“Gut feeling…trust your gut…what does your gut tell you?” There’s a reason phrases like these are so common. The gut, which is also known as the body’s second brain, plays a role in more than just digesting our food. In fact, the wall of the gut contains over 100 million nerve cells—comprising what’s known as the enteric nervous system (ENS)—and scientists have found that these cells communicate with the brain and affect an astounding variety of functions related to everything from physical to mental health. So what happens to our health when the gut gets out of balance and develops leaky gut syndrome?
What Is Leaky Gut Syndrome?
The gut, or gastrointestinal tract, is made up of all the so-called hollow organs that stretch from the mouth to the anus—that is, the esophagus, stomach, small intestine, and large intestine.
In addition to its over 100 million nerve cells, the gut lining covers more than 4,000 square feet of surface area and is designed to control what gets absorbed into the bloodstream. However, if the lining of the intestinal wall becomes damaged in some way, it may develop weak spots that allow undigested food particles, toxins, and microbes to enter the bloodstream.
When this happens, it may trigger an immune response that leads to inflammation and changes in the balance of gut bacteria. In fact, several conditions are already known to be linked to leaky gut syndrome. These include:
While some controversy continues to exist regarding whether leaky gut leads to diseases outside the gastrointestinal tract, some studies have shown that the syndrome may be linked to autoimmune diseases, such as lupus, type 1 diabetes, and multiple sclerosis. Additional health problems suspected to be associated with leaky gut include:
What Causes Leaky Gut Syndrome?
According to Harvard Medical School, everyone has leaky gut to some degree. The reason for this is that, as alluded to earlier, the lining of the gastrointestinal tract is semipermeable, which is necessary to allow for nutrient absorption, such as of vitamins, minerals, and amino acids.
This permeability of the gut lining is in turn governed by areas called epithelial tight junctions—areas where membranes of adjacent cells are joined together via strands of proteins to form a barrier.
Some people may have a genetic predisposition to developing decreased integrity of these tight junctions, which can lead to increased intestinal permeability, or leaky gut syndrome.
However, our modern lifestyles may very well play a part in this too, as more and more evidence is pointing to the typical Western diet—with its lack of fiber and high levels of sugar and saturated fats—heavy use of alcohol and nonsteroidal anti-inflammatory drugs (NSAIDs), and chronic stress as significant factors in the damage to the gut lining that results in leaky gut syndrome.
How Does Leaky Gut Lead to Symptoms?
When the lining of the intestinal wall weakens, allowing food particles, toxins, and microbes to enter the bloodstream, the body’s immune system reacts to these substances as if they were foreign invaders. After all, they’re not supposed to be in the bloodstream. They’re supposed to be, in the case of food, fully digested or, in the case of microbes and toxins, neutralized and passed out of the body.
So when they end up in the bloodstream, the body’s immune system responds the way it was designed to: by increasing inflammation around the damaged area—in this case, the gastrointestinal tract—and mobilizing immune cells to fix the problem.
But if the cause of the leaky gut isn’t addressed and more foreign particles continue to leak through the intestinal wall, a vicious cycle is perpetuated that can lead to chronic inflammation as the immune system continues to attack the body.
It’s this vicious cycle that a growing body of evidence suggests may result in various systemic conditions. One of these that clearly illustrates how leaky gut works is the development of food sensitivities.
How Does Leaky Gut Cause Food Sensitivities?
As we stated, when undigested food particles wind up in the bloodstream, the immune system treats them as foreign invaders. If the same food particles keep slipping through the gut wall, the immune system may develop antibodies to them. This means that every time you eat one of these foods—which can be as varied as your diet—your immune system goes into attack mode and you eventually develop food sensitivities. However, unlike a true food allergy, a food sensitivity can be dose-dependent and show up hours after you’ve eaten the offending food.
Symptoms of Leaky Gut
Because of the interconnectedness of the gastrointestinal tract with the rest of the body, the number of symptoms associated with leaky gut syndrome is incredibly varied. Complicating matters is the fact that leaky gut symptoms are usually mild in the beginning, progressing only gradually before they begin to affect the entire body.
This combination of gradual onset and wide symptom variety goes a long way toward explaining why so many people—and their health care providers—may run down blind alley after blind alley in their search for the true cause of their symptoms, which may include:
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Diagnosing Leaky Gut Syndrome
Because of the continuing controversy surrounding leaky gut syndrome and the difficulty many health care providers have in recognizing the condition, you might think there was no way to test for the condition.
Admittedly, people suffering from the condition and their doctors do continue to rely heavily on symptoms, but there are actually several tests that can help you discover whether leaky gut is the reason for what ails you. The most common of these tests include:
- Lactulose/mannitol test: One of the older tests for intestinal permeability, the lactulose/mannitol test measures urine for the clearance of two sugars—lactulose and mannitol—that are associated with both malabsorption and leaky gut syndrome. Using a baseline urine, followed by ingestion of a lactulose and mannitol solution and a timed 6-hour urine sample, this test measures the amount of lactulose and mannitol excreted in the urine, with lower levels indicating increased intestinal permeability. However, because rates of excretion can vary depending on dosage, timing of collection, individual factors, and NSAID usage, the lactulose/mannitol test may not always be accurate.
- Food sensitivity test: Several labs offer food sensitivity tests that analyze the presence of antibodies and allergy-inducing proteins in either blood or saliva. Although these tests are used mainly to diagnose food sensitivities, because they detect the presence of foreign substances outside the gastrointestinal tract, their results can also be used to infer a diagnosis of leaky gut syndrome.
