As early as the 1970s, the term “leaky gut” was used by researchers to describe increased intestinal permeability, or the ability of substances to easily pass out of the gut into the bloodstream, provoking an inflammatory response from the immune system. These researchers linked leaky gut to certain gastrointestinal autoimmune diseases such as celiac disease. Since then, interest in leaky gut has grown and researchers continue to search for ways to target intestinal permeability in the hopes of treating autoimmune disease.

Despite growing research on intestinal permeability and its link to chronic inflammation, leaky gut is still not a medically recognized disease. In this post, we dive into how leaky gut syndrome occurs, what the root causes are, and leave you with holistic healing methods to rebuild a healthy intestinal lining. (Source)

What Is Leaky Gut?

Leaky gut is a condition that results from a damaged gut lining, but what makes up the gut’s lining and how does it become damaged?

The gut, also known as the gastrointestinal (GI) or digestive tract, consists of a chain of organs that run all the way from the mouth to the anus. Leaky gut occurs in the small intestine, which comes after the stomach and before the colon. The inner lining of the small intestine is made of a single layer of epithelial cells coated in a mucosal membrane, creating a barrier between the GI tract and the rest of the body.

When this barrier is healthy, it keeps pathogens and harmful particles out of your body, while letting water and micronutrients in. Stress from inflammation, allergens, pathogens, and autoantibodies can damage the protective mucus and weaken the tight junctions connecting epithelial cells. This increases the permeability of the lining, resulting in a “leaky” gut that allows pathogens and inflammatory particles to pass into the body and stimulate the immune system.

Cellular pathway disruption can also lead to leaky gut. Our cells rely on pathways to communicate across our bodies. For example, a nerve cell must use a cellular pathway to signal a muscle cell to create movement. When certain pathways are disrupted, membrane cells aren’t able to send the signals needed to maintain the gut barrier.

In both cases, increased membrane permeability can eventually lead to openings in the gut lining. These openings allow harmful substances and pathogens from the gut to “leak” into the bloodstream. We call this increased intestinal permeability, or leaky gut. (Source, Source, Source)

Signs and Symptoms of Leaky Gut

It is thought that leaky gut allows bacteria and other substances to escape the gut and travel via the bloodstream to other parts of the body. When this occurs, the immune system is activated in the gut, which may lead to an autoimmune disease or make a pre-existing autoimmune disease worse. However, more research is needed to determine whether this causal relationship exists.

Common symptoms attributed to leaky gut include:

• excessive cramping and gas
• abdominal bloating
• food sensitivities
• brain fog
• nutrient deficiencies

(Source)

Inflammatory Bowel Disease (IBD)

Inflammatory bowel disease includes both ulcerative colitis and Crohn’s disease. Symptoms include bloody stools, weight loss, diarrhea, fatigue and abdominal pain. (Source)

Celiac Disease

Celiac disease occurs when the immune system attacks the epithelial cells that line the small intestine in response to dietary gluten, increasing gut permeability. Symptoms include diarrhea, bloating, constipation, weight loss, and abdominal pain. (Source)

Systemic Lupus Erythematosus (SLE)

Lupus is an inflammatory autoimmune disease that affects many parts of the body and has been associated with leaky gut. Symptoms include sensitivity to sun, facial rashes, fever, joint pain, weight loss, fatigue, and kidney and renal issues. (Source, Source)

Causes and Triggers of Leaky Gut

Causes of Leaky Gut

Although it is difficult to pinpoint what exactly causes the lining of the gut to become more permeable, there are a few factors that are thought to contribute to leaky gut.

Diet

The food you consume greatly affects your gut health, which in turn can affect the health of your intestinal lining. A diet that is heavy in inflammatory foods has a number of negative health consequences, one of which may be leaky gut. Excessive amounts of refined seed oils, gluten, processed sugars, chemical food additives, pesticides, and dairy products have been linked to inflammation. Because all the food we eat passes through our gut, it’s theorized that an inflammatory diet can contribute to a leaky gut.

