How do we aim to treat Leaky Gut?

• Reduce - excessive alcohol, caffeine and highly refined foods

• Identify and remove food allergens/intolerances (eg low reactive diet)

• Fibre and SCFA's
  -Soluble fibre
  -SCFA's - butyrate is a fuel source of colonic epithelium which induces enzymes promoting mucosal cell restoration via TJ production.
  -Increase bowel motility by stimulating contractions
  -Increases growth of beneficial microflora via decreasing colonic pH
  -Stimulates epithelial mucous secretion

• Prebiotics - eg: FOS, inulin, wheat, honey beer, onion, rye, asparagus, artichoke, chicory root, banana, and oats all increase beneficial microflora and SCFA production

• Glutamine - is a fuel source (mainly for small intestine enterocytes) and it is converted to glutamate - alpha ketoglutarate which is used in krebs cycle to make ATP.
  Glutamine is also a precursor for glutathione (with cysteine and glycine) - antioxidant, anti inflammatory and detoxification
  It is also a precursor for glucosamine - mucin - protective mucus layer in the gut
  It also increases slgA - protects against adherence of microbes

• Zinc: Improves paracellular barrier function - synthesis and regulation of expression of TJ proteins. Deficiency of zinc exacerbates permeability due to inflammation.

• Vitamin A- Works as an antioxidant, improves immune function, epithelial barrier integrity, growth and differenctiation of epithelial cells, synthesis of tight gap junctions. Vitamin A is found in red meat, eggs, dairy, plant sources of beta carotene.

• Fish oil/Omega 3 - Support barrier integrity by decreasing inflammatory eicosandids and cytokines

• Probiotics - to increase epithelial barrier function
  - Potential mechanisms - change composition of the microbata, reduce pathogenic microbes, ferment fiber to produce SCFA's to support intestinal barrier function, refulation expression of TJ proteins, decrease detrimental effects of inflammatory cytokines on epithelial lining, increase protective mucous production, regulate immune function

• Fermented foods