Is Leaky Gut Syndrome a possible root cause of Eczema?

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Introduction:

Atopic Dermatitis or as commonly known as Eczema is all about a skin condition which becomes abnormal developing cracks, bumps, red, the skin loses its ability to withhold the moisture thus becomes dry and itchy. The skin barrier becomes weak allowing certain microbes to enter leading an immune response resulting in inflammation. This Microbes in some case worsens the condition developing various infections in eczema. Most of the eczema treatment and care plan are external with steroids and topical treatment plan as suggested by the physician subject to the patient’s condition. But in many cases elimination of certain food category or ingredient drastically improves the condition. This is because food may act as a trigger in resulting in eczema flare-up. But how could a food which doesn’t make any contact with the external skin like other triggers (cloth, weather, dust etc. do) has an impact on the skin. Well, this could be due to the phenomenon which we will discuss ahead know as “Leaky gut syndrome”.


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What is the Gut?

Gut is one of the vital disease-fighting systems of the human body. Many of the body’s immune cells are located in the gut and the microbes are deeply intertwined with the immune system
Similar to the skin which acts a barrier preventing the foreign particles to enter the body, our intestine has an extensive lining which forms a tight barrier or junctions. These tight junctions form the gateway between the intestine and bloodstream which controls which substance should be allowed to enter.

The Main job of this junction is to maintain a balance between allowing vital nutrients to enter your bloodstream, but still remaining small enough to prevent other hazardous disease-causing substances from passing out of your digestive system into the rest of your body.

What does Leaky Gut Syndrome mean?

When this tight barrier gets disrupted, junction becomes loose developing cracks or holes, allowing very tiny undigested food particles, metabolic waste toxins, and other microbes to penetrate the tissues beneath it and enter the bloodstream. This triggers the inflammation and, in many cases, also causes the changes in gut flora (friendly microbes) that could lead to many problems like an autoimmune response.

 

What happens in leaky gut

 

An immune response from your immune system which is so normal that serves to fight infections and diseases, now fighting your own cells leading to chronic inflammation, which is a root cause of major diseases like eczema, asthma, autism and the list goes on.

This action of immune response due to the disrupted intestine lining is called Leaky Gut Syndrome. In medical literature, leaky gut is also referred to as “intestinal hyperpermeability.”

According to research noted down in the Journal of Investigative Dermatology with a subject Increased intestinal permeability in atopic eczema.  A research study was conducted on 26 children with eczema which concluded that 14 of the participants had leaky gut and eczema. The researchers said that leaky gut was likely caused by food intolerances so elimination diets were undertaken by many of the participants.

So does that mean that the main reason is undiagnosed food intolerance?

Well, Often it could be. But sometimes it’s not – remember eczema is not caused by one single issue, it can be different for different individuals.

More studies are required to determine if leaky gut is universal in atopic dermatitis or if there are specific subtypes/phenotypes for which it is relevant says Peter A. Lio, M.D.  Assistant Professor of Clinical Dermatology North-western University Feinberg School of Medicine.

So leaky gut could be one of the reasons for Eczema but not every eczema is caused by Leaky gut syndrome

An unhealthy Gut means a low immune system and thereby even a small trigger or other factors make you fall sick in eczema it causes eczema flare.

What causes Leaky Gut?

Though the clear cause of Leaky gut is mysterious, however, it was found that the following reasons may increase the intestinal permeability.

  • High Gluten consumption
  • Infections like candida, intestinal parasites, and small intestine bacterial overgrowth (SIBO)

Both Gluten and overgrowth of bacteria stimulate higher levels of a protein called zonulin, which is known to regulate tight junctions and increased level of this protein may loosen tight junction causing leaky gut

  • Excess consumption of inflammatory foods
  • Long term use of Antibiotics or non-steroidal anti-inflammatory drugs (NSAIDs) such as Aspirin may also cause intestinal permeability
  • Low levels of Healthy Gut Bacteria

Diagnosis

Diagnosis of Leaky Gut
                                             Tests to confirm Leaky Gut

Although there are no Diagnosis for Leaky Gut Syndrome that is thought in the school which can tell you how leaky is your gut, there are certain factors which can be tested to find the condition indirectly

