Nutritional protocols for gut permeability

Kyla Williams DipION BSc MSc

Overviewbull What is gut permeability leaky gut

bull Symptoms and health issues relating to increased gut permeability

bull Possible causes of gut permeability

bull Diagnosing gut permeability

ndash symptoms

ndash recommended diagnostic tests to identify specific causes

bull Nutritional protocol for healing a leaky gut

ndash diet ndash foods to avoid and foods to reduce inflammation

ndash supplements to support the healing process

Permeable gut vs lsquoleaky gut syndromersquobull These terms are often used interchangeably however they can be perceived very differently by health professionals

bull Controversy exists with the term lsquoleaky gut syndromersquo

bull lsquoLeaky gutrsquo is simply a term used for a permeable gut lining associated with inflammation

bull Nutrition practitioners - the term lsquoleaky gutrsquo is more commonly used

bull Medical doctors - may prefer to use the term lsquopermeable gut liningrsquo or lsquoinflammed digestive tractrsquo

What is gut permeability

bull In a permeable gut lining the single layer of mucosal cells covering the digestive tract are damaged

bull Cells become inflamed

bull Gaps appear between

the cells

bull Food particles and other

toxins may enter directly into the bloodstream

A healthy digestive tract

bull Closed and closely packed together mucosal

cells lining the digestive tract

bull Cells are plumped up thereby carefully

controlling the absorption of nutrients from food

bull Normal tight junction between cells keeps the mucosal barrier intact

bull This barrier prevents most large molecules and germs passing from inside the bowel into the bloodstream

An unhealthy permeable gut lining

bull Excess inflammation damaging cells and epithelium

bull Undigested food particles may pass through gaps

bull The immune system may react to this by

creating more inflammation

bull Commonly leads to food intolerances ndash an immune reaction to various foods which can change over time

bull A leaky gut is often an ongoing issue and frequently undiagnosed

The importance of gut healthNutritional

status ndash bile enzymes etc

Immune function ndash first line of defence

To balance hormones

To protect against food intolerances

B12 absorption (intrinsic factor)

Digestive symptoms associated with gut permeability

bull Digestive symptoms are often not a priority to clients

bull Clients may want to concentrate on other goals such as

overcoming fatigue (associated with leaky gut)

ndash diarrhoea

ndash constipation

ndash burning sensation in the stomach

ndash passing a stool shortly after eating

ndash pain after drinking alcohol or spicy food

ndash stomach cramps

ndash gas

Other symptoms associated with gut permeability

bull A leaky gut may not only present itself as digestive discomfort

bull Other symptoms relating to a leaky gut include

ndash hormone imbalances causing mood swings

ndash headaches

ndash skin breakouts

ndash tiredness and fatigue

ndash joint pains associated with inflammation

and intolerances

ndash depression and anxiety

Health issues linked to gut permeability

bull The following conditions may increase gut permeability

bull Inflammatory bowel diseases

ndash ulcerative colitis

ndash Crohnrsquos disease

bull Gastritis (inflammation of the stomach ndash several causes)

bull HIV AIDS

bull Type 1 diabetes

Causes of a leaky gut

bull There are several possible causes of a leaky gut

ndash chronic inflammation

ndash nutritional deficiencies

ndash fatty acid deficiencies

ndash improper digestion

ndashhigh intake of commonly aggravating foods

ndash stress

bull Other possible causes

ndash parasites

ndash pathogenic bacteria

ndash yeast infections

The role of inflammation in a permeable gut

bull Chronic inflammation causes continuous breakdown of cells

bull Excess inflammation can damage mucosal cellsrsquo tight junctions

bull Inflammation may be a result of an inflammatory diet or medication

bull Inflammation exacerbates pain and sensitivity to foods

bull Too much inflammation stalls the healing process

Nutritional deficiencies and a leaky gut

bull Nutrients required for the integrity of the mucosal cells

ndash zinc

ndash antioxidants

ndash protein

ndash fatty acids

bull A leaky gut may also result in nutritional

deficiencies due to inflamed villi and

reduced ability of mucosal cells to absorb

nutrients

Fatty acid deficiencies and a leaky gut

bull A deficiency in omega-3 fatty acids may increase inflammation

bull A low omega-3 index may also reduce fluidity of cell membranes

bull Low levels of omega-3 may also shrink cells (less plumped up) leading

to possible gaps between mucosal cells

bull Imbalanced ratio of omega-6 to omega-3

fatty acids may lead to inflammation

Improper digestion and leaky gut

bull Low stomach acid = improper breakdown of proteins

bull Low production of bile = improper breakdown of fats

bull Low levels of digestive enzymes = larger undigested food particles

Improper digestion

Undigested food

particles

Food passing through leaky gut

Possible intolerances

High intake of commonly aggravating foods

bull Foods commonly associated with a permeable gut liningndash gluten

ndash dairy

ndash peanuts

ndash pulses (lentils beans)

ndash spicy food

bull Foods which an individual has become intolerant to due to IgGantibody reaction or other immune reactions

Is gluten to blamebull Gluten - a protein found in grains

wheat barley and rye

bull It can be very difficult to process in the body and can result in immune reactions leading to unwanted symptoms such as digestive cramps

bull Gluten is one of the most common food intolerances and can negatively affect symptoms of a leaky gut

bull Gluten is not the cause of a leaky gut for everyone

bull Small quantities of gluten may be tolerated although constant intake of gluten is too much to handle for many people

Spicy food

bull Spicy food - chilli peppers contain a compound called capsaicin

bull Causes irritation to mucosal cells including the lips tongue mouth and digestive tract

bull Leaky gut + chilli = a burning sensation in the stomach and a bout of diarrhoea

Other foods which may aggravate a leaky gut

bull Ginger ndash the spicy irritating compound is gingerol (related to capsaicin)

bull Raw garlic

bull Raw onions

bull Although these foods are considered to be anti-inflammatory they can also cause irritation to your gut lining if it is already semi-permeable

bull Direct contact of such strong foods on already damaged cells can result in an instant burning sensation in the stomach or intestines

Stress and a leaky gut

bull Stress can increase stomach acid production

ndash often leading to gastritis ulcers

bull Stress may reduce ability to digest food by reducing production of digestive enzymes

bull Higher requirements for vitamins and minerals

Pathogens ndash yeast bacteria and parasites

bull Yeast infections such as candida albicans

bull Pathogenic bacterial infections

lack of beneficial bacteria

bull Parasites

bull Toxins produced by pathogens can cause

further damage

Alcohol

bull Drinking alcohol in excess ie more than

approximately 3 units in one day

can cause significant irritation to an already permeable gut

bull Alcohol is inflammatory and therefore is only going to make the situation worse

bull 2-3 units of alcohol may not cause any issue to someone with a healthy gut lining but for someone with a permeable gut lining alcohol can be very aggravating

Medication

bull Well known irritants of the bowel lining

ndash aspirin

ndash non-steroidal anti-inflammatory drugs

(nSAIDs) such as ibuprofen

bull These medications may cause inflammation of a particular area of the bowel which may result in ulcers or a permeable gut lining

bull Antibiotics wipe out beneficial bacteria and therefore may result in infections following treatment

bull Birth control pill

Diagnosing a leaky gut ndash symptoms

bull Recognise digestive symptoms relating to a leaky gut

ndash bloating

ndash diarrhoea

ndash pain

ndash stomach cramps after eating

ndash feeling of lsquosensitivityrsquo to certain foods such as bread

bull Also consider other symptoms

ndash sinusitis

ndash eczema

ndash migraines

ndash joint pains

ndashchronic fatigue

Diagnosing a leaky gut ndash tests

bull A digestive stool analysis can test secretory IgA (Immunoglobulin A) levels

bull IgA is an antibody used by the immune system to identify and fight off unwanted objects such as infectious bacteria this specific type of antibody is produced in mucosal linings (the gut wall)

bull As unwanted undigested food particles may pass through the gut lining an immune reaction involving high levels of IgA antibodies may suggest a permeable gut lining

bull Test for food intolerances if IgG antibodies are produced a leaky gut is very likely

Protocol Step 1 ndash eliminate irritating foods

bull Identify any irritating foods and eliminate these from the diet

bull Gluten is the most common culprit although many other foods ndash such as peanuts beans and lentils ndash can also cause problems in some individuals

bull If a food intolerance test has been carried out

ndash eliminate these foods temporarily only while concentrating on healing the gut

ndash intolerances to several foods are likely to develop over time

ndash simply cutting these foods out is not going to address the cause

ndash once the gut is properly healed these intolerances should

disappear

Protocol Step 1 ndash eliminate irritating foods

bull Spicy food should be eliminated (or at least significantly reduced) during this initial stage for approximately 2-4 months

bull Ideally eliminate alcohol completely for 2-4 months

bull Drinking alcohol even once a week while trying to heal your gut can make the healing process twice as long

Protocol Step 2 ndash test and eliminate pathogens

bull Identify pathogens and eliminate them ndash usually 3-6 months

bull If a digestive stool analysis identifies an infection such as a bacterial imbalance or yeast infection

ndash supplement with probiotics

ndash consider other supplements specific to eliminating bacteria (oregano oil garlic)

ndash support immune function (zinc antioxidants fermented foods)

ndash reduce sugar in the diet

bull Bacterial infections such as H pylori may require medical attention from a doctor and medication

Protocol Step 2 ndash test and eliminate pathogens

bull If a parasite infection exists some may be eliminated with supplements 6 month course of

ndash goldenseal

ndash oregano oil

ndash probiotics

bull Support liver detoxification

bull Some stubborn parasites may require medical attention from a doctor and medication

Protocol Step 3 ndash feed your cells

bull After all aggravating foods have been eliminated from your diet it is important to concentrate on feeding the cells lining your digestive system

bull Cells lining the digestive tract require the amino acid glutamine to be able to replenish themselves

bull The powder form mixed with water is ideal to maximise exposure to cells if your digestive system is not strong enough to break down supplement tablets

Protocol Step 4 ndash control inflammation

bull Keep inflammation down in order to promote healing and reduce pain

bull To control inflammation consider anti-inflammatory foods

ndash vegetables

ndash oily fish (containing omega-3 EPA)

ndash foods rich in antioxidants

bull Limit intake of inflammatory foods

ndash grain fed meats (containing omega-6 AA)

ndash vegetable oils such as refined corn oil and sunflower oil

ndash refined carbohydrate foods such as sugar and white flour

Protocol Step 4 ndash control inflammation

bull The most potent anti-inflammatory supplement which may help to calm and soothe the gut lining is omega-3 EPA

bull 1000mg omega-3 EPA per day to have a therapeutic effect on reducing inflammation

bull The ratio of omega-6 AA to omega-3 EPA needs to be balanced eg 21 ratio

bull Omega-3 EPA produces anti-inflammatory eicosanoids

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

Overviewbull What is gut permeability leaky gut

bull Symptoms and health issues relating to increased gut permeability

bull Possible causes of gut permeability

bull Diagnosing gut permeability

ndash symptoms

ndash recommended diagnostic tests to identify specific causes

bull Nutritional protocol for healing a leaky gut

ndash diet ndash foods to avoid and foods to reduce inflammation

ndash supplements to support the healing process

Permeable gut vs lsquoleaky gut syndromersquobull These terms are often used interchangeably however they can be perceived very differently by health professionals

bull Controversy exists with the term lsquoleaky gut syndromersquo

bull lsquoLeaky gutrsquo is simply a term used for a permeable gut lining associated with inflammation

bull Nutrition practitioners - the term lsquoleaky gutrsquo is more commonly used

bull Medical doctors - may prefer to use the term lsquopermeable gut liningrsquo or lsquoinflammed digestive tractrsquo

What is gut permeability

bull In a permeable gut lining the single layer of mucosal cells covering the digestive tract are damaged

bull Cells become inflamed

bull Gaps appear between

the cells

bull Food particles and other

toxins may enter directly into the bloodstream

A healthy digestive tract

bull Closed and closely packed together mucosal

cells lining the digestive tract

bull Cells are plumped up thereby carefully

controlling the absorption of nutrients from food

bull Normal tight junction between cells keeps the mucosal barrier intact

bull This barrier prevents most large molecules and germs passing from inside the bowel into the bloodstream

An unhealthy permeable gut lining

bull Excess inflammation damaging cells and epithelium

bull Undigested food particles may pass through gaps

bull The immune system may react to this by

creating more inflammation

bull Commonly leads to food intolerances ndash an immune reaction to various foods which can change over time

bull A leaky gut is often an ongoing issue and frequently undiagnosed

The importance of gut healthNutritional

status ndash bile enzymes etc

Immune function ndash first line of defence

To balance hormones

To protect against food intolerances

B12 absorption (intrinsic factor)

Digestive symptoms associated with gut permeability

bull Digestive symptoms are often not a priority to clients

bull Clients may want to concentrate on other goals such as

overcoming fatigue (associated with leaky gut)

ndash diarrhoea

ndash constipation

ndash burning sensation in the stomach

ndash passing a stool shortly after eating

ndash pain after drinking alcohol or spicy food

ndash stomach cramps

ndash gas

Other symptoms associated with gut permeability

bull A leaky gut may not only present itself as digestive discomfort

bull Other symptoms relating to a leaky gut include

ndash hormone imbalances causing mood swings

ndash headaches

ndash skin breakouts

ndash tiredness and fatigue

ndash joint pains associated with inflammation

and intolerances

ndash depression and anxiety

Health issues linked to gut permeability

bull The following conditions may increase gut permeability

bull Inflammatory bowel diseases

ndash ulcerative colitis

ndash Crohnrsquos disease

bull Gastritis (inflammation of the stomach ndash several causes)

bull HIV AIDS

bull Type 1 diabetes

Causes of a leaky gut

bull There are several possible causes of a leaky gut

ndash chronic inflammation

ndash nutritional deficiencies

ndash fatty acid deficiencies

ndash improper digestion

ndashhigh intake of commonly aggravating foods

ndash stress

bull Other possible causes

ndash parasites

ndash pathogenic bacteria

ndash yeast infections

The role of inflammation in a permeable gut

bull Chronic inflammation causes continuous breakdown of cells

bull Excess inflammation can damage mucosal cellsrsquo tight junctions

bull Inflammation may be a result of an inflammatory diet or medication

bull Inflammation exacerbates pain and sensitivity to foods

bull Too much inflammation stalls the healing process

Nutritional deficiencies and a leaky gut

bull Nutrients required for the integrity of the mucosal cells

ndash zinc

ndash antioxidants

ndash protein

ndash fatty acids

bull A leaky gut may also result in nutritional

deficiencies due to inflamed villi and

reduced ability of mucosal cells to absorb

nutrients

Fatty acid deficiencies and a leaky gut

bull A deficiency in omega-3 fatty acids may increase inflammation

bull A low omega-3 index may also reduce fluidity of cell membranes

bull Low levels of omega-3 may also shrink cells (less plumped up) leading

to possible gaps between mucosal cells

bull Imbalanced ratio of omega-6 to omega-3

fatty acids may lead to inflammation

Improper digestion and leaky gut

bull Low stomach acid = improper breakdown of proteins

bull Low production of bile = improper breakdown of fats

bull Low levels of digestive enzymes = larger undigested food particles

Improper digestion

Undigested food

particles

Food passing through leaky gut

Possible intolerances

High intake of commonly aggravating foods

bull Foods commonly associated with a permeable gut liningndash gluten

ndash dairy

ndash peanuts

ndash pulses (lentils beans)

ndash spicy food

bull Foods which an individual has become intolerant to due to IgGantibody reaction or other immune reactions

Is gluten to blamebull Gluten - a protein found in grains

wheat barley and rye

bull It can be very difficult to process in the body and can result in immune reactions leading to unwanted symptoms such as digestive cramps

bull Gluten is one of the most common food intolerances and can negatively affect symptoms of a leaky gut

bull Gluten is not the cause of a leaky gut for everyone

bull Small quantities of gluten may be tolerated although constant intake of gluten is too much to handle for many people

Spicy food

bull Spicy food - chilli peppers contain a compound called capsaicin

bull Causes irritation to mucosal cells including the lips tongue mouth and digestive tract

bull Leaky gut + chilli = a burning sensation in the stomach and a bout of diarrhoea

Other foods which may aggravate a leaky gut

bull Ginger ndash the spicy irritating compound is gingerol (related to capsaicin)

bull Raw garlic

bull Raw onions

bull Although these foods are considered to be anti-inflammatory they can also cause irritation to your gut lining if it is already semi-permeable

bull Direct contact of such strong foods on already damaged cells can result in an instant burning sensation in the stomach or intestines

Stress and a leaky gut

bull Stress can increase stomach acid production

ndash often leading to gastritis ulcers

bull Stress may reduce ability to digest food by reducing production of digestive enzymes

bull Higher requirements for vitamins and minerals

Pathogens ndash yeast bacteria and parasites

bull Yeast infections such as candida albicans

bull Pathogenic bacterial infections

lack of beneficial bacteria

bull Parasites

bull Toxins produced by pathogens can cause

further damage

Alcohol

bull Drinking alcohol in excess ie more than

approximately 3 units in one day

can cause significant irritation to an already permeable gut

bull Alcohol is inflammatory and therefore is only going to make the situation worse

bull 2-3 units of alcohol may not cause any issue to someone with a healthy gut lining but for someone with a permeable gut lining alcohol can be very aggravating

Medication

bull Well known irritants of the bowel lining

ndash aspirin

ndash non-steroidal anti-inflammatory drugs

(nSAIDs) such as ibuprofen

bull These medications may cause inflammation of a particular area of the bowel which may result in ulcers or a permeable gut lining

bull Antibiotics wipe out beneficial bacteria and therefore may result in infections following treatment

bull Birth control pill

Diagnosing a leaky gut ndash symptoms

bull Recognise digestive symptoms relating to a leaky gut

ndash bloating

ndash diarrhoea

ndash pain

ndash stomach cramps after eating

ndash feeling of lsquosensitivityrsquo to certain foods such as bread

bull Also consider other symptoms

ndash sinusitis

ndash eczema

ndash migraines

ndash joint pains

ndashchronic fatigue

Diagnosing a leaky gut ndash tests

bull A digestive stool analysis can test secretory IgA (Immunoglobulin A) levels

bull IgA is an antibody used by the immune system to identify and fight off unwanted objects such as infectious bacteria this specific type of antibody is produced in mucosal linings (the gut wall)

bull As unwanted undigested food particles may pass through the gut lining an immune reaction involving high levels of IgA antibodies may suggest a permeable gut lining

bull Test for food intolerances if IgG antibodies are produced a leaky gut is very likely

Protocol Step 1 ndash eliminate irritating foods

bull Identify any irritating foods and eliminate these from the diet

bull Gluten is the most common culprit although many other foods ndash such as peanuts beans and lentils ndash can also cause problems in some individuals

bull If a food intolerance test has been carried out

ndash eliminate these foods temporarily only while concentrating on healing the gut

ndash intolerances to several foods are likely to develop over time

ndash simply cutting these foods out is not going to address the cause

ndash once the gut is properly healed these intolerances should

disappear

Protocol Step 1 ndash eliminate irritating foods

bull Spicy food should be eliminated (or at least significantly reduced) during this initial stage for approximately 2-4 months

bull Ideally eliminate alcohol completely for 2-4 months

bull Drinking alcohol even once a week while trying to heal your gut can make the healing process twice as long

Protocol Step 2 ndash test and eliminate pathogens

bull Identify pathogens and eliminate them ndash usually 3-6 months

bull If a digestive stool analysis identifies an infection such as a bacterial imbalance or yeast infection

ndash supplement with probiotics

ndash consider other supplements specific to eliminating bacteria (oregano oil garlic)

ndash support immune function (zinc antioxidants fermented foods)

ndash reduce sugar in the diet

bull Bacterial infections such as H pylori may require medical attention from a doctor and medication

Protocol Step 2 ndash test and eliminate pathogens

bull If a parasite infection exists some may be eliminated with supplements 6 month course of

ndash goldenseal

ndash oregano oil

ndash probiotics

bull Support liver detoxification

bull Some stubborn parasites may require medical attention from a doctor and medication

Protocol Step 3 ndash feed your cells

bull After all aggravating foods have been eliminated from your diet it is important to concentrate on feeding the cells lining your digestive system

bull Cells lining the digestive tract require the amino acid glutamine to be able to replenish themselves

bull The powder form mixed with water is ideal to maximise exposure to cells if your digestive system is not strong enough to break down supplement tablets

Protocol Step 4 ndash control inflammation

bull Keep inflammation down in order to promote healing and reduce pain

bull To control inflammation consider anti-inflammatory foods

ndash vegetables

ndash oily fish (containing omega-3 EPA)

ndash foods rich in antioxidants

bull Limit intake of inflammatory foods

ndash grain fed meats (containing omega-6 AA)

ndash vegetable oils such as refined corn oil and sunflower oil

ndash refined carbohydrate foods such as sugar and white flour

Protocol Step 4 ndash control inflammation

bull The most potent anti-inflammatory supplement which may help to calm and soothe the gut lining is omega-3 EPA

bull 1000mg omega-3 EPA per day to have a therapeutic effect on reducing inflammation

bull The ratio of omega-6 AA to omega-3 EPA needs to be balanced eg 21 ratio

bull Omega-3 EPA produces anti-inflammatory eicosanoids

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

Permeable gut vs lsquoleaky gut syndromersquobull These terms are often used interchangeably however they can be perceived very differently by health professionals

bull Controversy exists with the term lsquoleaky gut syndromersquo

bull lsquoLeaky gutrsquo is simply a term used for a permeable gut lining associated with inflammation

bull Nutrition practitioners - the term lsquoleaky gutrsquo is more commonly used

bull Medical doctors - may prefer to use the term lsquopermeable gut liningrsquo or lsquoinflammed digestive tractrsquo

What is gut permeability

bull In a permeable gut lining the single layer of mucosal cells covering the digestive tract are damaged

bull Cells become inflamed

bull Gaps appear between

the cells

bull Food particles and other

toxins may enter directly into the bloodstream

A healthy digestive tract

bull Closed and closely packed together mucosal

cells lining the digestive tract

bull Cells are plumped up thereby carefully

controlling the absorption of nutrients from food

bull Normal tight junction between cells keeps the mucosal barrier intact

bull This barrier prevents most large molecules and germs passing from inside the bowel into the bloodstream

An unhealthy permeable gut lining

bull Excess inflammation damaging cells and epithelium

bull Undigested food particles may pass through gaps

bull The immune system may react to this by

creating more inflammation

bull Commonly leads to food intolerances ndash an immune reaction to various foods which can change over time

bull A leaky gut is often an ongoing issue and frequently undiagnosed

The importance of gut healthNutritional

status ndash bile enzymes etc

Immune function ndash first line of defence

To balance hormones

To protect against food intolerances

B12 absorption (intrinsic factor)

