先这么说吧：你的肠道很可能正在泄漏，你只是不知道⽽已。

Let me start out by saying: your gut is probably leaking, you just don’t know it.

这怎么可能呢？肠道不是消化、吸收和排除的封闭系统吗？怎么会有洞？

How can that be? Isn’t the gut a closed system for digestion, absorption and elimination? How can it have holes?

你知道吗，⼀个⼈肠道内壁的表⾯积可以覆盖 4000 平⽅英尺（超过 370 平⽅⽶）的场地，⼤约是⼀个⽹球场那么⼤。这个内壁只有⼀个细胞壁的厚度，技术名称为“内⽪”。它有着⼀项⾮常重要的⼯作：决定什么可以进⼊你的⾎液流通，什么不能进⼊。应该进⼊⾎液的是身体需要的营养物质，不应该进⼊⾎液的是未消化的⻝物、病原体、细菌等等。所以你的肠道内壁就像是⼀道屏障，时时刻刻在保护着你的健康。

This may surprise you, but our intestinal lining covers more than 4000 square feet (more than 370 square meters) of surface areas, approximately a tennis court. This lining is one cell layer thick, with a technical name of “endothelium”, has a very important job: decide what to get into your bloodstream, and what gets blocked. What are supposed to go into the bloodstream are nutrients, and what are not supposed to get into the bloodstream are undigested food, pathogens, bacteria, etc. So your gut lining is like a barrier protecting you all the time.

当这个内壁⼯作正常时，只有好的东⻄才能进⼊你的⾎液循环，天下太平。当这个内壁不能正常⼯作时，换句话说，它会“泄漏”， 所以叫做“肠漏”，不该进的东⻄就会进⼊你的⾎液，这就是很多麻烦的开始。当你的免疫系统发现⾎液⾥有不速之客时，包括未被完全消化的蛋⽩质，菌类等，它就会产⽣免疫反应。如果肠漏是持续的和慢性的，你最终得到的就是慢性炎症。关于慢性炎症，希望⼤家现在都知道，它是所有慢性疾病的根源。

When this lining works properly, only the good stuff gets in the blood circulation, all is fine. When this lining does not work properly, in other words, it gets “leaky”, hence the term “leaky gut”, then more bad guys slips into your bloodstream. This is where the trouble starts. When your immune system sees what is not supposed to be there, including partially digested proteins, fungus, etc, it mounts an immune response. If the leakiness is constant and chronic, what you end up with is chronic inflammation. By now, I hope we all understand that chronic inflammation is the root cause of all chronic diseases.

所以，你可以预想到，肠漏的后果不仅仅局限于胃肠道疾病：乳糜泻、克罗恩病和肠易激综合征等，肠漏也可能是导致表⾯上看来与肠道没有什么直接联系的疾病的原因：过敏、关节炎、慢性疲劳综合症、纤维肌痛、哮喘、粉刺，甚⾄精神⽅⾯的疾病。越来越多的研究指出了肠漏症与⾃身免疫性疾病之间的联系，⽐如狼疮、1 型糖尿病、多发性硬化症等。

So it should not be shocking to you that the consequences of a leaky gut are not just confined to gastrointestinal ailments: celiac disease, Crohn's disease, and irritable bowel syndrome, etc. It has been shown that leaky gut could be the cause of all sorts of diseases that may not have a direct link to the gut on the surface: allergies, arthritis, chronic fatigue syndrome, fibromyalgia, asthma, acne, even mental illnesses, you name it. More and more studies have pointed out the link between leaky gut and autoimmune diseases: lupus, type 1 diabetes, multiple sclerosis, etc.

