Written by Dr. Ryan Kneessi, ND
Quick answer: Chronic inflammation is a prolonged, low-grade immune response that often goes unnoticed. Inflammatory messengers such as TNF-alpha and interleukins can loosen the tight junctions in the gut lining and disturb the microbiome. A weaker barrier then lets more bacterial products into the body, which can keep the inflammation going.
Key takeaways
Inflammation is a normal response to injury or infection, but when it persists beyond its purpose it can damage healthy tissue.
Chronic inflammation and a leaky gut can feed each other, since inflammatory cytokines loosen tight junctions and a leaky barrier lets more triggers through.
Colorful plants, omega-3-rich fish, olive oil, daily movement, enough sleep and less sugar and alcohol can help calm inflammation.
Understanding chronic inflammation
Inflammation is the body’s natural response to injury or infection. When it persists beyond its purpose, it becomes chronic and can damage healthy tissue.
The leaky gut connection
Increased intestinal permeability happens when tight junctions are compromised. See introduction to leaky gut.
Pro-inflammatory cytokines
Chronic inflammation increases cytokines such as interleukin-1 beta, interleukin-6 and TNF-alpha, which can loosen tight junctions.
Damage to the intestinal barrier
Inflammation can damage the single layer of cells lining the gut and the mucus that protects it.
Altered gut microbiome
Inflammation shifts the balance of gut bacteria, which can further weaken the barrier. See dysbiosis.
Inflammation and healthy aging
Chronic, low-grade inflammation is closely tied to aging and age-related disease, sometimes called inflammaging. Increased gut permeability and changes in gut bacteria are thought to be among its sources. Read more in inflammaging or check your level with hs-CRP.
Ways to calm inflammation
Eat colorful plants, omega-3-rich fish and olive oil, and limit ultra-processed foods, sugar and alcohol. Move daily, sleep seven to nine hours, and manage stress.
When to see a naturopathic doctor
It may be time to see a naturopathic doctor if you have ongoing bloating, gas, diarrhea or constipation, or food reactions that seem to be multiplying. The same is true if you have fatigue, skin flares or joint aches alongside gut symptoms, or if you want a personalized gut plan instead of guessing.
See a medical provider promptly for blood in your stool, black stools, unexplained weight loss, persistent vomiting, severe abdominal pain, fever, or trouble swallowing.
What the research shows
Meals can briefly raise gut-derived inflammatory signals. In a 2007 study by Erridge and colleagues, 12 healthy men had their blood endotoxin (a bacterial product) measured for 4 hours after no meal, 3 cigarettes, a high-fat meal, or both. Endotoxin rose by about 50% after the high-fat meal, but not after smoking alone. This was a small, short study, and it did not show long-term effects.
Omega-3 fats may calm inflammatory responses. In a 2011 trial by Kiecolt-Glaser and colleagues, 68 medical students took 2.5 g a day of omega-3s (mostly EPA) or a placebo for 12 weeks. The omega-3 group had a 14% drop in IL-6 production by stimulated immune cells and 20% fewer anxiety symptoms. The participants were young and healthy, so results may differ in people with chronic inflammation.
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Questions to bring to your clinician
These questions can help you get the most out of your next visit.
Do my symptoms or labs suggest chronic inflammation that may involve my gut?
Could inflammation and my gut lining be affecting each other in my case?
Which first step would help calm both inflammation and my gut?
Would an inflammation lab or gut test help us track progress?
Frequently asked questions
Can inflammation cause leaky gut?
Chronic inflammation can weaken tight junctions and contribute to increased permeability.
Can leaky gut cause inflammation?
A weaker barrier may let bacterial products like LPS into the blood, fueling inflammation.
How do I know if I have chronic inflammation?
Symptoms are often vague. Tests like hs-CRP can help.
What diet reduces inflammation?
A whole-food, plant-rich diet with healthy fats.
Sources
- Erridge C, Attina T, Spickett CM, et al. A high-fat meal induces low-grade endotoxemia: evidence of a novel mechanism of postprandial inflammation. Am J Clin Nutr 2007. PMID: 17991637. https://pubmed.ncbi.nlm.nih.gov/17991637/
- Kiecolt-Glaser JK, Belury MA, Andridge R, et al. Omega-3 supplementation lowers inflammation and anxiety in medical students: a randomized controlled trial. Brain Behav Immun 2011. PMID: 21784145. https://pubmed.ncbi.nlm.nih.gov/21784145/
- Al-Sadi R, Boivin M, Ma T. Mechanism of cytokine modulation of epithelial tight junction barrier. Front Biosci (Landmark Ed) 2009. PMID: 19273235. https://pmc.ncbi.nlm.nih.gov/articles/PMC3724223/
- Capaldo CT, Nusrat A. Cytokine regulation of tight junctions. Biochim Biophys Acta 2009. PMID: 18952050. https://pmc.ncbi.nlm.nih.gov/articles/PMC2699410/
- Zeng MY, Inohara N, Nuñez G. Mechanisms of inflammation-driven bacterial dysbiosis in the gut. Mucosal Immunol 2017. PMID: 27554295. https://pmc.ncbi.nlm.nih.gov/articles/PMC5788567/
- Ferrucci L, Fabbri E. Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty. Nat Rev Cardiol 2018. PMID: 30065258. https://pmc.ncbi.nlm.nih.gov/articles/PMC6146930/
- Calder PC. Omega-3 fatty acids and inflammatory processes: from molecules to man. Biochem Soc Trans 2017. PMID: 28900017. https://pubmed.ncbi.nlm.nih.gov/28900017/
- MedlinePlus: C-Reactive Protein (CRP) Test
- MedlinePlus: Digestive Diseases
This article is for educational purposes only and is not medical advice. It does not replace an individual evaluation. Talk with your healthcare provider before starting supplements or changing medications, especially if you are pregnant, nursing, or managing a health condition.
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