Hippocrates already said over 2000 years ago that ‘all disease begins in the gut’. Today, we’re understanding more and more how right he was.
For me personally, gut issues preceded the onset of chronic cystitis and interstitial cystitis. When my gut was at its worst, so was my bladder. I have no doubt that, similarly to many other conditions, the gut is implicated in bladder problems.
Why the Gut plays such a big role in Health
Essentially, the gut is a barrier between our insides and the outside world. From mouth to anus, the digestive system is one continuous tube.
A large part of our immune system is therefore found in the gut, where it helps us deal with all the outside intruders entering the body on a daily basis.
The small intestine is the place where most nutrients are absorbed. Normally, only nutrients should make it through the barrier and into the bloodstream whilst everything else stays out.
Everything that can’t be digested by our bodies is excreted through the faeces.
The gut also provides a defensive barrier against pathogens entering the body.
Moreover, the gut houses the majority of our microbiome, which plays a very important part in our health. Disturbances in the balance of microbes in the gut have been implicated in many chronic disease states.
How the Urinary Tract is connected to the Gut
The urinary tract is one of the excretory organs of the body, meaning it is one of the organ systems dealing with waste products.
The urinary tract works with the intestines, as well as the lungs and skin (the other excretory organs).
After the nutrients have been absorbed in the gut, waste products are left behind in the bowel and blood. The blood is filtered through the kidneys, where urea (a protein waste product) is removed.
Other water-soluble waste products and toxins are also removed, and together with excess water urine is formed and passed into the bladder from where it can be excreted from the body.
Problems with increased intestinal-permeability (a.k.a ‘Leaky Gut’)
As mentioned above, the gut is normally selectively permeable – meaning some things (such as nutrients) get through into the bloodstream and lymph, whilst the rest is kept out.
Therefore, the cells lining the intestines are bound together by so-called ‘tight junctions’. These little structures are designed to open and close so that specific nutrients can be absorbed.
Problems arise when the mechanism for regulating the opening and closing of the tight junctions fails and they are left open.
This creates a situation where substances from the gut that normally aren’t supposed to enter the body can enter the bloodstream (and ultimately the urinary tract).
This can include food particles, microbes, pathogens and toxins. As you can probably imagine, this can create many problems for the body:
- The immune system recognizes these foreign particles and microbes as invaders and may mount an immune response, which always includes an inflammatory response. Inflammation plays a role in most chronic health issues.
- Food particles may be recognized as intruders, potentially leading to food intolerances.
- Pathogenic microbes may be able to get into the body.
Examples of factors that may cause tight junctions to open:
- Certain dietary proteins (especially gliadin from gluten)
- Some drugs
- Some infectious microbes
Implications for the Urinary Tract
It has been implicated that many infections on various body sites may stem from the gut, including urinary tract infections .
It has been suggested that microbes may translocate from the gut to other body sites such as the bladder, which in turn could play a role in urinary tract infections as well as IC .
Microbes could translocate via the anus and perineum to the bladder, or it may be possible that in cases of a ‘leaky gut’ they could enter from the gut via the bloodstream and the kidneys.
The translocation of bacterial waste products through an increasingly permeable gut wall into the blood may play a role in kidney disease by increasing inflammation  and in turn this could impact the bladder as what passes through the kidneys eventually ends up in the bladder.
Bacteria in the gut ferment the amino acids tyrosine and tryptophan, which results in waste compounds, including indoles that are excreted via the kidneys. An imbalance in gut bacteria may contribute to an excess of these compounds, which can create problems in the urinary tract .
In IC sufferers, it has been found that many also have issues with the gut (such as IBS) . IC has also been linked with autoimmune disorders , which in turn have been linked with increased intestinal permeability .
Moreover, research has shown that IC sufferers also have an imbalance in gut flora: they are deficient in certain microbial strains, namely O. splanchnicus, F. prausnitzii, C. aerofaciens, E. sinensis, and L. longoviformis . Two of these are of particular importance: F. prausnitzii is one of the butyrate producing bacteria, the fuel that keeps the gut cells healthy. L. longoviformis plays a role in oestrogen metabolism, and hormones in turn can play a role in bladder health.
For me, bladder issues have always gone hand in hand with gut issues. My bladder health improved significantly when I targeted my gut health.
Therefore, I think it is always important to look at the gut when someone has chronic bladder issues. Gut testing is part of the protocol I use for my clients.
How I your gut health? Do you think your bladder issues are connected to the gut? Let me know in the comments!
Pin it for later:
- Kidney & Urology Foundation Urinary System and How it Works October 2006 http://www.kidneyurology.org/Library/Urologic_Health.php/Urniary_system_and_how_works.php
- BioCare Education Series: Digestion in Practice
- Ballantyne, Sarah The Paleo Approach (USA, Victory Belt Publishing: 2013)
- IC Network The DIPP Mystery – Why are IC patients deficient in some good bacteria? June 16th, 2016 https://www.ic-network.com/dipp-mystery-ic-patients-deficient-bacteria-gut/
- Latorre, M., Krishnareddy, S., & Freedberg, D. E. (2015). Microbiome as mediator: Do systemic infections start in the gut? World Journal of Gastroenterology : WJG, 21(37), 10487–10492. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4588071/
- Al Khodor, S. & Shatat, I.F. Gut microbiome and kidney disease: a bidirectional relationship Pediatr Nephrol (2017) 32: 921
- Warren, J. et al Interstitial Cystitis/Bladder Pain Syndrome and Nonbladder Syndromes: Facts and Hypotheses Urology [78 (4): 727-732) https://www.sciencedirect.com/science/article/pii/S0090429511006273
- Van De Merwe, J. et al Systemic aspects of interstitial cystitis, immunology and linkage with autoimmune disorders Int J Urology October 2003 [10: S35-S38] https://onlinelibrary.wiley.com/doi/full/10.1046/j.1442-2042.10.s1.10.x
- Fasano, A. Leaky Gut and Autoimmune Diseases Clinic Rev Allerg Immunol (2012) 42: 71. https://link.springer.com/article/10.1007%2Fs12016-011-8291-x
- Braundmeier-Fleming, A. et al. “Stool-Based Biomarkers of Interstitial Cystitis/bladder Pain Syndrome.” Scientific Reports 6 (2016): 26083. PMC. Web. 29 Apr. 2018. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4870565/