Various substances, especially nutrients, water, salt, minerals and vitamins must pass through either through the cells lining gut or between the cells (paracelluar) when the tight junctions are allowed to open.
Small substances such as simple sugars and water pass easily through the cells but larger substances need more space and must come through between the cells in the paracelluar space by triggering zonulin to act on occludens to open up the tight junctions, making the gut lining in essence temporarily “leaky”.
The increase in gut permeability is important for normal absorption and secretion function of the digestive tract. However, abnormal increases in gut permeability are now recognized as being very important if not the critical step in various disease processes.
Though many in the medical field are now researching and publishing articles on gut permeability, including using terms such as leaky gut or leaky intestine, there is still a great deal of resistance to the term “leaky gut” because of its use by the lay public and complementary or alternative practitioners for years.
However, increase gut permeability or leaky gut is now believed to be critical in the risk for and development of Celiac disease and Crohn’s disease. Gluten increases gut permeability in normal individuals but much more so in those with Celiac disease. Many factors can increase gut permeability including stress, various medications especially non-steroidal anti-inflammatory (NSAIDS e.g. Motrin, ibuprofen, Advil, Aleve), infections especially viral gastroenteritis, and altered levels of normal gut microorganisms (yeast and bacteria).
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Wishing all of you a Happy New Year,
Sincerely,
Dr. Scot Michael Lewey
“Dr. Celiac, the food doc”
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2 comments:
You said, "larger substances need more space and must come through between the cells in the paracelluar space by triggering zonulin to act on occludens to open up the tight junctions,"
What other food substances trigger zonulin?
There is a zonulin inhibitor that is being tested to treat those with CD. If you don't allow zonulin to work normally, there must be a downside. What will that be?
Great articles Dr. Lewey! Keep 'em coming.
Thanks for all your hard work, we [the gluten intols] appreciate it!
Al
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