  1. Lactulose and Mannitol Test for Leaky Gut
    This test analyzes urine for the clearance of two sugars, lactulose and mannitol, which are by-products of the leaky gut syndrome. The patient has to consume these sugars and the ratio of Lactulose to mannitol ration in the urine.
  1. Organic acid Mineral and Vitamin Deficiency Test
    Nutrient Malabsorption or vitamin/ mineral deficiency are some of the serious warnings that you may have leaky gut. The organic acid test helps identify nutritional deficiencies.
  2. Blood Test for Zonulin
    As discussed earlier of Zonulin effects the opening of the tight junctions so the Increased amount of Zonulin shall cause the Tight junction to loosen resulting in intestinal permeability. A blood test is to identify the amount of Zonulin level in the blood.
  3. Stool test
    Just like blood test is done to see what’s wrong in the with the organs. Stool test is done to analyze the condition of the Gut. They’ll look for bacteria (good and bad), viruses, bacteriophages, fungi, yeast, parasites and all sorts of other goodies that may be contributing to my intestinal permeability, aka leaky gut.
  4. Food Tolerance Test
    Although it may not help in the direct diagnosis of the leaky gut, once you diagnosed with leaky gut this test plays an important role to plan your diet and to list out which food or ingredients have to be avoided. These tests are also available as a dried blood spot collection.

Signs and symptoms of Leaky gut syndrome

Symptoms may not be the same for everyone it may differ from person to person and one may have a combination of symptoms which may include

  1. Stomach pains, especially after eating due to undigested particles breaching the tight junction and entering the bloodstream leading to immune response
  2. Chronic diarrhea, constipation, gas or bloating, inflammatory bowel disease
  3. Nutritional deficiencies may occur due to improper absorption of Nutrients
  4. The Immune system weakens and person fall sick more frequently
  5. The person may suffer from Headaches, brain fog, memory loss, and Excessive fatigue
  6. Skin rashes and problems such as acne, eczema or rosacea may develop due to inflammation.
  7. The person craves for sugar or carbs due to loss of sugar in Urine
  8. Arthritis or joint pain
  9. Depression, anxiety, ADD, ADHD
  10. Autoimmune diseases such as rheumatoid arthritis, lupus, celiac disease or Crohn’s
  11. Food Allergies are believed to be one of the most common leaky gut symptoms.
    leaky gut has been shown to cause various neurocognitive disorders causing Mood issues and autism in some cases

Treatment

Leaky Gut Treatment

 

Whenever a person falls sick it is a common habit to change the diet may it be for a small period of time as short as a couple of days. The treatment for Leaky Gut revolves around a Healthy selective diet eliminating the foods that your body treats as toxic and Gut repairing supplement. the digestive tract is a key player in the manifestation of eczema, psoriasis, and allergy symptoms.

Remove foods that cause inflammation

A common initial step most of the practitioner’s advice is to remove foods that can be inflammatory. Among the most common are

  • Alcohol and Carbonated Beverages
  • Caffeine
  • Dairy products
  • Baked goods
  • Gluten-containing products and Grains
  • Sauces
  • Refined Oils
  • Artificial Sweeteners
  • Mushrooms
  • Nuts
  • Potatoes and Tomatoes
  • Any kind of processed foods, (especially canned foods)
  • certain medications,
  • any foods that may cause allergies or sensitivities.

Nutrients that repair the gut lining and protect it from injury are required to heal the leaky gut. Hence Eczema Diet and Eczema Detox programs have a great success rate.

Incorporate foods that have an anti-inflammatory effect

  • Bone Broth is rich in amino acids and minerals with gut-healing collagen providing perfect nourishment for the inflamed gut.
  • Turmeric’s anti-inflammatory property helps with the inflammation occurring in the gut lining and also acts as detox.
  • Coconut products such as coconut oil, milk, dried coconut, coconut water. Coconut helps fight the overgrowth of bacteria, yeast and fungus in the gut.
  • Fermented foods and vegetables like kimchi and sauerkraut bring good bacteria into the gut.
  • Choose a wide variety of colorful vegetables and fruits with plenty of leafy greens. Every diet should be “plant-based”.
  • Fruits with Low Glycaemic Index
  • Sprouted seeds (like chia seeds, flaxseeds, and hemp seeds)
  • Herbal teas
  • Olives and olive oil (Avoid deep frying)

Most of the eczema sufferers get eczema when they consume high salicylate-containing food. An eczema diet including a low salicylate broth are gentle on the gut and good for the skin specially to those who are sensitive to salicylate

Probiotic therapy

The best way to improve the gut is to keep the gut bacteria healthy by means of diet i.e. consume probiotics. Studies have shown that an increase of probiotic or cultured foods can help in nourishing good bacteria. Incorporate Vitamins B6 and C in diet or via supplements, which are very beneficial to help the gut lining to repair.

