The 7 Primary Gut Dysfunctions
There are seven primary gut pathologies that I will cover in this article, and they underlie virtually all gut diseases, syndromes, and symptoms, from IBS to GERD to constipation to inflammatory bowel disease to hemorrhoids.
And this is where you’ll really need to focus your attention in order to heal the gut and deal with some of the system problems that arise from gut pathology.
So let’s look at each of these in a little more detail.
1. Low Stomach Acid (Hypochlorhydria & bile/enzyme insufficiency)
The stomach produces hydrochloric acid, which is stomach acid, and it serves three primary functions:
- The chemical breakdown of food
- The absorption of nutrients
- Protection against pathogens
Bile (stored within the gallbladder) and other digestive enzymes created by the pancreas also play a major role in the way our body is digesting and absorbing nutrients.
Bile helps us to break down fat and enzymes help us break down protein, fat, and carbohydrate. So if the secretion of hydrochloric acid or bile or enzymes or all of the above is impaired, then that’s going to lead to problems all the way down the digestive tract.
2. Small Intestinal Bacterial Overgrowth (SIBO)
A poor diet, low stomach acid, antibiotic use, acid-suppressing drugs, impaired function of the migrating motor complex (MMC), constipation, gut infections, structural abnormalities of the GI tract, and immune dysfunction are all risk factors associated with small intestinal bacterial overgrowth.
This is a condition where you have overgrowth of bacteria in the small intestine, which then leads to several dysfunctions, including:
- decreased vitamin/mineral absorption (anemia, neuropathy, energetic problems, etc.)
- carbohydrate malabsorption
- excessive gas production (bloating, constipation, diarrhea)
- decreased fat absorption
- decreased protein absorption
- Intestinal permeability (leaky gut)
3. Infections (parasites, pathogenic bacteria, fungal overgrowth)
The world of parasites is interesting. To start, not everyone with the same parasite will have problems because of it. Ultimately, it simply depends on the individual’s current health status and immune function.
The primary risk factors of parasitic infections causing problems in your body include consuming contaminated food and water, increased use of
daycare centers, travel to developing countries, household pets, consumption of uncooked foods, antibiotic use, insect vectors, and sexual contact.
Symptoms are often general and nonspecific. They vary from fatigue and malaise to GI distress, diarrhea, and constipation to things like brain fog, sleep disturbance, or skin issues.
In addition, I have found that many patients don’t exhibit digestive symptoms but present with other cyclical symptoms because parasites have lifecycles that can influence their pathogenicity in the host.
So one red flag for parasitic infection is if someone feels relatively normal and then they feel really kind of rotten and then they feel normal again, and that
4. Dysbiosis (Imbalances in Good vs Bad bacteria)
Dysbiosis is a situation where there’s an underrepresentation of beneficial microbes and an overrepresentation of harmful microbes.
For example, Candida is a normal resident of the human gastrointestinal tract. However, Candida can become overrepresented when levels of beneficial microbes that protect against that colonization are low.
They have shown Candida colonization to promote low-level inflammation, delay healing of inflammatory lesions, and potentially elevate levels of pro-inflammatory cytokines like interleukin 17.
Overall host immune status and the body’s own ability to protect against unfavorable overgrowth also influence gut dysbiosis and fungal overgrowth.
Symptoms range from obvious things like gastrointestinal discomfort to less obvious symptoms like depression, anxiety, brain fog, ADHD, autism spectrum disorder, skin disease, neurological problems, etc.
5. Food Sensitivity & Intolerances
Most times, food intolerances are a consequence of other pathologies, such as disrupted gut microbiome, SIBO, or intestinal permeability.
However, food intolerances can also cause problems like intestinal permeability. Therefore, food intolerance needs to be addressed independently.
Individual food intolerances can be severe. Others may be less severe but cause chronic low-grade inflammation and intestinal permeability, which can then lead to antibody production in everything from the joints to the myelin sheath in the brain, and certainly over time can lead to more serious pathologies and disease.
One thing to know about food sensitivity or intolerance testing is that every single test is based on immune function. If your immune cells are low, the food sensitivity test may be inaccurate. In addition, if you have major gut infections, food sensitivity is going to be inaccurate.
6. Intestinal Permeability (Leaky Gut)
Respected researcher Dr. Alessio Fasano, who is well known for his discovery of zonulin, a protein that regulates tight junction permeability, believes that leaky gut is actually a precondition to developing autoimmunity, along with genetic vulnerability and environmental triggers.
He has argued that increased permeability of the intestinal barrier to macromolecules is associated with local and systemic inflammatory conditions, including, of course, celiac and non-celiac gluten sensitivity, food intolerances, IBD, many autoimmune diseases, neurological conditions like MS, cognitive dysfunction, behavioral disorders, skin conditions, and new connections that we’re discovering.
There are more than 80 different autoimmune diseases currently known.
Multiple sclerosis, type 1 diabetes, and rheumatoid arthritis all fall under this category, and even thyroid disorders are usually attributable to autoimmunity.
A variety of health factors likely play a role in these chronic illnesses, including the gut microbiome and intestinal permeability.
Risk factors include: Genetics, cigarette smoking, diet, physical inactivity, obesity, infections, antibiotics, NSAIDs, oral contraceptives, chronic stress, and sleep deprivation.