Digestive symptoms associated with gut permeability

bull Digestive symptoms are often not a priority to clients

bull Clients may want to concentrate on other goals such as

overcoming fatigue (associated with leaky gut)

ndash diarrhoea

ndash constipation

ndash burning sensation in the stomach

ndash passing a stool shortly after eating

ndash pain after drinking alcohol or spicy food

ndash stomach cramps

ndash gas

Other symptoms associated with gut permeability

bull A leaky gut may not only present itself as digestive discomfort

bull Other symptoms relating to a leaky gut include

ndash hormone imbalances causing mood swings

ndash headaches

ndash skin breakouts

ndash tiredness and fatigue

ndash joint pains associated with inflammation

and intolerances

ndash depression and anxiety

Health issues linked to gut permeability

bull The following conditions may increase gut permeability

bull Inflammatory bowel diseases

ndash ulcerative colitis

ndash Crohnrsquos disease

bull Gastritis (inflammation of the stomach ndash several causes)

bull HIV AIDS

bull Type 1 diabetes

Causes of a leaky gut

bull There are several possible causes of a leaky gut

ndash chronic inflammation

ndash nutritional deficiencies

ndash fatty acid deficiencies

ndash improper digestion

ndashhigh intake of commonly aggravating foods

ndash stress

bull Other possible causes

ndash parasites

ndash pathogenic bacteria

ndash yeast infections

The role of inflammation in a permeable gut

bull Chronic inflammation causes continuous breakdown of cells

bull Excess inflammation can damage mucosal cellsrsquo tight junctions

bull Inflammation may be a result of an inflammatory diet or medication

bull Inflammation exacerbates pain and sensitivity to foods

bull Too much inflammation stalls the healing process

Nutritional deficiencies and a leaky gut

bull Nutrients required for the integrity of the mucosal cells

ndash zinc

ndash antioxidants

ndash protein

ndash fatty acids

bull A leaky gut may also result in nutritional

deficiencies due to inflamed villi and

reduced ability of mucosal cells to absorb

nutrients

Fatty acid deficiencies and a leaky gut

bull A deficiency in omega-3 fatty acids may increase inflammation

bull A low omega-3 index may also reduce fluidity of cell membranes

bull Low levels of omega-3 may also shrink cells (less plumped up) leading

to possible gaps between mucosal cells

bull Imbalanced ratio of omega-6 to omega-3

fatty acids may lead to inflammation

Improper digestion and leaky gut

bull Low stomach acid = improper breakdown of proteins

bull Low production of bile = improper breakdown of fats

bull Low levels of digestive enzymes = larger undigested food particles

Improper digestion

Undigested food

particles

Food passing through leaky gut

Possible intolerances

High intake of commonly aggravating foods

bull Foods commonly associated with a permeable gut liningndash gluten

ndash dairy

ndash peanuts

ndash pulses (lentils beans)

ndash spicy food

bull Foods which an individual has become intolerant to due to IgGantibody reaction or other immune reactions

Is gluten to blamebull Gluten - a protein found in grains

wheat barley and rye

bull It can be very difficult to process in the body and can result in immune reactions leading to unwanted symptoms such as digestive cramps

bull Gluten is one of the most common food intolerances and can negatively affect symptoms of a leaky gut

bull Gluten is not the cause of a leaky gut for everyone

bull Small quantities of gluten may be tolerated although constant intake of gluten is too much to handle for many people

Spicy food

bull Spicy food - chilli peppers contain a compound called capsaicin

bull Causes irritation to mucosal cells including the lips tongue mouth and digestive tract

bull Leaky gut + chilli = a burning sensation in the stomach and a bout of diarrhoea

Other foods which may aggravate a leaky gut

bull Ginger ndash the spicy irritating compound is gingerol (related to capsaicin)

bull Raw garlic

bull Raw onions

bull Although these foods are considered to be anti-inflammatory they can also cause irritation to your gut lining if it is already semi-permeable

bull Direct contact of such strong foods on already damaged cells can result in an instant burning sensation in the stomach or intestines

Stress and a leaky gut

bull Stress can increase stomach acid production

ndash often leading to gastritis ulcers

bull Stress may reduce ability to digest food by reducing production of digestive enzymes

bull Higher requirements for vitamins and minerals

Pathogens ndash yeast bacteria and parasites

bull Yeast infections such as candida albicans

bull Pathogenic bacterial infections

lack of beneficial bacteria

bull Parasites

bull Toxins produced by pathogens can cause

further damage

Alcohol

bull Drinking alcohol in excess ie more than

approximately 3 units in one day

can cause significant irritation to an already permeable gut

bull Alcohol is inflammatory and therefore is only going to make the situation worse

bull 2-3 units of alcohol may not cause any issue to someone with a healthy gut lining but for someone with a permeable gut lining alcohol can be very aggravating

Medication

bull Well known irritants of the bowel lining

ndash aspirin

ndash non-steroidal anti-inflammatory drugs

(nSAIDs) such as ibuprofen

bull These medications may cause inflammation of a particular area of the bowel which may result in ulcers or a permeable gut lining

bull Antibiotics wipe out beneficial bacteria and therefore may result in infections following treatment

bull Birth control pill

Diagnosing a leaky gut ndash symptoms

bull Recognise digestive symptoms relating to a leaky gut

ndash bloating

ndash diarrhoea

ndash pain

ndash stomach cramps after eating

ndash feeling of lsquosensitivityrsquo to certain foods such as bread

bull Also consider other symptoms

ndash sinusitis

ndash eczema

ndash migraines

ndash joint pains

ndashchronic fatigue

Diagnosing a leaky gut ndash tests

bull A digestive stool analysis can test secretory IgA (Immunoglobulin A) levels

bull IgA is an antibody used by the immune system to identify and fight off unwanted objects such as infectious bacteria this specific type of antibody is produced in mucosal linings (the gut wall)

bull As unwanted undigested food particles may pass through the gut lining an immune reaction involving high levels of IgA antibodies may suggest a permeable gut lining

bull Test for food intolerances if IgG antibodies are produced a leaky gut is very likely

Protocol Step 1 ndash eliminate irritating foods

bull Identify any irritating foods and eliminate these from the diet

bull Gluten is the most common culprit although many other foods ndash such as peanuts beans and lentils ndash can also cause problems in some individuals

bull If a food intolerance test has been carried out

ndash eliminate these foods temporarily only while concentrating on healing the gut

ndash intolerances to several foods are likely to develop over time

ndash simply cutting these foods out is not going to address the cause

ndash once the gut is properly healed these intolerances should

disappear

Protocol Step 1 ndash eliminate irritating foods

bull Spicy food should be eliminated (or at least significantly reduced) during this initial stage for approximately 2-4 months

bull Ideally eliminate alcohol completely for 2-4 months

bull Drinking alcohol even once a week while trying to heal your gut can make the healing process twice as long

Protocol Step 2 ndash test and eliminate pathogens

bull Identify pathogens and eliminate them ndash usually 3-6 months

bull If a digestive stool analysis identifies an infection such as a bacterial imbalance or yeast infection

ndash supplement with probiotics

ndash consider other supplements specific to eliminating bacteria (oregano oil garlic)

ndash support immune function (zinc antioxidants fermented foods)

ndash reduce sugar in the diet

bull Bacterial infections such as H pylori may require medical attention from a doctor and medication

Protocol Step 2 ndash test and eliminate pathogens

bull If a parasite infection exists some may be eliminated with supplements 6 month course of

ndash goldenseal

ndash oregano oil

ndash probiotics

bull Support liver detoxification

bull Some stubborn parasites may require medical attention from a doctor and medication

Protocol Step 3 ndash feed your cells

bull After all aggravating foods have been eliminated from your diet it is important to concentrate on feeding the cells lining your digestive system

bull Cells lining the digestive tract require the amino acid glutamine to be able to replenish themselves

bull The powder form mixed with water is ideal to maximise exposure to cells if your digestive system is not strong enough to break down supplement tablets

Protocol Step 4 ndash control inflammation

bull Keep inflammation down in order to promote healing and reduce pain

bull To control inflammation consider anti-inflammatory foods

ndash vegetables

ndash oily fish (containing omega-3 EPA)

ndash foods rich in antioxidants

bull Limit intake of inflammatory foods

ndash grain fed meats (containing omega-6 AA)

ndash vegetable oils such as refined corn oil and sunflower oil

ndash refined carbohydrate foods such as sugar and white flour

Protocol Step 4 ndash control inflammation

bull The most potent anti-inflammatory supplement which may help to calm and soothe the gut lining is omega-3 EPA

bull 1000mg omega-3 EPA per day to have a therapeutic effect on reducing inflammation

bull The ratio of omega-6 AA to omega-3 EPA needs to be balanced eg 21 ratio

bull Omega-3 EPA produces anti-inflammatory eicosanoids

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

What is gut permeability

bull In a permeable gut lining the single layer of mucosal cells covering the digestive tract are damaged

bull Cells become inflamed

bull Gaps appear between

the cells

bull Food particles and other

toxins may enter directly into the bloodstream

A healthy digestive tract

bull Closed and closely packed together mucosal

cells lining the digestive tract

bull Cells are plumped up thereby carefully

controlling the absorption of nutrients from food

bull Normal tight junction between cells keeps the mucosal barrier intact

bull This barrier prevents most large molecules and germs passing from inside the bowel into the bloodstream

An unhealthy permeable gut lining

bull Excess inflammation damaging cells and epithelium

bull Undigested food particles may pass through gaps

bull The immune system may react to this by

creating more inflammation

bull Commonly leads to food intolerances ndash an immune reaction to various foods which can change over time

bull A leaky gut is often an ongoing issue and frequently undiagnosed

The importance of gut healthNutritional

status ndash bile enzymes etc

Immune function ndash first line of defence

To balance hormones

To protect against food intolerances

B12 absorption (intrinsic factor)

Digestive symptoms associated with gut permeability

bull Digestive symptoms are often not a priority to clients

bull Clients may want to concentrate on other goals such as

overcoming fatigue (associated with leaky gut)

ndash diarrhoea

ndash constipation

ndash burning sensation in the stomach

ndash passing a stool shortly after eating

ndash pain after drinking alcohol or spicy food

ndash stomach cramps

ndash gas

Other symptoms associated with gut permeability

bull A leaky gut may not only present itself as digestive discomfort

bull Other symptoms relating to a leaky gut include

ndash hormone imbalances causing mood swings

ndash headaches

ndash skin breakouts

ndash tiredness and fatigue

ndash joint pains associated with inflammation

and intolerances

ndash depression and anxiety

Health issues linked to gut permeability

bull The following conditions may increase gut permeability

bull Inflammatory bowel diseases

ndash ulcerative colitis

ndash Crohnrsquos disease

bull Gastritis (inflammation of the stomach ndash several causes)

bull HIV AIDS

bull Type 1 diabetes

Causes of a leaky gut

bull There are several possible causes of a leaky gut

ndash chronic inflammation

ndash nutritional deficiencies

ndash fatty acid deficiencies

ndash improper digestion

ndashhigh intake of commonly aggravating foods

ndash stress

bull Other possible causes

ndash parasites

ndash pathogenic bacteria

ndash yeast infections

The role of inflammation in a permeable gut

bull Chronic inflammation causes continuous breakdown of cells

bull Excess inflammation can damage mucosal cellsrsquo tight junctions

bull Inflammation may be a result of an inflammatory diet or medication

bull Inflammation exacerbates pain and sensitivity to foods

bull Too much inflammation stalls the healing process

Nutritional deficiencies and a leaky gut

bull Nutrients required for the integrity of the mucosal cells

ndash zinc

ndash antioxidants

ndash protein

ndash fatty acids

bull A leaky gut may also result in nutritional

deficiencies due to inflamed villi and

reduced ability of mucosal cells to absorb

nutrients

Fatty acid deficiencies and a leaky gut

bull A deficiency in omega-3 fatty acids may increase inflammation

bull A low omega-3 index may also reduce fluidity of cell membranes

bull Low levels of omega-3 may also shrink cells (less plumped up) leading

to possible gaps between mucosal cells

bull Imbalanced ratio of omega-6 to omega-3

fatty acids may lead to inflammation

Improper digestion and leaky gut

bull Low stomach acid = improper breakdown of proteins

bull Low production of bile = improper breakdown of fats

bull Low levels of digestive enzymes = larger undigested food particles

Improper digestion

Undigested food

particles

Food passing through leaky gut

Possible intolerances

High intake of commonly aggravating foods

bull Foods commonly associated with a permeable gut liningndash gluten

ndash dairy

ndash peanuts

ndash pulses (lentils beans)

ndash spicy food

bull Foods which an individual has become intolerant to due to IgGantibody reaction or other immune reactions

Is gluten to blamebull Gluten - a protein found in grains

wheat barley and rye

bull It can be very difficult to process in the body and can result in immune reactions leading to unwanted symptoms such as digestive cramps

bull Gluten is one of the most common food intolerances and can negatively affect symptoms of a leaky gut

bull Gluten is not the cause of a leaky gut for everyone

bull Small quantities of gluten may be tolerated although constant intake of gluten is too much to handle for many people

Spicy food

bull Spicy food - chilli peppers contain a compound called capsaicin

bull Causes irritation to mucosal cells including the lips tongue mouth and digestive tract

bull Leaky gut + chilli = a burning sensation in the stomach and a bout of diarrhoea

Other foods which may aggravate a leaky gut

bull Ginger ndash the spicy irritating compound is gingerol (related to capsaicin)

bull Raw garlic

bull Raw onions

bull Although these foods are considered to be anti-inflammatory they can also cause irritation to your gut lining if it is already semi-permeable

bull Direct contact of such strong foods on already damaged cells can result in an instant burning sensation in the stomach or intestines

Stress and a leaky gut

bull Stress can increase stomach acid production

ndash often leading to gastritis ulcers

bull Stress may reduce ability to digest food by reducing production of digestive enzymes

bull Higher requirements for vitamins and minerals

Pathogens ndash yeast bacteria and parasites

bull Yeast infections such as candida albicans

bull Pathogenic bacterial infections

lack of beneficial bacteria

bull Parasites

bull Toxins produced by pathogens can cause

further damage

Alcohol

bull Drinking alcohol in excess ie more than

approximately 3 units in one day

can cause significant irritation to an already permeable gut

bull Alcohol is inflammatory and therefore is only going to make the situation worse

bull 2-3 units of alcohol may not cause any issue to someone with a healthy gut lining but for someone with a permeable gut lining alcohol can be very aggravating

Medication

bull Well known irritants of the bowel lining

ndash aspirin

ndash non-steroidal anti-inflammatory drugs

(nSAIDs) such as ibuprofen

bull These medications may cause inflammation of a particular area of the bowel which may result in ulcers or a permeable gut lining

bull Antibiotics wipe out beneficial bacteria and therefore may result in infections following treatment

bull Birth control pill

Diagnosing a leaky gut ndash symptoms

bull Recognise digestive symptoms relating to a leaky gut

ndash bloating

ndash diarrhoea

ndash pain

ndash stomach cramps after eating

ndash feeling of lsquosensitivityrsquo to certain foods such as bread

bull Also consider other symptoms

ndash sinusitis

ndash eczema

ndash migraines

ndash joint pains

ndashchronic fatigue

Diagnosing a leaky gut ndash tests

bull A digestive stool analysis can test secretory IgA (Immunoglobulin A) levels

bull IgA is an antibody used by the immune system to identify and fight off unwanted objects such as infectious bacteria this specific type of antibody is produced in mucosal linings (the gut wall)

bull As unwanted undigested food particles may pass through the gut lining an immune reaction involving high levels of IgA antibodies may suggest a permeable gut lining

bull Test for food intolerances if IgG antibodies are produced a leaky gut is very likely

Protocol Step 1 ndash eliminate irritating foods

bull Identify any irritating foods and eliminate these from the diet

bull Gluten is the most common culprit although many other foods ndash such as peanuts beans and lentils ndash can also cause problems in some individuals

bull If a food intolerance test has been carried out

ndash eliminate these foods temporarily only while concentrating on healing the gut

ndash intolerances to several foods are likely to develop over time

ndash simply cutting these foods out is not going to address the cause

ndash once the gut is properly healed these intolerances should

disappear

Protocol Step 1 ndash eliminate irritating foods

bull Spicy food should be eliminated (or at least significantly reduced) during this initial stage for approximately 2-4 months

bull Ideally eliminate alcohol completely for 2-4 months

bull Drinking alcohol even once a week while trying to heal your gut can make the healing process twice as long

Protocol Step 2 ndash test and eliminate pathogens

bull Identify pathogens and eliminate them ndash usually 3-6 months

bull If a digestive stool analysis identifies an infection such as a bacterial imbalance or yeast infection

ndash supplement with probiotics

ndash consider other supplements specific to eliminating bacteria (oregano oil garlic)

ndash support immune function (zinc antioxidants fermented foods)

ndash reduce sugar in the diet

bull Bacterial infections such as H pylori may require medical attention from a doctor and medication

Protocol Step 2 ndash test and eliminate pathogens

bull If a parasite infection exists some may be eliminated with supplements 6 month course of

ndash goldenseal

ndash oregano oil

ndash probiotics

bull Support liver detoxification

bull Some stubborn parasites may require medical attention from a doctor and medication

Protocol Step 3 ndash feed your cells

bull After all aggravating foods have been eliminated from your diet it is important to concentrate on feeding the cells lining your digestive system

bull Cells lining the digestive tract require the amino acid glutamine to be able to replenish themselves

bull The powder form mixed with water is ideal to maximise exposure to cells if your digestive system is not strong enough to break down supplement tablets

Protocol Step 4 ndash control inflammation

bull Keep inflammation down in order to promote healing and reduce pain

bull To control inflammation consider anti-inflammatory foods

ndash vegetables

ndash oily fish (containing omega-3 EPA)

ndash foods rich in antioxidants

bull Limit intake of inflammatory foods

ndash grain fed meats (containing omega-6 AA)

ndash vegetable oils such as refined corn oil and sunflower oil

ndash refined carbohydrate foods such as sugar and white flour

Protocol Step 4 ndash control inflammation

bull The most potent anti-inflammatory supplement which may help to calm and soothe the gut lining is omega-3 EPA

bull 1000mg omega-3 EPA per day to have a therapeutic effect on reducing inflammation

bull The ratio of omega-6 AA to omega-3 EPA needs to be balanced eg 21 ratio

bull Omega-3 EPA produces anti-inflammatory eicosanoids

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

A healthy digestive tract

bull Closed and closely packed together mucosal

cells lining the digestive tract

bull Cells are plumped up thereby carefully

controlling the absorption of nutrients from food

bull Normal tight junction between cells keeps the mucosal barrier intact

bull This barrier prevents most large molecules and germs passing from inside the bowel into the bloodstream

An unhealthy permeable gut lining

bull Excess inflammation damaging cells and epithelium

bull Undigested food particles may pass through gaps

bull The immune system may react to this by

creating more inflammation

bull Commonly leads to food intolerances ndash an immune reaction to various foods which can change over time

bull A leaky gut is often an ongoing issue and frequently undiagnosed

The importance of gut healthNutritional

status ndash bile enzymes etc

Immune function ndash first line of defence

To balance hormones

To protect against food intolerances

B12 absorption (intrinsic factor)

Digestive symptoms associated with gut permeability

bull Digestive symptoms are often not a priority to clients

bull Clients may want to concentrate on other goals such as

overcoming fatigue (associated with leaky gut)

ndash diarrhoea

ndash constipation

ndash burning sensation in the stomach

ndash passing a stool shortly after eating

ndash pain after drinking alcohol or spicy food

ndash stomach cramps

ndash gas

Other symptoms associated with gut permeability

bull A leaky gut may not only present itself as digestive discomfort

bull Other symptoms relating to a leaky gut include

ndash hormone imbalances causing mood swings

ndash headaches

ndash skin breakouts

ndash tiredness and fatigue

ndash joint pains associated with inflammation

and intolerances

ndash depression and anxiety

Health issues linked to gut permeability

bull The following conditions may increase gut permeability

bull Inflammatory bowel diseases

ndash ulcerative colitis

ndash Crohnrsquos disease

bull Gastritis (inflammation of the stomach ndash several causes)

bull HIV AIDS

bull Type 1 diabetes

Causes of a leaky gut

bull There are several possible causes of a leaky gut

ndash chronic inflammation

ndash nutritional deficiencies

ndash fatty acid deficiencies

ndash improper digestion

ndashhigh intake of commonly aggravating foods

ndash stress

bull Other possible causes

ndash parasites

ndash pathogenic bacteria

ndash yeast infections

The role of inflammation in a permeable gut

bull Chronic inflammation causes continuous breakdown of cells

bull Excess inflammation can damage mucosal cellsrsquo tight junctions

bull Inflammation may be a result of an inflammatory diet or medication

bull Inflammation exacerbates pain and sensitivity to foods

bull Too much inflammation stalls the healing process

Nutritional deficiencies and a leaky gut

bull Nutrients required for the integrity of the mucosal cells

ndash zinc

ndash antioxidants

ndash protein

ndash fatty acids

bull A leaky gut may also result in nutritional

deficiencies due to inflamed villi and

reduced ability of mucosal cells to absorb

nutrients

Fatty acid deficiencies and a leaky gut

bull A deficiency in omega-3 fatty acids may increase inflammation

bull A low omega-3 index may also reduce fluidity of cell membranes

bull Low levels of omega-3 may also shrink cells (less plumped up) leading

to possible gaps between mucosal cells

bull Imbalanced ratio of omega-6 to omega-3

fatty acids may lead to inflammation

Improper digestion and leaky gut

bull Low stomach acid = improper breakdown of proteins

bull Low production of bile = improper breakdown of fats

bull Low levels of digestive enzymes = larger undigested food particles

Improper digestion

Undigested food

particles

Food passing through leaky gut

Possible intolerances

High intake of commonly aggravating foods

bull Foods commonly associated with a permeable gut liningndash gluten

ndash dairy

ndash peanuts

ndash pulses (lentils beans)

ndash spicy food

bull Foods which an individual has become intolerant to due to IgGantibody reaction or other immune reactions

Is gluten to blamebull Gluten - a protein found in grains

wheat barley and rye

bull It can be very difficult to process in the body and can result in immune reactions leading to unwanted symptoms such as digestive cramps

bull Gluten is one of the most common food intolerances and can negatively affect symptoms of a leaky gut

bull Gluten is not the cause of a leaky gut for everyone

bull Small quantities of gluten may be tolerated although constant intake of gluten is too much to handle for many people

Spicy food

bull Spicy food - chilli peppers contain a compound called capsaicin

bull Causes irritation to mucosal cells including the lips tongue mouth and digestive tract

bull Leaky gut + chilli = a burning sensation in the stomach and a bout of diarrhoea

Other foods which may aggravate a leaky gut

bull Ginger ndash the spicy irritating compound is gingerol (related to capsaicin)

bull Raw garlic

bull Raw onions

bull Although these foods are considered to be anti-inflammatory they can also cause irritation to your gut lining if it is already semi-permeable

bull Direct contact of such strong foods on already damaged cells can result in an instant burning sensation in the stomach or intestines

Stress and a leaky gut

bull Stress can increase stomach acid production

ndash often leading to gastritis ulcers

bull Stress may reduce ability to digest food by reducing production of digestive enzymes

bull Higher requirements for vitamins and minerals

Pathogens ndash yeast bacteria and parasites

bull Yeast infections such as candida albicans

bull Pathogenic bacterial infections

lack of beneficial bacteria

bull Parasites

bull Toxins produced by pathogens can cause

further damage

Alcohol

bull Drinking alcohol in excess ie more than

approximately 3 units in one day

can cause significant irritation to an already permeable gut

bull Alcohol is inflammatory and therefore is only going to make the situation worse

bull 2-3 units of alcohol may not cause any issue to someone with a healthy gut lining but for someone with a permeable gut lining alcohol can be very aggravating

Medication

bull Well known irritants of the bowel lining

ndash aspirin

ndash non-steroidal anti-inflammatory drugs

(nSAIDs) such as ibuprofen

bull These medications may cause inflammation of a particular area of the bowel which may result in ulcers or a permeable gut lining

bull Antibiotics wipe out beneficial bacteria and therefore may result in infections following treatment

bull Birth control pill

Diagnosing a leaky gut ndash symptoms

bull Recognise digestive symptoms relating to a leaky gut

ndash bloating

ndash diarrhoea

ndash pain

ndash stomach cramps after eating

ndash feeling of lsquosensitivityrsquo to certain foods such as bread

bull Also consider other symptoms

ndash sinusitis

ndash eczema

ndash migraines

ndash joint pains

ndashchronic fatigue

Diagnosing a leaky gut ndash tests

bull A digestive stool analysis can test secretory IgA (Immunoglobulin A) levels

bull IgA is an antibody used by the immune system to identify and fight off unwanted objects such as infectious bacteria this specific type of antibody is produced in mucosal linings (the gut wall)

bull As unwanted undigested food particles may pass through the gut lining an immune reaction involving high levels of IgA antibodies may suggest a permeable gut lining

bull Test for food intolerances if IgG antibodies are produced a leaky gut is very likely