“肠漏”是⼀个相对较新的术语，在另类疗法和⾃然疗法的领域提得⽐较多。⼀些传统医⽣甚⾄认为不存在“肠漏”这个概念。这当然不奇怪，因为这不是⼀个你可以在医学院教科书上学到的诊断。但在传统医学教学中确实有类似的概念，叫做“过度肠道通透性”。⼀些传统医学⼈⼠认为，肠漏症只是其他疾病的症状，⽽不是病因，因为缺乏⾜够的医学证据。

“Leaky gut” is a relatively new term that is mostly seen in alternative and natural health field.  Some conventional doctors don’t even think “leaky gut’ exists. This is not surprising at all, given that it is not a textbook diagnosis that is taught in medical schools. But there is indeed something in the traditional medical teaching that resembles it, called “increased intestinal permeability”. Some medical professionals believe leaky gut syndrome is merely a symptom of other diseases rather the cause, and there is not enough medical evidence to support it.

不管肠漏只是⼀种症状还是许多其他疾病的根本原因，它在过去⼏⼗年越来越受到医学界和⾃然疗法领域的关注。它⽐你想象的要普遍地多。

Regardless whether it is just a symptom or a cause of many other diseases, it is indeed something that has gathered more and more attention in the past decades. And it is more prevalent than you might think.

我很早就怀疑我有肠漏，因为过去我一直受腹胀和肠胃不适的困扰。⼤约两年前的⼀次测试证实了我的怀疑。 连蛋白（Zonulin）是⼀种调节细胞间紧密连接的蛋⽩质，是⽬前最常⽤的测试肠漏的⽣物标志。果然，我的连蛋白⽔平超出了正常范围：偏⾼。

I’ve long suspected I have leaky gut because of the constant bloating  and discomfort that used to bother me. A test about two years ago confirmed my suspicion. Zonulin, a protein that regulates the intercellular tight junctions, is now commonly used as the biomarker for leaky gut. And sure enough, my zonulin level is out of normal range on the high side.

肠漏的症状范围很⼴，如果你有任何以下不适，很有可能你有着⼀定程度的肠漏：

The symptoms of leaky gut have a wide range, but if you have the following problems, it may very well be a sign that your gut is too leaky.

• ⻝物过敏和和敏感，特别是如果你对以前根本不会困扰你的⻝物开始过敏

• 季节性过敏或哮喘

• 慢性消化问题，如胀⽓、腹胀、腹泻、便秘、肠易激综合征等

• ⾃身免疫性疾病

• 甲状腺问题，尤其是桥本⽒病

• 营养吸收不良

• 慢性⽪肤病

• 关节炎、关节痛

• 慢性疲劳

• 情绪问题，脑袋昏沉，难以集中注意⼒

• Food allergies and sensitivities, especially if you start to have allergies to foods that did not bother you before

• Seasonal allergies or asthma

• Chronic digestive problems, such as gas, bloating, diarrhea, constipation, irritable bowel syndrome, etc.

• Autoimmune diseases

• Thyroid problems, especially Hashimoto’s disease

• Poor nutrient absorption.

• Chronic skin conditions

• Arthritis, joint pain

• Chronic fatigue

• Mood issues, brain fog and difficulty to focus‍

史蒂文·冈德里（Steve Gundry） 是美国⼀位⼼脏外科医⽣和著名作家，他在⼀次接受采访时说：

Steve Gundry, a medical doctor, a heart surgeon, and a well-known author, said this in an interview:

“坦率地说，我从未⻅过患有⾃身免疫性疾病的⼈没有⼀定程度的肠漏的。我从来没有⻅过⼀个慢性疲劳或低能量的⼈没有⼀定程度的肠漏的......我想戴尔·布雷德森医生 （Dale Bredesen，⼀位以研究阿尔茨海默病⽽闻名的神经学家）和我从来没有发现⼀个患有神经性炎症的⼈没有⼀定程度的肠漏的……”

“I've quite frankly never seen a person with autoimmune disease who doesn't have a measurable leaky gut. I've never seen a person with fatigue or low energy that doesn't have a measurable leaky gut… I think Dr. Dale Bredesen (a neurologist known for his research on Alzheimer’s disease) and I have never found a person with neuro-inflammation that doesn't have a leaky gut…”

所以很可能，“我们都有⼀定程度的肠漏症”，正如⻢塞洛·坎波斯医生(Marcelo Campos) 在哈佛健康博客上的⽂章中所说的。

So probably “we all have some degree of leaky gut”, as Dr. Marcelo Campos stated in his article on Harvard Health Blog.