Probiotic supplements are generally safe and are potentially effective means of decreasing immune system triggers and improving eczema symptoms. Probiotic bacteria are thought to inhibit inflammation and promote proper development of young, immature intestinal, respiratory and immune cells into healthy, fully mature cells.

For a Leaky gut, optimal digestion can be obtained through diet, therapeutic nutrition, and targeted supplementation to realize the complete resolution of symptoms. By changing what you eat and healing your gut you can clear your skin if leaky gut is the cause of your eczema

Final Thoughts

Leaky gut is associated with the disruption of the intestinal lining or tight junctions which controls the entrance of the particles from the digestive system into the bloodstream. Avoiding and including a certain type of foods with probiotic therapy helps in curing the disease.

The leaky gut syndrome is not a recognized diagnosis in the medical community yet. Eczema or Atopic dermatitis still remains a complex disease with mysteries in its actual cause and no complete treatment. Even in today’s advanced and latest medical improvements, there are still questions that remain unanswered. The connection between Leaky Gut and Atopic Dermatitis arises many thoughts with diagnostic and treatment implications but also raises many queries. Still, there are ongoing studies and more research required if Leaky gut is the key cause of eczema or just limited to certain sub-categories of Eczema and what will be the solution that needs to be approached.

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Treatment & Care for Eczema Infections

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Abstract

Eczema also commonly know known as Atopic Dermatitis can become so infected that the person has to go to the hospital and stay over for treatment, this can be very upsetting, especially for youngsters which means missing days of school. Some infections, such as eczema herpeticum (a viral infection), are serious and need medical attention right away, you don’t have any option and in case, if left untreated it may cause sepsis which can be life-threatening.

Some kinds of skin infections can be treated with antibiotics (in the form of tablets, creams, injections or IV drips). Other kinds of skin infections are fungal (such as ringworm) and are treated with antifungal creams or tablets.

It is very obvious that one should immediately visit the physicians for advice to fight back the infection but as it always said that “prevention is better than cure”. Let’s check out what all things can be done to avoid infections and smooth eczema management.

Prevention measure to avoid Eczema Infection

  • It is important to keep your skin healthy as possible to avoid infection, especially during an Eczema flare. When flares occur, a person should follow the recommended treatment plan to help manage and reduce the flare.
  • If you are suffering from Eczema, avoid contact with anyone who has cold sores. Cold sores are highly infectious. Since the presence of Eczema reduces the immunity against viral infections, eczematous lesions can get infected easily.
  • Frequent hand washing – As we touch surfaces all the time, it is best to wash our hands frequently, especially if they get contaminated with germs.
  • Avoid touching your eczema lesions unnecessarily as you can introduce germs to the rash
  • Avoid scratching – Scratching can damage the skin and break the natural surface barrier for infections. Cut and maintain your nails so that it doesn’t hurt much in case you scratched unknowingly
  • Keep the rashes and skin moisturized well for extra protection.
  • Avoid trigger factors which worsen eczema (Synthetic fabrics, dyes, soaps etc)
  • Follow a healthy diet and avoid foods that you may be sensitive for e.g. nuts and dairy products
  • Keep your skin as clean as possible
  • Children who have eczema should be monitored closely and reminded not to scratch.
  • If flares of Eczema occur, seek treatment early and stick to the recommended treatment plan. The more severe your eczema, it is more prone to infection.
  • Keep your environment clean, free from dust and animal dander
  • Manage your stress – as stress is known to trigger eczema, managing your stress well can reduce flares and thus infections. Practice relaxation techniques, yoga and meditation.

 

What you can do as a home remedy?

Bath/shower

  • Bath or shower every day to clean the skin.
  • Use warm water and a soft cloth to gently soak and lift off any crusts.
  • Use a soap-free wash e.g. non-ionic cream, aqueous cream, emulsifying ointment. Don’t use soap and bubble bath as these make the skin dry.
  • Antiseptic baths two times a week can help. See bleach bath instructions.

Steroid creams and ointments

  • Apply steroid to all red and itchy skin (active eczema) at-least once a day. Immediately after the bath is best.
  • Use enough to make the skin shiny. Steroid for the face/neck: Steroid for the body/arms/legs:
  • When the skin is no longer red and itchy stop using the steroid but keep it moisturized. If eczema comes back, start using the steroid again

Moisturizer (emollient)

  • Smooth on lots of moisturizers many times a day to keep the skin soft.
  • Apply all over not just where there is eczema.

Treatment for Eczema Infection

Once the infection breaches your prevention immediately look for treatment.