Protocol Step 1 ndash eliminate irritating foods

bull Identify any irritating foods and eliminate these from the diet

bull Gluten is the most common culprit although many other foods ndash such as peanuts beans and lentils ndash can also cause problems in some individuals

bull If a food intolerance test has been carried out

ndash eliminate these foods temporarily only while concentrating on healing the gut

ndash intolerances to several foods are likely to develop over time

ndash simply cutting these foods out is not going to address the cause

ndash once the gut is properly healed these intolerances should

disappear

Protocol Step 1 ndash eliminate irritating foods

bull Spicy food should be eliminated (or at least significantly reduced) during this initial stage for approximately 2-4 months

bull Ideally eliminate alcohol completely for 2-4 months

bull Drinking alcohol even once a week while trying to heal your gut can make the healing process twice as long

Protocol Step 2 ndash test and eliminate pathogens

bull Identify pathogens and eliminate them ndash usually 3-6 months

bull If a digestive stool analysis identifies an infection such as a bacterial imbalance or yeast infection

ndash supplement with probiotics

ndash consider other supplements specific to eliminating bacteria (oregano oil garlic)

ndash support immune function (zinc antioxidants fermented foods)

ndash reduce sugar in the diet

bull Bacterial infections such as H pylori may require medical attention from a doctor and medication

Protocol Step 2 ndash test and eliminate pathogens

bull If a parasite infection exists some may be eliminated with supplements 6 month course of

ndash goldenseal

ndash oregano oil

ndash probiotics

bull Support liver detoxification

bull Some stubborn parasites may require medical attention from a doctor and medication

Protocol Step 3 ndash feed your cells

bull After all aggravating foods have been eliminated from your diet it is important to concentrate on feeding the cells lining your digestive system

bull Cells lining the digestive tract require the amino acid glutamine to be able to replenish themselves

bull The powder form mixed with water is ideal to maximise exposure to cells if your digestive system is not strong enough to break down supplement tablets

Protocol Step 4 ndash control inflammation

bull Keep inflammation down in order to promote healing and reduce pain

bull To control inflammation consider anti-inflammatory foods

ndash vegetables

ndash oily fish (containing omega-3 EPA)

ndash foods rich in antioxidants

bull Limit intake of inflammatory foods

ndash grain fed meats (containing omega-6 AA)

ndash vegetable oils such as refined corn oil and sunflower oil

ndash refined carbohydrate foods such as sugar and white flour

Protocol Step 4 ndash control inflammation

bull The most potent anti-inflammatory supplement which may help to calm and soothe the gut lining is omega-3 EPA

bull 1000mg omega-3 EPA per day to have a therapeutic effect on reducing inflammation

bull The ratio of omega-6 AA to omega-3 EPA needs to be balanced eg 21 ratio

bull Omega-3 EPA produces anti-inflammatory eicosanoids

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

An unhealthy permeable gut lining

bull Excess inflammation damaging cells and epithelium

bull Undigested food particles may pass through gaps

bull The immune system may react to this by

creating more inflammation

bull Commonly leads to food intolerances ndash an immune reaction to various foods which can change over time

bull A leaky gut is often an ongoing issue and frequently undiagnosed

The importance of gut healthNutritional

status ndash bile enzymes etc

Immune function ndash first line of defence

To balance hormones

To protect against food intolerances

B12 absorption (intrinsic factor)

Digestive symptoms associated with gut permeability

bull Digestive symptoms are often not a priority to clients

bull Clients may want to concentrate on other goals such as

overcoming fatigue (associated with leaky gut)

ndash diarrhoea

ndash constipation

ndash burning sensation in the stomach

ndash passing a stool shortly after eating

ndash pain after drinking alcohol or spicy food

ndash stomach cramps

ndash gas

Other symptoms associated with gut permeability

bull A leaky gut may not only present itself as digestive discomfort

bull Other symptoms relating to a leaky gut include

ndash hormone imbalances causing mood swings

ndash headaches

ndash skin breakouts

ndash tiredness and fatigue

ndash joint pains associated with inflammation

and intolerances

ndash depression and anxiety

Health issues linked to gut permeability

bull The following conditions may increase gut permeability

bull Inflammatory bowel diseases

ndash ulcerative colitis

ndash Crohnrsquos disease

bull Gastritis (inflammation of the stomach ndash several causes)

bull HIV AIDS

bull Type 1 diabetes

Causes of a leaky gut

bull There are several possible causes of a leaky gut

ndash chronic inflammation

ndash nutritional deficiencies

ndash fatty acid deficiencies

ndash improper digestion

ndashhigh intake of commonly aggravating foods

ndash stress

bull Other possible causes

ndash parasites

ndash pathogenic bacteria

ndash yeast infections

The role of inflammation in a permeable gut

bull Chronic inflammation causes continuous breakdown of cells

bull Excess inflammation can damage mucosal cellsrsquo tight junctions

bull Inflammation may be a result of an inflammatory diet or medication

bull Inflammation exacerbates pain and sensitivity to foods

bull Too much inflammation stalls the healing process

Nutritional deficiencies and a leaky gut

bull Nutrients required for the integrity of the mucosal cells

ndash zinc

ndash antioxidants

ndash protein

ndash fatty acids

bull A leaky gut may also result in nutritional

deficiencies due to inflamed villi and

reduced ability of mucosal cells to absorb

nutrients

Fatty acid deficiencies and a leaky gut

bull A deficiency in omega-3 fatty acids may increase inflammation

bull A low omega-3 index may also reduce fluidity of cell membranes

bull Low levels of omega-3 may also shrink cells (less plumped up) leading

to possible gaps between mucosal cells

bull Imbalanced ratio of omega-6 to omega-3

fatty acids may lead to inflammation

Improper digestion and leaky gut

bull Low stomach acid = improper breakdown of proteins

bull Low production of bile = improper breakdown of fats

bull Low levels of digestive enzymes = larger undigested food particles

Improper digestion

Undigested food

particles

Food passing through leaky gut

Possible intolerances

High intake of commonly aggravating foods

bull Foods commonly associated with a permeable gut liningndash gluten

ndash dairy

ndash peanuts

ndash pulses (lentils beans)

ndash spicy food

bull Foods which an individual has become intolerant to due to IgGantibody reaction or other immune reactions

Is gluten to blamebull Gluten - a protein found in grains

wheat barley and rye

bull It can be very difficult to process in the body and can result in immune reactions leading to unwanted symptoms such as digestive cramps

bull Gluten is one of the most common food intolerances and can negatively affect symptoms of a leaky gut

bull Gluten is not the cause of a leaky gut for everyone

bull Small quantities of gluten may be tolerated although constant intake of gluten is too much to handle for many people

Spicy food

bull Spicy food - chilli peppers contain a compound called capsaicin

bull Causes irritation to mucosal cells including the lips tongue mouth and digestive tract

bull Leaky gut + chilli = a burning sensation in the stomach and a bout of diarrhoea

Other foods which may aggravate a leaky gut

bull Ginger ndash the spicy irritating compound is gingerol (related to capsaicin)

bull Raw garlic

bull Raw onions

bull Although these foods are considered to be anti-inflammatory they can also cause irritation to your gut lining if it is already semi-permeable

bull Direct contact of such strong foods on already damaged cells can result in an instant burning sensation in the stomach or intestines

Stress and a leaky gut

bull Stress can increase stomach acid production

ndash often leading to gastritis ulcers

bull Stress may reduce ability to digest food by reducing production of digestive enzymes

bull Higher requirements for vitamins and minerals

Pathogens ndash yeast bacteria and parasites

bull Yeast infections such as candida albicans

bull Pathogenic bacterial infections

lack of beneficial bacteria

bull Parasites

bull Toxins produced by pathogens can cause

further damage

Alcohol

bull Drinking alcohol in excess ie more than

approximately 3 units in one day

can cause significant irritation to an already permeable gut

bull Alcohol is inflammatory and therefore is only going to make the situation worse

bull 2-3 units of alcohol may not cause any issue to someone with a healthy gut lining but for someone with a permeable gut lining alcohol can be very aggravating

Medication

bull Well known irritants of the bowel lining

ndash aspirin

ndash non-steroidal anti-inflammatory drugs

(nSAIDs) such as ibuprofen

bull These medications may cause inflammation of a particular area of the bowel which may result in ulcers or a permeable gut lining

bull Antibiotics wipe out beneficial bacteria and therefore may result in infections following treatment

bull Birth control pill

Diagnosing a leaky gut ndash symptoms

bull Recognise digestive symptoms relating to a leaky gut

ndash bloating

ndash diarrhoea

ndash pain

ndash stomach cramps after eating

ndash feeling of lsquosensitivityrsquo to certain foods such as bread

bull Also consider other symptoms

ndash sinusitis

ndash eczema

ndash migraines

ndash joint pains

ndashchronic fatigue

Diagnosing a leaky gut ndash tests

bull A digestive stool analysis can test secretory IgA (Immunoglobulin A) levels

bull IgA is an antibody used by the immune system to identify and fight off unwanted objects such as infectious bacteria this specific type of antibody is produced in mucosal linings (the gut wall)

bull As unwanted undigested food particles may pass through the gut lining an immune reaction involving high levels of IgA antibodies may suggest a permeable gut lining

bull Test for food intolerances if IgG antibodies are produced a leaky gut is very likely

Protocol Step 1 ndash eliminate irritating foods

bull Identify any irritating foods and eliminate these from the diet

bull Gluten is the most common culprit although many other foods ndash such as peanuts beans and lentils ndash can also cause problems in some individuals

bull If a food intolerance test has been carried out

ndash eliminate these foods temporarily only while concentrating on healing the gut

ndash intolerances to several foods are likely to develop over time

ndash simply cutting these foods out is not going to address the cause

ndash once the gut is properly healed these intolerances should

disappear

Protocol Step 1 ndash eliminate irritating foods

bull Spicy food should be eliminated (or at least significantly reduced) during this initial stage for approximately 2-4 months

bull Ideally eliminate alcohol completely for 2-4 months

bull Drinking alcohol even once a week while trying to heal your gut can make the healing process twice as long

Protocol Step 2 ndash test and eliminate pathogens

bull Identify pathogens and eliminate them ndash usually 3-6 months

bull If a digestive stool analysis identifies an infection such as a bacterial imbalance or yeast infection

ndash supplement with probiotics

ndash consider other supplements specific to eliminating bacteria (oregano oil garlic)

ndash support immune function (zinc antioxidants fermented foods)

ndash reduce sugar in the diet

bull Bacterial infections such as H pylori may require medical attention from a doctor and medication

Protocol Step 2 ndash test and eliminate pathogens

bull If a parasite infection exists some may be eliminated with supplements 6 month course of

ndash goldenseal

ndash oregano oil

ndash probiotics

bull Support liver detoxification

bull Some stubborn parasites may require medical attention from a doctor and medication

Protocol Step 3 ndash feed your cells

bull After all aggravating foods have been eliminated from your diet it is important to concentrate on feeding the cells lining your digestive system

bull Cells lining the digestive tract require the amino acid glutamine to be able to replenish themselves

bull The powder form mixed with water is ideal to maximise exposure to cells if your digestive system is not strong enough to break down supplement tablets

Protocol Step 4 ndash control inflammation

bull Keep inflammation down in order to promote healing and reduce pain

bull To control inflammation consider anti-inflammatory foods

ndash vegetables

ndash oily fish (containing omega-3 EPA)

ndash foods rich in antioxidants

bull Limit intake of inflammatory foods

ndash grain fed meats (containing omega-6 AA)

ndash vegetable oils such as refined corn oil and sunflower oil

ndash refined carbohydrate foods such as sugar and white flour

Protocol Step 4 ndash control inflammation

bull The most potent anti-inflammatory supplement which may help to calm and soothe the gut lining is omega-3 EPA

bull 1000mg omega-3 EPA per day to have a therapeutic effect on reducing inflammation

bull The ratio of omega-6 AA to omega-3 EPA needs to be balanced eg 21 ratio

bull Omega-3 EPA produces anti-inflammatory eicosanoids

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

The importance of gut healthNutritional

status ndash bile enzymes etc

Immune function ndash first line of defence

To balance hormones

To protect against food intolerances

B12 absorption (intrinsic factor)

Digestive symptoms associated with gut permeability

bull Digestive symptoms are often not a priority to clients

bull Clients may want to concentrate on other goals such as

overcoming fatigue (associated with leaky gut)

ndash diarrhoea

ndash constipation

ndash burning sensation in the stomach

ndash passing a stool shortly after eating

ndash pain after drinking alcohol or spicy food

ndash stomach cramps

ndash gas

Other symptoms associated with gut permeability

bull A leaky gut may not only present itself as digestive discomfort

bull Other symptoms relating to a leaky gut include

ndash hormone imbalances causing mood swings

ndash headaches

ndash skin breakouts

ndash tiredness and fatigue

ndash joint pains associated with inflammation

and intolerances

ndash depression and anxiety

Health issues linked to gut permeability

bull The following conditions may increase gut permeability

bull Inflammatory bowel diseases

ndash ulcerative colitis

ndash Crohnrsquos disease

bull Gastritis (inflammation of the stomach ndash several causes)

bull HIV AIDS

bull Type 1 diabetes

Causes of a leaky gut

bull There are several possible causes of a leaky gut

ndash chronic inflammation

ndash nutritional deficiencies

ndash fatty acid deficiencies

ndash improper digestion

ndashhigh intake of commonly aggravating foods

ndash stress

bull Other possible causes

ndash parasites

ndash pathogenic bacteria

ndash yeast infections

The role of inflammation in a permeable gut

bull Chronic inflammation causes continuous breakdown of cells

bull Excess inflammation can damage mucosal cellsrsquo tight junctions

bull Inflammation may be a result of an inflammatory diet or medication

bull Inflammation exacerbates pain and sensitivity to foods

bull Too much inflammation stalls the healing process

Nutritional deficiencies and a leaky gut

bull Nutrients required for the integrity of the mucosal cells

ndash zinc

ndash antioxidants

ndash protein

ndash fatty acids

bull A leaky gut may also result in nutritional

deficiencies due to inflamed villi and

reduced ability of mucosal cells to absorb

nutrients

Fatty acid deficiencies and a leaky gut

bull A deficiency in omega-3 fatty acids may increase inflammation

bull A low omega-3 index may also reduce fluidity of cell membranes

bull Low levels of omega-3 may also shrink cells (less plumped up) leading

to possible gaps between mucosal cells

bull Imbalanced ratio of omega-6 to omega-3

fatty acids may lead to inflammation

Improper digestion and leaky gut

bull Low stomach acid = improper breakdown of proteins

bull Low production of bile = improper breakdown of fats

bull Low levels of digestive enzymes = larger undigested food particles

Improper digestion

Undigested food

particles

Food passing through leaky gut

Possible intolerances

High intake of commonly aggravating foods

bull Foods commonly associated with a permeable gut liningndash gluten

ndash dairy

ndash peanuts

ndash pulses (lentils beans)

ndash spicy food

bull Foods which an individual has become intolerant to due to IgGantibody reaction or other immune reactions

Is gluten to blamebull Gluten - a protein found in grains

wheat barley and rye

bull It can be very difficult to process in the body and can result in immune reactions leading to unwanted symptoms such as digestive cramps

bull Gluten is one of the most common food intolerances and can negatively affect symptoms of a leaky gut

bull Gluten is not the cause of a leaky gut for everyone

bull Small quantities of gluten may be tolerated although constant intake of gluten is too much to handle for many people

Spicy food

bull Spicy food - chilli peppers contain a compound called capsaicin

bull Causes irritation to mucosal cells including the lips tongue mouth and digestive tract

bull Leaky gut + chilli = a burning sensation in the stomach and a bout of diarrhoea

Other foods which may aggravate a leaky gut

bull Ginger ndash the spicy irritating compound is gingerol (related to capsaicin)

bull Raw garlic

bull Raw onions

bull Although these foods are considered to be anti-inflammatory they can also cause irritation to your gut lining if it is already semi-permeable

bull Direct contact of such strong foods on already damaged cells can result in an instant burning sensation in the stomach or intestines

Stress and a leaky gut

bull Stress can increase stomach acid production

ndash often leading to gastritis ulcers

bull Stress may reduce ability to digest food by reducing production of digestive enzymes

bull Higher requirements for vitamins and minerals

Pathogens ndash yeast bacteria and parasites

bull Yeast infections such as candida albicans

bull Pathogenic bacterial infections

lack of beneficial bacteria

bull Parasites

bull Toxins produced by pathogens can cause

further damage

Alcohol

bull Drinking alcohol in excess ie more than

approximately 3 units in one day

can cause significant irritation to an already permeable gut

bull Alcohol is inflammatory and therefore is only going to make the situation worse

bull 2-3 units of alcohol may not cause any issue to someone with a healthy gut lining but for someone with a permeable gut lining alcohol can be very aggravating

Medication

bull Well known irritants of the bowel lining

ndash aspirin

ndash non-steroidal anti-inflammatory drugs

(nSAIDs) such as ibuprofen

bull These medications may cause inflammation of a particular area of the bowel which may result in ulcers or a permeable gut lining

bull Antibiotics wipe out beneficial bacteria and therefore may result in infections following treatment

bull Birth control pill

Diagnosing a leaky gut ndash symptoms

bull Recognise digestive symptoms relating to a leaky gut

ndash bloating

ndash diarrhoea

ndash pain

ndash stomach cramps after eating

ndash feeling of lsquosensitivityrsquo to certain foods such as bread

bull Also consider other symptoms

ndash sinusitis

ndash eczema

ndash migraines

ndash joint pains

ndashchronic fatigue

Diagnosing a leaky gut ndash tests

bull A digestive stool analysis can test secretory IgA (Immunoglobulin A) levels

bull IgA is an antibody used by the immune system to identify and fight off unwanted objects such as infectious bacteria this specific type of antibody is produced in mucosal linings (the gut wall)

bull As unwanted undigested food particles may pass through the gut lining an immune reaction involving high levels of IgA antibodies may suggest a permeable gut lining

bull Test for food intolerances if IgG antibodies are produced a leaky gut is very likely

Protocol Step 1 ndash eliminate irritating foods

bull Identify any irritating foods and eliminate these from the diet

bull Gluten is the most common culprit although many other foods ndash such as peanuts beans and lentils ndash can also cause problems in some individuals

bull If a food intolerance test has been carried out

ndash eliminate these foods temporarily only while concentrating on healing the gut

ndash intolerances to several foods are likely to develop over time

ndash simply cutting these foods out is not going to address the cause

ndash once the gut is properly healed these intolerances should

disappear

Protocol Step 1 ndash eliminate irritating foods

bull Spicy food should be eliminated (or at least significantly reduced) during this initial stage for approximately 2-4 months

bull Ideally eliminate alcohol completely for 2-4 months

bull Drinking alcohol even once a week while trying to heal your gut can make the healing process twice as long

Protocol Step 2 ndash test and eliminate pathogens

bull Identify pathogens and eliminate them ndash usually 3-6 months

bull If a digestive stool analysis identifies an infection such as a bacterial imbalance or yeast infection

ndash supplement with probiotics

ndash consider other supplements specific to eliminating bacteria (oregano oil garlic)

ndash support immune function (zinc antioxidants fermented foods)

ndash reduce sugar in the diet

bull Bacterial infections such as H pylori may require medical attention from a doctor and medication

Protocol Step 2 ndash test and eliminate pathogens

bull If a parasite infection exists some may be eliminated with supplements 6 month course of

ndash goldenseal

ndash oregano oil

ndash probiotics

bull Support liver detoxification

bull Some stubborn parasites may require medical attention from a doctor and medication

Protocol Step 3 ndash feed your cells

bull After all aggravating foods have been eliminated from your diet it is important to concentrate on feeding the cells lining your digestive system

bull Cells lining the digestive tract require the amino acid glutamine to be able to replenish themselves

bull The powder form mixed with water is ideal to maximise exposure to cells if your digestive system is not strong enough to break down supplement tablets

Protocol Step 4 ndash control inflammation

bull Keep inflammation down in order to promote healing and reduce pain

bull To control inflammation consider anti-inflammatory foods

ndash vegetables

ndash oily fish (containing omega-3 EPA)

ndash foods rich in antioxidants

bull Limit intake of inflammatory foods

ndash grain fed meats (containing omega-6 AA)

ndash vegetable oils such as refined corn oil and sunflower oil

ndash refined carbohydrate foods such as sugar and white flour

Protocol Step 4 ndash control inflammation

bull The most potent anti-inflammatory supplement which may help to calm and soothe the gut lining is omega-3 EPA

bull 1000mg omega-3 EPA per day to have a therapeutic effect on reducing inflammation

bull The ratio of omega-6 AA to omega-3 EPA needs to be balanced eg 21 ratio

bull Omega-3 EPA produces anti-inflammatory eicosanoids

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

Digestive symptoms associated with gut permeability

bull Digestive symptoms are often not a priority to clients

bull Clients may want to concentrate on other goals such as

overcoming fatigue (associated with leaky gut)

ndash diarrhoea

ndash constipation

ndash burning sensation in the stomach

ndash passing a stool shortly after eating

ndash pain after drinking alcohol or spicy food

ndash stomach cramps

ndash gas

Other symptoms associated with gut permeability

bull A leaky gut may not only present itself as digestive discomfort

bull Other symptoms relating to a leaky gut include

ndash hormone imbalances causing mood swings

ndash headaches

ndash skin breakouts

ndash tiredness and fatigue

ndash joint pains associated with inflammation

and intolerances

ndash depression and anxiety

Health issues linked to gut permeability

bull The following conditions may increase gut permeability

bull Inflammatory bowel diseases

ndash ulcerative colitis

ndash Crohnrsquos disease

bull Gastritis (inflammation of the stomach ndash several causes)

bull HIV AIDS

bull Type 1 diabetes

Causes of a leaky gut

bull There are several possible causes of a leaky gut

ndash chronic inflammation

ndash nutritional deficiencies

ndash fatty acid deficiencies

ndash improper digestion

ndashhigh intake of commonly aggravating foods

ndash stress

bull Other possible causes

ndash parasites

ndash pathogenic bacteria

ndash yeast infections

The role of inflammation in a permeable gut

bull Chronic inflammation causes continuous breakdown of cells

bull Excess inflammation can damage mucosal cellsrsquo tight junctions

bull Inflammation may be a result of an inflammatory diet or medication

bull Inflammation exacerbates pain and sensitivity to foods

bull Too much inflammation stalls the healing process

Nutritional deficiencies and a leaky gut

bull Nutrients required for the integrity of the mucosal cells

ndash zinc

ndash antioxidants

ndash protein

ndash fatty acids

bull A leaky gut may also result in nutritional

deficiencies due to inflamed villi and

reduced ability of mucosal cells to absorb

nutrients

Fatty acid deficiencies and a leaky gut

bull A deficiency in omega-3 fatty acids may increase inflammation

bull A low omega-3 index may also reduce fluidity of cell membranes

bull Low levels of omega-3 may also shrink cells (less plumped up) leading

to possible gaps between mucosal cells

bull Imbalanced ratio of omega-6 to omega-3

fatty acids may lead to inflammation

Improper digestion and leaky gut

bull Low stomach acid = improper breakdown of proteins

bull Low production of bile = improper breakdown of fats

bull Low levels of digestive enzymes = larger undigested food particles

Improper digestion

Undigested food

particles

Food passing through leaky gut

Possible intolerances

High intake of commonly aggravating foods

bull Foods commonly associated with a permeable gut liningndash gluten

ndash dairy

ndash peanuts

ndash pulses (lentils beans)

ndash spicy food

bull Foods which an individual has become intolerant to due to IgGantibody reaction or other immune reactions

