Intestinal Permeability

How Do You Treat Leaky Gut in Your Clinic?

By Jenn Gibbons, MSTOM, LAc

The digestive tract functions as an intermediary between the body and the external environment, taking in what it needs and expelling what it does not. To begin with, chewing food in the mouth cues the stomach to increase its production of stomach acid, which not only kills potential pathogens but also prompts the cascade of events that properly assimilates the incoming macronutrients. The pancreas then secretes enzymes and the gall bladder secretes bile such that the food is broken down into an absorbable form. Absorption takes place through the single layer wall of the small intestine, which becomes permeable and allows these nutrients to pass into our bloodstream. The unabsorbed matter continues to move further into the large intestine as either food for the microbiome or waste product to be removed. If this intestinal layer is compromised, it will become hyper-permeable and allow contents to leak into the blood. So what causes this layer to leak? Anything that goes wrong above or below this absorption site can contribute to hyper-permeability. When nutrient-poor food is ingested, the body expends a lot of energy with little gain. Over time, this can lead to nutrient deficiencies and the overfeed-ing of the gut bacteria. When the bacteria in the upper gut are overfed, a reduction in the stomach acid can occur, thus impairing the release of enzymes and bile necessary to properly assimilate nutrients for absorption. When the food then arrives at the absorption site and is not broken down sufficiently, it will not be absorbed. Rather, it will move into the large intestine and become food for the microbiome, thus leading to further bacterial overgrowth. Bacterial overgrowth in the small intestine (SIBO) is often the cause of upper abdominal gas that can cause bloating, belching, reflux, pain and impaired nutrient absorption.

This distention often interferes with normal peristalsis and impairs the function of the migrating-motor-complex, which handles the clearing of food fragments that remain in the upper gut. If these fragments do remain, they are fermented by local bacteria, thereby creating more gas. This can interfere with normal bowel movements and lead to constipation or diarrhea. Bacterial overgrowth in the large intestine, or dysbiosis, is often the cause of lower abdominal gas that can also lead to bloating, pain, flatulence, and bowel irregularities.

The pressure along the digestive tract is enough to increase the permeability of the absorption site but this barrier also does have a regulator. The protein zonulin modulates the opening and closing of the tight junctions at the absorption site, controlling how permeable it is. Based on research by Dr. Alessio Fasano, SIBO and dysbiosis stimulate the production of zonulin, which increases intestinal permeability.1 Gluten, one of the most commonly consumed nutrient-poor food additives also stimulates zonulin. Dr. Fasano reports that gluten causes intestinal permeability in all of us, since humans lack the enzymes necessary to fully assimilate it. He also explains that these undigested gluten fragments are perceived as an enemy by the immune system and that if a person has a certain genetic predisposition, they may develop celiac disease as a result of overconsumption. Comprehensive stool analysis tests such as the GI Map from Diagnostic Solutions can determine zonulin status. Food sensitivity labs such as KBMO and Cyrex Labs can also test for a patient’s sensitivity to gluten. In addition, human leukocyte allele testing for celiac disease (HLA-DQ) can be performed to assess genetic risk. Regardless of the result, a functional medicine practitioner is likely to advise their patient to optimize repair by adhering to the following points:

• prioritize eight hours of quality sleep

• avoid unnecessary stress

• improve your mood

• avoid an excess of either sedentary activities or strenuous overtraining

• and eat a nutrient-dense, anti-inflammatory diet that excludes acellular carbohydrates, added sugar, gluten, and any known food sensitivities.