- Zonulin family protein test: In people who want to avoid the sugar involved in the lactulose/mannitol test, the zonulin test may be used. This test analyzes blood for the presence of zonulin proteins—the proteins responsible for modulating the permeability of the tight junctions in the gastrointestinal tract. Theoretically, the presence of these proteins in the blood should be an indicator of damage to the intestinal lining. However, research has demonstrated that many of the tests currently on the market don’t actually detect the correct protein, so caution should be used when relying on a zonulin test as a marker for leaky gut syndrome.
- Bacterial dysbiosis test: The bacterial dysbiosis test uses the stool, breath, or urine to measure the body’s balance of good and bad bacteria as well as opportunistic pathogens such as yeast and parasites. Depending on the type of test used, results may indicate the presence of both small intestinal bacterial overgrowth (SIBO) and leaky gut syndrome.
Treatment of Leaky Gut Syndrome
To review, there’s evidence to suggest that leaky gut syndrome may be the result of the interplay between four factors:
While we may not be able to heal a leaky gut by changing our genetics, it is within our power to change our diets, manage our stress, and eliminate as many toxins from our lives as possible.
So how do we do that?
The first step to restoring gut health is eliminating the foods most commonly associated with leaky gut.
Even though processed foods run the gamut from minimally processed fare, such as canned green beans, to the highly processed, such as donuts, these types of foods tend to be everywhere in the Western diet. And ultra-processed foods like donuts are the very worst for the digestive system due to their low levels of nutrients and high levels of sugar, fat, salt, additives, refined oils, and genetically modified organisms (GMOs), which contain higher levels of pesticides and other toxins known to damage the intestinal lining. Many of the worst offenders are instantly recognizable by their blond color—think biscuits, corn dogs, french fries, pizza, etc.
Although whole grains are considered part of a healthy diet, some grains contain what are known as lectins—proteins that, in high levels, can irritate intestinal tissues and cause tight junction proteins to malfunction. Other grains also contain proteins that are difficult to digest. The most well known of these proteins is gluten, which is fine in small doses, but the combination of wheat varieties bred to have high levels of gluten and the preponderance of gluten-containing foods in the average Western diet can put stress on the digestive system.
As we hinted at in the section on processed foods, the basic Western diet is loaded with carbohydrates. Consumed mostly in the form of simple sugars and starches, carbohydrates make up so much of the average person’s daily calories that the body can’t possibly use them all. Thus, they become food for yeast and bacteria and are one of the greatest causes of both SIBO and leaky gut.
Conventional dairy products are some of the most allergy-producing foods known. This is the result of several factors, including the presence of a protein called casein and the pasteurization process that kills the enzymes in dairy products (especially lactase). Conventionally raised dairy cows also eat an unnatural diet, including GMO corn and soy, which results in illnesses in the cows that are often treated with high levels of antibiotics.
If this list seems overwhelming, don’t despair. Depending on the extent of your symptoms, it’s not necessary to eliminate what may seem like absolutely everything from your diet. Choosing just a few changes that seem doable to you will still go a long way toward improving gut health.
And when your symptoms have abated, it’s fine to add some of these items back in. Just pay attention to your symptoms. If you notice symptoms with certain foods, don’t eat them. And if you notice you can handle certain amounts of foods, just moderate your intake. As with most things in life, treating leaky gut syndrome is all about finding the right balance.
In the meantime, there are also certain foods that can help heal your gut too. These include:
- Fermented foods: Naturally fermented foods such as kombucha, sauerkraut, and kimchi contain gut-healing probiotics and digestive enzymes.
- Hydrolyzed collagen protein: This easily digested protein is rich in the amino acids arginine, glycine, proline, and hydroxyproline, which have been shown to protect the gut lining by preventing the breakdown of the epithelial tight junctions.
- Healthy fats: While refined oils contribute to inflammation and should be avoided in people with leaky gut syndrome, healthy fats—such as the omega-3 fatty acids found in flaxseeds and fatty fish as well as the fats found in avocados and coconut oil—are anti-inflammatory and help heal a damaged gut. In addition, coconut oil is not only rich in medium-chain fatty acids (MCFAs), which are easier to digest than other fats, but also has antifungal, antiviral, and antibacterial properties.
All of us have to deal with stress from time to time, and it’s not always a bad thing. But when stress is keeping you up at night, messing with your diet, or just plain making you miserable, it affects both your mental and physical health. In fact, chronic stress has even been shown in research to affect the balance of gut bacteria.
Although we can’t avoid all sources of stress all the time (nor should we want to), there are several palliatives that can help reduce levels of chronic stress, which can help take the load off the gut. These include:
- Exercising regularly
- Laughing more
- Eating a healthy diet
- Practicing yoga
- Learning to meditate
- Practicing deep breathing
- Getting plenty of sleep
In our modern world, we come in contact with more environmental toxins than our ancestors ever had to deal with. In fact, according to the 2010 report by the President’s Cancer Panel, almost 80,000 chemicals are currently on the market in the United States, many of which are either understudied or unregulated. And multiple studies have shown that these toxins have the ability to alter the gut microbiome.
Although we can’t remove every environmental toxin from our lives, we can control the number of toxins we bring into our homes and put in our bodies. Some of the best ways to do this are by:
- Using natural cleaning products
- Eating organic food
- Using natural paints
- Avoiding artificial fragrances
- Using natural personal care products
- Filtering tap water
- Avoiding plastic containers
There’s no denying the fact that a healthy gut is essential to our overall health. While some people may be more prone to dysfunction of the gastrointestinal tract due to genetic factors, for the vast majority of us, it’s our modern way of life that’s throwing us into disarray.
But good gut health doesn’t have to be a thing of the past. With a little education and some changes to our diets and daily routine, we can bring balance back to both our guts and our lives. And when we honor the importance our gut plays in our overall health, chances are it will honor us in return.