244 Diet Wise
possible pancreatic cancer [Braganza, J.M., Pancreatic disease: a casualty of
hepatic “detoxification”? Lancet, 1983. ii: p. 1000-1002].
But it is worse. For every toxic molecule excreted in the bile, the liver
has given up one molecule of precious glutathione, to create a conjugate.
That is what is supposed to happen. But when the conjugate enters the
bowel and encounters more toxic bile with active free radicals, these attack
the conjugate and release the toxin once more. The glutathione molecule is
wasted and the toxin is back on the loose.
You will see at once why a diet rich in antioxidants is really essential in
combating the chemical plague of our world. We cannot go on squandering
our biological reserve in this way, without facing increased risk of cancer
and, of course, accelerating the ageing process.
Verifying leaky gut syndrome
A neat and useful model. But is it valid? A test has been developed to establish
whether or not the gut is releasing larger molecules than are biologically
acceptable. It concerns absorption of two complex sugars, mannitol and
lactulose.
Mannitol is a relatively small molecule and should be absorbed;
lactulose is larger and should not be absorbed significantly. The patient fasts
and both sugars are administered simultaneously. The information which
can be gained is interesting:
· If the absorption of mannitol is low, suspect malabsorption.
· If the absorption of lactulose is high, suspect leaky gut.
· If both are normal, this suggests healthy gut performance.In fact what is normally measured is the mannitol/lactulose ratio. A recent
study published in the Lancet found that the lactulose-mannitol ratio was an
accurate predictor of relapse when measured in patients with Crohn’s disease
who were clinically in remission (Wyatt, J., et al., Intestinal permeability and
the prediction of relapse in Crohn’s disease. Lancet, 1993. 341(8858): p.
1437-9).
Improving a leaky gut
Obviously enzyme supplements, as described earlier in this chapter, will
assist in overcoming the problem, because more of the immunologically