What we know about leaky gut syndrome

Most of your internal organs are comfortably protected from the outside world. But gastrointestinal—More precisely, inside the gastrointestinal tract — exposed to items from the outside world on a daily basis.

The foods you eat enter your body through your mouth, go to your stomach, where they’re partially digested, and move to your intestines, where the real job of extracting the nutrients and energy we need to live takes place. and develop.

This system usually works pretty well, but for some people it can leak – just like any well-used plumbing system. These small leaks can become an ongoing problem and develop into a condition called leaky gut.
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“Leaky gut is a great visual term for the patient, but it is not a real medical diagnosis,” says Dr. John Whyte, a board-certified internist based in the area. area of ​​Washington, DC, said. Rather than being an exact diagnosis, the term “describes the fact that your intestines aren’t working properly.”

Sometimes called hyperpermeable or permeable bowel, says Lacey Dunn, leaky gut “is a condition in which the lining of the intestines becomes inflamed, damaged, or irritated, allowing microbial toxins and Undigested food particles spill into the bloodstream.” a functional medicine nutritionist and author of A woman’s guide to hormonal harmony.

The tight connections between the cells lining the intestines, called enterocytes, weaken and become more permeable than usual. This means that undigested food particles and the enzymes your body produces to break down and absorb nutrients from food are out of the intestinal tract, where they don’t belong. “Think of your gut lining like your front door. You want the good guys (vitamins and minerals) to come in, but the bad guys (toxins and pathogens) to stay out,” says Dunn. “The same goes for your gut.”

Dawn Beaulieu, director of the IBD clinic for functional medicine at the Vanderbilt Inflammatory Bowel Disease Clinic in Nashville, says the cells lining the inside of the intestines are very active. They fall off and are replaced every four to seven days. “This ongoing turnover provides an opportunity for ‘holes’ to form in the barrier”, said Beaulieu, a GI educator at the Institute of Functional Medicine. “The intestinal barrier isn’t impenetrable, and it shouldn’t be.” But that’s a suggestion from Goldilocks: some osmotic is necessary for the body to function, but too much can lead to problems.


Leakage of material from the intestines into the bloodstream can cause widespread infection and inflammation, which can even increase the risk of certain diseases. Autoimmune disorders. Plus, it can have an impact on nutrition. “That’s a big deal,” explains Whyte, because you’re not absorbing important vitamins and nutrients, and the toxins that pass through mess up your hormones and immune system.

Symptoms often include bloating, nausea and cramps, but “because the gut affects our entire body, it can also cause headaches, rashes, fatigue and joint pain.” , Whyte said.

A host of other symptoms, including mood disorders like anxiety and depression, chronic fatigue, brain fog, arthritis, and allergies can be attributed to increased intestinal permeability, Dunn says. In some cases, “leaky gut can manifest without gut-related symptoms,” she notes. “In many cases in my clinical practice, I have seen people who just suffer from skin problems or worry about intestinal infections like parasites next to leaky gut.”

Such broad symptoms can make pinpointing the problem difficult, says Dr Anil Singh, a gastroenterologist with Orlando Health in Florida. “There is no one specific symptom that identifies a leaky gut:” Some people will experience diarrhea or constipation, bloating, or may feel fatigued. Sometimes they suffer from nutritional deficiencies.”

All of these symptoms overlap with other GI conditions and diseases. “You have to rule out other conditions like celiac disease, irritable bowel, or colitis,” says Singh.

Unfortunately, while the barrier function of the intestinal lining has been studied extensively, this has not yet translated into an accurate way to diagnose leaky gut. Dr Kaunteya Reddy, medical director of gastroenterology at Redlands Community Hospital in Redlands, California, said: “Even after decades of scientific research, we still don’t have an accurate test to diagnose. guess.

A noninvasive test is sometimes used to measure the ratio of lactulose to mannitol – a marker of intestinal mucosal function – but Singh says it is not widely available. Testing for nutritional deficiencies can also be a good idea, whether the deficiency is due to a leaky gut or another medical condition.

Who gets leaky gut?

“Anyone can develop increased intestinal permeability,” says Beaulieu, although “there are some people whose genetics may predispose them to a more sensitive digestive tract.” For example, people with first-degree relatives with IBD, gluten sensitivity, celiac disease, frequent GI infections, or IBS may have a higher risk of increased intestinal permeability. However, “genetics is not the main factor,” Beaulieu said. “The food we eat and the way we live in the world around us may be a major driver of our intestinal barrier dysfunction.”