Is gluten to blamebull Gluten - a protein found in grains

wheat barley and rye

bull It can be very difficult to process in the body and can result in immune reactions leading to unwanted symptoms such as digestive cramps

bull Gluten is one of the most common food intolerances and can negatively affect symptoms of a leaky gut

bull Gluten is not the cause of a leaky gut for everyone

bull Small quantities of gluten may be tolerated although constant intake of gluten is too much to handle for many people

Spicy food

bull Spicy food - chilli peppers contain a compound called capsaicin

bull Causes irritation to mucosal cells including the lips tongue mouth and digestive tract

bull Leaky gut + chilli = a burning sensation in the stomach and a bout of diarrhoea

Other foods which may aggravate a leaky gut

bull Ginger ndash the spicy irritating compound is gingerol (related to capsaicin)

bull Raw garlic

bull Raw onions

bull Although these foods are considered to be anti-inflammatory they can also cause irritation to your gut lining if it is already semi-permeable

bull Direct contact of such strong foods on already damaged cells can result in an instant burning sensation in the stomach or intestines

Stress and a leaky gut

bull Stress can increase stomach acid production

ndash often leading to gastritis ulcers

bull Stress may reduce ability to digest food by reducing production of digestive enzymes

bull Higher requirements for vitamins and minerals

Pathogens ndash yeast bacteria and parasites

bull Yeast infections such as candida albicans

bull Pathogenic bacterial infections

lack of beneficial bacteria

bull Parasites

bull Toxins produced by pathogens can cause

further damage

Alcohol

bull Drinking alcohol in excess ie more than

approximately 3 units in one day

can cause significant irritation to an already permeable gut

bull Alcohol is inflammatory and therefore is only going to make the situation worse

bull 2-3 units of alcohol may not cause any issue to someone with a healthy gut lining but for someone with a permeable gut lining alcohol can be very aggravating

Medication

bull Well known irritants of the bowel lining

ndash aspirin

ndash non-steroidal anti-inflammatory drugs

(nSAIDs) such as ibuprofen

bull These medications may cause inflammation of a particular area of the bowel which may result in ulcers or a permeable gut lining

bull Antibiotics wipe out beneficial bacteria and therefore may result in infections following treatment

bull Birth control pill

Diagnosing a leaky gut ndash symptoms

bull Recognise digestive symptoms relating to a leaky gut

ndash bloating

ndash diarrhoea

ndash pain

ndash stomach cramps after eating

ndash feeling of lsquosensitivityrsquo to certain foods such as bread

bull Also consider other symptoms

ndash sinusitis

ndash eczema

ndash migraines

ndash joint pains

ndashchronic fatigue

Diagnosing a leaky gut ndash tests

bull A digestive stool analysis can test secretory IgA (Immunoglobulin A) levels

bull IgA is an antibody used by the immune system to identify and fight off unwanted objects such as infectious bacteria this specific type of antibody is produced in mucosal linings (the gut wall)

bull As unwanted undigested food particles may pass through the gut lining an immune reaction involving high levels of IgA antibodies may suggest a permeable gut lining

bull Test for food intolerances if IgG antibodies are produced a leaky gut is very likely

Protocol Step 1 ndash eliminate irritating foods

bull Identify any irritating foods and eliminate these from the diet

bull Gluten is the most common culprit although many other foods ndash such as peanuts beans and lentils ndash can also cause problems in some individuals

bull If a food intolerance test has been carried out

ndash eliminate these foods temporarily only while concentrating on healing the gut

ndash intolerances to several foods are likely to develop over time

ndash simply cutting these foods out is not going to address the cause

ndash once the gut is properly healed these intolerances should

disappear

Protocol Step 1 ndash eliminate irritating foods

bull Spicy food should be eliminated (or at least significantly reduced) during this initial stage for approximately 2-4 months

bull Ideally eliminate alcohol completely for 2-4 months

bull Drinking alcohol even once a week while trying to heal your gut can make the healing process twice as long

Protocol Step 2 ndash test and eliminate pathogens

bull Identify pathogens and eliminate them ndash usually 3-6 months

bull If a digestive stool analysis identifies an infection such as a bacterial imbalance or yeast infection

ndash supplement with probiotics

ndash consider other supplements specific to eliminating bacteria (oregano oil garlic)

ndash support immune function (zinc antioxidants fermented foods)

ndash reduce sugar in the diet

bull Bacterial infections such as H pylori may require medical attention from a doctor and medication

Protocol Step 2 ndash test and eliminate pathogens

bull If a parasite infection exists some may be eliminated with supplements 6 month course of

ndash goldenseal

ndash oregano oil

ndash probiotics

bull Support liver detoxification

bull Some stubborn parasites may require medical attention from a doctor and medication

Protocol Step 3 ndash feed your cells

bull After all aggravating foods have been eliminated from your diet it is important to concentrate on feeding the cells lining your digestive system

bull Cells lining the digestive tract require the amino acid glutamine to be able to replenish themselves

bull The powder form mixed with water is ideal to maximise exposure to cells if your digestive system is not strong enough to break down supplement tablets

Protocol Step 4 ndash control inflammation

bull Keep inflammation down in order to promote healing and reduce pain

bull To control inflammation consider anti-inflammatory foods

ndash vegetables

ndash oily fish (containing omega-3 EPA)

ndash foods rich in antioxidants

bull Limit intake of inflammatory foods

ndash grain fed meats (containing omega-6 AA)

ndash vegetable oils such as refined corn oil and sunflower oil

ndash refined carbohydrate foods such as sugar and white flour

Protocol Step 4 ndash control inflammation

bull The most potent anti-inflammatory supplement which may help to calm and soothe the gut lining is omega-3 EPA

bull 1000mg omega-3 EPA per day to have a therapeutic effect on reducing inflammation

bull The ratio of omega-6 AA to omega-3 EPA needs to be balanced eg 21 ratio

bull Omega-3 EPA produces anti-inflammatory eicosanoids

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

Other symptoms associated with gut permeability

bull A leaky gut may not only present itself as digestive discomfort

bull Other symptoms relating to a leaky gut include

ndash hormone imbalances causing mood swings

ndash headaches

ndash skin breakouts

ndash tiredness and fatigue

ndash joint pains associated with inflammation

and intolerances

ndash depression and anxiety

Health issues linked to gut permeability

bull The following conditions may increase gut permeability

bull Inflammatory bowel diseases

ndash ulcerative colitis

ndash Crohnrsquos disease

bull Gastritis (inflammation of the stomach ndash several causes)

bull HIV AIDS

bull Type 1 diabetes

Causes of a leaky gut

bull There are several possible causes of a leaky gut

ndash chronic inflammation

ndash nutritional deficiencies

ndash fatty acid deficiencies

ndash improper digestion

ndashhigh intake of commonly aggravating foods

ndash stress

bull Other possible causes

ndash parasites

ndash pathogenic bacteria

ndash yeast infections

The role of inflammation in a permeable gut

bull Chronic inflammation causes continuous breakdown of cells

bull Excess inflammation can damage mucosal cellsrsquo tight junctions

bull Inflammation may be a result of an inflammatory diet or medication

bull Inflammation exacerbates pain and sensitivity to foods

bull Too much inflammation stalls the healing process

Nutritional deficiencies and a leaky gut

bull Nutrients required for the integrity of the mucosal cells

ndash zinc

ndash antioxidants

ndash protein

ndash fatty acids

bull A leaky gut may also result in nutritional

deficiencies due to inflamed villi and

reduced ability of mucosal cells to absorb

nutrients

Fatty acid deficiencies and a leaky gut

bull A deficiency in omega-3 fatty acids may increase inflammation

bull A low omega-3 index may also reduce fluidity of cell membranes

bull Low levels of omega-3 may also shrink cells (less plumped up) leading

to possible gaps between mucosal cells

bull Imbalanced ratio of omega-6 to omega-3

fatty acids may lead to inflammation

Improper digestion and leaky gut

bull Low stomach acid = improper breakdown of proteins

bull Low production of bile = improper breakdown of fats

bull Low levels of digestive enzymes = larger undigested food particles

Improper digestion

Undigested food

particles

Food passing through leaky gut

Possible intolerances

High intake of commonly aggravating foods

bull Foods commonly associated with a permeable gut liningndash gluten

ndash dairy

ndash peanuts

ndash pulses (lentils beans)

ndash spicy food

bull Foods which an individual has become intolerant to due to IgGantibody reaction or other immune reactions

Is gluten to blamebull Gluten - a protein found in grains

wheat barley and rye

bull It can be very difficult to process in the body and can result in immune reactions leading to unwanted symptoms such as digestive cramps

bull Gluten is one of the most common food intolerances and can negatively affect symptoms of a leaky gut

bull Gluten is not the cause of a leaky gut for everyone

bull Small quantities of gluten may be tolerated although constant intake of gluten is too much to handle for many people

Spicy food

bull Spicy food - chilli peppers contain a compound called capsaicin

bull Causes irritation to mucosal cells including the lips tongue mouth and digestive tract

bull Leaky gut + chilli = a burning sensation in the stomach and a bout of diarrhoea

Other foods which may aggravate a leaky gut

bull Ginger ndash the spicy irritating compound is gingerol (related to capsaicin)

bull Raw garlic

bull Raw onions

bull Although these foods are considered to be anti-inflammatory they can also cause irritation to your gut lining if it is already semi-permeable

bull Direct contact of such strong foods on already damaged cells can result in an instant burning sensation in the stomach or intestines

Stress and a leaky gut

bull Stress can increase stomach acid production

ndash often leading to gastritis ulcers

bull Stress may reduce ability to digest food by reducing production of digestive enzymes

bull Higher requirements for vitamins and minerals

Pathogens ndash yeast bacteria and parasites

bull Yeast infections such as candida albicans

bull Pathogenic bacterial infections

lack of beneficial bacteria

bull Parasites

bull Toxins produced by pathogens can cause

further damage

Alcohol

bull Drinking alcohol in excess ie more than

approximately 3 units in one day

can cause significant irritation to an already permeable gut

bull Alcohol is inflammatory and therefore is only going to make the situation worse

bull 2-3 units of alcohol may not cause any issue to someone with a healthy gut lining but for someone with a permeable gut lining alcohol can be very aggravating

Medication

bull Well known irritants of the bowel lining

ndash aspirin

ndash non-steroidal anti-inflammatory drugs

(nSAIDs) such as ibuprofen

bull These medications may cause inflammation of a particular area of the bowel which may result in ulcers or a permeable gut lining

bull Antibiotics wipe out beneficial bacteria and therefore may result in infections following treatment

bull Birth control pill

Diagnosing a leaky gut ndash symptoms

bull Recognise digestive symptoms relating to a leaky gut

ndash bloating

ndash diarrhoea

ndash pain

ndash stomach cramps after eating

ndash feeling of lsquosensitivityrsquo to certain foods such as bread

bull Also consider other symptoms

ndash sinusitis

ndash eczema

ndash migraines

ndash joint pains

ndashchronic fatigue

Diagnosing a leaky gut ndash tests

bull A digestive stool analysis can test secretory IgA (Immunoglobulin A) levels

bull IgA is an antibody used by the immune system to identify and fight off unwanted objects such as infectious bacteria this specific type of antibody is produced in mucosal linings (the gut wall)

bull As unwanted undigested food particles may pass through the gut lining an immune reaction involving high levels of IgA antibodies may suggest a permeable gut lining

bull Test for food intolerances if IgG antibodies are produced a leaky gut is very likely

Protocol Step 1 ndash eliminate irritating foods

bull Identify any irritating foods and eliminate these from the diet

bull Gluten is the most common culprit although many other foods ndash such as peanuts beans and lentils ndash can also cause problems in some individuals

bull If a food intolerance test has been carried out

ndash eliminate these foods temporarily only while concentrating on healing the gut

ndash intolerances to several foods are likely to develop over time

ndash simply cutting these foods out is not going to address the cause

ndash once the gut is properly healed these intolerances should

disappear

Protocol Step 1 ndash eliminate irritating foods

bull Spicy food should be eliminated (or at least significantly reduced) during this initial stage for approximately 2-4 months

bull Ideally eliminate alcohol completely for 2-4 months

bull Drinking alcohol even once a week while trying to heal your gut can make the healing process twice as long

Protocol Step 2 ndash test and eliminate pathogens

bull Identify pathogens and eliminate them ndash usually 3-6 months

bull If a digestive stool analysis identifies an infection such as a bacterial imbalance or yeast infection

ndash supplement with probiotics

ndash consider other supplements specific to eliminating bacteria (oregano oil garlic)

ndash support immune function (zinc antioxidants fermented foods)

ndash reduce sugar in the diet

bull Bacterial infections such as H pylori may require medical attention from a doctor and medication

Protocol Step 2 ndash test and eliminate pathogens

bull If a parasite infection exists some may be eliminated with supplements 6 month course of

ndash goldenseal

ndash oregano oil

ndash probiotics

bull Support liver detoxification

bull Some stubborn parasites may require medical attention from a doctor and medication

Protocol Step 3 ndash feed your cells

bull After all aggravating foods have been eliminated from your diet it is important to concentrate on feeding the cells lining your digestive system

bull Cells lining the digestive tract require the amino acid glutamine to be able to replenish themselves

bull The powder form mixed with water is ideal to maximise exposure to cells if your digestive system is not strong enough to break down supplement tablets

Protocol Step 4 ndash control inflammation

bull Keep inflammation down in order to promote healing and reduce pain

bull To control inflammation consider anti-inflammatory foods

ndash vegetables

ndash oily fish (containing omega-3 EPA)

ndash foods rich in antioxidants

bull Limit intake of inflammatory foods

ndash grain fed meats (containing omega-6 AA)

ndash vegetable oils such as refined corn oil and sunflower oil

ndash refined carbohydrate foods such as sugar and white flour

Protocol Step 4 ndash control inflammation

bull The most potent anti-inflammatory supplement which may help to calm and soothe the gut lining is omega-3 EPA

bull 1000mg omega-3 EPA per day to have a therapeutic effect on reducing inflammation

bull The ratio of omega-6 AA to omega-3 EPA needs to be balanced eg 21 ratio

bull Omega-3 EPA produces anti-inflammatory eicosanoids

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

Health issues linked to gut permeability

bull The following conditions may increase gut permeability

bull Inflammatory bowel diseases

ndash ulcerative colitis

ndash Crohnrsquos disease

bull Gastritis (inflammation of the stomach ndash several causes)

bull HIV AIDS

bull Type 1 diabetes

Causes of a leaky gut

bull There are several possible causes of a leaky gut

ndash chronic inflammation

ndash nutritional deficiencies

ndash fatty acid deficiencies

ndash improper digestion

ndashhigh intake of commonly aggravating foods

ndash stress

bull Other possible causes

ndash parasites

ndash pathogenic bacteria

ndash yeast infections

The role of inflammation in a permeable gut

bull Chronic inflammation causes continuous breakdown of cells

bull Excess inflammation can damage mucosal cellsrsquo tight junctions

bull Inflammation may be a result of an inflammatory diet or medication

bull Inflammation exacerbates pain and sensitivity to foods

bull Too much inflammation stalls the healing process

Nutritional deficiencies and a leaky gut

bull Nutrients required for the integrity of the mucosal cells

ndash zinc

ndash antioxidants

ndash protein

ndash fatty acids

bull A leaky gut may also result in nutritional

deficiencies due to inflamed villi and

reduced ability of mucosal cells to absorb

nutrients

Fatty acid deficiencies and a leaky gut

bull A deficiency in omega-3 fatty acids may increase inflammation

bull A low omega-3 index may also reduce fluidity of cell membranes

bull Low levels of omega-3 may also shrink cells (less plumped up) leading

to possible gaps between mucosal cells

bull Imbalanced ratio of omega-6 to omega-3

fatty acids may lead to inflammation

Improper digestion and leaky gut

bull Low stomach acid = improper breakdown of proteins

bull Low production of bile = improper breakdown of fats

bull Low levels of digestive enzymes = larger undigested food particles

Improper digestion

Undigested food

particles

Food passing through leaky gut

Possible intolerances

High intake of commonly aggravating foods

bull Foods commonly associated with a permeable gut liningndash gluten

ndash dairy

ndash peanuts

ndash pulses (lentils beans)

ndash spicy food

bull Foods which an individual has become intolerant to due to IgGantibody reaction or other immune reactions

Is gluten to blamebull Gluten - a protein found in grains

wheat barley and rye

bull It can be very difficult to process in the body and can result in immune reactions leading to unwanted symptoms such as digestive cramps

bull Gluten is one of the most common food intolerances and can negatively affect symptoms of a leaky gut

bull Gluten is not the cause of a leaky gut for everyone

bull Small quantities of gluten may be tolerated although constant intake of gluten is too much to handle for many people

Spicy food

bull Spicy food - chilli peppers contain a compound called capsaicin

bull Causes irritation to mucosal cells including the lips tongue mouth and digestive tract

bull Leaky gut + chilli = a burning sensation in the stomach and a bout of diarrhoea

Other foods which may aggravate a leaky gut

bull Ginger ndash the spicy irritating compound is gingerol (related to capsaicin)

bull Raw garlic

bull Raw onions

bull Although these foods are considered to be anti-inflammatory they can also cause irritation to your gut lining if it is already semi-permeable

bull Direct contact of such strong foods on already damaged cells can result in an instant burning sensation in the stomach or intestines

Stress and a leaky gut

bull Stress can increase stomach acid production

ndash often leading to gastritis ulcers

bull Stress may reduce ability to digest food by reducing production of digestive enzymes

bull Higher requirements for vitamins and minerals

Pathogens ndash yeast bacteria and parasites

bull Yeast infections such as candida albicans

bull Pathogenic bacterial infections

lack of beneficial bacteria

bull Parasites

bull Toxins produced by pathogens can cause

further damage

Alcohol

bull Drinking alcohol in excess ie more than

approximately 3 units in one day

can cause significant irritation to an already permeable gut

bull Alcohol is inflammatory and therefore is only going to make the situation worse

bull 2-3 units of alcohol may not cause any issue to someone with a healthy gut lining but for someone with a permeable gut lining alcohol can be very aggravating

Medication

bull Well known irritants of the bowel lining

ndash aspirin

ndash non-steroidal anti-inflammatory drugs

(nSAIDs) such as ibuprofen

bull These medications may cause inflammation of a particular area of the bowel which may result in ulcers or a permeable gut lining

bull Antibiotics wipe out beneficial bacteria and therefore may result in infections following treatment

bull Birth control pill

Diagnosing a leaky gut ndash symptoms

bull Recognise digestive symptoms relating to a leaky gut

ndash bloating

ndash diarrhoea

ndash pain

ndash stomach cramps after eating

ndash feeling of lsquosensitivityrsquo to certain foods such as bread

bull Also consider other symptoms

ndash sinusitis

ndash eczema

ndash migraines

ndash joint pains

ndashchronic fatigue

Diagnosing a leaky gut ndash tests

bull A digestive stool analysis can test secretory IgA (Immunoglobulin A) levels

bull IgA is an antibody used by the immune system to identify and fight off unwanted objects such as infectious bacteria this specific type of antibody is produced in mucosal linings (the gut wall)

bull As unwanted undigested food particles may pass through the gut lining an immune reaction involving high levels of IgA antibodies may suggest a permeable gut lining

bull Test for food intolerances if IgG antibodies are produced a leaky gut is very likely

Protocol Step 1 ndash eliminate irritating foods

bull Identify any irritating foods and eliminate these from the diet

bull Gluten is the most common culprit although many other foods ndash such as peanuts beans and lentils ndash can also cause problems in some individuals

bull If a food intolerance test has been carried out

ndash eliminate these foods temporarily only while concentrating on healing the gut

ndash intolerances to several foods are likely to develop over time

ndash simply cutting these foods out is not going to address the cause

ndash once the gut is properly healed these intolerances should

disappear

Protocol Step 1 ndash eliminate irritating foods

bull Spicy food should be eliminated (or at least significantly reduced) during this initial stage for approximately 2-4 months

bull Ideally eliminate alcohol completely for 2-4 months

bull Drinking alcohol even once a week while trying to heal your gut can make the healing process twice as long

Protocol Step 2 ndash test and eliminate pathogens

bull Identify pathogens and eliminate them ndash usually 3-6 months

bull If a digestive stool analysis identifies an infection such as a bacterial imbalance or yeast infection

ndash supplement with probiotics

ndash consider other supplements specific to eliminating bacteria (oregano oil garlic)

ndash support immune function (zinc antioxidants fermented foods)

ndash reduce sugar in the diet

bull Bacterial infections such as H pylori may require medical attention from a doctor and medication

Protocol Step 2 ndash test and eliminate pathogens

bull If a parasite infection exists some may be eliminated with supplements 6 month course of

ndash goldenseal

ndash oregano oil

ndash probiotics

bull Support liver detoxification

bull Some stubborn parasites may require medical attention from a doctor and medication

Protocol Step 3 ndash feed your cells

bull After all aggravating foods have been eliminated from your diet it is important to concentrate on feeding the cells lining your digestive system

bull Cells lining the digestive tract require the amino acid glutamine to be able to replenish themselves

bull The powder form mixed with water is ideal to maximise exposure to cells if your digestive system is not strong enough to break down supplement tablets

Protocol Step 4 ndash control inflammation

bull Keep inflammation down in order to promote healing and reduce pain

bull To control inflammation consider anti-inflammatory foods

ndash vegetables

ndash oily fish (containing omega-3 EPA)

ndash foods rich in antioxidants

bull Limit intake of inflammatory foods

ndash grain fed meats (containing omega-6 AA)

ndash vegetable oils such as refined corn oil and sunflower oil

ndash refined carbohydrate foods such as sugar and white flour

Protocol Step 4 ndash control inflammation

bull The most potent anti-inflammatory supplement which may help to calm and soothe the gut lining is omega-3 EPA

bull 1000mg omega-3 EPA per day to have a therapeutic effect on reducing inflammation

bull The ratio of omega-6 AA to omega-3 EPA needs to be balanced eg 21 ratio

bull Omega-3 EPA produces anti-inflammatory eicosanoids

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

Causes of a leaky gut

bull There are several possible causes of a leaky gut

ndash chronic inflammation

ndash nutritional deficiencies

ndash fatty acid deficiencies

ndash improper digestion

ndashhigh intake of commonly aggravating foods

ndash stress

bull Other possible causes

ndash parasites

ndash pathogenic bacteria

ndash yeast infections

The role of inflammation in a permeable gut

bull Chronic inflammation causes continuous breakdown of cells

bull Excess inflammation can damage mucosal cellsrsquo tight junctions

bull Inflammation may be a result of an inflammatory diet or medication

bull Inflammation exacerbates pain and sensitivity to foods

bull Too much inflammation stalls the healing process

Nutritional deficiencies and a leaky gut

bull Nutrients required for the integrity of the mucosal cells

ndash zinc

ndash antioxidants

ndash protein

ndash fatty acids

bull A leaky gut may also result in nutritional

deficiencies due to inflamed villi and

reduced ability of mucosal cells to absorb

nutrients

Fatty acid deficiencies and a leaky gut

bull A deficiency in omega-3 fatty acids may increase inflammation

bull A low omega-3 index may also reduce fluidity of cell membranes

bull Low levels of omega-3 may also shrink cells (less plumped up) leading

to possible gaps between mucosal cells

bull Imbalanced ratio of omega-6 to omega-3

fatty acids may lead to inflammation

Improper digestion and leaky gut

bull Low stomach acid = improper breakdown of proteins

bull Low production of bile = improper breakdown of fats

bull Low levels of digestive enzymes = larger undigested food particles

Improper digestion

Undigested food

particles

Food passing through leaky gut

Possible intolerances

High intake of commonly aggravating foods

bull Foods commonly associated with a permeable gut liningndash gluten

ndash dairy

ndash peanuts

ndash pulses (lentils beans)

ndash spicy food

bull Foods which an individual has become intolerant to due to IgGantibody reaction or other immune reactions