那究竟是什么导致肠漏这么普遍呢？

So what exactly causes leaky gut and makes it so common?

⽬前并没有⼤家都认可的定论，仍然有⼤量的研究在继续，但这⾥是⼀些普遍认同的罪魁祸⾸：

Research is still ongoing, and there are different theories, but here are some of the most agreed-upon culprits:

• 基因遗传。有些⼈对环境因素更为敏感，更为容易出现肠漏

 •麸质是某些⾕物（包括⼩⻨）中的⼀种蛋⽩质，是导致肠漏的主要因素之⼀

• 农药，包括草⽢膦。我们之前不⽌⼀次讨论过（查看我们之前的⽂章和视频：“你想不到的健康隐患”），是我们肠道微⽣物群的主要破坏者

• 抗⽣素。即使你⾮常⼩⼼，不随便服⽤抗⽣素，不幸的是它在我们⻝品供应链中⽆处不在

• ⻝品添加剂

• 加⼯⻝品，尤其是⾼脂肪、⾼糖⻝品

• ⼤量使⽤酒精

• ⻝物中缺乏纤维

• ⻓期使⽤某些抗炎药物，如布洛芬和阿司匹林

• 慢性压⼒。是的，压⼒会通过改变细菌的组成从而破坏你的肠道！

• Genetic predisposition. Some people are more predisposed to be sensitive to environmental factors

• Gluten, which is a type of protein found in some grains, including wheat, is a major contributor

• Pesticide, including glyphosate, which we talked abut more than once before (check out our previous article and video: “The Health Risk you did not foresee”), is a major damager to our gut microbiome

• Antibiotics. Even if you are super careful not to take antibiotics often, it is unfortunately everywhere in the food supply

• Food additives

• Processed food, especially high fat, high sugar food

• Heavy use of alcohol

• Lack of fiber

• Long term use of certain anti-inflammatory medications, such as ibuprofen and aspirin

• Chronic stress. Yes, stress can mess up your gut by changing the make-up of the bacteria!‍

当然，最紧迫的问题是：肠漏可以治愈吗？

Of course the most pressing question is: can leaky gut be healed?

可以！！！

Yes Yes Yes!

如何治愈肠漏，这是⼀个可以让你越陷越深，迷失在各种细节和理论中的⼀个问题。市⾯上有数百种不同的膳⻝补充剂声称可以帮助你治愈。这也是⼀些⼈不太喜欢这个概念的原因之⼀，他们认为这是⼀种以销售补充剂为⽬的的虚构概念。但我完全不同意这个观点。科学已经⾜以证明肠漏的存在和它对身体的伤害。我服⽤过⼀些帮助肠道恢复健康的补充剂，对我帮助巨⼤。

As far as healing a leaky gut is concerned, there are thousands of rabbit holes you can get yourself into and there are hundreds of different supplements out there that claim to help you heal. This is one of the reasons some people don’t quite buy this concept because they think it is a made-up condition with the purpose of selling supplements. I completely disagree with this view. Science has advanced enough to show us it is real thing that causes real problems.I have taken some supplements over the years for my gut health, and they have helped me tremendously.

治愈肠漏，恢复肠道健康⽅⾯，我觉得功能医学倡导的5R计划是⾮常可取的。

When it comes to healing the gut, I find the 5 R program advocated by Functional Medicine the most sensible.

