Leaky gut: What is it, and what does it mean for you?

Marcelo Campos, MD
Marcelo Campos, MD, Contributor

Before the medical community had better understanding of the mechanisms that cause disease, doctors believed certain ailments could originate from imbalances in the stomach. This was called hypochondriasis. (In Ancient Greek, hypochondrium refers to the upper part of the abdomen, the region between the breastbone and the navel.) This concept was rejected as science evolved and, for example, we could look under a microscope and see bacteria, parasites, and viruses. The meaning of the term changed, and for many years doctors used the word “hypochondriac” to describe a person who has a persistent, often inexplicable fear of having a serious medical illness.

But what if this ancient concept of illnesses originating in the gut actually holds some truth? Could some of the chronic diseases our society faces today actually be associated with a dysfunctional gastrointestinal system?

The expression “leaky gut” is getting a lot of attention in medical blogs and social media lately, but don’t be surprised if your doctor does not recognize this term. Leaky gut, also called increased intestinal permeability, is somewhat new and most of the research occurs in basic sciences. However, there is growing interest to develop medications that may be used in patients to combat the effects of this problem.

What exactly is leaky gut?

Inside our bellies, we have an extensive intestinal lining covering more than 4,000 square feet of surface area. When working properly, it forms a tight barrier that controls what gets absorbed into the bloodstream. An unhealthy gut lining may have large cracks or holes, allowing partially digested food, toxins, and bugs to penetrate the tissues beneath it. This may trigger inflammation and changes in the gut flora (normal bacteria) that could lead to problems within the digestive tract and beyond. The research world is booming today with studies showing that modifications in the intestinal bacteria and inflammation may play a role in the development of several common chronic diseases.

Who gets a leaky gut (and why)?

We all have some degree of leaky gut, as this barrier is not completely impenetrable (and isn’t supposed to be!). Some of us may have a genetic predisposition and may be more sensitive to changes in the digestive system, but our DNA is not the only one to blame. Modern life may actually be the main driver of gut inflammation. There is emerging evidence that the standard American diet, which is low in fiber and high in sugar and saturated fats, may initiate this process. Heavy alcohol use and stress also seem to disrupt this balance.

We already know that increased intestinal permeability plays a role in certain gastrointestinal conditions such as celiac disease, Crohn’s disease, and irritable bowel syndrome. The biggest question is whether or not a leaky gut may cause problems elsewhere in the body. Some studies show that leaky gut may be associated with other autoimmune diseases (lupus, type 1 diabetes, multiple sclerosis), chronic fatigue syndrome, fibromyalgia, arthritis, allergies, asthma, acne, obesity, and even mental illness. However, we do not yet have clinical studies in humans showing such a cause and effect.

A path toward a healthier gut

Although it is unusual to hear the term “increased intestinal permeability” in most doctors’ offices, alternative and integrative medicine practitioners have worked on gut healing as an initial step to treat chronic diseases for decades. Other cultures around the world often recommend specific diets to make people feel better. Even in the United States, it is common to see people changing their diets after getting sick. A common initial step some practitioners take is to remove foods that can be inflammatory and could promote changes in the gut flora. Among the most common are alcohol, processed foods, certain medications, and any foods that may cause allergies or sensitivities. In my practice, I often see patients improve significantly when they start eating a healthier diet.

Controversy still exists on whether leaky gut causes the development of diseases outside the gastrointestinal tract in humans. However, it is always a good idea to eat a nutritious, unprocessed diet that includes foods that help quell inflammation (and avoids foods known to trigger inflammation), which may, at least in theory, help to rebuild the gut lining and bring more balance to the gut flora. This recipe could make you feel better, without any side effects. It is definitely worth a try.

Resources

Leaky Gut As a Danger Signal for Autoimmune Diseases. Frontiers in Immunology, May 2017.

The intestinal epithelial barrier: a therapeutic target? Nature Reviews Gastroenterology & Hepatology, November 2016.

Comments:

  1. Mary P

    What brand of probiotic and prebiotic are trustworthy? How about yogurts. As I read, some have little or no prebiotic in them.

    • Ellen

      Hi Mary, Look for “whey” (the liquid that rises to the top of very active cultures). I noticed it in Seven Stars, Brown Cow, Liberte, Greek Gods, Stonyfield sometimes and organic brands you find at the natural food stores. I have an autoimmune condition and was told to avoid thermophillus (which is what most yogurts are made of!!) because it is a “heat” thriving organism and my condition is inflammatory. Who knows if that’s true but to be on the safe side I consume Kefir and it’s great! I know its “alive” because the bottle expands with gas. Every time I open it it releases new gas. I also love Kevita–a probiotic beverage that while expensive–is full of very specific healthy types of probiotics. Its low in sugar which is also good because too much sugar in one sitting also can stimulate the immune system… again… so I was told. In any case its a MUCH healthier substitute for soda and makes us feel wonderful.

  2. Ramachandar Kambhatla, Dr.

    I have a problem of chronic constipation, and have been using
    an alternate (ayurvedic)medication along with Dulcolax . This has been for 3-4 years, and at times, I get liquid stools for twice .
    It has been possibly, dietary habits with less fibre (tho’ a prescribed fibre product, has not been of help)…

    I am hoping that it may be due to increased stimulant of laxatives.Rarely, IBS may be part of the problem, tho. I am a rather emotionally well-balanced individual,mostly. How does it,food
    in India with spices may be sensitive for bowel, is a possibility.?

  3. nars oeters

    symptoms?

  4. Lizzie

    How about the fact so few women breast feed their children? My mother didn’t feed me as it wasn’t the thing to do. She regrets it to this day and did breastfeed my brother. Not looking for a debate but there is research comparing GI systems of those breast fed verses formula fed.