Is gluten to blamebull Gluten - a protein found in grains

wheat barley and rye

bull It can be very difficult to process in the body and can result in immune reactions leading to unwanted symptoms such as digestive cramps

bull Gluten is one of the most common food intolerances and can negatively affect symptoms of a leaky gut

bull Gluten is not the cause of a leaky gut for everyone

bull Small quantities of gluten may be tolerated although constant intake of gluten is too much to handle for many people

Spicy food

bull Spicy food - chilli peppers contain a compound called capsaicin

bull Causes irritation to mucosal cells including the lips tongue mouth and digestive tract

bull Leaky gut + chilli = a burning sensation in the stomach and a bout of diarrhoea

Other foods which may aggravate a leaky gut

bull Ginger ndash the spicy irritating compound is gingerol (related to capsaicin)

bull Raw garlic

bull Raw onions

bull Although these foods are considered to be anti-inflammatory they can also cause irritation to your gut lining if it is already semi-permeable

bull Direct contact of such strong foods on already damaged cells can result in an instant burning sensation in the stomach or intestines

Stress and a leaky gut

bull Stress can increase stomach acid production

ndash often leading to gastritis ulcers

bull Stress may reduce ability to digest food by reducing production of digestive enzymes

bull Higher requirements for vitamins and minerals

Pathogens ndash yeast bacteria and parasites

bull Yeast infections such as candida albicans

bull Pathogenic bacterial infections

lack of beneficial bacteria

bull Parasites

bull Toxins produced by pathogens can cause

further damage

Alcohol

bull Drinking alcohol in excess ie more than

approximately 3 units in one day

can cause significant irritation to an already permeable gut

bull Alcohol is inflammatory and therefore is only going to make the situation worse

bull 2-3 units of alcohol may not cause any issue to someone with a healthy gut lining but for someone with a permeable gut lining alcohol can be very aggravating

Medication

bull Well known irritants of the bowel lining

ndash aspirin

ndash non-steroidal anti-inflammatory drugs

(nSAIDs) such as ibuprofen

bull These medications may cause inflammation of a particular area of the bowel which may result in ulcers or a permeable gut lining

bull Antibiotics wipe out beneficial bacteria and therefore may result in infections following treatment

bull Birth control pill

Diagnosing a leaky gut ndash symptoms

bull Recognise digestive symptoms relating to a leaky gut

ndash bloating

ndash diarrhoea

ndash pain

ndash stomach cramps after eating

ndash feeling of lsquosensitivityrsquo to certain foods such as bread

bull Also consider other symptoms

ndash sinusitis

ndash eczema

ndash migraines

ndash joint pains

ndashchronic fatigue

Diagnosing a leaky gut ndash tests

bull A digestive stool analysis can test secretory IgA (Immunoglobulin A) levels

bull IgA is an antibody used by the immune system to identify and fight off unwanted objects such as infectious bacteria this specific type of antibody is produced in mucosal linings (the gut wall)

bull As unwanted undigested food particles may pass through the gut lining an immune reaction involving high levels of IgA antibodies may suggest a permeable gut lining

bull Test for food intolerances if IgG antibodies are produced a leaky gut is very likely

Protocol Step 1 ndash eliminate irritating foods

bull Identify any irritating foods and eliminate these from the diet

bull Gluten is the most common culprit although many other foods ndash such as peanuts beans and lentils ndash can also cause problems in some individuals

bull If a food intolerance test has been carried out

ndash eliminate these foods temporarily only while concentrating on healing the gut

ndash intolerances to several foods are likely to develop over time

ndash simply cutting these foods out is not going to address the cause

ndash once the gut is properly healed these intolerances should

disappear

Protocol Step 1 ndash eliminate irritating foods

bull Spicy food should be eliminated (or at least significantly reduced) during this initial stage for approximately 2-4 months

bull Ideally eliminate alcohol completely for 2-4 months

bull Drinking alcohol even once a week while trying to heal your gut can make the healing process twice as long

Protocol Step 2 ndash test and eliminate pathogens

bull Identify pathogens and eliminate them ndash usually 3-6 months

bull If a digestive stool analysis identifies an infection such as a bacterial imbalance or yeast infection

ndash supplement with probiotics

ndash consider other supplements specific to eliminating bacteria (oregano oil garlic)

ndash support immune function (zinc antioxidants fermented foods)

ndash reduce sugar in the diet

bull Bacterial infections such as H pylori may require medical attention from a doctor and medication

Protocol Step 2 ndash test and eliminate pathogens

bull If a parasite infection exists some may be eliminated with supplements 6 month course of

ndash goldenseal

ndash oregano oil

ndash probiotics

bull Support liver detoxification

bull Some stubborn parasites may require medical attention from a doctor and medication

Protocol Step 3 ndash feed your cells

bull After all aggravating foods have been eliminated from your diet it is important to concentrate on feeding the cells lining your digestive system

bull Cells lining the digestive tract require the amino acid glutamine to be able to replenish themselves

bull The powder form mixed with water is ideal to maximise exposure to cells if your digestive system is not strong enough to break down supplement tablets

Protocol Step 4 ndash control inflammation

bull Keep inflammation down in order to promote healing and reduce pain

bull To control inflammation consider anti-inflammatory foods

ndash vegetables

ndash oily fish (containing omega-3 EPA)

ndash foods rich in antioxidants

bull Limit intake of inflammatory foods

ndash grain fed meats (containing omega-6 AA)

ndash vegetable oils such as refined corn oil and sunflower oil

ndash refined carbohydrate foods such as sugar and white flour

Protocol Step 4 ndash control inflammation

bull The most potent anti-inflammatory supplement which may help to calm and soothe the gut lining is omega-3 EPA

bull 1000mg omega-3 EPA per day to have a therapeutic effect on reducing inflammation

bull The ratio of omega-6 AA to omega-3 EPA needs to be balanced eg 21 ratio

bull Omega-3 EPA produces anti-inflammatory eicosanoids

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

The role of inflammation in a permeable gut

bull Chronic inflammation causes continuous breakdown of cells

bull Excess inflammation can damage mucosal cellsrsquo tight junctions

bull Inflammation may be a result of an inflammatory diet or medication

bull Inflammation exacerbates pain and sensitivity to foods

bull Too much inflammation stalls the healing process

Nutritional deficiencies and a leaky gut

bull Nutrients required for the integrity of the mucosal cells

ndash zinc

ndash antioxidants

ndash protein

ndash fatty acids

bull A leaky gut may also result in nutritional

deficiencies due to inflamed villi and

reduced ability of mucosal cells to absorb

nutrients

Fatty acid deficiencies and a leaky gut

bull A deficiency in omega-3 fatty acids may increase inflammation

bull A low omega-3 index may also reduce fluidity of cell membranes

bull Low levels of omega-3 may also shrink cells (less plumped up) leading

to possible gaps between mucosal cells

bull Imbalanced ratio of omega-6 to omega-3

fatty acids may lead to inflammation

Improper digestion and leaky gut

bull Low stomach acid = improper breakdown of proteins

bull Low production of bile = improper breakdown of fats

bull Low levels of digestive enzymes = larger undigested food particles

Improper digestion

Undigested food

particles

Food passing through leaky gut

Possible intolerances

High intake of commonly aggravating foods

bull Foods commonly associated with a permeable gut liningndash gluten

ndash dairy

ndash peanuts

ndash pulses (lentils beans)

ndash spicy food

bull Foods which an individual has become intolerant to due to IgGantibody reaction or other immune reactions

Is gluten to blamebull Gluten - a protein found in grains

wheat barley and rye

bull It can be very difficult to process in the body and can result in immune reactions leading to unwanted symptoms such as digestive cramps

bull Gluten is one of the most common food intolerances and can negatively affect symptoms of a leaky gut

bull Gluten is not the cause of a leaky gut for everyone

bull Small quantities of gluten may be tolerated although constant intake of gluten is too much to handle for many people

Spicy food

bull Spicy food - chilli peppers contain a compound called capsaicin

bull Causes irritation to mucosal cells including the lips tongue mouth and digestive tract

bull Leaky gut + chilli = a burning sensation in the stomach and a bout of diarrhoea

Other foods which may aggravate a leaky gut

bull Ginger ndash the spicy irritating compound is gingerol (related to capsaicin)

bull Raw garlic

bull Raw onions

bull Although these foods are considered to be anti-inflammatory they can also cause irritation to your gut lining if it is already semi-permeable

bull Direct contact of such strong foods on already damaged cells can result in an instant burning sensation in the stomach or intestines

Stress and a leaky gut

bull Stress can increase stomach acid production

ndash often leading to gastritis ulcers

bull Stress may reduce ability to digest food by reducing production of digestive enzymes

bull Higher requirements for vitamins and minerals

Pathogens ndash yeast bacteria and parasites

bull Yeast infections such as candida albicans

bull Pathogenic bacterial infections

lack of beneficial bacteria

bull Parasites

bull Toxins produced by pathogens can cause

further damage

Alcohol

bull Drinking alcohol in excess ie more than

approximately 3 units in one day

can cause significant irritation to an already permeable gut

bull Alcohol is inflammatory and therefore is only going to make the situation worse

bull 2-3 units of alcohol may not cause any issue to someone with a healthy gut lining but for someone with a permeable gut lining alcohol can be very aggravating

Medication

bull Well known irritants of the bowel lining

ndash aspirin

ndash non-steroidal anti-inflammatory drugs

(nSAIDs) such as ibuprofen

bull These medications may cause inflammation of a particular area of the bowel which may result in ulcers or a permeable gut lining

bull Antibiotics wipe out beneficial bacteria and therefore may result in infections following treatment

bull Birth control pill

Diagnosing a leaky gut ndash symptoms

bull Recognise digestive symptoms relating to a leaky gut

ndash bloating

ndash diarrhoea

ndash pain

ndash stomach cramps after eating

ndash feeling of lsquosensitivityrsquo to certain foods such as bread

bull Also consider other symptoms

ndash sinusitis

ndash eczema

ndash migraines

ndash joint pains

ndashchronic fatigue

Diagnosing a leaky gut ndash tests

bull A digestive stool analysis can test secretory IgA (Immunoglobulin A) levels

bull IgA is an antibody used by the immune system to identify and fight off unwanted objects such as infectious bacteria this specific type of antibody is produced in mucosal linings (the gut wall)

bull As unwanted undigested food particles may pass through the gut lining an immune reaction involving high levels of IgA antibodies may suggest a permeable gut lining

bull Test for food intolerances if IgG antibodies are produced a leaky gut is very likely

Protocol Step 1 ndash eliminate irritating foods

bull Identify any irritating foods and eliminate these from the diet

bull Gluten is the most common culprit although many other foods ndash such as peanuts beans and lentils ndash can also cause problems in some individuals

bull If a food intolerance test has been carried out

ndash eliminate these foods temporarily only while concentrating on healing the gut

ndash intolerances to several foods are likely to develop over time

ndash simply cutting these foods out is not going to address the cause

ndash once the gut is properly healed these intolerances should

disappear

Protocol Step 1 ndash eliminate irritating foods

bull Spicy food should be eliminated (or at least significantly reduced) during this initial stage for approximately 2-4 months

bull Ideally eliminate alcohol completely for 2-4 months

bull Drinking alcohol even once a week while trying to heal your gut can make the healing process twice as long

Protocol Step 2 ndash test and eliminate pathogens

bull Identify pathogens and eliminate them ndash usually 3-6 months

bull If a digestive stool analysis identifies an infection such as a bacterial imbalance or yeast infection

ndash supplement with probiotics

ndash consider other supplements specific to eliminating bacteria (oregano oil garlic)

ndash support immune function (zinc antioxidants fermented foods)

ndash reduce sugar in the diet

bull Bacterial infections such as H pylori may require medical attention from a doctor and medication

Protocol Step 2 ndash test and eliminate pathogens

bull If a parasite infection exists some may be eliminated with supplements 6 month course of

ndash goldenseal

ndash oregano oil

ndash probiotics

bull Support liver detoxification

bull Some stubborn parasites may require medical attention from a doctor and medication

Protocol Step 3 ndash feed your cells

bull After all aggravating foods have been eliminated from your diet it is important to concentrate on feeding the cells lining your digestive system

bull Cells lining the digestive tract require the amino acid glutamine to be able to replenish themselves

bull The powder form mixed with water is ideal to maximise exposure to cells if your digestive system is not strong enough to break down supplement tablets

Protocol Step 4 ndash control inflammation

bull Keep inflammation down in order to promote healing and reduce pain

bull To control inflammation consider anti-inflammatory foods

ndash vegetables

ndash oily fish (containing omega-3 EPA)

ndash foods rich in antioxidants

bull Limit intake of inflammatory foods

ndash grain fed meats (containing omega-6 AA)

ndash vegetable oils such as refined corn oil and sunflower oil

ndash refined carbohydrate foods such as sugar and white flour

Protocol Step 4 ndash control inflammation

bull The most potent anti-inflammatory supplement which may help to calm and soothe the gut lining is omega-3 EPA

bull 1000mg omega-3 EPA per day to have a therapeutic effect on reducing inflammation

bull The ratio of omega-6 AA to omega-3 EPA needs to be balanced eg 21 ratio

bull Omega-3 EPA produces anti-inflammatory eicosanoids

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

Nutritional deficiencies and a leaky gut

bull Nutrients required for the integrity of the mucosal cells

ndash zinc

ndash antioxidants

ndash protein

ndash fatty acids

bull A leaky gut may also result in nutritional

deficiencies due to inflamed villi and

reduced ability of mucosal cells to absorb

nutrients

Fatty acid deficiencies and a leaky gut

bull A deficiency in omega-3 fatty acids may increase inflammation

bull A low omega-3 index may also reduce fluidity of cell membranes

bull Low levels of omega-3 may also shrink cells (less plumped up) leading

to possible gaps between mucosal cells

bull Imbalanced ratio of omega-6 to omega-3

fatty acids may lead to inflammation

Improper digestion and leaky gut

bull Low stomach acid = improper breakdown of proteins

bull Low production of bile = improper breakdown of fats

bull Low levels of digestive enzymes = larger undigested food particles

Improper digestion

Undigested food

particles

Food passing through leaky gut

Possible intolerances

High intake of commonly aggravating foods

bull Foods commonly associated with a permeable gut liningndash gluten

ndash dairy

ndash peanuts

ndash pulses (lentils beans)

ndash spicy food

bull Foods which an individual has become intolerant to due to IgGantibody reaction or other immune reactions

Is gluten to blamebull Gluten - a protein found in grains

wheat barley and rye

bull It can be very difficult to process in the body and can result in immune reactions leading to unwanted symptoms such as digestive cramps

bull Gluten is one of the most common food intolerances and can negatively affect symptoms of a leaky gut

bull Gluten is not the cause of a leaky gut for everyone

bull Small quantities of gluten may be tolerated although constant intake of gluten is too much to handle for many people

Spicy food

bull Spicy food - chilli peppers contain a compound called capsaicin

bull Causes irritation to mucosal cells including the lips tongue mouth and digestive tract

bull Leaky gut + chilli = a burning sensation in the stomach and a bout of diarrhoea

Other foods which may aggravate a leaky gut

bull Ginger ndash the spicy irritating compound is gingerol (related to capsaicin)

bull Raw garlic

bull Raw onions

bull Although these foods are considered to be anti-inflammatory they can also cause irritation to your gut lining if it is already semi-permeable

bull Direct contact of such strong foods on already damaged cells can result in an instant burning sensation in the stomach or intestines

Stress and a leaky gut

bull Stress can increase stomach acid production

ndash often leading to gastritis ulcers

bull Stress may reduce ability to digest food by reducing production of digestive enzymes

bull Higher requirements for vitamins and minerals

Pathogens ndash yeast bacteria and parasites

bull Yeast infections such as candida albicans

bull Pathogenic bacterial infections

lack of beneficial bacteria

bull Parasites

bull Toxins produced by pathogens can cause

further damage

Alcohol

bull Drinking alcohol in excess ie more than

approximately 3 units in one day

can cause significant irritation to an already permeable gut

bull Alcohol is inflammatory and therefore is only going to make the situation worse

bull 2-3 units of alcohol may not cause any issue to someone with a healthy gut lining but for someone with a permeable gut lining alcohol can be very aggravating

Medication

bull Well known irritants of the bowel lining

ndash aspirin

ndash non-steroidal anti-inflammatory drugs

(nSAIDs) such as ibuprofen

bull These medications may cause inflammation of a particular area of the bowel which may result in ulcers or a permeable gut lining

bull Antibiotics wipe out beneficial bacteria and therefore may result in infections following treatment

bull Birth control pill

Diagnosing a leaky gut ndash symptoms

bull Recognise digestive symptoms relating to a leaky gut

ndash bloating

ndash diarrhoea

ndash pain

ndash stomach cramps after eating

ndash feeling of lsquosensitivityrsquo to certain foods such as bread

bull Also consider other symptoms

ndash sinusitis

ndash eczema

ndash migraines

ndash joint pains

ndashchronic fatigue

Diagnosing a leaky gut ndash tests

bull A digestive stool analysis can test secretory IgA (Immunoglobulin A) levels

bull IgA is an antibody used by the immune system to identify and fight off unwanted objects such as infectious bacteria this specific type of antibody is produced in mucosal linings (the gut wall)

bull As unwanted undigested food particles may pass through the gut lining an immune reaction involving high levels of IgA antibodies may suggest a permeable gut lining

bull Test for food intolerances if IgG antibodies are produced a leaky gut is very likely

Protocol Step 1 ndash eliminate irritating foods

bull Identify any irritating foods and eliminate these from the diet

bull Gluten is the most common culprit although many other foods ndash such as peanuts beans and lentils ndash can also cause problems in some individuals

bull If a food intolerance test has been carried out

ndash eliminate these foods temporarily only while concentrating on healing the gut

ndash intolerances to several foods are likely to develop over time

ndash simply cutting these foods out is not going to address the cause

ndash once the gut is properly healed these intolerances should

disappear

Protocol Step 1 ndash eliminate irritating foods

bull Spicy food should be eliminated (or at least significantly reduced) during this initial stage for approximately 2-4 months

bull Ideally eliminate alcohol completely for 2-4 months

bull Drinking alcohol even once a week while trying to heal your gut can make the healing process twice as long

Protocol Step 2 ndash test and eliminate pathogens

bull Identify pathogens and eliminate them ndash usually 3-6 months

bull If a digestive stool analysis identifies an infection such as a bacterial imbalance or yeast infection

ndash supplement with probiotics

ndash consider other supplements specific to eliminating bacteria (oregano oil garlic)

ndash support immune function (zinc antioxidants fermented foods)

ndash reduce sugar in the diet

bull Bacterial infections such as H pylori may require medical attention from a doctor and medication

Protocol Step 2 ndash test and eliminate pathogens

bull If a parasite infection exists some may be eliminated with supplements 6 month course of

ndash goldenseal

ndash oregano oil

ndash probiotics

bull Support liver detoxification

bull Some stubborn parasites may require medical attention from a doctor and medication

Protocol Step 3 ndash feed your cells

bull After all aggravating foods have been eliminated from your diet it is important to concentrate on feeding the cells lining your digestive system

bull Cells lining the digestive tract require the amino acid glutamine to be able to replenish themselves

bull The powder form mixed with water is ideal to maximise exposure to cells if your digestive system is not strong enough to break down supplement tablets

Protocol Step 4 ndash control inflammation

bull Keep inflammation down in order to promote healing and reduce pain

bull To control inflammation consider anti-inflammatory foods

ndash vegetables

ndash oily fish (containing omega-3 EPA)

ndash foods rich in antioxidants

bull Limit intake of inflammatory foods

ndash grain fed meats (containing omega-6 AA)

ndash vegetable oils such as refined corn oil and sunflower oil

ndash refined carbohydrate foods such as sugar and white flour

Protocol Step 4 ndash control inflammation

bull The most potent anti-inflammatory supplement which may help to calm and soothe the gut lining is omega-3 EPA

bull 1000mg omega-3 EPA per day to have a therapeutic effect on reducing inflammation

bull The ratio of omega-6 AA to omega-3 EPA needs to be balanced eg 21 ratio

bull Omega-3 EPA produces anti-inflammatory eicosanoids

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

Fatty acid deficiencies and a leaky gut

bull A deficiency in omega-3 fatty acids may increase inflammation

bull A low omega-3 index may also reduce fluidity of cell membranes

bull Low levels of omega-3 may also shrink cells (less plumped up) leading

to possible gaps between mucosal cells

bull Imbalanced ratio of omega-6 to omega-3

fatty acids may lead to inflammation

Improper digestion and leaky gut

bull Low stomach acid = improper breakdown of proteins

bull Low production of bile = improper breakdown of fats

bull Low levels of digestive enzymes = larger undigested food particles

Improper digestion

Undigested food

particles

Food passing through leaky gut

Possible intolerances

High intake of commonly aggravating foods

bull Foods commonly associated with a permeable gut liningndash gluten

ndash dairy

ndash peanuts

ndash pulses (lentils beans)

ndash spicy food

bull Foods which an individual has become intolerant to due to IgGantibody reaction or other immune reactions

Is gluten to blamebull Gluten - a protein found in grains

wheat barley and rye

bull It can be very difficult to process in the body and can result in immune reactions leading to unwanted symptoms such as digestive cramps

bull Gluten is one of the most common food intolerances and can negatively affect symptoms of a leaky gut

bull Gluten is not the cause of a leaky gut for everyone

bull Small quantities of gluten may be tolerated although constant intake of gluten is too much to handle for many people

Spicy food

bull Spicy food - chilli peppers contain a compound called capsaicin

bull Causes irritation to mucosal cells including the lips tongue mouth and digestive tract

bull Leaky gut + chilli = a burning sensation in the stomach and a bout of diarrhoea

Other foods which may aggravate a leaky gut

bull Ginger ndash the spicy irritating compound is gingerol (related to capsaicin)

bull Raw garlic

bull Raw onions

bull Although these foods are considered to be anti-inflammatory they can also cause irritation to your gut lining if it is already semi-permeable

bull Direct contact of such strong foods on already damaged cells can result in an instant burning sensation in the stomach or intestines

Stress and a leaky gut

bull Stress can increase stomach acid production

ndash often leading to gastritis ulcers

bull Stress may reduce ability to digest food by reducing production of digestive enzymes

bull Higher requirements for vitamins and minerals

Pathogens ndash yeast bacteria and parasites

bull Yeast infections such as candida albicans

bull Pathogenic bacterial infections

lack of beneficial bacteria

bull Parasites

bull Toxins produced by pathogens can cause

further damage

Alcohol

bull Drinking alcohol in excess ie more than

approximately 3 units in one day

can cause significant irritation to an already permeable gut

bull Alcohol is inflammatory and therefore is only going to make the situation worse

bull 2-3 units of alcohol may not cause any issue to someone with a healthy gut lining but for someone with a permeable gut lining alcohol can be very aggravating