On approaching the medical care, the physician may take skin from the site which will be sent for pathology testing. The Microbiological testing of the smear helps to identify the type of infection. The mode of treatment will majorly depend on the result of the test whereas empirical treatment can be started without delay. According to the results of the culture and antibiotic sensitivity testing, treatment can be modified.

  • If the infection is mild an antibiotic cream or ointment will be prescribed. e.g: Neosporin, Polysporin, Fucidine.
  • Sometimes the antibiotic is combined with a steroid. e.g: Betnovate N, Fucicort, Corticosporin.
  • When the infection is widespread, an oral antibiotic will be added. e.g: a course of Flucloxacillin or Co-Amoxyclav to fight the infection better.
  • To infants and children with infected Eczema, oral antibiotics will be given in syrup form, whereas for adults, tablets and capsules are preferred.
  • If the patient is ill with fever and chills, your doctor will admit you and treat the infected Eczema with IV antibiotics.
  • Sometimes steroids can worsen infections. Topical immune-modulators like Protopic ointment and Elidel cream are preferred to steroids by some doctors when treating infected Eczema.
  • Viral infections are treated with oral antiviral medications e.g: Oral Acyclovir for 1 week.
    Sometimes an antiviral cream (Herperax) can be applied topically over the rash. Eczema which is infected with a virus can heal spontaneously with time even without treatment with anti-viral medications. However, if it doesn’t heal seek treatment.
  • If Eczema Herpeticum is severe, hospital admission is required and drugs will be given via a drip.
  • If there is a pain, pain relief can be done by Tylenol (Acetaminophen) or Advil (Ibuprofen). These are also available as over the counter products. Make sure that you adhere to the proper dose and dosage instructions.
  • Treatment of Fungal infections of Eczema – Use of a cream or ointment containing antifungal and steroid combinations.
    e.g: Candacort (Clotrimazole and Hydrocortisone)
    Ecocort (Econazole and Triamcinolone)
    Candid B (Betamethasone and Clotrimazole)
    Once the inflammation is controlled you may be treated with a pure antifungal cream or an ointment. Sometimes your doctor may first control the fungal infection with a pure antifungal cream or ointment rather than a combination.
    e.g: Clotrimazole (Lotrimin), Lamisil (Terbinafin), Tolnaftate
    Once the fungal infection is controlled treatment will follow with usual topical products which control the Eczema rash.
  • Sometimes fungal infections can be widespread especially in immune-compromised patients such as those who suffer from immunity disorders, AIDS, Cancer etc. Then a course of oral or intravenous antifungal medication will be added depending on severity.

 

In addition to the specific treatment of infection, the usual treatment for Eczema should also be followed, such as;

Moisturizing the skin well – Moisturize your skin adequately with a good emollient twice a day, especially after a bath, while the skin is still damp. Emollients with minimal fragrance, which are alcohol and paraben free, are the best. Ingredients in a good moisturizer are glycerol, Dimethicone, aqueous cream, Lanolin oil, Shea butter, Argon oil, cocoa butter etc. Moisturizers are best when used in Ointment form rather than a cream form. Choose the best emollient which is suitable for your skin or get a prescription from your doctor which will be the best for you.

Management of itching with an antihistamine – These are also available as over the counter products.
e.g: cetirizine (Alerid, Cetzine), Loritidine (Claritin, Claratyne), fexofenadine (Allegra) or Chlorpheniramine (Piriton) to reduce itching.
As antihistamine products prevent you from the urge of scratching it will help the control of further skin damage and infection.

Wet dressing or bandages to cover and treat eczema rash – This helps to maintain moisture and to prevent further damage to the skin by scratching. However, bandages are preferred once the infection is controlled. Avoid applying bandages when eczema is infected.

When to look back to your physician

  • If you find that the infection is not at all improving after 2–3 days of treatment
  • If your child is missing school due to severe skin infections or not sleeping well because of eczema
  • Once you complete the course and find the symptoms are recurring

 

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Things you should know to detect Eczema Infection

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Eczema Infection

Eczema, also known as Atopic Dermatitis, a term marked by Dry, Red, Itchy and inflamed skin, itself a chronic condition that requires proper management, But When Such condition is caught by an Infection it only worsens it. The routine Eczema Treatment will not be effective in such condition and requires special care.

Infection is more common in wet eczema than Dry eczema because the former provides the Infection causing germs (Micro-organisms) a favourable environment to survive, grow and multiply.

One of the other common reason for the infection is the habit of uncontrolled scratching. Continuous scratching damages the layer of the skin which acts a barrier causing bruises.

Scratching Damages the skin layer
Atopic Dermatitis

These Open bruises from scratching dermatitis permit germs and microbes resulting in infection.

