Leaky Gut Syndrome/Intestinal Permeability

What Is Leaky Gut Syndrome?

Close-up of man having stomach pain (front view)
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In alternative medicine, a condition called leaky gut syndrome (or intestinal permeability) affects the lining of the intestines resulting in symptoms such as persistent muscle or joint pain, poor concentration, indigestion, gas, mood swings, nervousness, skin rashes, recurrent bladder or yeast infections, constipation, or anxiety.

The lining of the intestines is a barrier that normally only allows properly digested fats, proteins, and starches pass through and enter the bloodstream. It allows substances to pass in several ways.

Chloride, potassium, magnesium, sodium and free fatty acids diffuse through intestinal cells. Amino acids, fatty acids, glucose, minerals, and vitamins also cross through cells, but they do it by another mechanism called active transport.

There's a third way substances can pass through. The spaces in between the cells that line the intestines are normally sealed. These tight junctions are called desmosomes. When the intestinal lining becomes irritated, the junctions loosen and allow unwanted larger molecules in the intestines to pass through into the blood. These unwanted substances are seen by the immune system as foreign (because they aren't normally present in blood). This triggers an antibody reaction.

When the intestinal lining becomes further damaged, even larger substances, such as disease-causing bacteria, undigested food particles, and toxins, pass directly through the damaged cells. Again, the immune system is alerted and antibodies and substances called cytokines are released. Cytokines alert white blood cells to fight the particles. This fight produces oxidants, which cause irritation and inflammation throughout the body.

Symptoms of Leaky Gut Syndrome/Intestinal Permeability

In alternative medicine, symptoms are said to include: abdominal pain, asthma, chronic joint pain, chronic muscle pain, confusion, gas, indigestion, mood swings, nervousness, frequent colds, recurrent vaginal infections, skin rashes, diarrhea, recurrent bladder infections, poor memory, shortness of breath, constipation, bloating, anxiety, irritability, and fatigue.

Leaky gut syndrome is associated with the following conditions:

  • Autoimmune disease
  • Celiac disease
  • Crohn's disease
  • Environmental illness
  • Hives
  • Acne
  • Allergies
  • Inflammatory joint disease/arthritis
  • Intestinal infections
  • Pancreatic insufficiency
  • Ulcerative colitis
  • Giardia
  • Chronic fatigue syndrome
  • Eczema
  • Psoriasis
  • Food allergies and sensitivities
  • Liver dysfunction
  • Rheumatoid arthritis
  • Irritable bowel syndrome

Causes of Leaky Gut Syndrome/Intestinal Permeability

  • Chronic stress
  • Intestinal infections
  • Small intestine bacterial overgrowth
  • Environmental contaminants
  • Excess alcohol
  • Poor diet
  • NSAIDS and other medications


The standard test for leaky gut syndrome is the mannitol and lactulose test. Both are water-soluble molecules that the body can't use. Mannitol is easily absorbed by people with healthy intestinal linings. Lactulose is a larger molecule and is only slightly absorbed. A person drinks a solution contain both mannitol and lactulose. Urine is collected for six hours and the amount present in urine reflects how much was absorbed by the body. A healthy test shows high levels of mannitol and low levels of lactulose. If high levels of both molecules are found, it indicates a leaky gut condition. If low levels of both molecules are found, it indicates general malabsorption of all nutrients.


It's important to keep in mind that there is limited research about the condition, It's also important to note that self-treating a condition and avoiding or delaying standard care may have serious consequences. If you're experiencing any symptoms or have concerns about your health, make sure to consult your physician.

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Article Sources

  1. Solan M. Putting a stop to leaky gut. In: Harvard Health Publishing. Updated November 21, 2018.

  2. Bischoff SC, Barbara G, Buurman W, et al. Intestinal permeability--a new target for disease prevention and therapyBMC Gastroenterol. 2014;14:189. doi:10.1186/s12876-014-0189-7

  3. Harvard Health Publishing. Putting a stop to leaky gut. Updated December 2018.

  4. Michielan A, D'Incà R. Intestinal Permeability in Inflammatory Bowel Disease: Pathogenesis, Clinical Evaluation, and Therapy of Leaky GutMediators Inflamm. 2015;2015:628157. doi:10.1155/2015/628157

  5. Camilleri M. Leaky gut: mechanisms, measurement and clinical implications in humans. Gut. 2019;68(8):1516-1526. doi:10.1136/gutjnl-2019-318427

  6. Bishehsari F, Magno E, Swanson G, et al. Alcohol and Gut-Derived InflammationAlcohol Res. 2017;38(2):163–171.

  7. Sequeira IR, Lentle RG, Kruger MC, Hurst RD. Standardising the lactulose mannitol test of gut permeability to minimise error and promote comparabilityPLoS One. 2014;9(6):e99256. doi:10.1371/journal.pone.0099256

Additional Reading

  • Lipski, E. Digestive Wellness, Keats Publishing/McGraw Hill, 2001.