Leaky gut, also known as increased intestinal permeability, refers to a condition where the tiny holes in the intestinal lining grow larger and allow things to pass through that ordinarily couldn’t.
The inner lining of the intestines is a porous membrane, like a fishing net constructed of very fine mesh. Under normal circumstances fat, protein, and carbohydrates are broken down, absorbed through the tiny holes in the membrane into the bloodstream, and transported to cells. The gut membrane also keeps threats to the body from being absorbed through the net.
With leaky gut, the net develops large holes. Substances that are normally kept in the gut and excreted in the stool instead pass through the membrane into the bloodstream. The immune system, sensing invaders, is roused, increasing the potential for autoimmune disease as the body starts to mount reactions to these foreign substances. Large, incompletely digested food particles find their way into the bloodstream, resulting in multiple food sensitivities and allergies, as the body doesn’t fully recognize these unfamiliar substances and treats them as enemies. On constant alert, the immune system becomes very reactive, responding to stimuli it would normally ignore, and more serious disease can ensue.
Leaky gut is more of a mechanism than a disease, since there’s such a wide range of signs and symptoms associated with it. Those suffering from leaky gut have often seen multiple doctors trying to make sense of their symptoms, and conventional tests are unrevealing. There is sometimes a feeling of hopelessness and despair, because symptoms seem so disparate and unrelated, and there is no physical proof of a problem.
Leaky gut symptoms include:
- Brain fog
- Chronic sinus infections and colds
- Decreased nutrient absorption
- Food allergies & sensitivities
- GI distress (bloating, gas, and abdominal pain)
- Hair loss
- Increased susceptibility to infection
- Joint pain
- Memory loss
Leaky gut is associated with the following diseases and conditions:
- Autism (more research is needed to confirm this association)
- Celiac disease
- Chronic fatigue syndrome (CFS)
- Inflammatory bowel disease (IBD)
- Irritable bowel syndrome (IBS)
- Rheumatoid arthritis
Increased intestinal permeability is a condition that is still in its infancy in terms of what we know. Yet, the following factors seem to play important roles:
- Diet: A diet high in refined sugar, processed foods, preservatives, and chemicals; consumption of gluten; and excessive alcohol consumption are associated with leaky gut.
- Chronic Stress: Chronic stress can lead to a weakened immune system, affecting the ability to fight off invading pathogens and worsening the symptoms of leaky gut.
- Inflammation: Medications, such as aspirin and non-steroidal anti inflammatories (NSAIDs), antacids, steroids, and antibiotics are associated with increased intestinal permeability.
- Bacterial Imbalance: Dysbiosis is one of the leading theories about what causes increased intestinal permeability.
- Other Causes: Radiation and chemotherapy can damage the lining of the intestine. GM foods may also contribute to leaky gut.
Leaky gut does not cause changes to the GI tract that are detectable. As a result, skepticism exists in the mainstream medical community about the legitimacy of leaky gut as a diagnosis, although as evidence mounts that it is a real and recognizable condition, opinions are slowly changing.
Leaky gut is primarily a clinical diagnosis based on symptoms and patient history. An intestinal permeability (IP) test, or Genova IP test (a non-metabolized sugar is ingested and measured in the urine to evaluate how much sugar, if any, is able to permeate through the intestinal lining) to assess the integrity of the gut lining is sometimes performed, but the test is affected by many factors and is only a snapshot of intestinal permeability in the moment the test is taken. It is therefore not a test that confirms or negates a diagnosis of leaky gut.
There’s no cure-all for treating leaky gut, but there are things you can do if you think you’re suffering from it that can help heal inflammation and restore the integrity of your gut lining. Treatments include:
- Eliminate refined sugars, dairy, wheat, alcohol, and artificial sweeteners, which are foods that promote inflammation.
- Consume anti-inflammatory essential omega-3 fatty acids in foods like fish, flax, hemp, wheat germ, and walnuts to reduce inflammation.
- Fill up on green leafy vegetables and other high-fiber foods to promote the growth of good bacteria.
- Eat fermented foods that increase the ratio of good to bad bacteria.
Fecal Microbiota Transplant
FMT is a procedure where stool from a healthy donor is transplanted into the gastrointestinal tract by means of a nasogastric tube, colonoscope, or enema; it is used to repopulate a severely imbalanced microbiome with good bacteria. While there is anecdotal evidence to support the use of FMT in the management of leaky gut, more extensive clinical trials are needed to document a clear benefit.
These products prove effective in both clinical and research settings and are the identical products Dr. Chutkan uses in her practice. Positive results and real changes are seen in patients who use these supplements as part of their regimen in treating leaky gut:
- The Microbiome Solution Kit
- Psyllium Husk Powder or Capsules
Because we’re still learning about leaky gut, these treatment recommendations are mostly drawn from anecdotal observation, and most aren’t based on rigorous scientific studies. But they’re sensible recommendations that can lead to improvements in your overall health, whether or not you have increased intestinal permeability.