Hence you might have noticed that the Eczema Infection is more common amongst the children because they don’t have control over scratching and also their skin has less resistance to germs.

Child Eczema
Atopic Eczema in Children

Adults on the other hand somehow control the scratching, tempted by the itch in eczema. It is also common with the individuals who are currently on eczema treatment but have frequent sores and open wounds related to their eczema condition.

Atopic Eczema itself is not infectious or contagious (it cannot be spread to another person), but it can become infected if germs set in, which can pass on to person nearby as well. There are different kinds of infections that can develop with eczema also known as Atopic Dermatitis and these Infections can develop in or on eczema anywhere on the body right from the scalp to toe.

Causes of Eczema Infection

Infections in Atopic Eczema are caused by a variety of potential, bacteria, fungi or viruses. Coming up next are some of the common microbes which accounts for causing Eczema Infection.

  • Bacterial – Staphylococcus aureus (Staph infection)
  • Fungal – infections, such as ringworm(tinea)
  • Viral – herpes simplex virus
Bacteria, Virus, Fungi
Micro-organism causing Eczema Infection
  • Bacteria – Staphylococcus aureus, Streptococcus

Staphylococcus aureus is a bacterium which is found in almost all people with Eczema. They cause colonization, although may not infect the lesions. In 20% of healthy adults without eczema, Staphylococcus aureus lives as a commensal organism (The microorganisms which live on the skin without harming the host). However, when eczematous skin gets damaged these bacteria can get in and cause infection.

  • Viruses – commonly Herpes Simplex Virus 1 (HSV 1)

Presence of Eczema lowers the resistance to viral infections. HSV 1 virus spreads from skin to skin contact. HSV which commonly causes Cold sores can cause severe infection in eczematous rashes. This is also known as Eczema Herpeticum. It is an extensive skin eruption with vesicles which occur on eczema rash. Eczema Herpeticum commonly occurs in infants and children with severe eczema. These clusters of small blisters are itchy and painful.

  • Fungal infections – Candida (Thrush) can develop in warm and moist skin folds. When the eczema is in flexures such as elbows, behind knees or around abdominal folds, candida can freely infect eczema especially when the skin is damaged by scratching. If the person lives in warm and humid climates, increased sweating can cause infection to spread.

Tinea (Dermatophytes) or Ringworm can also infect eczema rashes causing ring like reddish patches or infect in between toes leading to Athletes foot.

When Eczema rash is infected, it worsens Eczema and allowing it to spread more quickly and making the Treatment and healing process difficult.

Diagnosing infection in Atopic Dermatitis is not always straightforward. But there are a few signs and indications which you can look up to and take prompt actions once you notice them. It’s critical for people with eczema or caregivers of children with eczema to get familiar with the indications of infected eczema so you can look for the proper treatment. Proper treatment at the right time during the infection will help to avoid further complication.

The symptoms of infected Eczema will be very different from normal eczema which suddenly starts getting worst spreading the rash across the body in no time.

Signs and Symptoms of infected Atopic Eczema

Eczema Infection Symptoms

  • The skin area becomes more inflamed (swollen, hot and red)
  • The eczematous lesions get blisters, ‘boils’ and cysts with red or yellow color spots with pus
  • pus/weepy fluid (often yellow or green) coming out of the skin and crusts or scabs
  • painful skin – “like you’ve got cuts everywhere”
  • Very tired and unwell feeling drains the person
  • Sudden flaring of eczema all over the body.
  • Lesions become sore and painful with a tender to touch in Eczema Herpeticum.
  • A person with infected eczema will also experience extreme Itching and burning
  • In more advanced cases, a person may experience more severe symptoms including fever, chills, aches, and fatigue

Complications in Eczema Infection

Atopic Eczema Infection may also lead to more dangerous complications such as a serious staph infection that may cause a blood infection known as sepsis (A life-threatening condition) if left untreated.

Some of the other complications include

  • Resistance to the topical steroids due to continuous and prolonged use
  • Increase in blisters and Itching out of control
  • Prolonged Eczema flare and Scarring
  • It may cause a growth problem in some children’s too.

When to Approach a Physician?

Visit Dermatologist

Because it’s not always obvious if eczema is infected, it’s important to get help from medical professionals.

If an individual is suffering from chronic eczema, he should approach the physician immediately in case he develops a fever, experience chills, Experiencing tiredness/fatigue, or develop signs of infection, such as oozing blisters and excessive itchiness.

Infants and young children with infected Eczema should be taken for medical care as soon as possible and monitored for a clinical outcome more carefully when encountered with Eczema Infection.

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