  5. Mary Healy

    I have had some success by following a gluten-free diet and taking a daily probiotic. This has been at the suggestion of my daughter who uses these methods for her son who is autistic,. Worth a try!!
    Mary

  6. MIKE COSTANTIELLO

    DO YOU HAVE ANY SOLUTION TO LOWER THE SYSTOLIC LEVEL ON HIGH BLOOD PRESSURE

    • DB

      Weight loss remains the most effective way to reduce blood pressure. That said, omega 3s, COq10 (100-200 mg per day) and 1000-2000 mg of taurine (a diuretic) will also lower your BP.

  7. Barbara

    Is H Pylori considered a form of leaky gut? I have had CFS for 15 years with a diagnosis of h pylori which has been asymtomatic. Just finished triple antibiotic therapy that GI Dr said I must go on which wiped me out! Waiting to get retested in a month and feeling worse than ever with CFS. Was hoping it would help with CFS symptoms.

    • Vikki

      Did you take a good probiotic with or after your triple therapy to restore your natural good flora after the antibiotics wiped them all out? You might try contacting a functional (or integrative or alternative) practitioner to help you get past the fallout from the triple therapy and also to fix the CFS. You can start with functional medicine institute and like places to find an experienced practitioner to work with you, even in an online relationship. (I did it; it was kind of slow progress, but it helped me fix all kinds of things that were big problems for me but that to my regular doctors wouldn’t qualify as needing medical attention.)

    • Moi

      I too have a CFS diagnosis among other things, including development of severe food allergies
      I can only share my experience:

      Several months ago, I was placed on steroids by my GI MD…it not only did not help, but I ended up with a nasty Candida infection on my skin (neck and chest and other areas ). It required several trip to dermatologist and several meds, and I ended up with constipation, which I didn’t have prior. And hadn’t had in YEARS.

      Also, after taking the steroids, I noticed that the CFS has been MUCH worse than it’s been in a long time and now I have pains in-between each bone even in my feet and spine. It makes walking and sitting very uncomfortable at best in the a.m. By night I’m in pain.

      I placed myself back on a course of quality High dose multi strained probiotics, chlorophyll capsules, and organic ACV shots, plus gluten-free, low sugar diet, methly-B vitamins, all of which I used years ago (for years as part of an improved lifestyle and chronic illness management plan) with resulting much success for CFS and gastro-issues.
      Well this time, once Again I noticed a reduction of all painful, intrusive, symptoms, after a week of switching back.

      Through the years a few others who had similar health stuggle have asked what I did to manage. Those who tried similar changes, often came back and also told me of improvement with their pain and fatigue…even positive weight loss and a reduction in sugar cravings.

      Again, only my repeated experience and the accounts of other that I can share. No official studies.

      Much success and improved health to you!

  8. Margreet

    My allergist diagnosed me with leaky gut or dysbiosis. I am in my late forties and have been developing several food allergies and food sensitivities. He tells me to eat healthier and to eat more probiotic foods. If I look around me my diet seems healthier than most. I did not grow up on American staple food. I feel like more and more foods will be cut out of my diet, because we haven’t found the culprit. It is rustrating

  9. Rhonda Witwer

    Leaky gut is not theoretical. See http://hyper.ahajournals.org/content/70/Suppl_1/A007. Researchers from Baylor College of Medicine have been developing an animal model for inflammation-induced hypertension from gut dysbiosis. They just started releasing data that resistant starch (a fermentable dietary fiber found in green bananas, intact whole grains but not refined whole grains, and beans) prevented the inflammation and hypertension. They attributed it to fixing the gut barrier disruption. To date, there are 294 animal studies (that I know of) on natural sources of resistant starch. See http://www.ResistantStarchResearch.com for the clinicals.

    Resistant starch is fermented by the microbiota, and produces more butyrate than other fibers tested. (http://ajcn.nutrition.org/content/73/2/415s.short). Butyrate is the preferred energy source for colonocytes. Without butyrate, the cells shrink and create gaps in the intestinal barrier. Adding resistant starch sealed these gaps and prevented the resulting health problems.

    This is NOT a generic fiber benefit – it’s a resistant starch benefit because of the high levels of butyrate produced. It doesn’t hurt that you can also consume high levels of resistant starch as well.

  10. Michelle

    I think I’ve had fibromyalgia for many years but was diagnosed approximately 10 years ago. I was working at Walmart and was just exhausted. Not the tiredness that sleep helps. I mean totally exhausted, with muscle pain. My primary doctor diagnosed fibromyalgia. I couldn’t move my right arm with out getting a lot of pain. I was taking Lyrica, it helps but I still have to be careful not to over do things. I was trying to have a child-don’t know if I’ll be able to do it! I lost touch with reality.I started on Health Herbal Clinic Fibromyalgia Disease Herbal formula treatment in September 2016, i read alot of positive reviews on their success rate treating Fibromyalgia disease through their Fibromyalgia Herbal formula and i immediately started on the treatment. Just 7 weeks into the Herbal formula treatment I had great improvements, my right hand pain seized and the stiffed, rigid muscle had succumbed. I am unbelievably back on my feet, this is a breakthrough for all Fibromyalgia sufferers, visit Health Herbal Clinic official website www. healthherbalclinic. net or email info@ healthherbalclinic. net.

  11. David

    It’s important to remember that leaky gut as a disease is still theoretical. It’s true that the intestinal lining can become dysfunctional, but this is not necessarily the source of disease. In other words, intestinal permeability could be a symptom or a side effect of another problem. Evidence supporting something is not the same as something being wholly true.

  12. Layla L.

    I’m pleasantly shocked that the ‘mainstream’ medical community actually recognizes this. If only more funds were allocated to researching this and other digestive diseases. Thanks for your article.

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