Leaky Gut 

That Does Not Sound Like Medical Terminology… What is That?

The term “Leaky Gut” is a common way to describe abnormal intestinal permeability or intestinal “hyper-permeability”. It refers to a breakdown in the integrity of the intestinal wall that lines your digestive system. While Leaky Gut is currently not a formal medical diagnosis, it is a widely accepted theory that could help explain a lot of the nagging GI symptoms people experience today.

Anatomy refresher:

Our gut is lined with special cells that are bound tightly together by what are called “tight junctions”. Think of these tight junctions as little security guards. Their job is to decide what can be allowed to pass through the intestinal wall and into the bloodstream and what needs to stay in our intestines. Typically, the tight junctions only want water molecules and small food particles that have been fully broken down to be passing through. Leaky Gut occurs when this normally well-regulated intestinal lining has been weakened, and it has lost the ability to keep the invaders out, so to speak.

When this gut barrier is compromised, large particles, toxins, viruses, and bacteria are able to pass through these “not-so-tight anymore” junctions and enter directly into our bloodstream. This results in an immune response which can have wide ranging effects on the whole body, not just the gut. When this issue becomes chronic, we are left with sustained inflammation, which can ultimately wreak havoc on our bodies.

Think of it this way:

The gut lining is as much of a protective layer as it is an absorbent pad to pull the nutrients from our food into our bodies. In many ways, the gut is our first line of defense responsible for keeping the outside world out.

Side note:

We are simplifying the explanation of Leaky Gut to help make this very complex and multi-layered process more digestible (no pun intended). The passing of particles from the gut and into the bloodstream is actually a very complicated process and has many different steps to it. There are several players that have to work together in order for the intestinal border to stay secure. Things like immunoglobulins, mucous, defensins, and other antimicrobial “good guys" are needed to keep things running smoothly.

What are the symptoms of Leaky Gut?

The symptoms of Leaky Gut are very broad, and you will notice there is a lot of overlap with other common GI conditions. This is because Leaky Gut serves as an umbrella term, responsible for a wide range of GI dysfunction.

With that being said, these are some of the classic symptoms:

• Abdominal Pain   
• Bloating
• Indigestion
• Diarrhea
• Excessive gas
• Ulcers
• Food sensitivities

Other frequently reported symptoms:

• Brain Fog
• Joint Pain
• Wide variety of skin issues
• Generalized Pain
• Migraines
• Sleep issues
• Fatigue/Low energy
• Depression/Anxiety

Diseases associated with Leaky Gut include:

• Inflammatory Bowel Disease (Crohn’s, Ulcerative Colitis)
• Irritable Bowel Syndrome
• Celiac Disease
• SIBO
• Diverticulitis or Diverticulosis
• HIV/AIDs
• Obesity
• Diabetes
• Arthritis
• Asthma
• Chronic Fatigue Syndrome
• Several Autoimmune diseases (Multiple Sclerosis, Type 1 Diabetes, Hashimoto’s)

If you are exhibiting any of the symptoms listed above, then this is your body communicating with you. By the time you are experiencing symptoms, the problem has been going on for far too long and some action on your part is required in order to improve those symptoms.

What can Cause a “Leakproof Gut” to Become a “Leaky Gut”?

Without a doubt, the primary driver for developing Leaky Gut is: Chronic Inflammation.

If we can minimize chronic inflammation being triggered in our bodies, then a lot of people would be free from everyday suffering. So, what are the main causes of inflammation?

The common offenders:

Dietary triggers:

• Excessive sugar intake (particularly fructose and high fructose corn syrup)
• Intolerances to foods like wheat, gluten, and dairy
• Glyphosate exposure (click on the link to learn more)
• Chronic Stress
• Excessive Alcohol Use
• Chronic drug use

Antibiotics

• Radiation Therapy
• Poor Sleep
• Chemotherapy
• NSAIDs (long term use)
• Nutrient Deficiencies (Vitamin A, Vitamin D, Zinc)
• Yeast Overgrowth
• Bacterial Overgrowth
• Heavy Metals

Can I Test for Leaky Gut?

Unfortunately, there is no definitive test that can prove a person has Leaky Gut.  This is part of the problem with “proving” Leaky Gut exists. However, there are a number of tests available which could raise suspicion that Leaky Gut is part of your health picture. We don’t entirely support the need for testing, and we will outline our reasons below.

Currently, there are a number of tests that are being researched in clinical practice to see if we can prove intestinal permeability is present. We are going to make this section short and sweet and try to give you the basic knowledge for each test. Just know there is much more that can be explained about each of these.

