Leaky Gut Syndrome, Chinese Medicine & Functional Medicine: the Optimal Solution

June 16, 2010

By Mark Schwartz

The subject of this blog is entirely too complex and interesting to cover in 1 blog, however, know that I’ll be writing more about this in blogs to come so you can properly digest it.

As most of my patients know, I often light up upon the mention of food. As a feinschmecker equally passionate about Acupuncture & Chinese Herbs, this subject is particularly palatable as a specialty and well-suited for my background in Western Nutrition Science and my background in eating all kinds of stuff.

Digestive system diagram edit

Everyone knows vibrant health is contingent upon several factors: healthy exercise, diet, positive outlook, social interaction, and spiritual connectedness.  We can go for days, weeks, and unfortunately, even months without exercising or having meaningful community and spiritual connections.  We can be grumpy for years.  The eating piece though, most of us can’t go more than 4 hours before thinking about what is for lunch or dinner.  Starting here is convenient and can have a great impact.

Largely influenced by dietary habits, Leaky Gut Syndrome (LGS) is both common and complex.  Its manifestations and etiology cannot be limited to the simply the gastrointestinal (GI) system.  Like any syndrome or pattern in Chinese Medicine, it requires a more global understanding and system thinking (see previous blog, Chinese Med. 101…).  Besides the usual GI dysbiosis, gas, bloating, diarrhea, constipation and fatigue, symptoms can be neurological, dermatological, and even auto-immune in nature such as arthritis affecting the joints.

Jake Fratkin, O.M.D., L.Ac., has a number of great presentations and articles on this subject and on how to integrate TCM and functional medicine into treatment (see links below).  He states that about 50% of all chronic disease conditions are rooted in a Leaky Gut scenario.  This is a lot of people.

So what is Leaky Gut Syndrome?

Well to put it bluntly, it’s when your gut is out of whack and it starts leading to problems elsewhere in your body.  There could be dysbiosis.  Again, crudely, this means that the flora in your GI are out of balance.  There could be either too many of the bad bacteria, too few of the good bacteria, some combination of the 2, pathogenic parasites, yeast, etc. Repeated antibiotic use can often wreak this kind of intestinal havoc.   Maybe some uninvited parasite (candida albicans, cryptosporidium, giardia, etc.) is camping out in your breadbasket.  There could be insufficient enzymes to break down your food (lactase, proteases, etc.).  There could be a pH imbalance.  There could be inflammation (markers include CRP, WBC’s, Lactoferrin, etc.)  There could be food allergies (IgG4, S-IgA, IgE, Celiac’s, etc.).  There could be some nasty combination of all of the above where one causes and/or aggravates the other factor causing a chain reaction.  LGS could lead to anything from dermatitis, allergies, asthma, fatigue, eczema, to rheumatoid arthritis and that catch-all, one-size-fits-all Western diagnosis of “Irritable Bowel Syndrome.”  No matter exactly what type of symptoms and dysbiosis, one hallmark of LGS is impaired intestinal permeability.  This means that things that are not supposed to pass through into the body from the gut end up passing through.  This also means that things–nutrients– that are supposed to pass through from the gut, sometimes don’t.  Gone unchecked, this can lead to toxicities and deficiencies in the body.

What is Functional Medicine?

Functional Medicine embraces the holistic, Mind/Body, system-thinking approaches of CAM modalities, but approaches health and disease from a scientific, evidence-based perspective.  To quote Lord and Bralley in Laboratory Evaluations for Integrative and Functional Medicine, 2nd Ed., “with its science-based emphasis, functional medicine relies heavily on laboratory tests for identifying nutritional, biochemical, and metabolic imbalances underlying patient symptoms.”
In short, the Functional Medicine practitioner isn’t satisfied with treating symptoms, but rather seeks to correct the
underlying imbalance causing the symptom and/or set of symptoms (pattern).  This underlying imbalance may, at first glance, seem unrelated to the chief complaint.

Treatments?

Ever since Li Dong-Yuan wrote the Treatise on Spleen & Stomach (Pi Wei Lun) in 1249 CE (Yuan Dynasty), Chinese Medicine has had a pretty good handle on the gut, its global influence, and its therapeutic interventions: herbal formulas, acupuncture, and dietary therapy.Li-Dong-Yuan

In the last 10-15yrs or so, Functional Medicine has also been adept at zeroing in on specific gut imbalances and analyzing what may be driving those imbalances.  Specific interventions could include probiotic, prebiotic, and enzymatic supplements.  They could also include recommendations to simply chew food more.

A combination of Ancient Chinese Wisdom and Modern Functional Science-Based Medicine is, in my opinion, is the optimal solution.

I’ll give concrete examples in coming blogs.

In the meantime, occupy yourselves checking these out:

http://www.drjakefratkin.com/pdf/LeakyGutHandout.pdf

www.ei-resource.org/articles/leaky-gut-syndrome-articles/leaky-gut-syndrome:-a-modern-epidemic-part-ii/

Oscar Sierra, L.Ac.

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