Fiber is also essential to cultivating gut health because it feeds our microbiome, which in turn keeps the growth of bad bacteria at bay. A low fiber diet can lead to a thinner mucus membrane and increase the permeability of the gut lining. (Source, source)

Prolonged Stress

Chronic mental stress or exposure to a prolonged stressor such as chronic alcohol consumption can negatively affect the community of microorganisms that live in the gut. These microorganisms are important in maintaining intestinal homeostasis.

When prolonged stress disrupts the gut microbiota, the mucosal membrane can be impaired. There is also evidence that prolonged mental stress weakens the immune system. Over time, this may result in decreased removal of toxins in the gut, which in turn damages the gut lining. (Source, Source)

Gut Infections

If you have a stomach infection caused by a bacteria or virus, your gut can be negatively affected. A balanced gut microbiota is important for maintaining the integrity of your intestinal lining. Harmful bacteria and fungi can infect the gut and cause small intestinal bacterial overgrowth (SIBO) or gut dysbiosis. Your WellTheory team can guide you through microbiome testing to identify any gut infections and empower you with treatment options for rebalancing your microbiome. (Source)

Triggers of Leaky Gut Flares

Generally, the term flare is used to describe a period during which you experience active symptoms of a given condition, and your condition “flares up.” This is thought to happen with leaky gut.

Leaky Gut Flare Triggers

• Processed foods, as well as food allergens, may cause inflammation of the gut. If you have leaky gut, your gut lining is more permeable and has developed openings that food allergens may pass through. This may cause you to feel worse after eating a meal that contains too much of these inflammatory foods.
• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, can damage the gut lining and allow contaminants to flow from the gut to the bloodstream. Use of these types of drugs may trigger leaky gut flares.
• Radiation treatments and chemotherapy can damage good bacteria in the gut and disrupt the gut microbiota. This imbalance can further damage the gut lining and lead to a leaky gut flare.
• Excessive alcohol consumption can cause a leaky gut flare because alcohol damages the cells that form the gut lining. There is evidence that people who drink heavily have increased intestinal permeability to the point where large molecules can pass through the gut lining. Excessive alcohol consumption also promotes inflammation in the gut, which may trigger leaky gut flares.

(Source, Source)

Managing Leaky Gut Flares

Although there are no approved drug treatments to repair the gut lining, you may be able to avoid triggers for leaky gut flares by:

• lowering your consumption of processed foods
• avoiding foods to which you are allergic or sensitive
• limiting use of nonsteroidal anti-inflammatories such as aspirin and ibuprofen
• limiting your exposure to radiation, if possible
• lowering your alcohol consumption
  

Leaky Gut Risk Factors

History of Disease

There is evidence of a positive correlation between increased intestinal permeability (leaky gut) and diabetes, liver diseases, and autoimmune conditions such as Crohn’s disease and celiac disease.

Diet

Our Western diet tends to be high in processed foods and refined sugars, while low in fiber. This diet is linked to low gut bacterial diversity, which can contribute to leaky gut and increase your risk of developing autoimmune diseases.

Common foods in the Western diet such as refined sugars and carbohydrates, seed oils, and processed foods can cause inflammation, which may trigger leaky gut. A lack of dietary fiber depletes the microbiome of the fuel it needs to proliferate, which can cause gut dysbiosis, another driver of leaky gut. (Source)

Biomarkers

Biomarkers are measurable characteristics that may be helpful in diagnosing diseases. They may be substances, such as toxins, or signs of susceptibility to certain conditions, such as genetic variations. Elevated glucose levels and certain inflammatory protein levels are also weakly associated with leaky gut.

Age

With age, the stomach begins to produce less acid, which is important for breaking food down into small particles for metabolism, preventing the overgrowth of harmful microbes in the gut, and the absorption of vital proteins and nutrients. Some of the inflammation that results from lack of stomach acid may contribute to leaky gut syndrome. (Source, Source)

When Should I Get Medical Care for Leaky Gut?

