When discussing intestinal permeability, you showed a slide that listed a number of conditions associated with IP such as IBD, celiac, and other autoimmune diseases. I’m familiar with mechanisms connecting IP and these other conditions, and the connection makes a lot of sense. However, you also listed gastric ulcers as a symptom of intestinal permeability, and the mechanism behind that wasn’t clear to me. Can you explain how gastric ulcers could be a symptom of IP?

Chris Kresser: I think what happens with IAP is disruption of the gut microbiome, which, of course, could be a cause of IP in the first place, so that might be a deeper cause and can be a result as well, and then you get inflammation. You get an overproduction of inflammatory cytokines, and that inflammation can affect all of the tissues in the digestive tract including the stomach, and that could lead to changes in the stomach that predispose to ulcer formation. Of course, the inflammation isn’t just limited to the gut it. The cytokines get into the bloodstream, and they can then go and affect other tissues elsewhere. I’m not sure of the exact mechanism off the top of my head, but that’s what I would suspect.