Medication

bull Well known irritants of the bowel lining

ndash aspirin

ndash non-steroidal anti-inflammatory drugs

(nSAIDs) such as ibuprofen

bull These medications may cause inflammation of a particular area of the bowel which may result in ulcers or a permeable gut lining

bull Antibiotics wipe out beneficial bacteria and therefore may result in infections following treatment

bull Birth control pill

Diagnosing a leaky gut ndash symptoms

bull Recognise digestive symptoms relating to a leaky gut

ndash bloating

ndash diarrhoea

ndash pain

ndash stomach cramps after eating

ndash feeling of lsquosensitivityrsquo to certain foods such as bread

bull Also consider other symptoms

ndash sinusitis

ndash eczema

ndash migraines

ndash joint pains

ndashchronic fatigue

Diagnosing a leaky gut ndash tests

bull A digestive stool analysis can test secretory IgA (Immunoglobulin A) levels

bull IgA is an antibody used by the immune system to identify and fight off unwanted objects such as infectious bacteria this specific type of antibody is produced in mucosal linings (the gut wall)

bull As unwanted undigested food particles may pass through the gut lining an immune reaction involving high levels of IgA antibodies may suggest a permeable gut lining

bull Test for food intolerances if IgG antibodies are produced a leaky gut is very likely

Protocol Step 1 ndash eliminate irritating foods

bull Identify any irritating foods and eliminate these from the diet

bull Gluten is the most common culprit although many other foods ndash such as peanuts beans and lentils ndash can also cause problems in some individuals

bull If a food intolerance test has been carried out

ndash eliminate these foods temporarily only while concentrating on healing the gut

ndash intolerances to several foods are likely to develop over time

ndash simply cutting these foods out is not going to address the cause

ndash once the gut is properly healed these intolerances should

disappear

Protocol Step 1 ndash eliminate irritating foods

bull Spicy food should be eliminated (or at least significantly reduced) during this initial stage for approximately 2-4 months

bull Ideally eliminate alcohol completely for 2-4 months

bull Drinking alcohol even once a week while trying to heal your gut can make the healing process twice as long

Protocol Step 2 ndash test and eliminate pathogens

bull Identify pathogens and eliminate them ndash usually 3-6 months

bull If a digestive stool analysis identifies an infection such as a bacterial imbalance or yeast infection

ndash supplement with probiotics

ndash consider other supplements specific to eliminating bacteria (oregano oil garlic)

ndash support immune function (zinc antioxidants fermented foods)

ndash reduce sugar in the diet

bull Bacterial infections such as H pylori may require medical attention from a doctor and medication

Protocol Step 2 ndash test and eliminate pathogens

bull If a parasite infection exists some may be eliminated with supplements 6 month course of

ndash goldenseal

ndash oregano oil

ndash probiotics

bull Support liver detoxification

bull Some stubborn parasites may require medical attention from a doctor and medication

Protocol Step 3 ndash feed your cells

bull After all aggravating foods have been eliminated from your diet it is important to concentrate on feeding the cells lining your digestive system

bull Cells lining the digestive tract require the amino acid glutamine to be able to replenish themselves

bull The powder form mixed with water is ideal to maximise exposure to cells if your digestive system is not strong enough to break down supplement tablets

Protocol Step 4 ndash control inflammation

bull Keep inflammation down in order to promote healing and reduce pain

bull To control inflammation consider anti-inflammatory foods

ndash vegetables

ndash oily fish (containing omega-3 EPA)

ndash foods rich in antioxidants

bull Limit intake of inflammatory foods

ndash grain fed meats (containing omega-6 AA)

ndash vegetable oils such as refined corn oil and sunflower oil

ndash refined carbohydrate foods such as sugar and white flour

Protocol Step 4 ndash control inflammation

bull The most potent anti-inflammatory supplement which may help to calm and soothe the gut lining is omega-3 EPA

bull 1000mg omega-3 EPA per day to have a therapeutic effect on reducing inflammation

bull The ratio of omega-6 AA to omega-3 EPA needs to be balanced eg 21 ratio

bull Omega-3 EPA produces anti-inflammatory eicosanoids

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

Improper digestion and leaky gut

bull Low stomach acid = improper breakdown of proteins

bull Low production of bile = improper breakdown of fats

bull Low levels of digestive enzymes = larger undigested food particles

Improper digestion

Undigested food

particles

Food passing through leaky gut

Possible intolerances

High intake of commonly aggravating foods

bull Foods commonly associated with a permeable gut liningndash gluten

ndash dairy

ndash peanuts

ndash pulses (lentils beans)

ndash spicy food

bull Foods which an individual has become intolerant to due to IgGantibody reaction or other immune reactions

Is gluten to blamebull Gluten - a protein found in grains

wheat barley and rye

bull It can be very difficult to process in the body and can result in immune reactions leading to unwanted symptoms such as digestive cramps

bull Gluten is one of the most common food intolerances and can negatively affect symptoms of a leaky gut

bull Gluten is not the cause of a leaky gut for everyone

bull Small quantities of gluten may be tolerated although constant intake of gluten is too much to handle for many people

Spicy food

bull Spicy food - chilli peppers contain a compound called capsaicin

bull Causes irritation to mucosal cells including the lips tongue mouth and digestive tract

bull Leaky gut + chilli = a burning sensation in the stomach and a bout of diarrhoea

Other foods which may aggravate a leaky gut

bull Ginger ndash the spicy irritating compound is gingerol (related to capsaicin)

bull Raw garlic

bull Raw onions

bull Although these foods are considered to be anti-inflammatory they can also cause irritation to your gut lining if it is already semi-permeable

bull Direct contact of such strong foods on already damaged cells can result in an instant burning sensation in the stomach or intestines

Stress and a leaky gut

bull Stress can increase stomach acid production

ndash often leading to gastritis ulcers

bull Stress may reduce ability to digest food by reducing production of digestive enzymes

bull Higher requirements for vitamins and minerals

Pathogens ndash yeast bacteria and parasites

bull Yeast infections such as candida albicans

bull Pathogenic bacterial infections

lack of beneficial bacteria

bull Parasites

bull Toxins produced by pathogens can cause

further damage

Alcohol

bull Drinking alcohol in excess ie more than

approximately 3 units in one day

can cause significant irritation to an already permeable gut

bull Alcohol is inflammatory and therefore is only going to make the situation worse

bull 2-3 units of alcohol may not cause any issue to someone with a healthy gut lining but for someone with a permeable gut lining alcohol can be very aggravating

Medication

bull Well known irritants of the bowel lining

ndash aspirin

ndash non-steroidal anti-inflammatory drugs

(nSAIDs) such as ibuprofen

bull These medications may cause inflammation of a particular area of the bowel which may result in ulcers or a permeable gut lining

bull Antibiotics wipe out beneficial bacteria and therefore may result in infections following treatment

bull Birth control pill

Diagnosing a leaky gut ndash symptoms

bull Recognise digestive symptoms relating to a leaky gut

ndash bloating

ndash diarrhoea

ndash pain

ndash stomach cramps after eating

ndash feeling of lsquosensitivityrsquo to certain foods such as bread

bull Also consider other symptoms

ndash sinusitis

ndash eczema

ndash migraines

ndash joint pains

ndashchronic fatigue

Diagnosing a leaky gut ndash tests

bull A digestive stool analysis can test secretory IgA (Immunoglobulin A) levels

bull IgA is an antibody used by the immune system to identify and fight off unwanted objects such as infectious bacteria this specific type of antibody is produced in mucosal linings (the gut wall)

bull As unwanted undigested food particles may pass through the gut lining an immune reaction involving high levels of IgA antibodies may suggest a permeable gut lining

bull Test for food intolerances if IgG antibodies are produced a leaky gut is very likely

Protocol Step 1 ndash eliminate irritating foods

bull Identify any irritating foods and eliminate these from the diet

bull Gluten is the most common culprit although many other foods ndash such as peanuts beans and lentils ndash can also cause problems in some individuals

bull If a food intolerance test has been carried out

ndash eliminate these foods temporarily only while concentrating on healing the gut

ndash intolerances to several foods are likely to develop over time

ndash simply cutting these foods out is not going to address the cause

ndash once the gut is properly healed these intolerances should

disappear

Protocol Step 1 ndash eliminate irritating foods

bull Spicy food should be eliminated (or at least significantly reduced) during this initial stage for approximately 2-4 months

bull Ideally eliminate alcohol completely for 2-4 months

bull Drinking alcohol even once a week while trying to heal your gut can make the healing process twice as long

Protocol Step 2 ndash test and eliminate pathogens

bull Identify pathogens and eliminate them ndash usually 3-6 months

bull If a digestive stool analysis identifies an infection such as a bacterial imbalance or yeast infection

ndash supplement with probiotics

ndash consider other supplements specific to eliminating bacteria (oregano oil garlic)

ndash support immune function (zinc antioxidants fermented foods)

ndash reduce sugar in the diet

bull Bacterial infections such as H pylori may require medical attention from a doctor and medication

Protocol Step 2 ndash test and eliminate pathogens

bull If a parasite infection exists some may be eliminated with supplements 6 month course of

ndash goldenseal

ndash oregano oil

ndash probiotics

bull Support liver detoxification

bull Some stubborn parasites may require medical attention from a doctor and medication

Protocol Step 3 ndash feed your cells

bull After all aggravating foods have been eliminated from your diet it is important to concentrate on feeding the cells lining your digestive system

bull Cells lining the digestive tract require the amino acid glutamine to be able to replenish themselves

bull The powder form mixed with water is ideal to maximise exposure to cells if your digestive system is not strong enough to break down supplement tablets

Protocol Step 4 ndash control inflammation

bull Keep inflammation down in order to promote healing and reduce pain

bull To control inflammation consider anti-inflammatory foods

ndash vegetables

ndash oily fish (containing omega-3 EPA)

ndash foods rich in antioxidants

bull Limit intake of inflammatory foods

ndash grain fed meats (containing omega-6 AA)

ndash vegetable oils such as refined corn oil and sunflower oil

ndash refined carbohydrate foods such as sugar and white flour

Protocol Step 4 ndash control inflammation

bull The most potent anti-inflammatory supplement which may help to calm and soothe the gut lining is omega-3 EPA

bull 1000mg omega-3 EPA per day to have a therapeutic effect on reducing inflammation

bull The ratio of omega-6 AA to omega-3 EPA needs to be balanced eg 21 ratio

bull Omega-3 EPA produces anti-inflammatory eicosanoids

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

High intake of commonly aggravating foods

bull Foods commonly associated with a permeable gut liningndash gluten

ndash dairy

ndash peanuts

ndash pulses (lentils beans)

ndash spicy food

bull Foods which an individual has become intolerant to due to IgGantibody reaction or other immune reactions

Is gluten to blamebull Gluten - a protein found in grains

wheat barley and rye

bull It can be very difficult to process in the body and can result in immune reactions leading to unwanted symptoms such as digestive cramps

bull Gluten is one of the most common food intolerances and can negatively affect symptoms of a leaky gut

bull Gluten is not the cause of a leaky gut for everyone

bull Small quantities of gluten may be tolerated although constant intake of gluten is too much to handle for many people

Spicy food

bull Spicy food - chilli peppers contain a compound called capsaicin

bull Causes irritation to mucosal cells including the lips tongue mouth and digestive tract

bull Leaky gut + chilli = a burning sensation in the stomach and a bout of diarrhoea

Other foods which may aggravate a leaky gut

bull Ginger ndash the spicy irritating compound is gingerol (related to capsaicin)

bull Raw garlic

bull Raw onions

bull Although these foods are considered to be anti-inflammatory they can also cause irritation to your gut lining if it is already semi-permeable

bull Direct contact of such strong foods on already damaged cells can result in an instant burning sensation in the stomach or intestines

Stress and a leaky gut

bull Stress can increase stomach acid production

ndash often leading to gastritis ulcers

bull Stress may reduce ability to digest food by reducing production of digestive enzymes

bull Higher requirements for vitamins and minerals

Pathogens ndash yeast bacteria and parasites

bull Yeast infections such as candida albicans

bull Pathogenic bacterial infections

lack of beneficial bacteria

bull Parasites

bull Toxins produced by pathogens can cause

further damage

Alcohol

bull Drinking alcohol in excess ie more than

approximately 3 units in one day

can cause significant irritation to an already permeable gut

bull Alcohol is inflammatory and therefore is only going to make the situation worse

bull 2-3 units of alcohol may not cause any issue to someone with a healthy gut lining but for someone with a permeable gut lining alcohol can be very aggravating

Medication

bull Well known irritants of the bowel lining

ndash aspirin

ndash non-steroidal anti-inflammatory drugs

(nSAIDs) such as ibuprofen

bull These medications may cause inflammation of a particular area of the bowel which may result in ulcers or a permeable gut lining

bull Antibiotics wipe out beneficial bacteria and therefore may result in infections following treatment

bull Birth control pill

Diagnosing a leaky gut ndash symptoms

bull Recognise digestive symptoms relating to a leaky gut

ndash bloating

ndash diarrhoea

ndash pain

ndash stomach cramps after eating

ndash feeling of lsquosensitivityrsquo to certain foods such as bread

bull Also consider other symptoms

ndash sinusitis

ndash eczema

ndash migraines

ndash joint pains

ndashchronic fatigue

Diagnosing a leaky gut ndash tests

bull A digestive stool analysis can test secretory IgA (Immunoglobulin A) levels

bull IgA is an antibody used by the immune system to identify and fight off unwanted objects such as infectious bacteria this specific type of antibody is produced in mucosal linings (the gut wall)

bull As unwanted undigested food particles may pass through the gut lining an immune reaction involving high levels of IgA antibodies may suggest a permeable gut lining

bull Test for food intolerances if IgG antibodies are produced a leaky gut is very likely

Protocol Step 1 ndash eliminate irritating foods

bull Identify any irritating foods and eliminate these from the diet

bull Gluten is the most common culprit although many other foods ndash such as peanuts beans and lentils ndash can also cause problems in some individuals

bull If a food intolerance test has been carried out

ndash eliminate these foods temporarily only while concentrating on healing the gut

ndash intolerances to several foods are likely to develop over time

ndash simply cutting these foods out is not going to address the cause

ndash once the gut is properly healed these intolerances should

disappear

Protocol Step 1 ndash eliminate irritating foods

bull Spicy food should be eliminated (or at least significantly reduced) during this initial stage for approximately 2-4 months

bull Ideally eliminate alcohol completely for 2-4 months

bull Drinking alcohol even once a week while trying to heal your gut can make the healing process twice as long

Protocol Step 2 ndash test and eliminate pathogens

bull Identify pathogens and eliminate them ndash usually 3-6 months

bull If a digestive stool analysis identifies an infection such as a bacterial imbalance or yeast infection

ndash supplement with probiotics

ndash consider other supplements specific to eliminating bacteria (oregano oil garlic)

ndash support immune function (zinc antioxidants fermented foods)

ndash reduce sugar in the diet

bull Bacterial infections such as H pylori may require medical attention from a doctor and medication

Protocol Step 2 ndash test and eliminate pathogens

bull If a parasite infection exists some may be eliminated with supplements 6 month course of

ndash goldenseal

ndash oregano oil

ndash probiotics

bull Support liver detoxification

bull Some stubborn parasites may require medical attention from a doctor and medication

Protocol Step 3 ndash feed your cells

bull After all aggravating foods have been eliminated from your diet it is important to concentrate on feeding the cells lining your digestive system

bull Cells lining the digestive tract require the amino acid glutamine to be able to replenish themselves

bull The powder form mixed with water is ideal to maximise exposure to cells if your digestive system is not strong enough to break down supplement tablets

Protocol Step 4 ndash control inflammation

bull Keep inflammation down in order to promote healing and reduce pain

bull To control inflammation consider anti-inflammatory foods

ndash vegetables

ndash oily fish (containing omega-3 EPA)

ndash foods rich in antioxidants

bull Limit intake of inflammatory foods

ndash grain fed meats (containing omega-6 AA)

ndash vegetable oils such as refined corn oil and sunflower oil

ndash refined carbohydrate foods such as sugar and white flour

Protocol Step 4 ndash control inflammation

bull The most potent anti-inflammatory supplement which may help to calm and soothe the gut lining is omega-3 EPA

bull 1000mg omega-3 EPA per day to have a therapeutic effect on reducing inflammation

bull The ratio of omega-6 AA to omega-3 EPA needs to be balanced eg 21 ratio

bull Omega-3 EPA produces anti-inflammatory eicosanoids

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

Is gluten to blamebull Gluten - a protein found in grains

wheat barley and rye

bull It can be very difficult to process in the body and can result in immune reactions leading to unwanted symptoms such as digestive cramps

bull Gluten is one of the most common food intolerances and can negatively affect symptoms of a leaky gut

bull Gluten is not the cause of a leaky gut for everyone

bull Small quantities of gluten may be tolerated although constant intake of gluten is too much to handle for many people

Spicy food

bull Spicy food - chilli peppers contain a compound called capsaicin

bull Causes irritation to mucosal cells including the lips tongue mouth and digestive tract

bull Leaky gut + chilli = a burning sensation in the stomach and a bout of diarrhoea

Other foods which may aggravate a leaky gut

bull Ginger ndash the spicy irritating compound is gingerol (related to capsaicin)

bull Raw garlic

bull Raw onions

bull Although these foods are considered to be anti-inflammatory they can also cause irritation to your gut lining if it is already semi-permeable

bull Direct contact of such strong foods on already damaged cells can result in an instant burning sensation in the stomach or intestines

Stress and a leaky gut

bull Stress can increase stomach acid production

ndash often leading to gastritis ulcers

bull Stress may reduce ability to digest food by reducing production of digestive enzymes

bull Higher requirements for vitamins and minerals

Pathogens ndash yeast bacteria and parasites

bull Yeast infections such as candida albicans

bull Pathogenic bacterial infections

lack of beneficial bacteria

bull Parasites

bull Toxins produced by pathogens can cause

further damage

Alcohol

bull Drinking alcohol in excess ie more than

approximately 3 units in one day

can cause significant irritation to an already permeable gut

bull Alcohol is inflammatory and therefore is only going to make the situation worse

bull 2-3 units of alcohol may not cause any issue to someone with a healthy gut lining but for someone with a permeable gut lining alcohol can be very aggravating

Medication

bull Well known irritants of the bowel lining

ndash aspirin

ndash non-steroidal anti-inflammatory drugs

(nSAIDs) such as ibuprofen

bull These medications may cause inflammation of a particular area of the bowel which may result in ulcers or a permeable gut lining

bull Antibiotics wipe out beneficial bacteria and therefore may result in infections following treatment

bull Birth control pill

Diagnosing a leaky gut ndash symptoms

bull Recognise digestive symptoms relating to a leaky gut

ndash bloating

ndash diarrhoea

ndash pain

ndash stomach cramps after eating

ndash feeling of lsquosensitivityrsquo to certain foods such as bread

bull Also consider other symptoms

ndash sinusitis

ndash eczema

ndash migraines

ndash joint pains

ndashchronic fatigue

Diagnosing a leaky gut ndash tests

bull A digestive stool analysis can test secretory IgA (Immunoglobulin A) levels

bull IgA is an antibody used by the immune system to identify and fight off unwanted objects such as infectious bacteria this specific type of antibody is produced in mucosal linings (the gut wall)

bull As unwanted undigested food particles may pass through the gut lining an immune reaction involving high levels of IgA antibodies may suggest a permeable gut lining

bull Test for food intolerances if IgG antibodies are produced a leaky gut is very likely

Protocol Step 1 ndash eliminate irritating foods

bull Identify any irritating foods and eliminate these from the diet

bull Gluten is the most common culprit although many other foods ndash such as peanuts beans and lentils ndash can also cause problems in some individuals

bull If a food intolerance test has been carried out

ndash eliminate these foods temporarily only while concentrating on healing the gut

ndash intolerances to several foods are likely to develop over time

ndash simply cutting these foods out is not going to address the cause

ndash once the gut is properly healed these intolerances should

disappear

Protocol Step 1 ndash eliminate irritating foods

bull Spicy food should be eliminated (or at least significantly reduced) during this initial stage for approximately 2-4 months

bull Ideally eliminate alcohol completely for 2-4 months

bull Drinking alcohol even once a week while trying to heal your gut can make the healing process twice as long

Protocol Step 2 ndash test and eliminate pathogens

bull Identify pathogens and eliminate them ndash usually 3-6 months

bull If a digestive stool analysis identifies an infection such as a bacterial imbalance or yeast infection

ndash supplement with probiotics

ndash consider other supplements specific to eliminating bacteria (oregano oil garlic)

ndash support immune function (zinc antioxidants fermented foods)

ndash reduce sugar in the diet

bull Bacterial infections such as H pylori may require medical attention from a doctor and medication

Protocol Step 2 ndash test and eliminate pathogens

bull If a parasite infection exists some may be eliminated with supplements 6 month course of

ndash goldenseal

ndash oregano oil

ndash probiotics

bull Support liver detoxification

bull Some stubborn parasites may require medical attention from a doctor and medication

Protocol Step 3 ndash feed your cells

bull After all aggravating foods have been eliminated from your diet it is important to concentrate on feeding the cells lining your digestive system

bull Cells lining the digestive tract require the amino acid glutamine to be able to replenish themselves

bull The powder form mixed with water is ideal to maximise exposure to cells if your digestive system is not strong enough to break down supplement tablets

Protocol Step 4 ndash control inflammation

bull Keep inflammation down in order to promote healing and reduce pain

bull To control inflammation consider anti-inflammatory foods

ndash vegetables

ndash oily fish (containing omega-3 EPA)

ndash foods rich in antioxidants

bull Limit intake of inflammatory foods

ndash grain fed meats (containing omega-6 AA)

ndash vegetable oils such as refined corn oil and sunflower oil

ndash refined carbohydrate foods such as sugar and white flour

Protocol Step 4 ndash control inflammation

bull The most potent anti-inflammatory supplement which may help to calm and soothe the gut lining is omega-3 EPA

bull 1000mg omega-3 EPA per day to have a therapeutic effect on reducing inflammation

bull The ratio of omega-6 AA to omega-3 EPA needs to be balanced eg 21 ratio

bull Omega-3 EPA produces anti-inflammatory eicosanoids

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

Spicy food

bull Spicy food - chilli peppers contain a compound called capsaicin

bull Causes irritation to mucosal cells including the lips tongue mouth and digestive tract

bull Leaky gut + chilli = a burning sensation in the stomach and a bout of diarrhoea

Other foods which may aggravate a leaky gut

bull Ginger ndash the spicy irritating compound is gingerol (related to capsaicin)

bull Raw garlic

bull Raw onions

bull Although these foods are considered to be anti-inflammatory they can also cause irritation to your gut lining if it is already semi-permeable

bull Direct contact of such strong foods on already damaged cells can result in an instant burning sensation in the stomach or intestines

Stress and a leaky gut

bull Stress can increase stomach acid production

ndash often leading to gastritis ulcers

bull Stress may reduce ability to digest food by reducing production of digestive enzymes

bull Higher requirements for vitamins and minerals

Pathogens ndash yeast bacteria and parasites

bull Yeast infections such as candida albicans

bull Pathogenic bacterial infections

lack of beneficial bacteria

bull Parasites

bull Toxins produced by pathogens can cause

further damage

Alcohol

bull Drinking alcohol in excess ie more than

approximately 3 units in one day

can cause significant irritation to an already permeable gut

bull Alcohol is inflammatory and therefore is only going to make the situation worse

bull 2-3 units of alcohol may not cause any issue to someone with a healthy gut lining but for someone with a permeable gut lining alcohol can be very aggravating

