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Leaky Gut and Malabsorption by Pierre Brunschwig, MD

Did you know that having healthy tight junctions are key to protecting the brain and gut? Watch this video as Dr. Pierre Brunschwig talks about the Leaky Gut and Malabsorption.


Now I spoke to you about gluten related disease, Candida related complex and malabsorption. And how that interplays with our tight junction structures in both the gut and the brain, and we’re going to develop some further concepts about that. But in particular, today we’re going to talk about how to clean out the riffraff.

Restoring the biofilm and removing the tight junction inflammation

Healthy tight junctions are key to protecting the brain and gut.

We talk about cleaning out abnormal organisms in the biofilm, we’re really adding to our ability to remove inflammation and protect the tight junctions and the intestinal line. Because as you may recall that as we protect those tight junctions, we are also protecting the tight junctions in the blood-brain barrier. Healthy tight junctions are key to protecting our gut and our brain. So, gluten related disease, dysbiosis and other tight junction disruptors are important to identify as we want to work with the psychological and cognitive function of our patients.

And remember, we’re in a sea change regarding our understanding of the gut. And we’re moving away from the notion of pathogenics and moving into more the ecology and ecological approach to restoring gut balance.

Ecological approach to cleaning up the biofilm

So back to our ecological approach to the biofilm. Today, we’re going to specifically talk about the remove part of it, that remember, this is part of the complete sense of restoring digestive fire, if you will, making sure that there’s adequate digestion. And then following up with re-inoculation with prebiotics and probiotics, and looking for, particularly in patients who have got significant inflammation, giving elements of repair. And then rebalancing has to do with of course, the gut lining does not exist in isolation. So, all the things that are good for the body in general, including sleep and proper diet, and inner life, and outer life, and exercise are all important for digestive health as well.

Key findings in maldigestion

For pharmaceutical antibiotics, if the infection seems to be pronounced, or the consequences seem to be high BCC or autoimmune disease, you certainly may use a pharmaceutical antibiotic. I would, however, not use a quinolone. I basically stopped using quinolones because of long standing side effects involving nerves and tendons. And so, it is pretty rare for me to use quinolones. My two go-to antibiotics would be doxycycline, which doesn’t show up as a specific on the sensitivity panels that tetracycline does. So, in its stead, you could use doxycycline if it’s indeed sensitive to it, and then sulfa. So, sulfamethoxazole, trimethylamine sulfate can be used as well. These are not broad-spectrum antibiotics, and they’re reasonably inexpensive.

When to Deworm

Don’t wait for a positive stool test because you’ll wait a long time. So worms remain very difficult to find under the microscope and until we have PCR testing or something comparable, we’re going to be thinking about treating presumptively. So, this is common in tropical countries, where deworming is not unusually done every year, or with the onset of a diarrheal disease. If you’re going to do presumptive treatment for worms, consider it for people who’ve had either extensive third world travel, or frequent third world travel, or ill while traveling in a third world country.