Your immune system is genetically and environmentally conditioned to recognize what is “self” and what is “non-self.” A normal immune response is one that is directed at attacking and eliminating a foreign or non-self protein (antigen) that threatens the body. It can be a bacteria, a virus, an allergen, or even a chemical agent. Inflammation is the result of this reaction. However, when a normal immune response goes awry, it can become misdirected against your body and body tissues. When this happens, a condition of autoimmunity results causing chronic inflammation and destruction of those tissues involved. Some common autoimmune conditions include Rheumatoid arthritis, Lupus, multiple sclerosis, inflammatory bowel disease, and Type 1 diabetes.
How is the “leaky gut” associated with autoimmune disorders?
The primary functions of the gastrointestinal (GI) tract have traditionally been thought to be limited to only the digestion and absorption of nutrients and electrolytes, and to the absorption and regulation of water balance (homeostasis). However, more recently another extremely important function of the GI tract has been recognized. It is its ability to act as a barrier regulating the trafficking of large protein and cellular molecules (macromolecules) between your body’s external environment and your body’s internal environment. Together with various gut-associated immune, structural, and neuroendocrine mechanisms and a healthy microbial environment your GI tract controls the equilibrium between your tolerance and immune response to non-self proteins (antigens). When this trafficking of macromolecules and your gut microbial environment become dysregulated, your GI tract begins to “leak” these macromolecules into your body’s systemic circulation. This, in turn, sets off all kinds of immune and inflammatory reactions in your body. In susceptible individuals, both intestinal and extraintestinal autoimmune disorders can occur from this situation.
Understanding the role of the intestinal barrier and the “leaky gut” in the cause of autoimmune disease is an area of interest and specialty for us at Meridian Medicine. In our patients suffering from autoimmune disorders, we commonly evaluate GI leakiness and its association with their autoimmune, inflammatory reaction. We treat this leakiness in an integrative fashion using dietary changes, nutrition, botanical medicines, probiotics, and prescription medications as appropriate. We also consult, co-manage, and refer regularly to various clinical specialists such as rheumatologists and gastroenterologists in the care and management of our patients with autoimmune disorders.