An Overview of Leaky Gut Syndrome

Learn about this controversial condition

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Photo: Steve McAlister/Image Bank/Getty Images

"Leaky gut syndrome" is a controversial gastrointestinal condition that some have proposed contributes to a range of whole-body health problems, such as irritable bowel syndrome, skin rashes, chronic fatigue syndrome, and mood disorders.

The term "leaky gut syndrome" is typically used by alternative medicine practitioners. However, doctors sometimes use the phrase "leaky gut" to explain increased intestinal permeability (intestinal hyperpermeability).

The cause of intestinal hyperpermeability isn't clear, but it's sometimes seen in people who have certain conditions like inflammatory bowel or celiac disease.

"Leaky gut" from intestinal hyperpermeability and "leaky gut syndrome" have some commonalities, but the latter is not recognized as a legitimate medical diagnosis.

A doctor's use of the term "leaky gut" to explain hyperpermeability of the intestines should not be confused with an alternative practitioner's use of the term "leaky gut syndrome" as an underlying cause for whole-body symptoms.

Symptoms

Alternative and complementary medicine practitioners often use the term "leaky gut syndrome" to explain digestive and systemic (whole-body) symptoms.

Symptoms may be present from childhood or begin in adulthood. They are usually described as fluctuating and may be influenced by diet, stress, inflammation levels, infections, or environmental toxins.

In addition to gastrointestinal symptoms (such as abdominal discomfort, pain, gas, indigestion, constipation, bloating, diarrhea), symptoms outside the digestive tract have also been attributed to "leaky gut syndrome," including:

  • Allergic and autoimmune reactions, such as asthma, skin rashes, and swelling
  • Joint and muscle issues, such as chronic joint or muscle pain, chronic fatigue syndrome, and fibromyalgia
  • Neuropsychiatric conditions, including memory problems, mood swings, and agitation
  • Skin conditions such as acne and psoriasis
  • Infections, such as frequent respiratory infections, vaginal infections, recurrent bladder infections

Proponents of leaky gut syndrome clarify that a person with the condition may experience some, but not necessarily all, of these symptoms.

Autism

One of the major controversies surrounding "leaky gut syndrome" is the proposed association with autism. While there is research exploring the brain-gut connection and autism, there is no definitive evidence that a "leaky gut" alone causes autism.

Medical organizations such as the American Medical Association (AMA) do not feel the proposed association is scientifically valid and do not support the use of any unapproved treatments (including those for "leaky gut") in people with autism.

Causes

Many of the theories proposed for "leaky gut syndrome" are similar to those that explain increased intestinal permeability; both seem to involve intestinal absorption and inflammation.

Research has demonstrated that the intestines can be hyperpermeable, but there is not enough evidence to support the theory that having a weak gut barrier can cause specific symptoms or health conditions.

Tight Junction Instability

Nutrients are normally absorbed by the body through capillaries (tiny blood vessels) throughout the digestive system. The gastrointestinal tract is lined with cells that are attached to tight junctions.

When functioning properly, the junctions keep materials from freely flowing from the intestines into the bloodstream.

It's been proposed that bacterial overgrowth and other factors could interfere with the structure and function of the tight junctions in the intestines.

Inflammatory Response

With increased intestinal permeability, it's been proposed that molecular substances flow from the digestive tract into the body and trigger an inflammatory response.

Similarly, proponents of "leaky gut syndrome" believe that if bacteria, toxins, and other material leaks from the gut into the bloodstream, the effect is systemic and may drive the development of particular health conditions.

It's also been proposed that certain risk factors influence "leaky gut syndrome," including:

  • GI Infections
  • Inflammatory bowel disease (IBD)
  • Gut bacteria imbalance (intestinal dysbiosis)
  • Diet, nutritional deficiencies, poor gut health
  • Medications
  • Stress
  • Alcohol
  • Environmental toxins

It's unclear whether infections or inflammatory bowel diseases cause increased intestinal permeability, or if having increased intestinal permeability makes someone more prone to these conditions.

Diagnosis

The symptoms frequently attributed to "leaky gut syndrome" are common in other medical conditions, so your doctor will want to do tests to rule out these causes.

Diagnostic tests are guided by the symptoms you have, your medical history, and what your doctor notices when they do a physical exam.

For example, if you have joint swelling or pain, your doctor may order blood tests to look for inflammation. If you have abdominal pain, you might need an imaging test such as an ultrasound.

If you have intestinal hyperpermeability, your doctor might use the term "leaky gut" to help explain it to you. However, that does not mean they have diagnosed you with "leaky gut syndrome."

Most medical professionals do not consider "leaky gut syndrome" to be a valid clinical diagnosis. However, an alternative medicine practitioner may be more likely to use the term "leaky gut syndrome" to explain your symptoms.

Urine Test

A urine test has been used to help diagnose increased intestinal permeability, however, it is not considered to be consistently reliable.

For the test, you drink a solution that contains "probe molecules"—typically mannitol and lactulose. Urine samples are taken at specific intervals and the ratio of lactulose and mannitol is calculated.

It's been proposed that having high levels of both molecules indicates increased intestinal permeability.

Establishing diagnostic criteria for "leaky gut syndrome" remains controversial—as does a diagnosis of the condition itself. Alternative practitioners may make the diagnosis if a person's symptoms improve with dietary changes or probiotic supplements.

Treatment

The primary way to address symptoms attributed to "leaky gut syndrome" is making changes to one's diet. These dietary strategies are aimed at changing the intestinal bacteria, often with probiotics. Anti-inflammatory medications and antibiotics have also been suggested.

Diet

Dietary approaches to managing "leaky gut syndrome" vary. Some focus on eating fresh fruits and vegetables to reduce inflammation while others restrict entire food groups.

People who are diagnosed with celiac disease usually need to adhere to a gluten-free diet to control symptoms of the condition. While some people with celiac may have a "leaky gut" as a result of intestinal inflammation, having a "leaky gut" does not mean you need to, or should, avoid gluten and wheat.

Probiotics

Probiotic supplements can help balance the bacteria in the intestines. Probiotics are also found in many foods, such as yogurt, kefir, kimchi, and other fermented foods.

Supplements

Companies can sell supplements or products that claim to treat or cure "leaky gut syndrome" or correct an imbalance of gut bacteria directly to consumers through mail order or online storefronts.

You should be wary of any product that makes such claims. There is no research in support of these claims and these products are not regulated. Doctors and medical organizations have issued warnings about the safety of products aimed at treating "leaky gut syndrome."

Medications

Anti-inflammatory medications, steroids, and antibiotics have been explored as possible treatments for intestinal hyperpermeability, but there is no definitive way to treat or cure the condition.

Likewise, these methods have not been shown to address the broader concept of "leaky gut." For example, in one small study, a drug called lubiprostone (which has been approved for the treatment of constipation) was shown to reduce the lactulose-mannitol ratio in participants' urine. However, it did not change their symptoms.

A Word From Verywell

Research regarding "leaky gut syndrome" is scant and inconsistent. While alternative medicine practitioners often attribute a range of symptoms to the condition, it is not considered a clinical diagnosis by the medical community.

"Leaky gut" is sometimes used to explain increased intestinal permeability, a phenomenon that can exist in inflammatory bowel conditions or celiac disease.

However, this is not what is meant by "leaky gut syndrome," which is a term mostly used in alternative and complementary medicine.

If you're having digestive symptoms, talk to your doctor. The symptoms attributed to a "leaky gut" can have many causes. Your doctor can do tests to rule these causes out and recommend ways to manage your symptoms, including dietary changes or medication.

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Article Sources

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