The standard American diet is high in saturated fat, sugar, and processed foods, while low in fiber. Increasingly, studies show that this eating pattern “is a major driver of our decline in gut function,” says Beaulieu. She says that heavy alcohol use, stress and poor sleep also disrupt the delicate structure of the intestinal tract.

Reddy notes that the use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen sodium, “is known to damage the lining of the gut and has been linked to leaky gut.” Minimizing NSAID use can help heal a leaky barrier.

People who already have health problems related to the digestive tract, such as irritable bowel symptomsCrohn’s disease, or colitis, is more likely to develop leaky gut, says Singh. Other risk factors include autoimmune disorders, arthritis, lupus, and Hashimoto’s disease, which is an autoimmune disease that affects the thyroid gland and the metabolic-regulating hormones it makes.

Exactly why this happens is not well understood, but Singh says that normal bacteria reside in the gut and help support a healthy immune system, proper digestion and a host of functions. Other bodies tend to be replaced or lost, causing inflammation. “Inflammation leads to symptoms or signs of leaky gut syndrome, because when there’s inflammation, there’s increased permeability,” he said.

Health meaning

While an autoimmune disorder like Crohn’s disease may increase your risk of developing leaky gut syndrome, it seems the risk goes both ways: increased intestinal permeability has been linked to an increased risk of developing certain other conditions, such as arthritis , lupus and diabetes. More research is needed to solidify the connection.

Additionally, leaky gut can also increase your chances of developing other conditions associated with the overgrowth of pathogens, such as Candida Nấm (Yeast infection); H. pylori (a bacteria that causes stomach upset, nausea, and other GI symptoms); and parasites, Dunn said.

A leaky gut can also lead to nutritional deficiencies, predisposing you to other illnesses. For example, if your body doesn’t absorb enough iodine, you can develop hypothyroidism. And tachycardia can arise in people low vitamin B12 levels.

Coping with leaky gut syndrome

If your doctor suspects leaky gut syndrome or if you’re at risk of developing it, you’ll likely be advised to make some lifestyle changes to help ease symptoms and better control the disease. “There is no medicine that we can use,” Singh said. “It’s basically lifestyle changes, such as changing your diet and avoiding stress.

Some patients find that working with a functional medicine doctor can help guide treatment. “The concept of functional medicine is to create balance in our body systems, and this all starts in the gut,” says Beaulieu. A functional medicine specialist will typically “follow a 5R framework for intestinal rehab,” which includes five steps:

Eliminate things that negatively affect your digestive tract, such as medications that can harm your gut, foods you’re allergic to, toxins, and stressors. This means no more processed foods or excess sugar.

Replacing those items with higher quality foods can promote proper digestion. A diet rich in plant-based fiber is a great place to start, says Dunn. “Plant variety in your diet is one of the biggest contributors to a healthy gut. Fiber is your friend”.

Improves gut health by helping beneficial bacteria grow through increased prebiotics, beneficial bacteria, and postbiotic food. Fermented foods, such as kimchi and sauerkraut, can Helps the gut microbiota thrive and diversification.

Repair damaged intestinal lining through foods and supplements. Beaulieu recommends “eating rainbow foods.” Vitamin and mineral supplements such as vitamin D, omega-3 fatty acids, L-glutamine, and aloe vera can help support the body’s efforts to repair the lining of the intestines.

Rebalance your overall life to support better health. “Sleep, exercise, and stress all affect the digestive tract,” says Beaulieu. “Balance of all of these is crucial for gut health.” While staying physically active is a good idea for overall health, Beaulieu notes that endurance exercises, such as running, cycling, or boxing, can increase the risk of leaky gut. , because intense exercise is a “stressor state” that can alter barrier function in the gut. Be active, but don’t overdo it.

Although some vendors recommend adding a probiotic supplementsBeaulieu notes that evidence that probiotics improve barrier function is scant and has generally only been conducted in animals. More data and research is needed.

Dunn says staying hydrated is a good way to support gut health and overall health. “Every day, drink at least half your body weight in an ounce of water.” But stay away from alcoholic beverages; The sugar in alcohol can worsen symptoms of leaky gut.

Beaulieu notes that in some mainstream medical circles, “the concept of leaky gut is controversial,” in part because “there is no gold standard by which everyone can agree that this can be tested and There is no documented scientific evidence for these changes in intestinal mucosal function. will always lead to metabolic changes. ”

However, “the data is fascinating and we are learning more every day,” Beaulieu said. There’s no reason not to eat right and reduce your stress levels—and if you suspect you may have leaky gut, connect with a provider who can help you get it under control.

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