If your gastrointestinal symptoms interfere with your quality of life, it's a good idea to see your primary care provider or a gastroenterologist. These professionals can help you find the root cause of your symptoms, which may be related to leaky gut. With this in mind, it’s critical to seek medical evaluation for leaky gut when:

• You experience severe abdominal pain accompanied by:

• fever
• persistent vomiting
• swollen abdomen
• weight loss
• yellowing of the skin

• You experience symptoms of any autoimmune disease linked to leaky gut, such as IBD, celiac disease, or SLE. Your health care provider will be able to discuss treatment options and ways to manage an autoimmune disease.

(Source)

How Is Leaky Gut Diagnosed?

There’s no established medical protocol for the diagnosis of leaky gut, but there are many different laboratory tests that can be performed to look for evidence of leaky gut. Many of these are blood or urine tests, but others measure the concentration of specific proteins in the body. Your WellTheory team can guide you through the testing process to identify leaky gut and empower you with integrative options to help rebuild your intestinal lining. (Source)

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Lab Tests for Leaky Gut

Lipopolysaccharide (LPS) Assay

Lipopolysaccharide is a bacterial antigen, or substance that stimulates an immune response. With leaky gut, bacterial antigens can move from the gut to other parts of the body. An LPS assay measures the concentration of lipopolysaccharide that has escaped the gut and migrated. This movement is an indication of impaired intestinal barrier function. (Source)

Tight Junction (TJ) Test

Tight junctions are important connections between neighboring epithelial cells in the gut. The intestinal membrane is covered with tight junctions that prevent undigested food and toxins from escaping the gut into the bloodstream. A TJ test measures the level of a protein called claudin that makes up tight junctions. (Source)

Butyrate Test

A fecal test can be performed to measure the concentration of an important compound called butyrate. Butyrate is produced in the large intestine and helps preserve the intestinal barrier through regulation of tight junctions. If you are butyrate deficient, you likely have an impaired intestinal membrane. (Source)

Zonulin Test

Zonulin is an important protein that regulates tight junctions in the epithelial barrier of the gut. Elevated zonulin levels are associated with an increase in intestinal permeability, as well as many chronic inflammatory diseases such as celiac disease and inflammatory bowel disease. Abnormal zonulin levels can be detected using an enzyme-linked immunosorbent assay (ELISA). (Source)

Calprotectin Test

A calprotectin test is a simple fecal test that can be used to check for inflammation in the intestines. Calprotectin is a protein that is involved in the inflammatory response. Since leaky gut can cause inflammation of the intestines and nearby tissue, these inflammatory tests are strong indicators of leaky gut. (Source)

Holistic Approach to Leaky Gut Treatment

There is no standard medical treatment for leaky gut, so holistic methods and diet adjustments are used to heal the small intestine lining and prevent further inflammation. Here are some alternative methods you can use to repair your gut.

Improve Your Diet

Since 70% of the immune system is housed in the gut, altering your diet is a powerful method to manage inflammatory conditions including leaky gut. Your gut operates best when it has a rich variety of microbiome bacteria and a good balance of macronutrients.

Try to base your diet around protein, healthy fats, cruciferous vegetables, and clean starches to lower inflammation and nourish your body. Steer clear of gluten, processed foods, fried foods, and anything you notice triggers symptoms. Many people find that once they heal leaky gut syndrome, they are able to tolerate foods that once gave them symptoms.

Eating adequate fiber is especially critical to gut health, because fiber is the main fuel source for the good bacteria in your gut. Good fiber sources include fruits, vegetables, legumes, nuts, and seeds. Research shows that a high fiber diet significantly changes the composition of the microbiome, and can increase certain strains of good bacteria in the gut. (Source, Source)

You may also want to consider eating a low gluten diet, as some research suggests gliadin, the part of gluten that can cause an intestinal immune response, increases intestinal permeability. Gluten itself may alter the gut microbiome and, in autoimmune diseases such as celiac disease, the presence of gluten may lead to gut injury. (Source, Source)

Although there isn't an established diet for treating leaky gut, there are diets that help manage symptoms for people with IBS and autoimmune gastrointestinal diseases. The low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet eliminates and then slowly reintroduces carbohydrates that are difficult for the body to absorb and can cause flare ups. The autoimmune protocol (AIP) diet is a more universal approach to managing autoimmune disease and gut inflammation. This diet eliminates allergenic foods to lower inflammation, then slowly reintroduces them once the gut has been reset. (Source, Source, Source)

Reduce Stress

Stress, even short term, can have significant and lasting effects on intestinal barrier permeability and gut health. Stress can alter your microbial diversity and is associated with increased intestinal permeability, which puts you at higher risk for developing leaky gut.