They would also likely order both a SIBO breath test to determine whether or not there is bacterial overgrowth in the upper gut and a comprehensive stool analysis to see if there is a gut infection. This also can determine the state of the patient’s microbiome and indicate how well they absorb their nutrients. Also, a thorough diet history and nutritional lab testing are useful to determine potential nutrient deficiencies. In addition to treatment based on the lab tests, they will often recommend that the patient optimize their stomach’s acidity by completing what is known as the “hydrochloric acid challenge” using betaine HCl with digestive enzymes. This not only protects the patient from potential pathogens but also helps to improve digestive function and thereby absorption. In addition to advising on sleep, stress, movement and diet, Chinese medicine practitioners may also differentiate the patient’s pattern of disharmony, which allows them to further personalize their patient’s treatment plan. Reflecting on the different presentations above, a patient might present with Excess in the Stomach, Small Intestine, or Large Intestine. This Excess may impede the descending function of Stomach qi, causing Counterflow. It may also back up the Liver and Gall Bladder, creating Stagnation of qi and Blood. Patients often turn to antacids or proton-pump inhibitors to reduce their Stomach-Counterflow symptoms. This anchors the ascension, but it also reduces digestive strength and invites Cold. When dysbiosis is present, the Liver may be burdened with increased toxicity causing qi Stagnation and Heat. The increase in pressure and Heat throughout the digestive tract can burn off fluids reducing precious yin. The reduction in digestive function and nutrients can lead to deficiency patterns of the Spleen manifesting as Damp-Accumulation. Over time, the overworked Spleen can lose support from the Kidneys, which can lead to weakness along the entire digestive tract wall. This can present as a leaky esophagus or a leaky blood-brain barrier.

Reference 1.

How to Look and Feel Your Best for Your Wedding Day (or Any Day)

Weddings are wonderful.

They’re also a massive headache. On top of spending weeks, if not months, to plan an unforgettable ceremony in which nary a detail is overlooked, brides and grooms face the all too stressful task of getting in picture-perfect form.

Whether that means booking all the beauty routines, committing to healthy eating, or working out like a CrossFit champion, the road to wedding readiness is no easy feat.

That’s why we touched base with Hudson Valley makeup artist Alexandria Gilleo for her insider tips. An internationally recognized expert in the beauty industry and the owner of Bridal by Alexandria, Gilleo has glowed up everyone from Bumble & Bumble models to, more recently, soccer stars Ali Krieger and Ashlyn Harris for their celebrity-studded wedding. Here’s what she had to say about getting glam before a big day.

1. Work It Out

A good workout regimen should begin six to 12 months before the wedding day to achieve the most effective results.

“I highly suggest avoiding a crash diet or aggressive workout schedule right before the wedding to avoid looking dull, tired, or not feeling your best,” she says. Instead, she stresses the importance of committing to a steadfast schedule. For variety, she recommends hitting boutique fitness centers like Studio 8 in Fishkill for a challenging Lagree Fitness workout, The Studio @ Beacon for full-body boxing, and FitSocial in Poughkeepsie for a 30-minute spin class that fits into a lunch break.

2. Get a Lymphatic Drainage Massage

Scary as it may sound, a lymphatic drainage massage is actually a relaxing way to remove toxins and improve overall appearance. It’s best scheduled for three to five days before the wedding.

“This is great for decreasing the appearance of cellulite, reducing swelling or bloating, boosting your immune system, and increasing circulation,” Gilleo explains, adding that HV Massageworks in Hopewell Junction offers a version of this.

3. Slow Down in the Sauna

Love relaxing in the sauna after an intense gym workout? Try incorporating it into your pre-wedding routine, too. According to Gilleo, infrared saunas like the one at Functional Alternative in Beacon are ideal to detoxify the body, calm nerves, boost immunity, and promote healthy skin. She recommends going once a week for four to five weeks before the wedding day.

4. Glow It Up With an IV Drip

If you like the idea of vitamins but don’t love the time it takes for them to kick in, consider an IV drip, like the one at Hebe Medical Spa in Fishkill, about one to two weeks prior to the wedding. Based on one-on-one consultations, the IV drips are created by medical spa practitioners to suit individual needs.

“[An IV drip] provides you with a radiant, youthful complexion and can fight off any sickness in the body by strengthening the immune system,” she notes.