从你的饮⻝中去除所有可能导致问题的⻝物，过敏原和所有加⼯⻝品。最常⻅的过敏原是麸质、乳制品、⽟⽶、鸡蛋和⼤⾖。是的，这些也许是你没有想到的，这可能意味着⾄少有⼀段时间不能吃⾯包、⾯条、⾖腐。但是给⾃⼰⼏周的挑战，你身体的感觉和变化有可能会让你震惊。根据个⼈情况，有可能还需要去除海鲜、坚果等。记住远离⻝品添加剂、防腐剂、⼈造⾹料和⾊素。在这个阶段，服⽤⼀些清除肠道中病原体的膳⻝补充剂会有所帮助。

Get all the problematic foods, allergens, and all processed food out of your diet. The most common allergens are gluten, dairy, corn, eggs, and soy. Yes, that may mean no bread, no noodles, no tofu, at least for some time. But challenge yourself for at least a couple of weeks, you may be amazed at how you feel just by removing these foods. Depending on your own situation, you may also want to remove seafood, nuts, etc. that you suspect may be causing problems. Also remember to stay away from food additives, preservatives, artificial flavors and colorings. At this stage, taking some supplements to remove pathogens in the gut may be helpful.

增加帮助你消化和吸收营养的东⻄，包括盐酸、胆汁和消化酶。这个阶段补充剂⽐较有必要。

Replace things that help you digest and absorb nutrients, which includes hydrochloric acid, bile and digestive enzymes. Supplements are necessary at this stage.

重建肠道菌群。增加益⽣菌和益⽣元的摄⼊。很多⼈都熟悉益⽣菌。益⽣元则是肠胃内好细菌的⻝物。多吃富含纤维的⻝物，多吃发酵⻝品。可能需要⼀些补充剂。好的益⽣菌可以帮助你重建肠道的健康。

Rebuild the gut flora. Think probiotics and prebiotics. Many people are familiar with probiotics. Prebiotics are foods that feed the good bugs. Eat fiber rich foods, eat fermented foods. Supplements may be necessary. A good probiotics can go a long way to help you rebuild the gut.

让你的肠道内壁恢复健康。⻣头汤、胶原蛋⽩粉、L-⾕氨酰胺都⾮常有帮助。

Make your gut lining healthy again. Bone broth, collagen powder, L-glutamine are all very helpful.

这个指的是⽣活⽅式。即便你在饮⻝和补充剂⽅⾯都做得很到位，但如果你总是有很⼤的压⼒和焦虑，那也很难维持好的肠道健康。建⽴属于你的减压系统，拥有平衡的⽣活⽅式，这对⻓期肠道健康⾄关重要。

This is where the lifestyle factors come in. You gut health cannot be maintained if you do all the right things with food and supplements but feel overwhelmed and stressed out all the time. Build your de-stress system, have a balanced lifestyle. This is crucial for your long term gut health.

功能医学在中国还是⼀个相对较新的概念。整个过程听起来可能很复杂。这可能需要⼀些时间、⼀些耐⼼、⼀些挫折和⼀些⾦钱的付出。但是，没有肠道健康，你就没有其他健康可⾔。记住这些基本原则：去除那些可能扰乱你系统，让你敏感的东⻄，多样化的饮⻝，多吃富含纤维的⻝物和新鲜蔬菜，服⽤⼀些必要的膳⻝补充剂，包括良好的益⽣菌，有效减压。

Functional medicine is relatively new concept in China. This whole process may sound complicated. It may take some time, some patience, some setbacks, and some money. But, without gut health, there is no other health to speak of. Just remember the basics: remove things that may upset your system, have a diverse diet with lots of fibre and fresh vegetables, take necessary supplements including a good probiotics, and manage your stress.

照顾好你的肠道，保持肠道屏障的完整性，保持肠壁的紧实，你未来的⾃⼰会感谢你的。

Take care of your gut, maintain the integrity of the gut barrier, keep those junctures tight, your future self will thank you.

References:

• Harvard Health Publishing. Leaky gut: What is it, and what does it mean for you?

• Neurohacker Collective. The Connections Between Lectins and Leaky Gut

• Alessio Fasano. Leaky Gut and Autoimmune Diseases

• Harvard Health Publishing. Putting a Stop to Leaky Gut

• Mark Hyman; Elizabeth Boham. What is Leaky Gut and How Do You Treat It?

• Dr. Axe. Leaky Gut Syndrome: 7 Signs You May Have It

• The Institute for Functional Medicine. The 5R Framework for Gut Health