I am honoured to be able to present a guest article by Prof. Dr. Burkhard Schütz on the topic of leaky gut.
Prof. Dr. Schütz is a luminary in his field, you can find out more about him at the end of this article.Enjoy reading!

Numerous diseases can be traced back to increased intestinal per meability. Not only intestinal diseases but also allergies or autoimmune diseases such as coeliac disease, type 1 diabetes, multiple sclerosis, rheumatoid arthritis and more can be the result.

The intestine has many functions in the body. These include the controlled and highly selective absorption of substances, which ensures the body's nutrient supply. An effective defense against infection is also an important function, because nowhere is the contact between the body and the environment more intense than at the intestinal mucosa.

In order to perform all its tasks as a barrier between the body and the environment, the intestine needs:

1. an intact bacterial colonization of the intestine (intestinal microflora)

2. sufficient production of mucosal mucusand

3. secretory immunogloblin A (sIgA)and

4. an intact intestinal epithelial cell layer.

The intestinal microflora is an important instrument for warding off endogenous infections. A dense colonization of the mucosa with "healthy" germs makes it difficult for pathogenic pathogens to gain access to mucosal receptors. Endogenous infections are thus prevented. Furthermore, the intestinal bacteria compete with potential attackers for nutrients, which prevents the latter from multiplying and spreading.

The mucus produced by the mucosa protects the mucosa, is important for its integrity and is therefore a pillar for maintaining normal permeability. On the other hand, it helps the mucus to achieve the right consistency for regular substance absorption.

In addition, sIgA is released into the intestine with the mucosa mucus. The formation of mucosal mucus and sIgA are therefore directly related.

sIgA has the task of binding antigens of all kinds in the intestinal lumen, for example bacteria, viruses, large macromolecules and more. The antigens remain in the intestinal lumen and are excreted with the stool. In this way, sIgA effectively controls the body's antigen load.

The controlled passage of (nutrients) from the intestinal lumen into the bloodstream takes place at the intestinal epithelial layer. This occurs firstly through the cells themselves (transcellular) and secondly between the cells (paracellular). Transcellular transport occurs without further intervention by the cells via simple diffusion, via specialized receptors or by endocytosis. The paracellular passage through the single-layer epithelial layer takes place at so-called "tight junctions", i.e. parts of a protein network that surrounds the cells and seals their intercellular spaces more or less well.

If there are disturbances in one of the areas mentioned, this impairs the intestinal barrier function, the permeability of the intestinal mucosa to antigens of all kinds increases and the "downstream" immune system in the body is burdened.

Intestinal permeability and its significance

If there is an increase in intestinal permeability (i.e. the intestine becomes more permeable), more substances enter the bloodstream that should not be present there in these quantities. This leads to a massive reaction of the immune system against these substances, the intestinal mucosa becomes inflamed, which leads to long-term damage to the intestinal mucosa.

Other immunological reactions also occur: antibodies are formed against food components, which can lead to food allergies or food intolerances.

However, antibodies are also formed against the body's own organ surfaces, which favors the development of autoimmune diseases. Concrete evidence of such connections has been found for type 1 diabetes, multiple sclerosis and rheumatoid polyarthritis in particular.

However, it is also suspected that increased intestinal permeability can be a (co-)cause of many other diseases.

Causes of increased intestinal permeability

Intestinal diseases can have an influence on the permeability of the intestine.

Crohn's disease and ulcerative colitis lead to inflammation of the intestine and thus to increased permeability. Increased permeability can also be caused by intolerances (coeliac disease, lactose malabsorption, fructose intolerance) or exocrine pancreatic insufficiency, infections and colonization defects.

Last but not least, psychological and physical stress also has an effect on intestinal permeability. Stress hormones and neurotransmitters (CRH and noradrenaline) cause the intestinal mucosa to "swell" (edema formation), resulting in increased intestinal permeability.

"Leaky gut" - the diagnosis

Leaky gut can be diagnosed on the basis of serum, urine and stool tests. The parameters zonulin and the inflammatory protein alpha-1-antitrypsin are particularly important for this.

Zonulin is a protein that controls the permeability of the tight junctions via receptors. If zonulin is elevated, the permeability of the intestine increases, resulting in "leaky gut". Patients with active coeliac disease show significantly increased levels of the protein. In the development of coeliac disease, but also in type 1 diabetes, multiple sclerosis and rheumatoid polyarthritis, elevated zonulin levels indicate that a permeable intestine is an important causative factor for the onset of the disease.

Alpha-1-antitrypsin indicates inflammation of the intestinal mucosa, but it is often also a reliable indicator of increased intestinal permeability.

We have been working with Laobor BIOVIS, headed by Prof. Dr. Schütz, for many years. You can find out more about the diagnostics here.

What to do about leaky gut

Our guest author and naturopath Julia Steffen, who also works with Prof. Dr. Schütz, has written a detailed blog article on leaky gut syndrome and its treatment. You can find out more about typical symptoms, causes and ways to counteract leaky gut, so it's worth reading the article right now.

About the author

Prof. Dr. Burkhard Schütz is Managing Partner and Scientific Director of BIOVIS Diagnostik MVZ GmbH, Limburg. He also has his own practice specializing in microbiology and laboratory diagnostics. We are also very pleased that he is on the scientific advisory board of Arktis BioPharma Switzerland and is thus available to us with his immense expertise.

He is a welcome speaker at medical congresses and events, and we are delighted that he can also be seen regularly giving lectures here in Einsiedeln.These lectures are especially intended for therapists, so if you work in the health sector and would like to be informed about them, please contact us via the chat or by e-mail.

Prof. Dr. Schütz's association activities consist of:

• Board of the International Society for Applied Preventive Medicine
• Board of the German Society for Probiotic Medicine
• Board of the German Society for Probiotics Research
• Scientific Advisory Board of the International Society for Bioimmunotherapy
• Member of the Medical Society for Empirical Medicine

Do you have a question for Dr. Schütz or for us? You are welcome to use the comments or send us an e-mail.