Medications That Cause Leaky Gut (Intestinal Permeability)

Millions of people are commonly diagnosed with illnesses and the solutions given to them by their doctors is usually a pill to fix the ill. Doctors who continually prescribe medications to treat symptoms, but fail to identify the root cause of disease are a huge part of the health problem. As a result, properly prescribed medications are the fourth leading cause of death in the United States¹. There are many side effects from these prescribed medications that can hinder, damage or even destroy any part of the gastrointestinal tract.

For those with a gluten sensitivity, gluten consumption causes inflammation that leads to many painful and chronic autoimmune conditions. These diseases are typically “drugged” by doctors. The adverse side effects of many of these medications can lead to a host of gastrointestinal problems and nutritional deficiencies, which subsequently interfere with the natural ability of the body to properly heal. This causes a vicious cycle – what I often times refer to as “The Prescription Pain Trap”.

The GI Tract Is Fundamental to Human Health & Wellness

As the saying goes – “All disease begins and ends in the gut”. So then, why do so many doctors fail to address the issue of gut damaging mediation use? The gastrointestinal (GI) tract is a pathway that begins in the mouth, through the esophagus, small and large intestines, and ends with evacuation at the rectum. Food is processed through these organs as nutrients are absorbed to nourish the body. The gut’s role doesn’t stop there. Remember that an estimated 70-80% of the immune system is housed in the GI tract. This immune function is vital to our health because it helps protect us from disease causing agents, the development of food allergies, and helps to ensure that we eliminate toxins from the body.

Don’t forget that the GI tract also needs the “accessory organs” to help it properly function. The liver, gallbladder, pancreas, parotid, submandibular, & sublingual glands all aid in the vital role of the gut. Any medications (OTC or prescription) that alter the functions of these organs can have unintended and even devastating long term consequences.

Digestion begins in the mouth.

Remember that the mouth is responsible for many functions. The health of the teeth, gums, tongue, salivary glands, and oral mucosa are critical for proper digestion and immune function. As digestion begins in the mouth with chewing food, there are many medications that can alter the taste of your food. Hypertension controlling drugs, antacids, antibiotics, female hormones, anti-inflammatories, diuretics, anti-virals, antihistamines, cholesterol lowering, antidepressants and chemotherapy are such medications⁵.

Some of these medications hinder the production of saliva, which aids in moistening and breaking down starches from food. A decrease in saliva can cause dry mouth (xerostomia). Thus making it difficult to taste, chew and swallow food. Some of these drugs cause zinc deficiency leading to altered taste and smell and subsequently people gravitating toward processed foods with added salt, sugar, and flavor enhancers. Many drugs including anti-inflammatory medications can also deplete vitamin C, iron, and folate, which can lead to bleeding gums, interrupted dentin formation, and mouth ulcer formation.

Esophagus

As these drugs pass through the esophagus, antibiotics, anti-inflammatory, bone builders (Fosamax, etc), and pain medications can cause further inflammation. Changes in motility, mucosal integrity (esophageal lining), and infection can lead to gastroesophageal reflux (GERD), where stomach contents come back up through the esophagus². Additionally, swallowing can become painful leading to esophagitis and suppressed appetite ⁴.

Stomach

The role of the frequently abused stomach is often overlooked. Stomach acid doesn’t just aid in digestion of protein, it helps to protect us from acquiring bacterial, viral, and parasitic infections. Food passes through from the esophagus into the stomach for digestion. It mixes with digestive enzymes and acid produced by the glands in the stomach’s lining. Many drugs can erode and destroy this mucosal layer. This layer also serves as a barrier providing a physical protection containing a mucus and the antibody, secretory IgA (SIgA). The mucus prevents damage and ulcer formation, and the SIgA antibodies protect the gut from allergens and infections, and is crucial for immune function. Chemotherapy medications, pain reducers, anti-inflammatory medications, antibiotics, acid reflux medications, antidepressants, and female hormones can damage the mucosa and cause or contribute to the formation of a leaky gut leading to more chronic pain and inflammation.

The pH of the stomach is very important for proper digestion. Antacids and antibiotics can readily change the acidity level in the stomach. As a result, the acidic environment needed to destroy potentially dangerous bacteria, viruses, and parasites will be absent and increase the risk for infections and increased toxic burden on the colon. The digestion of nutrients including protein, calcium and vitamin B12 can all be hindered due to lower stomach acid function. These medications can also contribute to an rate of stomach emptying (increase of decrease) as is typically seen in IBS ⁵.

Gall Bladder and Pancreas

The gall bladder’s job is to secrete bile to bind toxins and digest fats. Many medications can inhibit this important process. Estrogen and cholesterol lowering medications can interrupt gall bladder function and induce the formation of gallstones leading to severe pain and fever.

