A healthy digestive tract is linked to overall wellness. Here are answers to some of the most common questions about leaky gut syndrome:
What is leaky gut syndrome?
Leaky gut syndrome is a condition in which the lining of the gut is compromised by small holes. These holes, like tears in a paper coffee filter, allow toxins and food particles to pass into the bloodstream, where they are not supposed to be, and where they can trigger health problems. The condition is also known as intestinal permeability.
In a healthy gut, the lining is thin but durable. It forms a tight barrier that allows important nutrients to pass through to the bloodstream while keeping large food particles and bacteria inside the gastrointestinal (GI) tract and headed toward the exit. In a leaky gut, larger particles are able to pass through the gut barrier and disrupt the body’s internal ecosystem.
What causes leaky gut?
A wide variety of factors can irritate the delicate lining of the gut, including diets high in sugar and processed foods, diets low in phytonutrient-rich whole foods, exposure to toxins and synthetic chemicals, exposure to unwelcome bacteria (via food poisoning, for example), medications such as ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs), overtraining or insufficient rest between bouts of exercise, poor-quality or insufficient sleep, circadian clock disruption, and stress.
Over time, the irritation caused by one or more of these factors can lead to inflammation, which weakens the tight junctions between the cells in the gut lining. Then, in a vicious cycle, the particles that leak through the weak cell junctions trigger more inflammation, making gut health even worse and adding fuel to the fire of other inflammatory conditions (more on that below).
How common is leaky gut?
Because the environmental factors that irritate the gut are common, leaky gut is common. Functional-medicine experts believe that most people experience some degree of leaky gut.
Are there tests for leaky gut?
There is no single, definitive test for leaky gut. That said, a handful of different tests can pinpoint direct and indirect signs of intestinal permeability. Experts recommend these six tests.
What are the symptoms of leaky gut syndrome?
Leaky gut symptoms can be gut related or more systemwide. These are some of the telltale GI symptoms:
These body-wide symptoms and conditions have also been associated with leaky gut:
- Joint pain
- Respiratory issues
- Autoimmune diseases
- Ulcerative colitis
- Food intolerances
- Chronic pain
- Multiple food and chemical sensitivities
- Hyperactivity (in children)
- Seasonal allergies
- Chronic fatigue or fibromyalgia
- Weight loss resistance
- Brain fog/trouble concentrating
How does a leaky gut lead to body-wide problems?
Problems in the gut can lead to problems all over the body in several key ways:
→ Leaky gut stresses the liver. One way leaky gut affects the larger ecosystem is by taxing the liver. The liver is in charge of processing and eliminating toxins from the body. When the flow of undigested food particles, carcinogens, and toxins coming into the bloodstream is significant, as is often the case with leaky gut, the liver can get overwhelmed and sluggish, allowing toxins to accumulate in the body. A buildup of toxins, in turn, can lead to oxidative stress and inflammation, which are factors in many of the conditions associated with leaky gut, including acne, achy joints, arthritis, fibromyalgia, and chronic fatigue.
The damage doesn’t stop there. Inflammation can be a contributing factor in the development of leaky gut, and the more severe the case of leaky gut, the more inflammation in the body — it is a vicious, self-perpetuating cycle.
→ Leaky gut puts pressure on the immune system. The immune system responds to toxins in the bloodstream by ramping up its efforts to protect you — as it should. (The immune system’s job is to protect the body from harmful bacteria, toxins, and other pathogens.) But in some cases, a large flow of toxins leaking into the body triggers the immune system to overreact. It’s as if the immune system senses a five-alarm fire and goes on high alert, but then, eventually, it becomes a bit too alert, mistaking otherwise harmless food or body tissue for dangerous pathogens. This process can contribute to the development of autoimmune conditions and food intolerances and allergies.
→ Leaky gut disrupts the gut microbiome. A third way leaky gut can affect the whole body is by triggering unwanted changes in the gut microbiome. In recent years, research has identified the gut microbiome as a major player in overall health. Studies link gut dysbiosis, or an imbalance in the good and bad bacteria in the gut, with a wide range of conditions, including mental health and cognitive issues, skin conditions, lung diseases, cardiovascular diseases, and more. If leaky gut throws off the balance of good and bad bacteria in the gut, it has the potential to negatively affect systems across the body.
Gut dysbiosis is also one of the irritants that can trigger a leaky gut. This creates another vicious cycle related to leaky gut: The more severe the case of leaky gut, the greater the chance of gut dysbiosis — and the more dysbiosis, the greater chance of leaky gut.
It’s in these three ways — by fueling inflammation, triggering unwanted immune system reactions, and disrupting the healthy ecosystem of the gut flora — that leaky gut affects whole-body health.
How do you heal a leaky gut?
Functional-medicine experts recommend a five-step process for healing leaky gut. Here is an overview of the healing protocol. For complete details on following the five-step plan, including dose recommendations for supplements and how to do an elimination diet, see “How to Heal a Leaky Gut.”
Step 1: Remove
If you’re experiencing symptoms, it’s tempting to start with drugs to quiet them. But many drugs, including NSAIDs like ibuprofen, make leaky gut worse. At best, they pave over symptoms without treating the root cause. Experts agree that the best place to start is doing an elimination diet.
An elimination diet is a temporary protocol that involves removing foods that irritate and inflame the gut lining and then reintroducing them one by one to track symptoms. You can find details on doing an elimination protocol here, including what foods to avoid and when and how to reintroduce them. (There’s a downloadable chart of the Institute for Functional Medicine’s elimination diet protocol here.)
It can be valuable to work with a trusted healthcare practitioner when you do an elimination diet. Be sure to seek a practitioner’s help if you try the protocol on your own and don’t experience any symptom relief.
Step 2: Replace
Once you’ve removed foods that aggravate the gut, it’s important to incorporate ones that actively heal the gut lining. Specifically, experts recommend eating a wide cast of whole foods, including lots of phytonutrient-rich vegetables, low-glycemic fruits, pastured and organic meat (or healthy vegetarian protein sources, such as legumes), and sources of healthy fat, such as avocados, small oily fish, and olive oil. The nutrients and other compounds in these foods, including fiber and omega-3 fats, are necessary for rebuilding tissue and repairing the tight junctions in the gut lining. Building a gut-friendly plate at each meal is important, and Sarah Kay Hoffman, author of The Leaky Gut Meal Plan: 4 Weeks to Detox and Improve Digestive Health, offers delicious gut-healing recipes here.
Supplements can help speed the healing process, too. A high-quality digestive enzyme can help a beleaguered GI tract absorb the nutrients it needs to heal. Experts advise taking one for a couple of weeks or up to a month. L-glutamine is another powerful supplement for rebuilding the integrity of the gut lining and, like digestive enzymes, can be used during the active healing phase. Taking a high-quality omega-3 supplement can quiet inflammation and help fortify the gut lining. You can find dosing recommendations for glutamine and omega-3 supplements here.)
Step 3: Reinoculate
The irritation and inflammation caused by leaky gut take a toll on the overall health of the GI tract. So, the next step, after working to heal the gut lining, is to help reinoculate the gut microbiome with beneficial bacteria. Experts recommend taking a high-quality probiotic and eating probiotic-rich fermented foods. You can find recommended doses for probiotics, as well as fermented-food suggestions, here.
Steps 4 and 5: Repair and Rebalance
Once you’ve moved through the first three steps, maintenance is key — and the best way to keep your gut in good working order is with lasting dietary changes. This involves key shifts in what you eat, how you eat, and when you eat. Broader lifestyle changes — such as prioritizing stress management, getting regular exercise, regulating your sleep–wake cycle— also play an important role.