhelmed by more foreign substances than it can effectively detoxify, toxins accumulate, resulting in a variety of reactions and symptoms throughout the body, including allergies of all kinds.(1) Leaky gut has been clinically associated with inflammatory joint disease. This association was recognized and written about as far back as the ancient Indian text of Ayurvedic medicine.(2)

Changes in intestinal permeability may occur as a result of irritation of the gut lining, chronic nutritional insufficiency, overgrowth or imbalance of intestinal flora, and exposure to circulating bacterial toxins.(3) Use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and aspirin can damage the intestinal lining.(1,4) It is ironic that patients with joint pain are normally prescribed NSAIDs for relief of pain and inflammation when those drugs may contribute to the condition.

Research and clinical experience indicate that certain nutrients are required for maintaining the integrity of gastrointestinal mucosal cells and, therefore, may benefit the healing process.

The amino acid L-Glutamine is a major respiratory fuel for the gut and is the preferred fuel for intestinal epithelial cells. Glutamine is involved in nitrogen exchange, regulation of protein synthesis and provision of a precursor in nucleotide synthesis. Supplementary glutamine can boost body levels of glutathione, a potent antioxidant which is also used in hepatic detoxification processes.

Increased intestinal permeability and villous atrophy have been associated with use of standard total parenteral nutrition solutions. When glutamine is added to these solutions, intestinal permeability does not increase. Mucosal weight and DNA content is increased in the upper (jejunal) portion of the small intestines and villous atrophy is significantly decreased.(5)

N-Acetyl-Glucosamine (NAG) belongs to a class of compounds called amino sugars. NAG and other amino sugars are an integral part of cell membranes and the interstitial tissue which holds cells together. Amino sugars are especially important in the intestine because they form the protective mucous layer and cellular cement that regulate intestinal permeability.(6)

Doctors who have worked with the Peruvian herb cat’s claw (also known as uña de gato in Spanish) report that it has a remarkable ability to cleanse the entire intestinal tract. Dr. Brent Davis, who used the herb in working with approximately 150 patients between 1988 and 1992 reported positive results in treating patients suffering from many different stomach and bowel disorders including leaky gut syndrome, irritable bowel syndrome, Crohn’s disease, diverticulitis, hemorrhoids, fistulas, gastritis, ulcers, parasites and intestinal flora imbalance. Oxindol alkaloids isolated from cat’s claw have shown a pronounced enhancement effect on phagocytosis (the ability of the white blood cells and macrophages to attack, engulf and digest harmful micro-organisms, foreign matter and debris).(11)

Clinical studies show that orally administered gamma oryzanol, an extract of rice bran oil, is effective in treating a broad range of gastrointestinal disorders including stress-induced gastric and duodenal ulcers. In a review of 23 research studies, therapeutic improvement was seen in 85 to 90 per cent of the cases.(7)

More than 200 enzymes require the trace metal zinc for their activity, including the enzymes involved in the production of DNA and RNA and at least 25 enzymes involved in digestion and metabolism. It is also important for absorption and action of vitamins, especially the B complex, and it also plays a role in the structure and function of cell membranes.(8) Supplementary zinc has been reported to accelerate wound healing dramatically and has been particularly effective when used to accelerate healing of gastric ulcers.(9) Picolinic acid, which occurs naturally in the body, is a very effective chelator of metal ions. Mineral picolinates can accomplish their therapeutic goals at lower doses, thereby minimizing the risk of mineral imbalances. Zinc in the picolinate form may also leave more intestinal picolinic acid free to aid absorption of other minerals.(10)

Folic acid is a part of the water-soluble B complex family and functions as a coenzyme, together with vitamins B12 and C, in the breakdown and utilization of proteins. Any condition that interferes with the absorption of food can result in a folic deficiency. Some folic acid is manufactured by bacteria in the intestine. An imbalance in the intestinal microflora can also lead to deficiency.(8)

Vitamin A strengthens mucous membranes such as the linings of the digestive tract, kidneys and bladder as well as respiratory organs. By strengthening the cell walls, it helps protect the mucous membrane against invading bacteria. Vitamin A aids in the healing process by enhancing production of RNA. Studies reveal that new RNA can be produced in vitamin A deficient bodies; however, the rate of production is much less than if sufficient vitamin A is available. It also stimulates the production of mucus which in turn can prevent scarring while the tissues heal.(8)

In addition to supplying nutrients which are specific for support of the intestinal mucosal cells, any nutritional insufficiencies should be addressed.(1) Since the leaky gut does not operate very efficiently, some nutrients may not be absorbed in sufficient quantities and the body’s need for some nutrients may be increased. For example the requirement for dietary sulfur amino acids may be increased because of the need for hepatic detoxification of foreign substances that are leaked into the portal circulation.(12)

Adequate digestion is a must. This could mean increasing stomach acidity,  supporting pancreatic function with appropriate enzymes,  lipotropic agents for fat digestion, or a combination of  these.

Restoring and maintaining a proper balance of intestinal microflora is important for intestinal health. Intestinal microflora imbalances may occur due to environmental factors such as a diet high in refined foods, overuse of antibiotics and other drugs. Supplementing with beneficial acidophilus and bifidobacteria can help restore balance.

Since NSAIDs have been shown to increase intestinal permeability, their use should be avoided. Foods that are known to produce allergic reactions should also be avoided. It has been documented that allergic individuals have increased intestinal permeability following ingestion of specific foods.(13)

WARNING:   This publication and the product contained herein have not been approved or evaluated by the Federal Drug Administration. This publication, and the product contained herein are not intended to diagnose, treat, cure or prevent any disease. The product relates to nutritional support only.