Endo Battery

QC: Leaky Gut, Dysbiosis, and Endometriosis: Are GLP-1 Agonists O.K. For Compromised G.I

Alanna Episode 128

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Neurogastroenterologist Dr. Zachary Spiritos explains the likely connection between leaky gut and rising rates of inflammatory conditions like endometriosis. He discusses how intestinal permeability may be influenced by stress and dietary factors, potentially contributing to various chronic conditions.

• Leaky gut (increased intestinal permeability) may be bidirectionally linked with endometriosis and other inflammatory conditions
• Reliable testing for leaky gut doesn't exist yet, but research suggests connections with autoimmune conditions
• Modern lifestyle factors including processed foods and stress may contribute to intestinal permeability issues
• GLP-1 agonists like semaglutide can benefit many GI conditions but may worsen gastroparesis or constipation
• Personalized risk assessment is crucial when considering weight management medications with pre-existing GI issues

Send in your questions by using the link in the description, emailing contact@endobattery.com, or visiting the endobattery.com contact page.


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Alanna:

Life moves fast and so should the answers to your biggest questions. Welcome to EndoBattery's Quick Connect, your direct line to expert insights Short, powerful and right to the point. You send in the questions, I bring in the experts and in just five minutes you get the knowledge you need. No long episodes, no extra time needed, and just remember expert opinions shared here are for general information and not for personalized medical advice. Always consult your provider for your case-specific guidance. Got a question? Send it in and let's quickly get you the answers. I'm your host, alana, and it's time to connect. Today I'm joined by my guest, dr Zachary Spiritos, a board-certified neurogastroenterologist with a passion for treating irritable bowel syndrome, functional abdominal pain and mobility disorders. With a strong background in teaching, research and patient-centered care, he brings a wealth of knowledge and compassion to the table. Please help me in welcoming Dr Zach Spiritos to the table. Do you know the relationship between leaky gut and dysbiosis and endometriosis?

Dr. Spiritos:

What a great question. How much time do I have? So leaky gut is another way to say increased intestinal permeability, where the tight junctions between our cells and our intestines are a little bit lax, permitting influx of food particles and toxins. So we don't have a reliable way to test for that, but some think that it's at the base for a lot of these chronic autoimmune and inflammatory conditions, and endometriosis certainly fits into a hugely inflammatory condition. I can't say that one directly leads to the other and perhaps it's bidirectional. Maybe endometriosis leads to leaky gut.

Dr. Spiritos:

But the question you've mentioned that the rate of endometriosis is really rising and so we're all of these autoimmune kind of neuroinflammatory conditions, pots, irritable bowel syndrome, crohn's disease, ulcerative colitis and kind of. The common denominator between all of these conditions is potentially increased intestinal permeability. So the answer is there probably is a link between the two and the question is why do we have increased intestinal permeability? Is it increased stress, like increased sympathetic tone? Is it microbiome changes because we're eating a lot more processed foods? So I think it's a very intriguing concept and something that hopefully will be elucidated in the next 10 to 15 years.

Alanna:

What are your thoughts on semiglutide use in patients that have a complicated GI history?

Dr. Spiritos:

Yeah, I support the GLP-1 agonists for the right reasons. They're incredibly helpful and a lot of GI conditions. You know, in some GI conditions obesity or increased like visceral adiposity can really make GI conditions worse Diverticular disease, reflux disease, what was previously known as fatty liver disease but is now known as metabolic dysfunction-associated liver disease. So they can help quite a bit. So it all depends on what the underlying GI pathology is.

Dr. Spiritos:

The one thing you'd worry about is if someone has pre-existing gastroparesis so the stomach doesn't move or empty as well as it should, like what happens in patients with postural orthostatic tachycardia syndrome or people who deal with underlying constipation. Glp-1 agonists can worsen that. But with every medication we always talk about the risk calculus. Do the benefits of using medication outweigh the risks? So if someone really needs to lose weight for whatever reason they have really bad obstructive sleep apnea, their diabetes is out of control and someone's a little bit constipated, the medication probably makes sense if we can kind of get the constipation under control. And similarly, if someone has delayed gastric emptying or gastroparesis, there's certainly interventions that we can employ to make the GLP-1 safe.

Alanna:

So it all boils down to does this make sense for me from a risk profile perspective? That's a wrap For this Quick Connect. I hope today's insights helped you move forward with more clarity and confidence. Do you have more questions? Keep them coming, send them in and I'll bring you the expert answers. You can send them in by using the link in the top of the description of this podcast episode, or by emailing contact at endobatterycom or visiting the endobatterycom contact page. Until next time, keep feeling empowered through knowledge.