When the gut ails, it leaks! The wall of the gut is our barrier to the world (to the ingested world, the digested world). The healthy gut does not let just anything pass through and into you.

Proteins are made up of dozens and dozens of amino acids. When we digest proteins we break them down first into "peptides" (small chains of amino acids), and then to their basic amino acids.

With a healthy gut, 99% of the proteins you ingest are absorbed as amino acids and about 1% are absorbed as peptides. The amino acids are available as building blocks.

With almost all serious gut disorders, Irritable Bowel Syndrome, Ulcerative Colitis, Candidiasis, you name it, the gut losses its "integrity" and becomes "leaky" to peptides. With any of these gut disorders perhaps 20% of protein will be absorbed as peptides, and that is a big problem. Peptides are antigens. They stimulate, or should I say "provoke", the immune system. And these peptides are bits of your food. So, with leaky gut you will start to develop multiple food sensitivities. And food sensitivities are just the sort of thing that will create leaky gut. A vicious circle.

What can you do about leaky gut. First you need to work out the foods to which you are sensitive and avoid them. Also, because of the likelihood of your developing sensitivities to anything to which you have a large exposure, a rotation diet is often needed. Many doctors recommend a four day rotation. My patients usually find a seven day rotation easier to organise. Avoid all processed foods and food additives. This is all a bother, but it is not forever. These problems can be healed.

Lactobacilus acidophilus, a "friendly" beneficial bacteria (it turns milk into buttermilk, cabbage into sourkraut), is very useful in re-establishing normal gut function. Nowaday we call this "probiotics" (cute).

Herbs can be very helpful. Plantain (rib grass/plantain major) is a great healer and very helpful, as too would be a "demulcent" like marshmellow. Gentle carminatives, like chamomile, can be mixed in there too.

Most of the major healing modalities, acupuncture, homeopathy, can be helpful, as indeed can many minor or obscure treatments. As always we are at the mercy of our intuition, our knowledge, and our luck.

The tests for leaky gut is to eat two harmless compounds that just pass through the body without being metabolised. One of these is normally absorbed to some extent and then excreted. The other is normally not absorbed, but with leaky gut it is, and can be measured in the urine. "Mannitol, a monosaccharide, is passively transported through intestinal epithelial cells; mean absorption is 14% of the administered dose (range 5-25%). In contrast, the intestinal tract is impermeable to lactulose, a disaccharide; less than 1% of the administered dose is normally absorbed. The differential excretion of lactulose and mannitol in urine is then measured. The normal ratio of lactulose/mannitol recovered in urine is less than 0.03." (This last from Leaky Gut Syndromes: Breaking the Vicious Cycle, Leo Galland www.healthy.net/asp/templates/article.asp?PageType=Article&ID=425 , which seems quite comprehensive.)