Leaky Gut (Intestinal Permeability): Part 2 — Tests and Treatments
By: BioDesign Wellness Center Staff
July 18, 2018 | Category: Gut HealthRequest A Call From Us
In Part 1 of this two-part series on leaky gut and intestinal permeability, we explained what leaky gut is, described its symptoms, and revealed its most common causes/triggers. We also pointed out that many in the conventional medical community still do not recognize leaky gut as a legitimate medical illness. However, those of us in the medical community who are more familiar with diagnosing and treating the condition believe otherwise. We know that there are several lab tests for diagnosing leaky gut (or ruling it out), and we have witnessed the positive impact treatment has had on the lives of our patients.
In this part, we describe the various tests we use for diagnosing or ruling out leaky gut and the treatment protocol we follow to restore gut health, address related conditions caused by leaky gut, and start making our patients feel better overall.
Testing for Leaky Gut
There are currently three main tests for leaky gut, each of which provides unique information that can guide treatment:
- Intestinal Permeability Assessment (a urine test)
- Array 2 —Intestinal Antigenic Permeability Screen (a blood test)
- GI-Map (a stool test)
The best test can be determined during a discussion with your physician. At BioDesign, we commonly use blood tests and stool tests.
Intestinal Permeability Assessment
The Intestinal Permeability Assessment directly measures the ability of two non-metabolized sugar molecules to permeate the intestinal mucosa. You drink a premeasured amount of lactulose and mannitol, and then you provide urine samples over the next six hours. The degree of intestinal permeability or malabsorption is reflected in the levels of the two sugars recovered in the urine samples.
Array 2 —Intestinal Antigenic Permeability Screen
The Intestinal Antigenic Permeability Screen measures the antibodies to proteins that bind or hold the intestinal barrier together. Imagine these proteins acting like glue to hold two pieces of paper together. If the glue starts to melt, then the papers peel apart. In the gut, the proteins occludin, zonulin, and actin hold the cells intact, preventing undigested food, viruses, bacteria, and lipopolysaccharides (LPS) from passing through the intestines into the bloodstream. (Lipopolysaccharides are the major component of the outer membrane of gram-negative bacteria, and they are toxic.)
Levels of antibodies to the proteins that hold the intestinal barrier together and to lipopolysaccharides are a good indication that the barrier has been compromised.
The GI-Map test identifies leaky gut through testing zonulin and also uses a DNA technology to find the most common pathogenic and beneficial bacteria, viruses, and parasites in the stool sample. This provides your doctor a way to understand what needs to be treated in order to support healing your gut and improving intestinal barrier dysfunction. It also provides a look at bacteria that are known to initiate autoimmune responses. By identifying these bacterial targets, treatment can be further individualized.
This is no ordinary stool test like those commonly performed at a Gastro or internal medicine office. This test digs deeper into the presence of normal, pathogenic, and opportunistic gut bacteria and markers of fat and protein digestion; gut inflammation, and leaky gut. It is an excellent test for identifying specific bacterial, parasitical, or viral strains that often account for hidden infections associated with leaky gut and other chronic health problems.
Treating Leaky Gut in 5 Steps
At BioDesign Wellness Center, we treat patients with leaky gut by taking an individual approach. Sure, there are some go-to treatments like glutamine to help repair intestinal lining cells and Aloe to soothe inflammation. However, each of these on its own is not enough. Without, the proper understanding of what is causing the leaky gut, treatment rarely leads to long-term resolution, even for the most committed patients. Therefore, we start with a detailed history and timeline of each concern presented by the patient.
Step One: We want to find out about previous traumas, infections, use of antibiotics, living environments, tick bites, travel, and so on. Then we detail the patient’s family history of autoimmunity, digestive issues, and food allergies. Next, we go into detail about each symptom the patient is experiencing, from intestinal distress to brain fog.
Step Two: This is followed by a physical exam, detailing not only vital signs, but specific areas of pain in the abdomen, checking for swelling in the arms, legs, or lymphatic system. The exam can often identify problems that may be located farther up the digestive tract — in the gallbladder (very common), liver, or stomach. This is important as it’s often missed by many patients who are either self-treating or received a cursory examination by a “rushed” provider.
Step Four: The next logical step is to run tests as described above. This is where we start to further confirm and detail the problem. Many patients are surprised to see that we find previously undetected inflammation markers elevated in the stool test, even after their visit to a gastroenterologist who already ran a colonoscopy. This is because we are checking for markers of inflammation that cannot be detected by the naked eye in a colonoscopy, only chemically. The inflammation is occurring in the tissues and cells that cannot be seen during routine testing and examination. Blood tests often reveal vitamin and nutritional deficiencies due to the malabsorption.
Step Five: After we receive the lab results, patients return to the office, where together we review the findings. We carefully explain each detail in the lab results, so patients feel confident that they understand the underlying issues that must be addressed. We then lay out a treatment plan, and we follow up with the patient on a regular basis until the underlying issues are resolved and symptoms subside.
Treatment includes dietary planning, therapies using natural supplements to heal the gut, solutions to address fat digestion, nutrients to replenish deficiencies, and treatments for any infections or inflammation revealed in the stool test.
If you are experiencing any of the symptoms described in Part 1 of this two-part post or any other unexplained symptoms or have been receiving treatment with less than outstanding results, we strongly encourage you to see a medical professional who has a thorough understanding of the diagnosis and treatment of leaky gut and other underlying conditions. Don’t settle for cursory examinations, tests and quick fixes that address only symptoms. The best approach to treating any medical condition is to get to the root of the problem and treat it from starting there.
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