Hi LymeMother
Very interesting question. From my understanding damage from leaky gut would look a little like missing or flattened villi but also, there would be penetration to the mucosal lining, which may or may not show up on an endoscopy. Also, there are multiple causes of leaky gut/altered permeability and "intraepithelial lymphocytes". Excerpt from an article I link to below:
"Abnormal tight junctions result in increase intestinal permeability or a leaky gut. This altered intestinal permeability or barrier function is implicated in several diseases, especially celiac disease and the inflammatory bowel diseases ulcerative colitis and Crohn’s disease. Chemicals released as part of the innate immune system can increase gut permeability. Some bacteria, yeast and virus cause toxic injury to intestinal cells resulting in increased permeability. Some medications, such as ibuprofen (Motrin, Advil) can increase intestinal permeability. Stress has implicated in increased intestinal permeability. In fact one of research models for Crohn’s disease is a rat that when water stressed develops increased intestinal permeability allowing certain bacteria through the bowel wall resulting in Crohn’s like disease that is used to study this disease in humans."
Rebuildng gut flora (the purpose of fecal transplants) would be phase 2. Phase 1 is gut repair and to allow the mucosal lining and villi to repair. And this is as straightforward as eliminating everything damaging to the lining (bacteria, chemicals and toxins, gluten, GMOs, yeast/fungal overgrowth) and helping support your immune system… and as unbelievably painstaking and arduous as changing everything about
your life for many many months, sometimes years.
And, from what I know about
celiac (I think others who have their own experiences or have kids who have it might correct me on this) but you either have the genes that make you susceptible to celiac or you don't… and you either react like a celiac or you don't. So the MD's declaration that your son is showing evidence of "early celiacs" doesn't make a whole lot of sense. You can be a little or very sensitive to gluten without having celiacs and the damage is the same as leaky gut damage. In other words, I think if your son had celiacs, you would know it due to extreme responses to gluten, not from the endosopy. The endoscopy is showing evidence of damage—which could be from any number of things damaging the gut. Another excerpt:
"Chronic gluten exposure has been shown to activate zonulin resulting in increased intestinal permeability (or leaky gut) even in the absence of celiac disease. Intestinal permeability with malabsorption has been described in celiac patients and their relatives who don’t have atrophy of the intestine on biopsy but only increased inflammatory cells known as lymphocytes or increased intraepithelial lymphocytosis (IEL). In celiac disease, genetically predisposed people can have marked increased and sustained leaky gut from gluten. This combined with other factors results in the characteristic abnormal blood tests, damaged intestine seen on biopsy, and symptoms and signs of celiac disease including malabsorption of nutrients and diarrhea."
I would explore the following:
Does your son have reactions to foods? If so, what kind of reactions or symptoms develop? What kinds of foods cause the reactions? Has he ever implemented an elimination diet, where you eliminate most foods except for a few known to be "easy" on the gut and then slowly reintroduced some foods to see how he reacts?
Does your son show signs of a weak immune system? Does he have any common lyme symptoms? Does he exhibit any mood imbalances or psychological symptoms?
Does he show any signs of chron's or IBS or h. pylori infection?
Does he exhibit signs of yeast/fungal overgrowth? Bloating/distended belly after eating, sugar or carbs cravings, foggy brain, itchy parts, white tongue, (there are tons more sx but these are the basic ones).
Here is an excellent article on lympocyctes and leaky gut—one of the best I've ever read:
www.thefooddoc.com/diagnoses/leaky_gut-p