Chronic stress is also generally associated with inflammation that can worsen leaky gut symptoms or cause more leaky gut flares. Stress management is an effective way to reduce the severity of your symptoms and protect your gut health. (Source)

Take a Probiotic

The gut microbiome plays important roles in regulating inflammation and immune system function. Consult a health care provider about taking prebiotic and probiotic supplements, which may help repair the gut microbiome and reduce intestinal permeability. One probiotic that may protect the intestinal lining is Bacteroides fragilis. Your WellTheory Team can help you find a high quality probiotic that suits the needs of your microbiome.

Take Care of Your Mental Health

Mood and mental health conditions are also able to negatively affect your gut. Your mood can influence your gut composition, or the types of good and harmful bacteria living in your gut. If you have low bacterial diversity in your gut, your gut lining is not as healthy. Mental health conditions such as depression can trigger inflammatory responses in your body, which can worsen leaky gut symptoms. (Source)

Supplement With L-Glutamine

L-glutamine is an amino acid that's produced by your body, and has powerful regulatory properties in the small intestine. L-glutamine is a direct fuel source for both the epithelial cells that line the small intestine, and the immune cells found in the protective mucosa. These cells are damaged by leaky gut, so supplementing with L-glutamine helps them proliferate and heal.

Extensive research has found that L-glutamine makes the intestinal lining less permeable, preventing pathogens and particles from entering the body. When taken consistently, L-glutamine may be able to maintain a healthy gut lining, which reduces inflammation in the gut and body, and can protect against autoimmunity. If you're curious about supplementing with L-glutamine, it's best to consult your health care provider first. Your WellTheory team also provides tailored supplementation advice depending on your symptoms and test results. (Source)

Leaky Gut Prognosis

Leaky gut is a new condition in the field of gut research and researchers are not certain of its prognosis. Research indicates that the best way to manage leaky gut long term is to identify any underlying disease or source of inflammation.

Once an underlying cause is determined, your leaky gut symptoms can likely be treated using the established treatment plans for that disease. For example, long term treatment options for celiac disease or IBD may prove useful for leaky gut.

Until health care providers are sure how leaky gut progresses, it may be best to manage your leaky gut symptoms using dietary changes and the holistic approach discussed above. (Source)

Potential Complications of Leaky Gut

There are potential complications you may face when treating leaky gut.

• Leaky gut is heavily associated with the haywire immune responses that cause autoimmune diseases, and has even been proposed as a root cause. (Source)
• You may experience uncertainty when treating your leaky gut, because there are many unanswered questions surrounding intestinal permeability. This makes leaky gut difficult to manage long term if it is not a symptom of a diagnosed autoimmune disease. (Source)
• You may feel overwhelmed managing your gut health, which may require experimenting with dietary adjustments and lifestyle changes. WellTheory offers community coaching to help you connect with others who are experiencing similar health struggles and can support you on your health journey. (Source)

Where Can I Find the Best Resources About Leaky Gut?

Outside of WellTheory’s Ultimate Guide to Leaky Gut, we recommend looking at:

• The Canadian Society of Intestinal Research to learn about different gastrointestinal conditions and the importance of gut health in managing these conditions.
• The Intestinal Research Journal for in-depth research articles on topics ranging from the importance of microbiome diversity to gut infections to intestinal diseases.
• Gut Microbiota For Health to to read about the relationship between your diet, your gut microbiota diversity, and your overall health.

What’s the Bottom Line on Leaky Gut?

Although the symptoms and prognosis of leaky gut require further research, there is strong evidence that leaky gut is connected to autoimmune diseases such as celiac disease and IBD. However, because it has not yet been fully established as a medical condition, there are no medically approved treatment options for leaky gut.

For now, we recommend exploring science-backed diet and lifestyle changes, as well as consulting a health care provider on additional ways to manage your leaky gut symptoms.

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