Medication

bull Well known irritants of the bowel lining

ndash aspirin

ndash non-steroidal anti-inflammatory drugs

(nSAIDs) such as ibuprofen

bull These medications may cause inflammation of a particular area of the bowel which may result in ulcers or a permeable gut lining

bull Antibiotics wipe out beneficial bacteria and therefore may result in infections following treatment

bull Birth control pill

Diagnosing a leaky gut ndash symptoms

bull Recognise digestive symptoms relating to a leaky gut

ndash bloating

ndash diarrhoea

ndash pain

ndash stomach cramps after eating

ndash feeling of lsquosensitivityrsquo to certain foods such as bread

bull Also consider other symptoms

ndash sinusitis

ndash eczema

ndash migraines

ndash joint pains

ndashchronic fatigue

Diagnosing a leaky gut ndash tests

bull A digestive stool analysis can test secretory IgA (Immunoglobulin A) levels

bull IgA is an antibody used by the immune system to identify and fight off unwanted objects such as infectious bacteria this specific type of antibody is produced in mucosal linings (the gut wall)

bull As unwanted undigested food particles may pass through the gut lining an immune reaction involving high levels of IgA antibodies may suggest a permeable gut lining

bull Test for food intolerances if IgG antibodies are produced a leaky gut is very likely

Protocol Step 1 ndash eliminate irritating foods

bull Identify any irritating foods and eliminate these from the diet

bull Gluten is the most common culprit although many other foods ndash such as peanuts beans and lentils ndash can also cause problems in some individuals

bull If a food intolerance test has been carried out

ndash eliminate these foods temporarily only while concentrating on healing the gut

ndash intolerances to several foods are likely to develop over time

ndash simply cutting these foods out is not going to address the cause

ndash once the gut is properly healed these intolerances should

disappear

Protocol Step 1 ndash eliminate irritating foods

bull Spicy food should be eliminated (or at least significantly reduced) during this initial stage for approximately 2-4 months

bull Ideally eliminate alcohol completely for 2-4 months

bull Drinking alcohol even once a week while trying to heal your gut can make the healing process twice as long

Protocol Step 2 ndash test and eliminate pathogens

bull Identify pathogens and eliminate them ndash usually 3-6 months

bull If a digestive stool analysis identifies an infection such as a bacterial imbalance or yeast infection

ndash supplement with probiotics

ndash consider other supplements specific to eliminating bacteria (oregano oil garlic)

ndash support immune function (zinc antioxidants fermented foods)

ndash reduce sugar in the diet

bull Bacterial infections such as H pylori may require medical attention from a doctor and medication

Protocol Step 2 ndash test and eliminate pathogens

bull If a parasite infection exists some may be eliminated with supplements 6 month course of

ndash goldenseal

ndash oregano oil

ndash probiotics

bull Support liver detoxification

bull Some stubborn parasites may require medical attention from a doctor and medication

Protocol Step 3 ndash feed your cells

bull After all aggravating foods have been eliminated from your diet it is important to concentrate on feeding the cells lining your digestive system

bull Cells lining the digestive tract require the amino acid glutamine to be able to replenish themselves

bull The powder form mixed with water is ideal to maximise exposure to cells if your digestive system is not strong enough to break down supplement tablets

Protocol Step 4 ndash control inflammation

bull Keep inflammation down in order to promote healing and reduce pain

bull To control inflammation consider anti-inflammatory foods

ndash vegetables

ndash oily fish (containing omega-3 EPA)

ndash foods rich in antioxidants

bull Limit intake of inflammatory foods

ndash grain fed meats (containing omega-6 AA)

ndash vegetable oils such as refined corn oil and sunflower oil

ndash refined carbohydrate foods such as sugar and white flour

Protocol Step 4 ndash control inflammation

bull The most potent anti-inflammatory supplement which may help to calm and soothe the gut lining is omega-3 EPA

bull 1000mg omega-3 EPA per day to have a therapeutic effect on reducing inflammation

bull The ratio of omega-6 AA to omega-3 EPA needs to be balanced eg 21 ratio

bull Omega-3 EPA produces anti-inflammatory eicosanoids

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

Other foods which may aggravate a leaky gut

bull Ginger ndash the spicy irritating compound is gingerol (related to capsaicin)

bull Raw garlic

bull Raw onions

bull Although these foods are considered to be anti-inflammatory they can also cause irritation to your gut lining if it is already semi-permeable

bull Direct contact of such strong foods on already damaged cells can result in an instant burning sensation in the stomach or intestines

Stress and a leaky gut

bull Stress can increase stomach acid production

ndash often leading to gastritis ulcers

bull Stress may reduce ability to digest food by reducing production of digestive enzymes

bull Higher requirements for vitamins and minerals

Pathogens ndash yeast bacteria and parasites

bull Yeast infections such as candida albicans

bull Pathogenic bacterial infections

lack of beneficial bacteria

bull Parasites

bull Toxins produced by pathogens can cause

further damage

Alcohol

bull Drinking alcohol in excess ie more than

approximately 3 units in one day

can cause significant irritation to an already permeable gut

bull Alcohol is inflammatory and therefore is only going to make the situation worse

bull 2-3 units of alcohol may not cause any issue to someone with a healthy gut lining but for someone with a permeable gut lining alcohol can be very aggravating

Medication

bull Well known irritants of the bowel lining

ndash aspirin

ndash non-steroidal anti-inflammatory drugs

(nSAIDs) such as ibuprofen

bull These medications may cause inflammation of a particular area of the bowel which may result in ulcers or a permeable gut lining

bull Antibiotics wipe out beneficial bacteria and therefore may result in infections following treatment

bull Birth control pill

Diagnosing a leaky gut ndash symptoms

bull Recognise digestive symptoms relating to a leaky gut

ndash bloating

ndash diarrhoea

ndash pain

ndash stomach cramps after eating

ndash feeling of lsquosensitivityrsquo to certain foods such as bread

bull Also consider other symptoms

ndash sinusitis

ndash eczema

ndash migraines

ndash joint pains

ndashchronic fatigue

Diagnosing a leaky gut ndash tests

bull A digestive stool analysis can test secretory IgA (Immunoglobulin A) levels

bull IgA is an antibody used by the immune system to identify and fight off unwanted objects such as infectious bacteria this specific type of antibody is produced in mucosal linings (the gut wall)

bull As unwanted undigested food particles may pass through the gut lining an immune reaction involving high levels of IgA antibodies may suggest a permeable gut lining

bull Test for food intolerances if IgG antibodies are produced a leaky gut is very likely

Protocol Step 1 ndash eliminate irritating foods

bull Identify any irritating foods and eliminate these from the diet

bull Gluten is the most common culprit although many other foods ndash such as peanuts beans and lentils ndash can also cause problems in some individuals

bull If a food intolerance test has been carried out

ndash eliminate these foods temporarily only while concentrating on healing the gut

ndash intolerances to several foods are likely to develop over time

ndash simply cutting these foods out is not going to address the cause

ndash once the gut is properly healed these intolerances should

disappear

Protocol Step 1 ndash eliminate irritating foods

bull Spicy food should be eliminated (or at least significantly reduced) during this initial stage for approximately 2-4 months

bull Ideally eliminate alcohol completely for 2-4 months

bull Drinking alcohol even once a week while trying to heal your gut can make the healing process twice as long

Protocol Step 2 ndash test and eliminate pathogens

bull Identify pathogens and eliminate them ndash usually 3-6 months

bull If a digestive stool analysis identifies an infection such as a bacterial imbalance or yeast infection

ndash supplement with probiotics

ndash consider other supplements specific to eliminating bacteria (oregano oil garlic)

ndash support immune function (zinc antioxidants fermented foods)

ndash reduce sugar in the diet

bull Bacterial infections such as H pylori may require medical attention from a doctor and medication

Protocol Step 2 ndash test and eliminate pathogens

bull If a parasite infection exists some may be eliminated with supplements 6 month course of

ndash goldenseal

ndash oregano oil

ndash probiotics

bull Support liver detoxification

bull Some stubborn parasites may require medical attention from a doctor and medication

Protocol Step 3 ndash feed your cells

bull After all aggravating foods have been eliminated from your diet it is important to concentrate on feeding the cells lining your digestive system

bull Cells lining the digestive tract require the amino acid glutamine to be able to replenish themselves

bull The powder form mixed with water is ideal to maximise exposure to cells if your digestive system is not strong enough to break down supplement tablets

Protocol Step 4 ndash control inflammation

bull Keep inflammation down in order to promote healing and reduce pain

bull To control inflammation consider anti-inflammatory foods

ndash vegetables

ndash oily fish (containing omega-3 EPA)

ndash foods rich in antioxidants

bull Limit intake of inflammatory foods

ndash grain fed meats (containing omega-6 AA)

ndash vegetable oils such as refined corn oil and sunflower oil

ndash refined carbohydrate foods such as sugar and white flour

Protocol Step 4 ndash control inflammation

bull The most potent anti-inflammatory supplement which may help to calm and soothe the gut lining is omega-3 EPA

bull 1000mg omega-3 EPA per day to have a therapeutic effect on reducing inflammation

bull The ratio of omega-6 AA to omega-3 EPA needs to be balanced eg 21 ratio

bull Omega-3 EPA produces anti-inflammatory eicosanoids

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

Stress and a leaky gut

bull Stress can increase stomach acid production

ndash often leading to gastritis ulcers

bull Stress may reduce ability to digest food by reducing production of digestive enzymes

bull Higher requirements for vitamins and minerals

Pathogens ndash yeast bacteria and parasites

bull Yeast infections such as candida albicans

bull Pathogenic bacterial infections

lack of beneficial bacteria

bull Parasites

bull Toxins produced by pathogens can cause

further damage

Alcohol

bull Drinking alcohol in excess ie more than

approximately 3 units in one day

can cause significant irritation to an already permeable gut

bull Alcohol is inflammatory and therefore is only going to make the situation worse

bull 2-3 units of alcohol may not cause any issue to someone with a healthy gut lining but for someone with a permeable gut lining alcohol can be very aggravating

Medication

bull Well known irritants of the bowel lining

ndash aspirin

ndash non-steroidal anti-inflammatory drugs

(nSAIDs) such as ibuprofen

bull These medications may cause inflammation of a particular area of the bowel which may result in ulcers or a permeable gut lining

bull Antibiotics wipe out beneficial bacteria and therefore may result in infections following treatment

bull Birth control pill

Diagnosing a leaky gut ndash symptoms

bull Recognise digestive symptoms relating to a leaky gut

ndash bloating

ndash diarrhoea

ndash pain

ndash stomach cramps after eating

ndash feeling of lsquosensitivityrsquo to certain foods such as bread

bull Also consider other symptoms

ndash sinusitis

ndash eczema

ndash migraines

ndash joint pains

ndashchronic fatigue

Diagnosing a leaky gut ndash tests

bull A digestive stool analysis can test secretory IgA (Immunoglobulin A) levels

bull IgA is an antibody used by the immune system to identify and fight off unwanted objects such as infectious bacteria this specific type of antibody is produced in mucosal linings (the gut wall)

bull As unwanted undigested food particles may pass through the gut lining an immune reaction involving high levels of IgA antibodies may suggest a permeable gut lining

bull Test for food intolerances if IgG antibodies are produced a leaky gut is very likely

Protocol Step 1 ndash eliminate irritating foods

bull Identify any irritating foods and eliminate these from the diet

bull Gluten is the most common culprit although many other foods ndash such as peanuts beans and lentils ndash can also cause problems in some individuals

bull If a food intolerance test has been carried out

ndash eliminate these foods temporarily only while concentrating on healing the gut

ndash intolerances to several foods are likely to develop over time

ndash simply cutting these foods out is not going to address the cause

ndash once the gut is properly healed these intolerances should

disappear

Protocol Step 1 ndash eliminate irritating foods

bull Spicy food should be eliminated (or at least significantly reduced) during this initial stage for approximately 2-4 months

bull Ideally eliminate alcohol completely for 2-4 months

bull Drinking alcohol even once a week while trying to heal your gut can make the healing process twice as long

Protocol Step 2 ndash test and eliminate pathogens

bull Identify pathogens and eliminate them ndash usually 3-6 months

bull If a digestive stool analysis identifies an infection such as a bacterial imbalance or yeast infection

ndash supplement with probiotics

ndash consider other supplements specific to eliminating bacteria (oregano oil garlic)

ndash support immune function (zinc antioxidants fermented foods)

ndash reduce sugar in the diet

bull Bacterial infections such as H pylori may require medical attention from a doctor and medication

Protocol Step 2 ndash test and eliminate pathogens

bull If a parasite infection exists some may be eliminated with supplements 6 month course of

ndash goldenseal

ndash oregano oil

ndash probiotics

bull Support liver detoxification

bull Some stubborn parasites may require medical attention from a doctor and medication

Protocol Step 3 ndash feed your cells

bull After all aggravating foods have been eliminated from your diet it is important to concentrate on feeding the cells lining your digestive system

bull Cells lining the digestive tract require the amino acid glutamine to be able to replenish themselves

bull The powder form mixed with water is ideal to maximise exposure to cells if your digestive system is not strong enough to break down supplement tablets

Protocol Step 4 ndash control inflammation

bull Keep inflammation down in order to promote healing and reduce pain

bull To control inflammation consider anti-inflammatory foods

ndash vegetables

ndash oily fish (containing omega-3 EPA)

ndash foods rich in antioxidants

bull Limit intake of inflammatory foods

ndash grain fed meats (containing omega-6 AA)

ndash vegetable oils such as refined corn oil and sunflower oil

ndash refined carbohydrate foods such as sugar and white flour

Protocol Step 4 ndash control inflammation

bull The most potent anti-inflammatory supplement which may help to calm and soothe the gut lining is omega-3 EPA

bull 1000mg omega-3 EPA per day to have a therapeutic effect on reducing inflammation

bull The ratio of omega-6 AA to omega-3 EPA needs to be balanced eg 21 ratio

bull Omega-3 EPA produces anti-inflammatory eicosanoids

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

Pathogens ndash yeast bacteria and parasites

bull Yeast infections such as candida albicans

bull Pathogenic bacterial infections

lack of beneficial bacteria

bull Parasites

bull Toxins produced by pathogens can cause

further damage

Alcohol

bull Drinking alcohol in excess ie more than

approximately 3 units in one day

can cause significant irritation to an already permeable gut

bull Alcohol is inflammatory and therefore is only going to make the situation worse

bull 2-3 units of alcohol may not cause any issue to someone with a healthy gut lining but for someone with a permeable gut lining alcohol can be very aggravating

Medication

bull Well known irritants of the bowel lining

ndash aspirin

ndash non-steroidal anti-inflammatory drugs

(nSAIDs) such as ibuprofen

bull These medications may cause inflammation of a particular area of the bowel which may result in ulcers or a permeable gut lining

bull Antibiotics wipe out beneficial bacteria and therefore may result in infections following treatment

bull Birth control pill

Diagnosing a leaky gut ndash symptoms

bull Recognise digestive symptoms relating to a leaky gut

ndash bloating

ndash diarrhoea

ndash pain

ndash stomach cramps after eating

ndash feeling of lsquosensitivityrsquo to certain foods such as bread

bull Also consider other symptoms

ndash sinusitis

ndash eczema

ndash migraines

ndash joint pains

ndashchronic fatigue

Diagnosing a leaky gut ndash tests

bull A digestive stool analysis can test secretory IgA (Immunoglobulin A) levels

bull IgA is an antibody used by the immune system to identify and fight off unwanted objects such as infectious bacteria this specific type of antibody is produced in mucosal linings (the gut wall)

bull As unwanted undigested food particles may pass through the gut lining an immune reaction involving high levels of IgA antibodies may suggest a permeable gut lining

bull Test for food intolerances if IgG antibodies are produced a leaky gut is very likely

Protocol Step 1 ndash eliminate irritating foods

bull Identify any irritating foods and eliminate these from the diet

bull Gluten is the most common culprit although many other foods ndash such as peanuts beans and lentils ndash can also cause problems in some individuals

bull If a food intolerance test has been carried out

ndash eliminate these foods temporarily only while concentrating on healing the gut

ndash intolerances to several foods are likely to develop over time

ndash simply cutting these foods out is not going to address the cause

ndash once the gut is properly healed these intolerances should

disappear

Protocol Step 1 ndash eliminate irritating foods

bull Spicy food should be eliminated (or at least significantly reduced) during this initial stage for approximately 2-4 months

bull Ideally eliminate alcohol completely for 2-4 months

bull Drinking alcohol even once a week while trying to heal your gut can make the healing process twice as long

Protocol Step 2 ndash test and eliminate pathogens

bull Identify pathogens and eliminate them ndash usually 3-6 months

bull If a digestive stool analysis identifies an infection such as a bacterial imbalance or yeast infection

ndash supplement with probiotics

ndash consider other supplements specific to eliminating bacteria (oregano oil garlic)

ndash support immune function (zinc antioxidants fermented foods)

ndash reduce sugar in the diet

bull Bacterial infections such as H pylori may require medical attention from a doctor and medication

Protocol Step 2 ndash test and eliminate pathogens

bull If a parasite infection exists some may be eliminated with supplements 6 month course of

ndash goldenseal

ndash oregano oil

ndash probiotics

bull Support liver detoxification

bull Some stubborn parasites may require medical attention from a doctor and medication

Protocol Step 3 ndash feed your cells

bull After all aggravating foods have been eliminated from your diet it is important to concentrate on feeding the cells lining your digestive system

bull Cells lining the digestive tract require the amino acid glutamine to be able to replenish themselves

bull The powder form mixed with water is ideal to maximise exposure to cells if your digestive system is not strong enough to break down supplement tablets

Protocol Step 4 ndash control inflammation

bull Keep inflammation down in order to promote healing and reduce pain

bull To control inflammation consider anti-inflammatory foods

ndash vegetables

ndash oily fish (containing omega-3 EPA)

ndash foods rich in antioxidants

bull Limit intake of inflammatory foods

ndash grain fed meats (containing omega-6 AA)

ndash vegetable oils such as refined corn oil and sunflower oil

ndash refined carbohydrate foods such as sugar and white flour

Protocol Step 4 ndash control inflammation

bull The most potent anti-inflammatory supplement which may help to calm and soothe the gut lining is omega-3 EPA

bull 1000mg omega-3 EPA per day to have a therapeutic effect on reducing inflammation

bull The ratio of omega-6 AA to omega-3 EPA needs to be balanced eg 21 ratio

bull Omega-3 EPA produces anti-inflammatory eicosanoids

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

Alcohol

bull Drinking alcohol in excess ie more than

approximately 3 units in one day

can cause significant irritation to an already permeable gut

bull Alcohol is inflammatory and therefore is only going to make the situation worse

bull 2-3 units of alcohol may not cause any issue to someone with a healthy gut lining but for someone with a permeable gut lining alcohol can be very aggravating

Medication

bull Well known irritants of the bowel lining

ndash aspirin

ndash non-steroidal anti-inflammatory drugs

(nSAIDs) such as ibuprofen

bull These medications may cause inflammation of a particular area of the bowel which may result in ulcers or a permeable gut lining

bull Antibiotics wipe out beneficial bacteria and therefore may result in infections following treatment

bull Birth control pill

Diagnosing a leaky gut ndash symptoms

bull Recognise digestive symptoms relating to a leaky gut

ndash bloating

ndash diarrhoea

ndash pain

ndash stomach cramps after eating

ndash feeling of lsquosensitivityrsquo to certain foods such as bread

bull Also consider other symptoms

ndash sinusitis

ndash eczema

ndash migraines

ndash joint pains

ndashchronic fatigue

Diagnosing a leaky gut ndash tests

bull A digestive stool analysis can test secretory IgA (Immunoglobulin A) levels

bull IgA is an antibody used by the immune system to identify and fight off unwanted objects such as infectious bacteria this specific type of antibody is produced in mucosal linings (the gut wall)

bull As unwanted undigested food particles may pass through the gut lining an immune reaction involving high levels of IgA antibodies may suggest a permeable gut lining

bull Test for food intolerances if IgG antibodies are produced a leaky gut is very likely

Protocol Step 1 ndash eliminate irritating foods

bull Identify any irritating foods and eliminate these from the diet

bull Gluten is the most common culprit although many other foods ndash such as peanuts beans and lentils ndash can also cause problems in some individuals

bull If a food intolerance test has been carried out

ndash eliminate these foods temporarily only while concentrating on healing the gut

ndash intolerances to several foods are likely to develop over time

ndash simply cutting these foods out is not going to address the cause

ndash once the gut is properly healed these intolerances should

disappear

Protocol Step 1 ndash eliminate irritating foods

bull Spicy food should be eliminated (or at least significantly reduced) during this initial stage for approximately 2-4 months

bull Ideally eliminate alcohol completely for 2-4 months

bull Drinking alcohol even once a week while trying to heal your gut can make the healing process twice as long

Protocol Step 2 ndash test and eliminate pathogens

bull Identify pathogens and eliminate them ndash usually 3-6 months

bull If a digestive stool analysis identifies an infection such as a bacterial imbalance or yeast infection

ndash supplement with probiotics

ndash consider other supplements specific to eliminating bacteria (oregano oil garlic)

ndash support immune function (zinc antioxidants fermented foods)

ndash reduce sugar in the diet

bull Bacterial infections such as H pylori may require medical attention from a doctor and medication

Protocol Step 2 ndash test and eliminate pathogens

bull If a parasite infection exists some may be eliminated with supplements 6 month course of

ndash goldenseal

ndash oregano oil

ndash probiotics

bull Support liver detoxification

bull Some stubborn parasites may require medical attention from a doctor and medication

Protocol Step 3 ndash feed your cells

bull After all aggravating foods have been eliminated from your diet it is important to concentrate on feeding the cells lining your digestive system

bull Cells lining the digestive tract require the amino acid glutamine to be able to replenish themselves

bull The powder form mixed with water is ideal to maximise exposure to cells if your digestive system is not strong enough to break down supplement tablets

Protocol Step 4 ndash control inflammation

bull Keep inflammation down in order to promote healing and reduce pain

bull To control inflammation consider anti-inflammatory foods

ndash vegetables

ndash oily fish (containing omega-3 EPA)

ndash foods rich in antioxidants

bull Limit intake of inflammatory foods

ndash grain fed meats (containing omega-6 AA)

ndash vegetable oils such as refined corn oil and sunflower oil

ndash refined carbohydrate foods such as sugar and white flour

Protocol Step 4 ndash control inflammation

bull The most potent anti-inflammatory supplement which may help to calm and soothe the gut lining is omega-3 EPA

bull 1000mg omega-3 EPA per day to have a therapeutic effect on reducing inflammation

bull The ratio of omega-6 AA to omega-3 EPA needs to be balanced eg 21 ratio

bull Omega-3 EPA produces anti-inflammatory eicosanoids

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

Medication

bull Well known irritants of the bowel lining

ndash aspirin

ndash non-steroidal anti-inflammatory drugs

(nSAIDs) such as ibuprofen

bull These medications may cause inflammation of a particular area of the bowel which may result in ulcers or a permeable gut lining

bull Antibiotics wipe out beneficial bacteria and therefore may result in infections following treatment

bull Birth control pill

Diagnosing a leaky gut ndash symptoms

bull Recognise digestive symptoms relating to a leaky gut

ndash bloating

ndash diarrhoea

ndash pain

ndash stomach cramps after eating

ndash feeling of lsquosensitivityrsquo to certain foods such as bread

bull Also consider other symptoms

ndash sinusitis

ndash eczema

ndash migraines

ndash joint pains

ndashchronic fatigue

Diagnosing a leaky gut ndash tests

bull A digestive stool analysis can test secretory IgA (Immunoglobulin A) levels

bull IgA is an antibody used by the immune system to identify and fight off unwanted objects such as infectious bacteria this specific type of antibody is produced in mucosal linings (the gut wall)

bull As unwanted undigested food particles may pass through the gut lining an immune reaction involving high levels of IgA antibodies may suggest a permeable gut lining

bull Test for food intolerances if IgG antibodies are produced a leaky gut is very likely

