What Is a 'Leaky Gut' and Does It Really Affect You?

A 'leaky gut' is a catch-all term for symptoms experienced when the intestine’s protective barrier allows bacteria, toxins, and undigested food particles into the bloodstream. A 'leaky gut' is believed by many to be the cause of a wide variety of disorders. However, while a disruption to the intestinal barrier is associated with certain conditions, it is not a recognized medical diagnosis for which approved treatment options exist.

What is a 'leaky gut?'

Your intestines have a protective layer called the intestinal barrier. It is made up in part of specialized cells and tight protein junctions, which selectively regulate what enters your bloodstream, allowing helpful substances like nutrients while blocking harmful bacteria, toxins, and undigested food from passing through.

When this barrier is compromised, it results in increased intestinal permeability, or a 'leaky gut,' in which substances are able to pass through more easily. This can:

• Affect nutrition absorption
• Allow harmful agents to move into the bloodstream
• Lead to widespread inflammation
• Alter gut bacteria balance

Similar conditions to 'leaky gut'

'Leaky gut' is recognized mostly as a symptom rather than a medically diagnosed condition. However, it is a symptom that can be correlated to other conditions like irritable bowel disease (IBD), irritable bowel syndrome (IBS), and celiac disease. When it comes to 'leaky gut' syndrome, it is theorized that a 'leaky gut' is the cause for such conditions as well as type 1 diabetes, rheumatoid arthritis, multiple sclerosis, and more due to inflammatory toxins entering the bloodstream and eliciting an immune response.

We know chronic inflammation is tied to many of these diseases. However, research has not been definitive in identifying if it truly causes other diseases or is simply a symptom of underlying gastrointestinal conditions.

Some studies say that a 'leaky gut' paves the way to the development of autoimmune diseases, while others show that the intestinal barrier alone is insufficient to initiate disease.

Symptoms of a 'leaky gut'

It can be difficult to differentiate the symptoms of a 'leaky gut' from generic gastrointestinal complaints. A 'leaky gut' or increased intestinal permeability may affect nutrient absorption, increase inflammation, and alter gut microbiome composition, leading to a variety of symptoms. Many people claiming to have a 'leaky gut' experience abdominal pain, bloating, gas, food sensitivities, diarrhea, or indigestion. However, other explanations exist for these types of symptoms aside from a 'leaky gut.'

What causes a 'leaky gut?'

The development and progression of 'leaky gut' is not fully understood, but current scientific literature does suggest a variety of environmental factors as risk factors for increased intestinal permeability:

• An imbalance in gut microbiota (also known as dysbiosis)
• Gut infections
• Antibiotic use
• Long-term use of non-steroidal anti-inflammatories (NSAIDs) like aspirin or ibuprofen
• Excessive alcohol
• Stress
• Diet (particularly one high in refined carbs and saturated fats)

Additionally, as previously mentioned, there is a correlation between a 'leaky gut' and certain inflammatory conditions. However, to know which one is causing the other needs more investigation.

How is 'leaky gut' diagnosed?

The difficulty in being able to detect a 'leaky gut' is the fact that there are no standardized or validated tests available for direct intestinal permeability measurement. A few testing options do exist, but they are limited due to our general lack of understanding and ability to interpret what a normal value should be.

• Urine test. Involves drinking a solution of different kinds of sugars, some of which are not usually absorbed in the intestines. Then, the urine analysis will detect the amounts and types of sugars present to see how they metabolize and move through your gut wall.
• Tissue biopsy. A sample of intestinal tissue is taken to be able to simulate and test how substances move across the barrier or also to analyze the tight junction proteins.
• Confocal endomicroscopy. This is an enhanced endoscopy exam that allows scientists to view the movement of injected fluid to identify any leaks. An endoscopic is another way of using a catheter and sensors to measure the flow across barriers.

Consumers should consult with their healthcare provider for testing. Be cautious of any individual or group that offers at-home testing options promising to diagnose a 'leaky gut' or 'leaky gut' syndrome.

How to prevent 'leaky gut'

While individuals believing they have a 'leaky gut' can experience certain symptoms, not all of these are the result of increased intestinal permeability. However, addressing certain risk factors that may lead to conditions linked to increased intestinal permeability can help support your gut health.

1. Eat a balanced diet rich in whole foods like fruits and vegetables and limited in refined sugars and saturated fats
2. Include prebiotic and probiotic-rich foods
3. Reduce your alcohol intake
4. Manage inflammatory bowel conditions like IBD, IBS, and celiac disease
5. Be mindful of your use of certain over-the-counter drugs like aspirin and ibuprofen
6. Find ways to manage and cope with stress

Treatment for 'leaky gut'

It’s important to note that currently, the only approved treatment for a 'leaky gut' is to treat underlying conditions. However, in addition to the preventive steps just mentioned, there are other approaches you may discuss with your healthcare provider to address your gut health concerns.

A low-FODMAP diet is a specific dietary management approach for IBS, which removes fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (types of sugars that the body absorbs poorly) for a certain period from your diet. A similar approach, which removes gluten and dairy from the diet for those with celiac disease, is also a common intervention.

When making any changes to your diet, particularly if cutting out certain food groups, consult with your healthcare provider or a registered dietitian to make sure you are able to maintain adequate nourishment.

You may also consider checking your vitamin status. Vitamins A and D play crucial roles in maintaining gastrointestinal health. Deficiencies in either can be associated with intestinal concerns and infection.

Lastly, discuss the possible use of supplements. Glutamine is an amino acid that plays a role in absorption, secretion, and digestion. It is also an important nutrient for maintaining intestinal barrier function. Studies suggest that adding glutamine to your diet can help reduce intestinal inflammation. Some research also supports the use of polyphenols like quercetin, catechin, and berberine for intestinal permeability, yet the evidence is limited.

What happens if a 'leaky gut' is not treated?

If gone unaddressed, a disrupted gut will have consequences such as abdominal discomfort, indigestion, and malabsorption, which have the potential to lead to larger issues like malnutrition and other conditions due to the inability to properly absorb nutrients and because of chronic inflammation.

While there is no medically recognized definition for a 'leaky gut,' we know that disruptions in the intestine’s barrier are related to a variety of adverse health outcomes. More research is needed to identify the exact cause-and-effect relationship between intestinal permeability and diseases and to establish testing and treatment options. However, until then, there are strategies we can implement with diet and lifestyle to promote a healthy gut in general.