1. Zonulin:

This is a blood or stool test that is typically obtained through commercial labs or through third party testing (specialty lab companies like “Diagnostic Solutions”). Zonulin is a protein that has been found to be elevated when there is a breakdown in the gut lining. There are some conflicting opinions regarding this test, however it is a popular one when Leaky Gut is suspected.

Hint: Specialty lab companies such as Diagnostic Solutions will test Zonulin via stool sample. KBMO Diagnostics is another specialty lab that uses the “Blood Spot” method to check Zonulin levels. These tests must be ordered by your doctor or specialty provider.

2. Lactulose-Mannitol (Urine test):

This test involves you drinking a solution of these sugar molecules (Lactulose and Mannitol) and then testing your urine to see the amount of each that gets excreted. Basically, Lactulose is quite a large molecule and is not typically absorbed by the small intestine. However, if high amounts of this sugar are found in the urine sample, then this can mean these large molecules are passing through the gut and into the bloodstream (not where they should be) and eventually making their way to the kidneys.

The ratio of these two sugars is reportedly helpful in diagnosing severity of disease. There are some conflicting opinions regarding this test, hence why it is still not considered a “standard of care” test.

3. Antibody testing:

These are blood tests in which your doctor can check for specific antibodies to see if your immune system is responding to invaders found in the blood. This could be indicative of gut bacteria “leaking” into the bloodstream. This can include Zonulin antibody testing (different than directly testing Zonulin levels) and also Lipopolysaccharide (LPS) antibody testing.

4. Tissue biopsy:

This is a test where doctors take a sample of your intestinal lining and measure the ion transport across the intestinal barrier using an electrical current. This test is quite invasive and still has some conflicting evidence as to what is exactly being measured. They are performing these tests mostly for clinical research at this point, although it could become publicly available in the future.

5. Confocal endomicroscopy:

This is rarely performed and would be wildly expensive, but we will mention it anyway. This is an exam where dye is injected into your bloodstream and your gut lining is closely examined for signs of leaks. It is very, very unlikely that you would be offered this test, but it does exist.

Our take on testing…

A test to confirm that you have Leaky Gut is not really a game changer. It is likely only going to cost you money that you could be spending on improving your health. That said, if it is important to you to investigate, the tests above are the best ones we know about.

If you have symptoms of Leaky Gut, your efforts will be best spent by making some foundational changes in your life in order to improve your gut health.

So, what exactly do these changes look like?

Can’t You Just Put a Plug in the Leak?

Wouldn’t that be nice? Unfortunately, it’s not as easy as that… The reality is that it comes down to treating the underlying factors that are likely causing Leaky Gut to exist in the first place.

Here are 8 things you can do in your daily life to help offset inflammation and improve or prevent Leaky Gut:

1. Diet:

• Reduce your sugar intake! Added sugars, especially. This is so important in the early stage of healing because sugar is known to be a major cause of inflammation. Aim for less than 25 grams of added sugar per day.

• Consider a short trial of reducing dietary fats. Several studies show that excessive fats directly impair and disrupt the intestinal wall. This can be confusing because our bodies do require healthy fats. However, if you are suspicious of having Leaky Gut, then a reduced fat diet would help you during the healing and repair stage of your gut.

• Increase intake of fruits and vegetables. It has been proven the polyphenols and anthocyanins present in fruits and vegetables can be responsible for reversing a damaged and imbalanced gut.

• Correct nutrient deficiencies. Consider asking your doctor to order a nutrient test so that you can get a better idea as to the overall health of your gut ( “Nutri-Eval” from Genova or “Organic Acid Test” from Great Plains are good options).

• Increase your fiber intake. Fiber is seen as a protective nutrient for maintaining a strong intestinal gut wall. Fiber is also vitally important for feeding healthy gut bacteria. This results in a more balanced microbiome and reduces the harmful bacteria that contribute to Leaky Gut.

Fun Fiber Fact: If there is not enough fiber present for the bacteria to feed, they will eat away at the mucous layer in the gut for fuel. Not good!

• Moderate alcohol intake. Alcohol is known to disrupt the tight junctions and induce body-wide inflammation. If you are battling Leaky Gut symptoms, it may be in your best health interest to temporarily pause your alcohol intake.

2. Exercise:

• This is key for reducing inflammation in the body. If you can help reduce inflammation, then your body is able to focus on healing. We know exercise has SO many benefits, so we won’t get into all of that here. (Click on the Exercise tab for a much deeper dive).

• There are several studies that support the health benefits of a low intensity post meal walk. Even a short walk - like 2 minutes! This could be a great starting point. One trip around the block after dinner can do great things for your digestion, blood sugar regulation (important piece to reducing inflammation), increasing fat metabolism, and even sleep!