October 14, 2009


Celiac Disease & Leaky Gut

This post is third in a series.  You can read the first two here:

Celiac Disease – A Little History
Celiac Disease – Three Causes

The average person has 20 feet of intestines.  The intestines are covered by a single layer of cells. The total surface area of the intestines, made up by those cells is 3,000 square feet – about the size of a tennis court.  Yes, all that surface area is crammed inside you.

Medical students used to be taught that the cells were like ceramic tiles, glued together by grout. Through a study that didn’t go as expected, Dr. Fasano helped discover that the cells were not separated by “grout” as they thought, but rather by “gates.”

Zonulin is the name given to the molecule that opens and shuts the gates.  In a healthy individual these gates will open and close quickly allowing certain things to pass through.   When there is too much zonulin, such as in celiac disease, the gates stay open, and large molecules such as gluten, pass through where they should not.

Once through the gates there are two immune responses.  The first is the innate immune response which occurs quickly, such as an allergic reaction to a bee sting.  It is your body’s immediate response to a problem.

The second response is the adaptive immune response.  This is the long term solution to a problem.  In the case of celiac disease, it is the adaptive  response that develops antibodies so the innate response does not have to react every time.

Celiac Disease vs. Gluten Intolerance

Celiac disease engages both the innate and adaptive immune systems.  Antibodies are developed by the adaptive system.  These are the antibodies used for celiac screening.  In a person that is gluten intolerant, they have the leaky gut problem which causes symptoms (many the same as celiac symptoms), but it stops with the innate immune system.  Antibodies are not developed and intestinal damage does not occur.
My final post in this series will be Celiac Disease – The Future.


Excellent write-up, Linda. The tennis court analogy is a great one. Is there any wonder that it's hard to find damaged areas of the small intestine? And, sadly, some doctors still deny that leaky gut exists even though Dr. Fasano has proven that it does. Thinking positive ... this, too, will change. Awareness and diagnosis will come!


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