Leaky Gut and Dysbiosis

As I was having tea with a Chinese friend the other day, she was telling me about her daughter’s recent medical care. She said that each time her daughter had a cough, the doctor would give her three days worth of antibiotics. She asked me if this was a bad idea. Before jumping to the conclusion that the antibiotics were unnecessarily prescribed, I tried to find out more about the problem. “Why was she given antibiotics?” I asked (trying to sound neutral). My friend matter-of-factly responded “because she had bacteria.” This made me pause. Of course, there is such a thing as a three-day course of azithromycin (if that was the medicine), but I had many questions running through my head. What’s wrong with bacteria? Not all bacteria are bad. Do people know there are good bacteria that our bodies need? Do people know there is a lot of unhealthy resistance to antibiotics here in China? Did you know there is a push by the Chinese government to significantly reduce the overuse of antibiotics?

Functional Medicine on Digestive Dysfunction

As I was thinking (but not speaking) these thoughts, I was already fast-forwarding to the possibility that my friend’s daughter could have dysbiosis and a leaky gut. “What’s that?” These two conditions are fundamental to understanding the basis of diseases from the Functional Medicine viewpoint. I was initially a bit skeptical, but as I see more and more patients with digestive issues and multiple symptoms that many doctors can’t seem to cure, I am starting to wonder if treatment of these two maladies as needed might just be the golden ticket to better overall health.

Functional Medicine is one of many holistic approaches to medicine. It seeks to identify and address the root causes of disease and views the body as one integrated system, not a collection of independent organs divided up by medical specialties. Functional Medicine says that, in order to cure patients of their symptoms, a multi-dimensional approach is required. With this perspective, doctors explore the details of a patient’s diet, exercise, stress, psychology, medical history, environmental exposures and medications. Beijing might be the perfect environment for research in this field. As I started paying more attention to the above questions, I discovered that many of my patients with multiple chronic symptoms had taken repeated courses of antibiotics. Often, they experienced symptoms additional to their maladies that included high stress or off-and-on stomach problems (possibly caused by toxins) after moving to Beijing.

In these cases, the digestive system always seems to be involved. This makes sense because the majority of our bodies’ serotonin is in our gut. According to Functional Medicine theories, the combination of these factors eventually leads to an inflamed digestive system, which suffers from an abundance of bad bacteria (overgrowth), a lack of good bacteria (known as dysbiosis) and a leaky gut (intestinal or bowel hyperpermeability caused by disruption of the tight junction cells that line the digestive tract). In essence, our intestines are unable to keep out the bad things and keep in the good.

Functional Medicine Treatment Approach

Although this is an over-simplification, treatment usually starts by testing for nutritional deficiencies, dysbiosis, food allergies, infections and toxins. The individual will usually be instructed to avoid all dairy, eggs, allergens and wheat for two to four weeks. The good bacteria are reintroduced through probiotics (ingestible good bacteria). Deficient nutrients are replenished via the appropriate foods and supplements. Eventually, other foods can gradually be reintroduced to observe any possible association with symptoms. Lifestyle changes – such as stress management, exercise and, to the extent possible, detoxification – are also prescribed.

Think Long-Term

Clearly the treatment approach is long-term and more difficult than just popping a pill. Although I have had limited experience and just recently started investigating this approach, I have already seen encouraging results. I have a handful of patients with gluten intolerance (discovered through tests for celiac disease), and after trying the above approach, some patients have said they feel better. Recent research has even demonstrated the utility of fecal microbacterial transplants. Yes, stool transplants. This has proven beneficial to patients who suffer from various forms of colitis.

In these times of overeating and high stress, give your gut a rest. Pay attention to foods and substances that irritate your stomach or make you feel unwell. You are, after all, what you eat.