The pancreas secretes several enzymes that break down carbohydrates, fats, and proteins in food. Many medications such as anti-viral, anti-inflammatory and pain medications can lead to increased inflammation in the pancreas (pancreatitis). This can lead to a reduced capacity to produce digestive enzymes and subsequently, the inability to break down food properly. The pancreas also releases hormones to control blood sugar levels. Bottom line – inflammation in the pancreas, caused by medications can decrease both enzymatic digestion of food and elevated blood glucose levels³.

Liver and Kidneys

The liver plays a central role in many metabolic processes in the body. It converts nutrients from food into substances our body uses and it also rids the body of toxins. The liver stores nutrients, regulates cholesterol, helps in hormone metabolism (especially the thyroid), and much more. The liver’s function is crucial. Anti-inflammatory, pain and anti-viral medications can disrupt many of its important metabolic processes. Some medications cause glutathione deficiency, and reduce the ability of the liver to detoxify. Drug induced liver disease and hepatotoxicity, a toxic liver, can occur due to adverse effects of many medications². This is why doctors will often times keep checks on your liver function.

The kidneys have very powerful functions. They help remove waste products and excess fluid from the body. Salt, acids, and potassium levels are all regulated by the kidneys. They also help regulate blood pressure and RBC production, as well produce the active form of vitamin D. Anti-inflammatories, antibiotics, hypertension controlling drugs and laxatives can cause damage to the kidneys which can lead to the loss of many water-soluble nutrients as well as protein wasting.

Small and Large Intestines

In the small intestine, antibiotics, pain medications, anti-inflammatories, and oral contraceptives can cause a decrease in the digestion and absorption of food. 90% of our food is digested and absorbed in the small intestine. Any decrease in gut function can lead to vitamin and mineral deficiencies. In addition to malabsorption, ulcers, gastrointestinal hemorrhages, and hindered motility can occur in the small intestine⁵.

The large intestine’s function is to absorb water from remaining indigestible food and to transmit waste from the body. Medications including antibiotics, antacids, pain and anti-inflammatory drugs can interfere with proper function and IBS and colitis can develop. Gas, bloating and constipation can be induced with the use of antibiotics, antacids, laxatives, and anti-depressants. Diarrhea can be caused with the use of female hormones, antibiotics, blood pressure medications, antacids, diabetes medications, laxatives, and cholesterol lowering medications.

Prescription Pain Trap

Medications artificially mask symptoms in the body without addressing the underlying cause of disease. The game of chasing symptoms needs to come to an end. It doesn’t work. If it did, people would achieve health through medication. The fact of the matter is, health deterioration is the actual and unfortunate outcome This prescription pain trap begins as medications are given without concern over their impact on the GI tract and your nutritional status. The subsequent nutrient loss makes healing more of a challenge, while giving the patient a false sense of security. The underlying problem continues unchecked creating more chronic inflammation, more symptoms and problems, and the cycle goes on ad infinitum⁴.

Don’t Forget About Drug Induced Nutritional Deficiencies

Remember that one of the most common side effects of medications is that they have the ability to rob you of essential nutrients. The diagram below lists several examples of some of the most common drug induced nutritional deficiencies.

What is the solution?

Proper nutrition, adequate sleep, exercise, sunshine, and human connection are the keys to avoid getting caught in the vicious medication cycle. Eating nutrient dense foods, organic fruits and vegetables, and avoiding any foods that can trigger an allergic or inflammatory response will help maintain a healthy gastrointestinal tract.

There are many anti-inflammatory foods that can help with reduce pain and inflammation. Turmeric and an Omega Fatty Acid supplement are natural remedies that do not come with detrimental side effects.

If you are already stuck in this cycle, natural support to help restore proper gut function in the form of supplements can be helpful. GI Soothe, Ultra Digest, Ultra Acid, Vitamin A, Ultra Zinc and a good probiotic can assist in regaining normal gut function. If you are looking for grain and gluten free versions, you can find them here.

Do me a favor…If you have been able to get off of medications in lieu of lifestyle changes, share below and help give someone hope for a brighter future and better health…

Always looking out for you,

Dr. Osborne

References

1. CDC/National Center for Health Statistics. (2016). Leading cause of death. Retrieved from https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm
2. Hadjibabaie, et al. (2005). The Adverse Drug Reaction in the Gastrointestinal Tract: An Overview. International Journal of Pharmacology 1 (1), 1-8.
3. Norman, A. and Hawkey, C. (2011). Drug-induced gastrointestinal disorders. Medicine 29(3), 162-168.
4. Osborne, P. (2016). No Grain, No pain. Touchstone: New York, NY.
5. Richter, Joel E. (2007). Advances in Gerd. Gastroenterology & Hepatology, 3(4).
6. Tolstoi, Linda G. (2002). Drug-induced Gastrointestinal Disorders. Medscape Pharmacotherapy, 4(1).