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Vulvar Itching, Food Allergies & Leaky Gut Syndrome

Lissa Rankin's picture

Dr. Lissa Rankin's medical blog is based on her upcoming book What's Up Down There? Questions You'd Only Ask Your Gynecologist If She Was Your Best Friend, which you can preorder here. If you have a question you'd like Dr. Lissa Rankin to answer in her blog, please join the What's Up Down There posse in our Owning Pink community, or contact us.

Q: I have an insanely itchy vulva and sometimes a rash that just won’t go away no matter what I try. I’ve been to three different doctors, including one who specializes in itchy vulvas, and I’ve tried every antibiotic, antifungal, steroid cream, pill, boric acid, etc. I’ve even cut back dramatically on sugar. (Not easy for me!) Nothing helps — I’m at the end of my rope. What could be going on here?

Funny you should ask. Cases like yours are tough for gynecologists, but I have some thoughts. I’ve seen several patients in the past few months with complaints just like yours. One young woman (we’ll call her Ellie) had seen every specialist at every university in the area. They even biopsied her vulva to try to figure out what was going on. But alas, nobody could figure it out. I ordered food allergy testing and we discovered that she was allergic to gluten, dairy, eggs, and several fruits. When we took her off the offending foods, her 7 year itch magically disappeared. But I was concerned about why she had so many food allergies, so we investigated further.

Turns out that a controversial gastrointestinal condition -- “leaky gut syndrome”-- may be at the root of her chronic vulvar itching. Although clinical data on “leaky gut syndrome” and its link to gynecological conditions is limited, this very issue has been coming up a lot in my holistic gynecology practice lately.

How does this happen?

When friendly bacteria (like Lactobacillus) are eliminated, often through the use of antibiotics, yeasts (such as Candida albicans) can start to grow out of control, not just in the vagina, but in the gut. The yeast burrows into the gut wall, causing “leaks” in the protective barrier. Toxins and allergens, including microscopic undigested food particles, are allowed to enter the bloodstream. These “leaks” can cause antigens to travel anywhere in the body, spurring an inflammatory response that may result in a whole host of symptoms, such as gas, bloating, mood disorders, chronic fatigue, eczema, food allergies -- and yes, rarely -- chronic vulvar itching.  

To begin healing, see your OB/GYN or primary health care provider to rule out any other causes of vaginitis, such as infection, irritants/allergies, other dermatological conditions (like eczema, psoriasis) or autoimmune problems (like lichen sclerosis).

To find out if you have “leaky gut syndrome,” you may need to see an integrative medicine doctor or naturopathic doctor.  Although many conventional physicians do not acknowledge the existence of this controversial condition, evidence is mounting to support that it does exist and can be treated. “Leaky gut syndrome” is diagnosed with an inexpensive lactulose-mannitol intestinal permeability test, which is based on an oral challenge with lactulose and mannitol, two non-metabolized sugar molecules. Normally, tiny water-soluble molecules such as mannitol are easily absorbed through cell membranes, whereas larger molecules like the lactulose are normally excluded by cell membranes but can be slightly absorbed between cells. The amount of lactulose and mannitol found in a urine test 6 hours after the oral challenge can determine whether large molecules like mannitol are seeping through the normally barely permeable membrane.

So how do you treat it? 

This is where things get tricky. Every alternative medicine doctor has their own recipe of elimination diets, supplements, yeast-fighting treatments, gut healing potions, and the like. Because there is no standardization about treatment, there is little proof that any one regimen works better than others, so the diagnosis can lead to treatments that risk falling into the category of snake oil.

Things you can do at home include avoiding alcohol and NSAIDs such as Motrin, taking high doses of quality probiotic supplements, cutting out frequent food offenders such as dairy and gluten, and eating raw garlic, which may be helpful for curbing intestinal yeast because the herb’s organosulfur compounds suppress intestinal secretion of inflammatory cytokines that perpetuate leakage. More treatment may be necessary to repair the intestinal permeability itself. Personally, I use a leaky gut protocol created by the pharmaceutical grade company Integrative Therapeutics, in addition to a host of lifestyle modifications.

If itching is unbearable, I usually prescribe a high potency prescription steroid cream such as clobetasol for symptomatic relife, until the underlying condition begins to repair.

Bottom line? You're not alone! Talk to your doctor and see what "leaky gut syndrome" solutions can work best for you.

Yours in health,

Lissa

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This blog, and the book on which it is based, is a complement to - not a substitute for - professional advice and intervention, and is not intended to replace the advice of a gynecologist or medical professional, who should be consulted about any health care issues that may affect the individual reader. The information contained in this book is the product of observations made by the author in her practice, as well as her review of relevant literature in her field of expertise. The literature at times reflects conflicting opinions and conclusions. The views expressed herein are the personal views of the author and are not intended to reflect the views of any group or organization with whom the author is affiliated.

Comments

Lissa Rankin's picture

Absolutely!

Thanks for educating us all. I second all that!

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Anonymous's picture

more on itchy

If like the doctor says if you do have leaky gut then you most likely do have gluten intolorence. When you have leaky gut it allows the gliadin to sneak through the walls of the gut. Once you have a reaction your body will always fight against it. The best way to find out is avoid all gluten for several weeks than reintroduce it back in your diet one day and wait for four days and see if you have any symptoms. Anything. When avoiding watch out for snickers.
No soy sauce, no rye, oats, most dressings, most packaged foods (read the labels) no grain alcohol, no beer.
Read up on it before you do it.

It made my life so much better. Wheat is a inflammation builder. I had real bad back problems until I stopped wheat (gluten).

Anonymous's picture

more on itchy

If like the doctor says if you do have leaky gut then you most likely do have gluten intolorence. When you have leaky gut it allows the gliadin to sneak through the walls of the gut. Once you have a reaction your body will always fight against it. The best way to find out is avoid all gluten for several weeks than reintroduce it back in your diet one day and wait for four days and see if you have any symptoms. Anything. When avoiding watch out for snickers.
No soy sauce, no rye, oats, most dressings, most packaged foods (read the labels) no grain alcohol, no beer.
Read up on it before you do it.

It made my life so much better. Wheat is a inflammation builder. I had real bad back problems until I stopped wheat (gluten).

Lissa Rankin's picture

Totally.

Thanks for pointing that out. I always recommend avoiding gluten to all my patients who are having gut issues. Good call.

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Anonymous's picture

itchy

Have you tried to go gluten free. Many have had odd reactions. Usually itchy hands or other body parts.

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