Leaky gut is the name used to describe a wide range of symptoms that may appear disconnected from each other. As with any condition described as a syndrome, diagnosis of made based on the presence of symptoms, rather than clear test results. For example, in Irritable bowel syndrome.
However, certain studies how looked into markers that may indicate increased permeability along the lining of the digestive tract. This increased permeability can be referred to as leaky gut.
In this article, I’ll discuss the term in more detail, what it actually means and how it can be assessed and addressed.
What is leaky gut?
In medical literature, the term leaky gut is not used. Instead, increased intestinal permeability is used to discuss this gut issue. This is why, if a medical literature search is carried out for leaky gut, fewer research papers are found when compared to searching for intentional permeability.
Rather than the gut becoming leaky or permeable by itself, it’s helpful to consider the reason the gut lining has been impacted. Going further upstream can help to understand the underlying reasons or mechanisms. Essentially, there needs to be a trigger for a leaky gut.
There are 2 subtypes of leaky gut:
- Paracellular permeability
- Transcellular permeability
Paracellular permeability describes permeability that impacts the gaps between the cells, referred to as tight junctions.
Whereas, transcellular permeability describes permeability that travels through the cells. This is associated with more damage to the cells and the intestinal mucosa (gut lining).
How can it affect your health?
While increased permeability in the gut can lead to a range of symptoms, it may also contribute to pre-existing health issues.
This can caused by compounds normally contained in the gut finding their way into general circulation and influencing the immune response elsewhere in the body. In particular, this can be from compounds called LPS, which, when entering into the bloodstream, may lead to inflammation.
This inflammatory response may then worsen pre-existing conditions or make the body more sceptical of further issues developing.
What are the symptoms of leaky gut?
We can consider two sets of symptoms for leaky gut. Since this is impacting the lining of the digestive tract, it’s common for there to be digestive symptoms. However, as this irritation and permeability is taking place along the gut lining, this may lead to symptoms appearing elsewhere in the body.
Digestive symptoms
The common digestive symptoms of leaky gut include:
- Bloating
- Food sensitivities
- Abdominal pain and discomfort
- Changes in bowel patterns (constipation and diarrhoea)
- Nausea (with or without vomiting)
Other common symptoms
The irritation to the gut and gut lining may then contribute to symptoms that appear outside of the digestive system.
These are referred to as extra-digestive symptoms and include:
- Fatigue
- Altered mood (depression and/or anxiety)
- Weight loss
- Skin issues (eczema, psoriasis)
- Brain fog and headaches
- Allergies responses (which may include respiratory symptoms such as asthma)
What causes leaky gut syndrome?
A wide range of factors are believed to contribute to alterations in the gut which can then impact the integrity of the gut lining. It’s understood that while these are all risk factors, the combined impact of multiple risk factors will increase the likelihood of leaky gut.
These risk factors include:
- A Western diet (for example, high in refined carbohydrates and low in natural fibres)
- Increased alcohol intake
- Genetics
- Stressful experiences (this can related to emotional stress and distress)
- Medications
- Exposure to environmental chemicals (these may be from food and environmental toxins such as plastics)
How is it diagnosed?
There are several tests that report to diagnose leaky gut, however, there isn’t a test that is considered accurate for this.
Instead, the diagnosis of a syndrome is considered based on a range of symptoms that commonly appear together.
Some of the tests that report to diagnose leaky gut include:
- Zonulin, measured in the blood or stool.
- Blood tests that look for markers of bacteria that may have made their way into the bloodstream
- Urine test using a lactulose and mannitol solution. After drinking a solution containing these 2 sugars, the amounts found in the urine indicate how permeable the gut is.
- Tissue biopsy is not a common test as it is invasive and involves taking a sample of the tissue from the small intestine.
- Confocal endomicroscopy is used in assessing several health conditions and is considered to assess the permeability along the gut lining. This is consider in inflammatory bowel conditions.
Treatment and management of leaky gut
When patients are treated, an important part of an initial assessment is to gather information regarding possible risk factors. These are the range of factors that may be contributing to the onset of leaky gut.
Following these areas of what can be considered foundational support, further therapeutics can be introduced. These can be in the form of targeted supplements, specific dietary approaches and additional therapies.
Dietary changes
There are 2 foundational steps in adjusting the diet to treat leaky gut. The first is to, where possible, improve the overall quality of the diet.
This is related to removing highly processed foods, and high levels of alcohol and sugar while introducing a wider range of plant foods, good quality protein as well as herbs and spices. These adjustments are often referred to as a Mediterranean Diet.
The second set of considerations can then be considered, especially if symptoms are persisting. This may be to remove certain foods that are irritating the gut, in particular leading to activation of the immune response in the gut.
Lifestyle modifications
Simple lifestyle medications can help to address and support the integrity of the gut lining.
These include:
- Good quality sleep
- Stress support and management
- Time in nature
Medical treatment
There isn’t a specific medical treatment for leaky gut itself, however, there can be a focus on the condition that is leading to leaking gut.
For example, in those with coeliac disease, the medical treatment should be to remove gluten-containing foods from the diet.
Here are further examples:
- Inflammatory bowel disease – working towards remission with medications, targeted supplements and dietary modifications.
- IBS – treatments can include addressing the possible underlying factors such as dysbiosis, SIBO, food intolerances and low-grade inflammation
- Food reactions – assessing and removing foods that may be triggering the immune system in the bowel lining.
Prevention and gut health tips
To prevent leaky gut and maintain a healthy gut, there are a range of long-term gut health strategies that can be considered.
These will be more helpful once any underlying issue has been addressed but these same tips will also help to set a firmer foundation during treatment also.
How to maintain a healthy gut
Focus on Food
The main dietary approaches to maintaining a healthy gut are very similar to treating one. This is focusing on food that is natural and unprocessed, aiming to keep additives, emulsifiers and flavouring to a minimum.
Consider Supplements
While certain supplements can help to repair the gut and treat intestinal permeability, there are also certain supplements that can be considered to support overall gut resilience. These can be used to maintain gut health.
These include:
- Prebiotics
- Sodium butyrate
- Glutamine
- Colostrum
Manage Stress
Stress is a factor known to impact the gut. Both the microbiome and the gut lining. Working to keep stress levels to a good level is important for most areas of health, especially the gut.
Support can include:
- Breathing practices
- Meditation and mindfulness
- Therapy
- Exercise
Long term health strategies
In the long term, the focus should be on sustainable ways to support overall health and well-being. These are related to reducing all-cause mortality which is the risk of developing health conditions.
Therefore, by focusing on several areas of health as a long-term aim will help with reducing the risk of developing other conditions, not only leaky gut syndrome.
Conclusion
Leaky gut may be controversial in certain circles, but clinical research has concluded it is a valid clinical issue. However, diagnosis is not always straightforward.
The benefit of a holistic approach to gut health is that these strategies not only take into account possible leaky gut but also a range of other causes of digestive health complaints.
Contact the clinic for an initial gut health assessment to get to the root of your gut issues.
