Beneath the Surface: Exploring Leaky Gut- Part 1

What Exactly Is Leaky Gut, and Why Does It Matter?

You don’t have to have a gut problem to have a gut problem.

Over the past few years, gut health has found a significant spotlight within the social media community. Many recommendations span from probiotics, prebiotics, and gut-healing bone broth to gut-healing foods and gluten-free diets. 

You may have questions like: What the heck is leaky gut syndrome? What are the symptoms, and do I have this? How can I check to see if I have it, and what can I do about it if I do? In this 2-part article series, I aim to answer these questions and more.

What is increased intestinal permeability, aka leaky gut?

You may not know it, but the gut lining is semi-permeable, which allows some things to enter and some to stay out. So, if one has increased intestinal permeability (IP), that means more things are getting through this semi-permeable membrane than they should be.

While the medical community has yet to assign an official ICD-10 diagnosis code to leaky gut, and many traditional clinicians do not believe the condition fully exists, within the holistic and integrative/alternative community, the concept of increased intestinal permeability is very real. There have been many studies linking changes in the gut, its lining and the microbiome, the gut bacteria makeup, to various conditions such as obesity, gastrointestinal reflux disease (GERD), and many autoimmune conditions such as inflammatory bowel disease (IBS), Celiac disease, Crohn's disease, type 1 diabetes, multiple sclerosis and many more. 

We can get technical into the layers of the gut lining from the lamina propria layer to epithelial cells, goblet cells, Paneth cells, mucus layer, and apical junction complex, but let's leave the sciency-talk behind and break this down in plain English.

Picture the gut barrier as a fine mesh strainer. If we put rice in the strainer, its fine mesh would allow water to pass through while retaining the rice. In the same way, the gut's tight junctions and its mucus layer serve as gatekeepers. They permit the passage of water, nutrients, and tiny particles into the bloodstream, preventing larger items like undigested food particles and harmful bacteria from entering. This separation maintenance helps prevent inflammation and helps promote our body's immunity and hormone balance.

However, consider what happens when that same strainer develops larger holes. Now, the rice and water, and larger items can freely pass through. This scenario depicts what occurs when the mucus membrane, tight junctions, and other layers of the gut lining become compromised and inflamed. Hippocrates said hundreds of years ago, “all disease begins in the gut,” and I believe it still holds true to this day.

What causes a leaky gut?

The causes contributing to a leaky gut encompass many factors ranging from dietary choices to environmental exposures such as toxins and chronic stress; however, this is highly individualized. What causes one person to have increased intestinal permeability can be completely different for another. 

Common causes include the standard American diet high in sugars, processed foods, and low in fiber. Medications like non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen or naproxen, antibiotics, birth control pills, acid reflux medications, and imbalances in the gut microbiome also have been linked to changes in the gut lining. 

Alcohol use, chemotherapy, and radiation treatment may alter gut homeostasis. The key is to find out what is causing you to have increased intestinal permeability. 

What are the symptoms of leaky gut (IP)?

Even without noticeable gastrointestinal (GI) or stomach symptoms, could you still be dealing with leaky gut syndrome? The Cleveland Clinic states that common GI symptoms like bloating, abdominal discomfort, diarrhea, and excessive gas may have links to leaky gut. 

However, leaky gut syndrome can also tie to symptoms such as brain fog, headaches, fatigue, joint pains, skin rashes like eczema, food sensitivities, post-nasal drip, depression, and even autoimmune conditions.

How do you know if you have it?  

While there are different ways to test for leaky gut, from certain stool and urine testing, some of them may be unreliable. However, if you have experienced exposure to the above causes of leaky gut, it's almost safe to say that you probably have some degree of intestinal permeability dysfunction.

A quick and easy symptoms checklist questionnaire, which you can find here, can help identify symptoms that may be ongoing and require a little more attention. 

Stay tuned for part 2, where we will discuss more on functional testing and how you can start to improve your symptoms in five simple steps.  

1. _{Camilleri, M. (2019). The Leaky Gut: Mechanisms, Measurement and Clinical Implications in Humans. GUT, 68(8), 1516-1526.}
2. _{Canadian Digestive Health Foundation. (2022, November 29). What is Leaky Gut Syndrome? Canadian Digestive Health Foundation. Retrieved August 19, 2023.}
3. _{Farré, R., Fiorani, M., Rahiman, S. A., & Matteoli, G. (2020). Intestinal Permeability, Inflammation and the Role of Nutrients. Nutrients, 12(4), 1185.}
4. _{Marcelo Campos, M. (2021, November 16). Leaky gut: What is it, and what does it mean for you?. Harvard Health.}
5. _{Paray, B. A., Albeshr, M. F., Jan, A. T., & Rather, I. A. (2020). Leaky Gut and Autoimmunity: An Intricate Balance in Individuals Health and the Diseased State. International Journal of Molecular Sciences, 21(24), 9770.}
6. _{Andreu Prados. (2022, December 27). In which circumstances is intestinal permeability increased and what can be done to improve it?. Gut Microbiota for Health.}