gutWhat is Leaky Gut Syndrome?
Leaky gut syndrome, otherwise known as increased intestinal permeability, is a condition characterized by inflammation in the lining of the gastrointestinal tract. When the GI tract is inflamed, the cells lining this tract lose the tight junctions they once had between each other. As a result, the highly regulated, tight barrier created by our intestinal lining loses its integrity, allowing unwanted organisms, toxins, and partially digested food particles to leak from the gut into the body. The leaking of these unwanted particles is responsible for many of the systemic symptoms associated with leaky gut syndrome: abdominal bloating and cramping, fatigue, food sensitivities, skin rashes, joint pain, and auto-immune disease.

Inflammation in the GI tract is often caused by a multitude of factors. The following is a list of common triggers for gastrointestinal inflammation that I see in many of my patients:

  • Stress: Stress increases inflammation in the body as whole, and is independently associated with increased gastrointestinal permeability.
  • Poor floral balance: Our bodies are covered with bacteria (or flora) that help regulate immune function. A deficiency in certain species of bacteria in the GI tract is associated with increased intestinal inflammation and permeability.
  • Medications: NSAIDs, such as aspirin and ibuprofen, increase gastrointestinal permeability. Antibiotics disrupt our floral balance, contributing to GI inflammation.
  • Toxins: Excessive exposure to pesticides in our foods and environmental toxins from air pollution can increase systemic and gastrointestinal inflammation.
  • Poor diet: Diets high in refined carbohydrates like sugar and white bread increase gastrointestinal permeability. Furthermore, eating foods that your body is sensitive to or intolerant to, such as gluten in individuals with Celiac disease, increases gastrointestinal permeability.

How does leaky gut affect the immune system?
When an inflamed gastrointestinal tract allows viruses and bacteria, undigested food particles, and toxins into our blood stream, an immune response is triggered. The immune system detects these unwanted particles as foreign and mounts a response to rid the body of these particles. One theory of leaky gut syndrome proposes that as part of this immune response, antibodies are produced to specifically attack these foreign particles. However, some of these antibodies, particularly ones created to attack against common food allergens, such as casein from dairy and gluten from wheat, cross react with specific tissues in our body like connective tissue in the musculoskeletal system or the thyroid gland. This cross-reaction causes the body to attack itself, as in an autoimmune disorder. This theory can help explain why avoiding certain foods like dairy or wheat can sometimes have a beneficial effect on individuals with certain types of autoimmune disease like lupus, rheumatoid arthritis, or Hashimoto’s thyroiditis.

Another theory of leaky gut syndrome proposes that the immune response triggered by the leaking of unwanted particles into the blood stream causes the release of inflammatory chemicals into the blood stream causing symptoms of fatigue, low-grade fever, and GI pain. In my experience, I feel that both theories can be true to a degree in many patients, however a lot depends on genetics and individual variability.

How is leaky gut syndrome diagnosed?
There are a variety of ways to diagnose leaky gut syndrome, but most of the diagnosis will be based on a patient’s symptoms and their response to treatments aimed at lowering GI inflammation. Symptoms that make me consider leaky gut syndrome as a diagnosis are: multiple food sensitivities, fatigue, waxing and waning joint pain, nutritional deficiency, and eczema. Lab tests commonly used to evaluate inflammation in the GI tract include:

  • Stool testing for floral balance and inflammatory markers
  • Blood testing for nutritional deficiencies like iron and Vit B12 that are commonly low in individuals with GI inflammation.
  • Blood testing for gluten sensitivity in Celiac disease.
  • Urine testing for mannitol and lactulose. This test involves drinking a solution of mannitol and lactulose and collecting the urine over a 6 hour period. High levels of mannitol and lactulose in the urine is indicative of leaky gut syndrome.
  • Blood testing for food allergies.

How to treat leaky gut syndrome?
The best way to treat leaky gut syndrome is to address the causes of leaky gut by avoiding irritants to the gastrointestinal tract. Avoiding irritants to the gastrointestinal tract involves avoiding reactive foods, minimizing toxic exposures and medications that increase gastrointestinal permeability, and managing stress. Additionally, it is important to incorporate nutrients, herbs, and foods that help heal the gut to re-establish a healthy intestinal lining with a regulated and tight barrier between the lumen of the GI tract and the blood stream. Some common natural therapies known to reduce gastrointestinal permeability and heal the gut include probiotics and fermented foods, glutamine, aloe, licorice root, marshmallow root and oats.

An anti-inflammatory diet:
Following an anti-inflammatory diet by avoiding foods that promote GI inflammation and increasing foods that decrease GI inflammation is the best way to prevent and treat leaky gut syndrome.

Foods that promote inflammation:

  • Refined carobohydrates: sugars, high fructose corn-syrup, white bread, wheat pasta, pastries
  • Dairy: cow’s milk, yogurt, ice cream, cream sauces, cheese
  • Wheat: wheat bread, wheat pasta
  • Alcohol

Foods that reduce inflammation:

  • Fiber: grean leafy veggies, legumes, nuts and seeds, whole grains
  • Omega 3 Fatty acids: cold water fish, walnuts and almonds, hemp and chia seeds, organic eggs
  • Antioxidants: bright colored fruits and vegetables, green tea and white tea, dark chocolate
  • Water: 60-100 ounces of filtered water daily