How to Treat Autoimmune Gastritis

Foods that trigger autoimmunity

Virtually all autoimmune diseases require both inherited (genetic) factors and environmental factors. The main inherited factor associated with autoimmune diseases is a set of genes that code for many functions of the immune system, called the human leukocyte antigen (HLA) system. Mutations of some of the genes in the HLA complex are associated with autoimmune diseases. If you have inherited one of these so-called HLA susceptibility haplotypes, then your risk for an autoimmune disease rises significantly.

While its generally necessary to have one of these gene mutations, it is still estimated that about 70 percent of the risk for autoimmunity comes from environmental factors. Many immunologists and scientists (Dr. Cordain included) studying autoimmune diseases now believe that increased intestinal permeability or a "leaky gut" represents a fundamental environmental trigger that precedes the development of most autoimmune diseases.

Gluten-free diets are therapeutic for many autoimmune patients (not just celiac patients). That's because wheat contains at least four compounds (gliadin, wheat germ agglutinin [WGA], amylase-trypsin inhibitors, and thaumatin-like proteins) that can increase intestinal permeability and inappropriately activate the body's immune system.

However, this issue isn't limited to wheat. There are other gliadin-containing grains including rye and barley. In Dr. Cordain’s most recent book, The Paleo Answer, he outlines the nutritional problems with grains and how they increase intestinal permeability.

Besides grains, other elements that can also increase intestinal permeability include legumes (peanuts and beans), potatoes, and nightshade plants.

Its important to point out that tomatoes are also a nightshade, but their impact is less black-and-white than grains. Green tomatoes, cherry tomatoes, and yellow tomatoes contain high concentrations of the compound alpha-tomatine which can also increase intestinal permeability. Fortunately, ripe red tomatoes are almost devoid of this compound.

Potatoes contain two toxic glycoalkaloid compounds; saponins, which are known as alpha solanine, and alpha chaconine. These compounds damage the intestinal barrier, increase intestinal permeability, and rapidly enter the bloodstream, often causing adverse health effects.

Other foods which increase intestinal permeability and may be problematic for autoimmune patients are:

• Ethanol (alcohol)
• Aspirin, ibuprofen and other NSAIDs
• Antacids containing aluminum hydroxide (Alum)
• Birth control pills
• Hot spicy peppers containing capsaicin (salsa, hot sauce, chili peppers, cayenne peppers, etc.).

This may come as a surprise, but there’s one final food to consider avoiding: egg whites. They contain a compound called lysozyme which can impair intestinal function and allow large protein molecules (antigens) access to the immune system.

If you have an autoimmune disease, we recommend that you eliminate grains, dairy, and legumes from your diet first. If you still experience adverse effects, try eliminating the other listed foods that increase intestinal permeability.

Can The Paleo Diet help autoimmune gastritis?

While there is no guarantee that The Paleo Diet will help autoimmune gastritis to go into remission, many people all over the world with a variety of autoimmune diseases have reported therapeutic effects or even complete remission of their symptoms after following this lifelong way of eating.

Dr. Cordain and The Paleo Diet’s CEO, Trevor Connor, then a graduate student of Dr. Cordain, completed a large case study involving about 100 autoimmune patients who had adopted the Paleo Diet. The results were encouraging, particularly for patients with autoimmune diseases involving the GI tract. However, no subjects with autoimmune atrophic gastritis participated in the study.

There are no health or nutritional risks of adopting The Paleo Diet. In fact, the opposite is true. This way of eating actually reduces the risk for many common chronic diseases and increases the nutrient density of the diet because fruits, veggies, seafood, and meat are vastly superior nutritionally to grains, processed foods, and dairy products which comprise about 70 percent of the calories in the typical U.S. diet.

A final note from The Paleo Diet

Autoimmune atrophic gastritis presents a unique challenge. Because one of the symptoms is a lack of stomach acid, it would be prudent to eat less animal protein in the early stages of adopting the diet. As the condition improves, so too will the production of stomach acid, and a higher protein consumption may be possible.

Supporting digestion can also be accomplished by choosing fish versus beef or poultry, making sure you chew your food thoroughly, and taking 1-2 teaspoons of apple cider vinegar before eating. There are many other ways to support digestion, so consider working with a nutritionist that has experience in this area.

References:

[1] Kulnigg-Dabsch S. (2016). Autoimmune gastritis. Autoimmungastritis. Wiener medizinische Wochenschrift (1946), 166(13-14), 424–430. https://doi.org/10.1007/s10354-016-0515-5

[2] Fasano A. (2011). Zonulin and its regulation of intestinal barrier function: the biological door to inflammation, autoimmunity, and cancer. Physiological reviews, 91(1), 151–175. https://doi.org/10.1152/physrev.00003.2008

[3] Genetics and Rare Diseases Information Center. (2016). Autoimmune atrophic gastritis. National Center for Advancing Translational Sciences. Retrieved from: https://rarediseases.info.nih.gov/diseases/10310/autoimmune-atrophic-gastritis