5. Establish a Skincare Routine Early

Because brides (and grooms) want to put their best face forward on their wedding day, it’s critical to establish a consistent skincare routine well before the time to walk down the aisle arrives. During a professional skincare consultation, which Gilleo’s team of experts at Bridal By Alexandria regularly provides, brides-to-be can address skincare concerns so as to combat them effectively within a given time frame.

According to Gilleo, earlier really is better when it comes to skincare. Think six to eight months ahead of schedule to see maximum results.

6. Don’t Forget the Basics

With all the beauty-forward to-dos, sometimes the little things slip under the radar in the rush to tie the knot. Don’t let them! Gilleo points out that staying hydrated, cutting out sugary drinks, and limiting alcohol and processed foods are often overlooked steps that can lead to significant mental and physical improvements when regularly implemented.

Along these lines, Gilleo stresses sleep as one of her top basic beauty tips and notes that eight hours is her golden number to look and feel well-rested. To aid with this, she suggests wearing blue light-blocking glasses to protect melatonin levels and promote easier sleep. That way, makeup artists “don’t have to use too much concealer and your makeup application will be smooth,” she explains.

Mind Body Radio

Get Moving

Get Moving

Couple opens studio for ‘not-so-urgent’ care

When Sean Gibbons needed someone to swing a stick at, he turned to his wife, Jenn.

Sean is a disciple of a Filipino martial arts called Perkiti Tirsia Kali, which he began studying eight years ago. The couple were living in Queens at the time and he began nagging his wife to attend classes with him.

The sticks are a fundamental part of PTK. The couple now live in Beacon and it is among the forms taught at their studio of “not-so-urgent care,” Functional Alternative, on East Main Street near the Roundhouse. It offers classes, consultations and treatments that each incorporates elements of traditional Chinese medicine.

PTK is based on mobility, counter-attacking and triangular movement, explains Jenn Gibbons. “The coolest thing is its cognitive benefits,” she says. “It’s fun and practical, with stepping patterns, where shapes are followed. The brain has to do this and also deal with being given a pattern of numbers and swinging a stick in that pattern. Your arms are doing two different things at once. It’s an art that’s not only exercise but a way of learning to defend yourself while challenging your brain in a way to benefit neuroplasticity.”

The rattan sticks and trainer blades can be used by geriatric patients who have brain degeneration or people with movement disorders such as cerebral palsy, she says. “The confidence you develop through mastering it stops you from going to a default fear experience if you’re ever attacked,” she says.

Functional Alternative — its name reflects the studio’s mix of functional and alternative medicine — also offers Tai Chi, fencing and martial cardio. The emphasis is on services “key to improving and maintaining health,” Jenn Gibbons says. There is nutritional guidance incorporating botanical formulations; health education and coaching; acupuncture and acupressure; massage; and a sauna.

“As practitioners of medicine and the arts, we follow a framework of the four fundamentals: sleep, movement, stress management and nutrition,” she says. Movement exercises are “a way to get people out of their heads, into their bodies, stretching the body and opening up the joints, allowing flow. Joints are intersections. If they’re not as open as they can be, it’s hard to get things through them. Imagine rooting legs into the earth like the strength of a tree.”

After growing up in a military family, then entering the service, Gibbons was introduced to traditional Chinese medicine when she broke her back at age 20. “I had a major surgery and was given calcium supplements and told to do resistance exercises,” she recalls. “I moved to New York City, and there was a gym near my office with a teacher who offered Tai Chi. It was so intriguing.”

She met Sean 20 years ago while she was earning a master’s degree at the Pacific College of Oriental Medicine in New York City; he taught Tuina acupressure, Tai Chi Chuan and Qugong. She later studied pediatrics and trained as a clinician and a functional health coach. The couple, who have two children (ages 8 and 11) moved to Beacon five years ago but still run a wellness center in the financial district.

Functional Alternative is located at 508 Main St. Call 845-670-4514 or visit

Interview about SIBO