876 - The Science of Leaky Gut with Dr Michael Camilleri MD (Mayo Clinic)
Jan 22, 2024
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Renowned gastroenterology researcher and professor at the Mayo Clinic, Dr. Michael Camilleri, discusses the science of leaky gut, exploring its causes, prevalence, and impact on diseases. He delves into the importance of leaky gut testing and treatment, including biomarkers and gluten intolerance. The podcast also touches on the effects of processed food and alcohol consumption, the role of the small intestine, and the need for reasonable avoidance and food freedom.
Treating the underlying condition rather than solely targeting leaky gut is often a more effective approach to improve gut health and overall well-being.
Gluten sensitivity can contribute to leaky gut, particularly in individuals with specific genetic types associated with celiac disease.
Dietary modifications, including removing substances that may damage the gut and using specific prebiotic and probiotic supplements, have shown promise in reducing leaky gut.
Deep dives
The Link Between Leaky Gut and Gut Health
Leaky gut refers to increased permeability in the lining of the intestines, which can lead to various health issues. While leaky gut has been associated with conditions like rheumatoid arthritis and celiac disease, it is important to note that not all diseases can be attributed to leaky gut. Treating the underlying condition rather than solely targeting leaky gut is often a more effective approach.
Understanding Gluten and its Impact on Leaky Gut
Gluten sensitivity, including non-celiac gluten sensitivity (NCGS), can contribute to leaky gut. Research has shown that individuals with HLA-DQ2/DQ8 genetic types, associated with celiac disease, may experience increased intestinal permeability in response to gluten. While gluten may also contribute to symptoms through its high FODMAP content, additional factors, such as microbiome involvement, may be at play.
The Role of Dietary Changes in Gut Health
Dietary modifications can play a significant role in improving gut health. Removing substances that may damage the gut, such as emulsifiers, alcohol, and processed foods, can be a cost-effective strategy. Additionally, the use of specific prebiotic and probiotic supplements, like galacto-oligosaccharides and certain bifidobacteria strains, have shown promise in reducing leaky gut. Clinical outcome studies, such as those focusing on a low FODMAP diet for IBS, can help prioritize dietary interventions based on individual symptomatic reactions.
Reasonable Level of Consumption for Processed Food and Alcohol
It is important to find a balance when it comes to consuming processed food and alcohol. Although ultra processed foods are generally not beneficial for overall health, it is important to avoid developing orthorexia, a fear of certain foods. Consuming a moderate amount of processed food (less than 18% of the diet) is generally acceptable for those who prioritize their health. Similarly, having an occasional dinner with friends that includes a couple of glasses of wine is generally not problematic as long as it is done in moderation.
Validity of Zonulin as a Marker for Intestinal Permeability
The marker zonulin has been commonly used to assess intestinal permeability. However, there are concerns about the accuracy of this marker. Studies have shown that the commercially available zonulin assay actually measures a compound similar to zonulin, but not the actual zonulin protein. Therefore, its reliability as a marker is questionable. There is a need for further validation and development of more accurate markers, such as blood tests that can evaluate leakiness of the gut. Alternative markers like fatty acid binding protein and other sugar probes have shown promise but require further investigation.
There’s still a lot we don’t understand about the science of leaky gut. Does it cause disease or is it a symptom? What’s the best way to test for it? Which treatments actually work to repair it?
Today’s guest is one of the best people to begin to answer these questions.
Dr. Camilleri is a renowned gastroenterology researcher and professor at the Mayo Clinic.
Tune in to hear about cutting-edge innovations and informed understandings around leaky gut testing and treatment.
If you have any additional questions you would like answered in the future, let me know in the comments!
Development and Validation of Test for "Leaky Gut" Small Intestinal and Colonic Permeability Using Sugars in Healthy Adults: https://pubmed.ncbi.nlm.nih.gov/33865841/
A case for improved assessment of gut permeability: a meta-analysis quantifying the lactulose:mannitol ratio in coeliac and Crohn's disease: https://pubmed.ncbi.nlm.nih.gov/35012471/
Food Additive Emulsifiers and Their Impact on Gut Microbiome, Permeability, and Inflammation: Mechanistic Insights in Inflammatory Bowel Disease: https://pubmed.ncbi.nlm.nih.gov/33336247/
Psychological and Gastrointestinal Symptoms of Patients with Irritable Bowel Syndrome Undergoing a Low-FODMAP Diet: The Role of the Intestinal Barrier: https://pubmed.ncbi.nlm.nih.gov/34371976/
DISCLAIMER: The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment.