Protocol Step 1 ndash eliminate irritating foods

bull Identify any irritating foods and eliminate these from the diet

bull Gluten is the most common culprit although many other foods ndash such as peanuts beans and lentils ndash can also cause problems in some individuals

bull If a food intolerance test has been carried out

ndash eliminate these foods temporarily only while concentrating on healing the gut

ndash intolerances to several foods are likely to develop over time

ndash simply cutting these foods out is not going to address the cause

ndash once the gut is properly healed these intolerances should

disappear

Protocol Step 1 ndash eliminate irritating foods

bull Spicy food should be eliminated (or at least significantly reduced) during this initial stage for approximately 2-4 months

bull Ideally eliminate alcohol completely for 2-4 months

bull Drinking alcohol even once a week while trying to heal your gut can make the healing process twice as long

Protocol Step 2 ndash test and eliminate pathogens

bull Identify pathogens and eliminate them ndash usually 3-6 months

bull If a digestive stool analysis identifies an infection such as a bacterial imbalance or yeast infection

ndash supplement with probiotics

ndash consider other supplements specific to eliminating bacteria (oregano oil garlic)

ndash support immune function (zinc antioxidants fermented foods)

ndash reduce sugar in the diet

bull Bacterial infections such as H pylori may require medical attention from a doctor and medication

Protocol Step 2 ndash test and eliminate pathogens

bull If a parasite infection exists some may be eliminated with supplements 6 month course of

ndash goldenseal

ndash oregano oil

ndash probiotics

bull Support liver detoxification

bull Some stubborn parasites may require medical attention from a doctor and medication

Protocol Step 3 ndash feed your cells

bull After all aggravating foods have been eliminated from your diet it is important to concentrate on feeding the cells lining your digestive system

bull Cells lining the digestive tract require the amino acid glutamine to be able to replenish themselves

bull The powder form mixed with water is ideal to maximise exposure to cells if your digestive system is not strong enough to break down supplement tablets

Protocol Step 4 ndash control inflammation

bull Keep inflammation down in order to promote healing and reduce pain

bull To control inflammation consider anti-inflammatory foods

ndash vegetables

ndash oily fish (containing omega-3 EPA)

ndash foods rich in antioxidants

bull Limit intake of inflammatory foods

ndash grain fed meats (containing omega-6 AA)

ndash vegetable oils such as refined corn oil and sunflower oil

ndash refined carbohydrate foods such as sugar and white flour

Protocol Step 4 ndash control inflammation

bull The most potent anti-inflammatory supplement which may help to calm and soothe the gut lining is omega-3 EPA

bull 1000mg omega-3 EPA per day to have a therapeutic effect on reducing inflammation

bull The ratio of omega-6 AA to omega-3 EPA needs to be balanced eg 21 ratio

bull Omega-3 EPA produces anti-inflammatory eicosanoids

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

Diagnosing a leaky gut ndash symptoms

bull Recognise digestive symptoms relating to a leaky gut

ndash bloating

ndash diarrhoea

ndash pain

ndash stomach cramps after eating

ndash feeling of lsquosensitivityrsquo to certain foods such as bread

bull Also consider other symptoms

ndash sinusitis

ndash eczema

ndash migraines

ndash joint pains

ndashchronic fatigue

Diagnosing a leaky gut ndash tests

bull A digestive stool analysis can test secretory IgA (Immunoglobulin A) levels

bull IgA is an antibody used by the immune system to identify and fight off unwanted objects such as infectious bacteria this specific type of antibody is produced in mucosal linings (the gut wall)

bull As unwanted undigested food particles may pass through the gut lining an immune reaction involving high levels of IgA antibodies may suggest a permeable gut lining

bull Test for food intolerances if IgG antibodies are produced a leaky gut is very likely

Protocol Step 1 ndash eliminate irritating foods

bull Identify any irritating foods and eliminate these from the diet

bull Gluten is the most common culprit although many other foods ndash such as peanuts beans and lentils ndash can also cause problems in some individuals

bull If a food intolerance test has been carried out

ndash eliminate these foods temporarily only while concentrating on healing the gut

ndash intolerances to several foods are likely to develop over time

ndash simply cutting these foods out is not going to address the cause

ndash once the gut is properly healed these intolerances should

disappear

Protocol Step 1 ndash eliminate irritating foods

bull Spicy food should be eliminated (or at least significantly reduced) during this initial stage for approximately 2-4 months

bull Ideally eliminate alcohol completely for 2-4 months

bull Drinking alcohol even once a week while trying to heal your gut can make the healing process twice as long

Protocol Step 2 ndash test and eliminate pathogens

bull Identify pathogens and eliminate them ndash usually 3-6 months

bull If a digestive stool analysis identifies an infection such as a bacterial imbalance or yeast infection

ndash supplement with probiotics

ndash consider other supplements specific to eliminating bacteria (oregano oil garlic)

ndash support immune function (zinc antioxidants fermented foods)

ndash reduce sugar in the diet

bull Bacterial infections such as H pylori may require medical attention from a doctor and medication

Protocol Step 2 ndash test and eliminate pathogens

bull If a parasite infection exists some may be eliminated with supplements 6 month course of

ndash goldenseal

ndash oregano oil

ndash probiotics

bull Support liver detoxification

bull Some stubborn parasites may require medical attention from a doctor and medication

Protocol Step 3 ndash feed your cells

bull After all aggravating foods have been eliminated from your diet it is important to concentrate on feeding the cells lining your digestive system

bull Cells lining the digestive tract require the amino acid glutamine to be able to replenish themselves

bull The powder form mixed with water is ideal to maximise exposure to cells if your digestive system is not strong enough to break down supplement tablets

Protocol Step 4 ndash control inflammation

bull Keep inflammation down in order to promote healing and reduce pain

bull To control inflammation consider anti-inflammatory foods

ndash vegetables

ndash oily fish (containing omega-3 EPA)

ndash foods rich in antioxidants

bull Limit intake of inflammatory foods

ndash grain fed meats (containing omega-6 AA)

ndash vegetable oils such as refined corn oil and sunflower oil

ndash refined carbohydrate foods such as sugar and white flour

Protocol Step 4 ndash control inflammation

bull The most potent anti-inflammatory supplement which may help to calm and soothe the gut lining is omega-3 EPA

bull 1000mg omega-3 EPA per day to have a therapeutic effect on reducing inflammation

bull The ratio of omega-6 AA to omega-3 EPA needs to be balanced eg 21 ratio

bull Omega-3 EPA produces anti-inflammatory eicosanoids

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

Diagnosing a leaky gut ndash tests

bull A digestive stool analysis can test secretory IgA (Immunoglobulin A) levels

bull IgA is an antibody used by the immune system to identify and fight off unwanted objects such as infectious bacteria this specific type of antibody is produced in mucosal linings (the gut wall)

bull As unwanted undigested food particles may pass through the gut lining an immune reaction involving high levels of IgA antibodies may suggest a permeable gut lining

bull Test for food intolerances if IgG antibodies are produced a leaky gut is very likely

Protocol Step 1 ndash eliminate irritating foods

bull Identify any irritating foods and eliminate these from the diet

bull Gluten is the most common culprit although many other foods ndash such as peanuts beans and lentils ndash can also cause problems in some individuals

bull If a food intolerance test has been carried out

ndash eliminate these foods temporarily only while concentrating on healing the gut

ndash intolerances to several foods are likely to develop over time

ndash simply cutting these foods out is not going to address the cause

ndash once the gut is properly healed these intolerances should

disappear

Protocol Step 1 ndash eliminate irritating foods

bull Spicy food should be eliminated (or at least significantly reduced) during this initial stage for approximately 2-4 months

bull Ideally eliminate alcohol completely for 2-4 months

bull Drinking alcohol even once a week while trying to heal your gut can make the healing process twice as long

Protocol Step 2 ndash test and eliminate pathogens

bull Identify pathogens and eliminate them ndash usually 3-6 months

bull If a digestive stool analysis identifies an infection such as a bacterial imbalance or yeast infection

ndash supplement with probiotics

ndash consider other supplements specific to eliminating bacteria (oregano oil garlic)

ndash support immune function (zinc antioxidants fermented foods)

ndash reduce sugar in the diet

bull Bacterial infections such as H pylori may require medical attention from a doctor and medication

Protocol Step 2 ndash test and eliminate pathogens

bull If a parasite infection exists some may be eliminated with supplements 6 month course of

ndash goldenseal

ndash oregano oil

ndash probiotics

bull Support liver detoxification

bull Some stubborn parasites may require medical attention from a doctor and medication

Protocol Step 3 ndash feed your cells

bull After all aggravating foods have been eliminated from your diet it is important to concentrate on feeding the cells lining your digestive system

bull Cells lining the digestive tract require the amino acid glutamine to be able to replenish themselves

bull The powder form mixed with water is ideal to maximise exposure to cells if your digestive system is not strong enough to break down supplement tablets

Protocol Step 4 ndash control inflammation

bull Keep inflammation down in order to promote healing and reduce pain

bull To control inflammation consider anti-inflammatory foods

ndash vegetables

ndash oily fish (containing omega-3 EPA)

ndash foods rich in antioxidants

bull Limit intake of inflammatory foods

ndash grain fed meats (containing omega-6 AA)

ndash vegetable oils such as refined corn oil and sunflower oil

ndash refined carbohydrate foods such as sugar and white flour

Protocol Step 4 ndash control inflammation

bull The most potent anti-inflammatory supplement which may help to calm and soothe the gut lining is omega-3 EPA

bull 1000mg omega-3 EPA per day to have a therapeutic effect on reducing inflammation

bull The ratio of omega-6 AA to omega-3 EPA needs to be balanced eg 21 ratio

bull Omega-3 EPA produces anti-inflammatory eicosanoids

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

Protocol Step 1 ndash eliminate irritating foods

bull Identify any irritating foods and eliminate these from the diet

bull Gluten is the most common culprit although many other foods ndash such as peanuts beans and lentils ndash can also cause problems in some individuals

bull If a food intolerance test has been carried out

ndash eliminate these foods temporarily only while concentrating on healing the gut

ndash intolerances to several foods are likely to develop over time

ndash simply cutting these foods out is not going to address the cause

ndash once the gut is properly healed these intolerances should

disappear

Protocol Step 1 ndash eliminate irritating foods

bull Spicy food should be eliminated (or at least significantly reduced) during this initial stage for approximately 2-4 months

bull Ideally eliminate alcohol completely for 2-4 months

bull Drinking alcohol even once a week while trying to heal your gut can make the healing process twice as long

Protocol Step 2 ndash test and eliminate pathogens

bull Identify pathogens and eliminate them ndash usually 3-6 months

bull If a digestive stool analysis identifies an infection such as a bacterial imbalance or yeast infection

ndash supplement with probiotics

ndash consider other supplements specific to eliminating bacteria (oregano oil garlic)

ndash support immune function (zinc antioxidants fermented foods)

ndash reduce sugar in the diet

bull Bacterial infections such as H pylori may require medical attention from a doctor and medication

Protocol Step 2 ndash test and eliminate pathogens

bull If a parasite infection exists some may be eliminated with supplements 6 month course of

ndash goldenseal

ndash oregano oil

ndash probiotics

bull Support liver detoxification

bull Some stubborn parasites may require medical attention from a doctor and medication

Protocol Step 3 ndash feed your cells

bull After all aggravating foods have been eliminated from your diet it is important to concentrate on feeding the cells lining your digestive system

bull Cells lining the digestive tract require the amino acid glutamine to be able to replenish themselves

bull The powder form mixed with water is ideal to maximise exposure to cells if your digestive system is not strong enough to break down supplement tablets

Protocol Step 4 ndash control inflammation

bull Keep inflammation down in order to promote healing and reduce pain

bull To control inflammation consider anti-inflammatory foods

ndash vegetables

ndash oily fish (containing omega-3 EPA)

ndash foods rich in antioxidants

bull Limit intake of inflammatory foods

ndash grain fed meats (containing omega-6 AA)

ndash vegetable oils such as refined corn oil and sunflower oil

ndash refined carbohydrate foods such as sugar and white flour

Protocol Step 4 ndash control inflammation

bull The most potent anti-inflammatory supplement which may help to calm and soothe the gut lining is omega-3 EPA

bull 1000mg omega-3 EPA per day to have a therapeutic effect on reducing inflammation

bull The ratio of omega-6 AA to omega-3 EPA needs to be balanced eg 21 ratio

bull Omega-3 EPA produces anti-inflammatory eicosanoids

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

Protocol Step 1 ndash eliminate irritating foods

bull Spicy food should be eliminated (or at least significantly reduced) during this initial stage for approximately 2-4 months

bull Ideally eliminate alcohol completely for 2-4 months

bull Drinking alcohol even once a week while trying to heal your gut can make the healing process twice as long

Protocol Step 2 ndash test and eliminate pathogens

bull Identify pathogens and eliminate them ndash usually 3-6 months

bull If a digestive stool analysis identifies an infection such as a bacterial imbalance or yeast infection

ndash supplement with probiotics

ndash consider other supplements specific to eliminating bacteria (oregano oil garlic)

ndash support immune function (zinc antioxidants fermented foods)

ndash reduce sugar in the diet

bull Bacterial infections such as H pylori may require medical attention from a doctor and medication

Protocol Step 2 ndash test and eliminate pathogens

bull If a parasite infection exists some may be eliminated with supplements 6 month course of

ndash goldenseal

ndash oregano oil

ndash probiotics

bull Support liver detoxification

bull Some stubborn parasites may require medical attention from a doctor and medication

Protocol Step 3 ndash feed your cells

bull After all aggravating foods have been eliminated from your diet it is important to concentrate on feeding the cells lining your digestive system

bull Cells lining the digestive tract require the amino acid glutamine to be able to replenish themselves

bull The powder form mixed with water is ideal to maximise exposure to cells if your digestive system is not strong enough to break down supplement tablets

Protocol Step 4 ndash control inflammation

bull Keep inflammation down in order to promote healing and reduce pain

bull To control inflammation consider anti-inflammatory foods

ndash vegetables

ndash oily fish (containing omega-3 EPA)

ndash foods rich in antioxidants

bull Limit intake of inflammatory foods

ndash grain fed meats (containing omega-6 AA)

ndash vegetable oils such as refined corn oil and sunflower oil

ndash refined carbohydrate foods such as sugar and white flour

Protocol Step 4 ndash control inflammation

bull The most potent anti-inflammatory supplement which may help to calm and soothe the gut lining is omega-3 EPA

bull 1000mg omega-3 EPA per day to have a therapeutic effect on reducing inflammation

bull The ratio of omega-6 AA to omega-3 EPA needs to be balanced eg 21 ratio

bull Omega-3 EPA produces anti-inflammatory eicosanoids

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

Protocol Step 2 ndash test and eliminate pathogens

bull Identify pathogens and eliminate them ndash usually 3-6 months

bull If a digestive stool analysis identifies an infection such as a bacterial imbalance or yeast infection

ndash supplement with probiotics

ndash consider other supplements specific to eliminating bacteria (oregano oil garlic)

ndash support immune function (zinc antioxidants fermented foods)

ndash reduce sugar in the diet

bull Bacterial infections such as H pylori may require medical attention from a doctor and medication

Protocol Step 2 ndash test and eliminate pathogens

bull If a parasite infection exists some may be eliminated with supplements 6 month course of

ndash goldenseal

ndash oregano oil

ndash probiotics

bull Support liver detoxification

bull Some stubborn parasites may require medical attention from a doctor and medication

Protocol Step 3 ndash feed your cells

bull After all aggravating foods have been eliminated from your diet it is important to concentrate on feeding the cells lining your digestive system

bull Cells lining the digestive tract require the amino acid glutamine to be able to replenish themselves

bull The powder form mixed with water is ideal to maximise exposure to cells if your digestive system is not strong enough to break down supplement tablets

Protocol Step 4 ndash control inflammation

bull Keep inflammation down in order to promote healing and reduce pain

bull To control inflammation consider anti-inflammatory foods

ndash vegetables

ndash oily fish (containing omega-3 EPA)

ndash foods rich in antioxidants

bull Limit intake of inflammatory foods

ndash grain fed meats (containing omega-6 AA)

ndash vegetable oils such as refined corn oil and sunflower oil

ndash refined carbohydrate foods such as sugar and white flour

Protocol Step 4 ndash control inflammation

bull The most potent anti-inflammatory supplement which may help to calm and soothe the gut lining is omega-3 EPA

bull 1000mg omega-3 EPA per day to have a therapeutic effect on reducing inflammation

bull The ratio of omega-6 AA to omega-3 EPA needs to be balanced eg 21 ratio

bull Omega-3 EPA produces anti-inflammatory eicosanoids

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

Protocol Step 2 ndash test and eliminate pathogens

bull If a parasite infection exists some may be eliminated with supplements 6 month course of

ndash goldenseal

ndash oregano oil

ndash probiotics

bull Support liver detoxification

bull Some stubborn parasites may require medical attention from a doctor and medication

Protocol Step 3 ndash feed your cells

bull After all aggravating foods have been eliminated from your diet it is important to concentrate on feeding the cells lining your digestive system

bull Cells lining the digestive tract require the amino acid glutamine to be able to replenish themselves

bull The powder form mixed with water is ideal to maximise exposure to cells if your digestive system is not strong enough to break down supplement tablets

Protocol Step 4 ndash control inflammation

bull Keep inflammation down in order to promote healing and reduce pain

bull To control inflammation consider anti-inflammatory foods

ndash vegetables

ndash oily fish (containing omega-3 EPA)

ndash foods rich in antioxidants

bull Limit intake of inflammatory foods

ndash grain fed meats (containing omega-6 AA)

ndash vegetable oils such as refined corn oil and sunflower oil

ndash refined carbohydrate foods such as sugar and white flour

Protocol Step 4 ndash control inflammation

bull The most potent anti-inflammatory supplement which may help to calm and soothe the gut lining is omega-3 EPA

bull 1000mg omega-3 EPA per day to have a therapeutic effect on reducing inflammation

bull The ratio of omega-6 AA to omega-3 EPA needs to be balanced eg 21 ratio

bull Omega-3 EPA produces anti-inflammatory eicosanoids

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

Protocol Step 3 ndash feed your cells

bull After all aggravating foods have been eliminated from your diet it is important to concentrate on feeding the cells lining your digestive system

bull Cells lining the digestive tract require the amino acid glutamine to be able to replenish themselves

bull The powder form mixed with water is ideal to maximise exposure to cells if your digestive system is not strong enough to break down supplement tablets

Protocol Step 4 ndash control inflammation

bull Keep inflammation down in order to promote healing and reduce pain

bull To control inflammation consider anti-inflammatory foods

ndash vegetables

ndash oily fish (containing omega-3 EPA)

ndash foods rich in antioxidants

bull Limit intake of inflammatory foods

ndash grain fed meats (containing omega-6 AA)

ndash vegetable oils such as refined corn oil and sunflower oil

ndash refined carbohydrate foods such as sugar and white flour

Protocol Step 4 ndash control inflammation

bull The most potent anti-inflammatory supplement which may help to calm and soothe the gut lining is omega-3 EPA

bull 1000mg omega-3 EPA per day to have a therapeutic effect on reducing inflammation

bull The ratio of omega-6 AA to omega-3 EPA needs to be balanced eg 21 ratio

bull Omega-3 EPA produces anti-inflammatory eicosanoids

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

Protocol Step 4 ndash control inflammation

bull Keep inflammation down in order to promote healing and reduce pain

bull To control inflammation consider anti-inflammatory foods

ndash vegetables

ndash oily fish (containing omega-3 EPA)

ndash foods rich in antioxidants

bull Limit intake of inflammatory foods

ndash grain fed meats (containing omega-6 AA)

ndash vegetable oils such as refined corn oil and sunflower oil

ndash refined carbohydrate foods such as sugar and white flour

Protocol Step 4 ndash control inflammation

bull The most potent anti-inflammatory supplement which may help to calm and soothe the gut lining is omega-3 EPA

bull 1000mg omega-3 EPA per day to have a therapeutic effect on reducing inflammation

bull The ratio of omega-6 AA to omega-3 EPA needs to be balanced eg 21 ratio

bull Omega-3 EPA produces anti-inflammatory eicosanoids

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

Protocol Step 4 ndash control inflammation

bull The most potent anti-inflammatory supplement which may help to calm and soothe the gut lining is omega-3 EPA

bull 1000mg omega-3 EPA per day to have a therapeutic effect on reducing inflammation

bull The ratio of omega-6 AA to omega-3 EPA needs to be balanced eg 21 ratio

bull Omega-3 EPA produces anti-inflammatory eicosanoids

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

Omega-3 EPA to control inflammationbull Pure EPA derived from wild anchovies sustainable source

bull Pharmepa Step 1 90 omega-3 EPA ndash 1000mg (added vitamin E)bull Pharmepa Step 2 80 omega-3 EPA ndash 640 mg GLA ndash 18mg

(added vitamins B5 D3 amp E)

bull Adherence to the regime for a minimum of 3 months is required for therapeutic outcomes

Directions for useAdults should take 1-2 (Pharmepa Step 1) or 2-4 (Pharmepa Step 2) capsules daily Take with food for optimal absorption

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

Omega-3 SDA to control inflammation

bull Vegetarian options - linseed algae hempseed

bull Echium seed oil (as Echiomega) is a source of the omega-3 fatty acids SDA (stearidonic acid) and ALA SDA is the precursor to EPA

bull 25-30 of SDA converts to EPA compared with just 5-8 of ALA ndash the principal omega-3 in most other plant-derived oils

bull Echiomega rich in SDA is the superior choice of omega-3 for vegetarians and vegans

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

Protocol Step 4 ndash control inflammationbull Aloe vera

ndash soothing properties

ndash anti-inflammatory

ndash healing properties

bull Liquorice

ndash soothing particularly to mucous irritations

ndash supports immune function

ndash use deglycyrrhizinated liquorice

bull Slippery elm

bull Marshmallow root

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

Long term digestive supportbull Chew food properly

bull Eat sufficient protein and omega-3 fatty acids

bull Limit intake of gluten

bull Manage stress

bull Include supplements on a regular basis where necessary

ndash Probiotics

ndash Digestive enzymes

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

References

bull Elamin E1 Jonkers D Juuti-Uusitalo K van Ijzendoorn S Troost F Duimel H Broers J Verheyen F Dekker JMasclee A (2012) Effects of ethanol and acetaldehyde on tight junction integrity in vitro study in a three dimensional intestinal epithelial cell culture model PLoS One 7(4)

bull Rapin JR1 Wiernsperger N (2010) Possible links between intestinal permeability and food processing A potential therapeutic niche for glutamine Clinics (Sao Paulo) 65(6)635-43

bull Suzuki T (2013) Regulation of intestinal epithelial permeability by tight junctions Cell Mol Life Sci 70(4)631-59

bull van der Hulst RR1 von Meyenfeldt MF Soeters PB (1996) Glutamine an essential amino acid for the gut Nutrition 12(11-12 Suppl)S78-81

bull Vazquez-Roque MI1 Camilleri M Smyrk T Murray JA Marietta E OrsquoNeill J Carlson P Lamsam J Janzow DEckert D Burton D Zinsmeister AR (2013) A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea effects on bowel frequency and intestinal function Gastroenterology 144(5)903-911

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educationigennuscom

Kyla Williams DipION BSc MScNutrition Technical Advisor

kylawigennuscom