With Inflammation, We Start With The Gut!

In functional medicine, we always “start with the gut” to uncover the root causes of inflammation and autoimmunity, even if you don’t have noticeable digestive symptoms. Understanding why we prioritize the gut—and specifically the small intestine lining—is key to grasping how we address autoimmune conditions and chronic inflammation holistically.

Meet the Small Intestine Lining

Your small intestine lining is the body’s central immune hub. In addressing inflammation and balancing the immune system, the small intestine is a critical focus. Why? The small intestine’s unique characteristics make it foundational to immune health and overall inflammation regulation. Let’s break down these essential elements:

1. The small intestine is a “hollow” organ exposed to the outside world.

Think of the GI tract as a long, hollow tube, beginning at the mouth and ending at the anus. Everything you ingest—food, beverages, medications, supplements, toxins, microbes—interacts with the lining of the GI tract. Furthermore, the lining of your small intestine, when unfolded, is a vast surface area. In fact, it’s the largest surface area of your body that is exposed to the outside world. This requires a significant amount of immune activity, as the dendritic cells of your immune system sort through every particle that enters your GI tract, identifying and tagging potential antigens.

2. The small intestine lining is thin, semi-permeable, and, therefore, vulnerable.

The epithelial lining of the small intestine is just one cell thick, allowing essential nutrients to pass easily into circulation. The cells are connected by tight junctions, selectively permeable to allow nutrient absorption. However, when these tight junctions become overly permeable (a state called “leaky gut”), they allow larger, undigested food particles, harmful microbes, and toxins to pass into the bloodstream, triggering systemic inflammation and a potential autoimmune response.

3. The small intestine houses the bulk of your immune cells

The small intestine, with its thin, semi-permeable lining and enormous surface area, requires extensive immune defense. It contains the gut-associated lymphoid tissue (GALT), which provides this defensive role. The GALT houses 70-80% of your body’s immune cells. It is your immune system’s powerful sorting center, constantly discerning friendly from harmful substances and initiating immune responses as needed.

The small intestine is the busiest immune hub in your entire body!

Regulating Gut and Immune Health

Given the role of the small intestine in managing immune activity, it’s clear why gut health is crucial for controlling inflammation and calming autoimmunity. We use a functional medicine approach known as the “5 R” program to address gut-immune health. Tailored to each individual, these steps help reset and strengthen the gut:

1. REMOVE inflammatory triggers (e.g., high cortisol, food sensitivities, medications, infections, alcohol).
2. REPLACE essential digestive secretions that may be low (like enzymes).
3. REPAIR the gut lining with supportive nutrients such as glutamine and butyrate.
4. REINOCCULATE beneficial bacteria through targeted probiotics and prebiotics.
5. REBALANCE the nervous system, recognizing the critical influence of stress and emotions on gut function.

The Small Intestine’s Energetic Perspective

In traditional Chinese medicine, the small intestine “sorts the pure from the impure.” This concept reflects its essential role in immunity, filtering what we allow into the body. Autoimmunity, in this light, arises when this protective boundary becomes compromised. Supporting the small intestine with positive affirmations like “I trust my choices,” “I trust my gut,” or “I am safe” can also help create a sense of calm and reinforce this boundary on an emotional level.

Ready to Start with the Gut?

Starting with the gut can be a transformative approach to addressing inflammation and reversing autoimmune conditions. If you’re ready to explore how gut health can support your journey to wellness, learn more about our Road to Remission program, designed for women recovering from autoimmune conditions.

I’d love to hear your thoughts! Feel free to share your questions or experiences in the comments below.