What is Leaky Gut Syndrome?
If you suffering from leaky gut syndrome, you'll want to know more about it, including symptoms, diet, and treatment options. Here's what you'll find on this page:
Leaky gut syndrome is a condition where the barrier function of the intestinal wall is damaged. This makes it less effective at both keeping out allergens, bacteria, and toxins and allowing in quality nutrients that our bodies need. It's as if a door opens, allowing food particles and pathogens to flow freely into our bloodstreams, causing an immune and inflammatory reaction resulting in a variety of uncomfortable symptoms.
A healthy gut lining plays a crucial role in maintaining wellness. It consists of a single-cell layer that serves as a selectively permeable barrier, permitting the absorption of nutrients, water, and electrolytes while defending against allergens and pathogenic bacteria, fungi, and parasites. This barrier is constructed like a brick wall, with a complex protein network serving as the mortar, linking adjacent cells and sealing the intercellular spaces - protecting our insides from the environment outside our bodies.
When cracks appear in our 'mortar' and our single defensive layer malfunctions, some bacteria and their toxins, incompletely digested proteins and fats, and other wastes may leak out of the intestines into the bloodstream. This can trigger adverse reactions and can lead to gastrointestinal problems such as bloating, excessive gas and cramps, fatigue, food sensitivities, joint pain, skin rashes, and autoimmune diseases.
The bottom line: leaky gut syndrome may be a root cause of a myriad of chronic diseases. If you are struggling to get your health back on track, it may be useful to explore whether or not you have this condition, and seeking treatment if you do.
Dr. Robynne Chutkan, assistant professor of medicine at Georgetown University Hospital, says leaky gut "is likely to emerge as one of the most significant medical concepts of our time."
Common digestive symptoms of leaky gut syndrome are bloating, gas, cramps, chronic diarrhea and constipation; but Susan Blum, MD, MPH, author of The Immune System Recovery Plan and Healing Arthritis, points out that it's also possible to have leaky gut syndrome and have no digestive symptoms at all.
"Instead, you might feel your hands and feet swell up after you eat," she explains. "Your muscles might be tight and stiff in the morning and you might have brain fog and difficulty thinking after eating certain foods. These symptoms are a result of what's called systemic inflammation, which simply means that there are irritating molecules running around your body after you eat certain foods... Leaky gut may also cause headaches or joint pain "so far from your stomach, you may not realize they are even related".
Symptoms of leaky gut syndrome include:
- Arthritis or joint pain (read more about leaky gut syndrome and arthritis)
- Autoimmune diseases such as rheumatoid arthritis, lupus, and celiac disease
- Chronic diarrhea, constipation, gas or bloating
- Cravings for sugar or carbohydrates
- Food sensitivities, especially to gluten and dairy
- Hashimoto's disease (hypothyroidism)
- Headaches, brain fog, and/or memory loss
- Inflammatory Bowel Diseases, including Ulcerative colitis and Chron's Disease
- Neurocognitive and mood disorders, including depression, anxiety, ADD, and ADHD
- Nutrient malabsorption and deficiencies
- Poor immune system functioning
- Inflammatory skin disorders and rashes, especially acne, eczema, psoriasis or rosacea
- Weight gain
Dr. Blum says, "If a patient has any inflammatory disease, I assume they have leaky gut, until proven otherwise."
Leaky gut syndrome manifests in so many ways that it serves as an excellent example of the popular joke that holistic medicine is good at treating a 'whole list' of problems. The good news? Successfully treating your leaky gut can make a huge difference in your health.
Specific known causes of damage to the gut lining and leaky gut syndrome include:
We're learning more all the time about what causes leaky gut syndrome. Researchers at the University of MarylandSchool of Medicine recently identified a molecule called zonulin that is part of the "mortarW creating the tight joints in the single-cell layer lining of our gut. They found that when the zonulin is triggered and the levels increase, it breaks down the mortar and this is one of the ways you can get a leaky gut syndrome.
The intestinal lining may be damaged by:
- Antibiotic use. Damage may be caused by taking antibiotics multiple times over multiple years, but one-time use can also be an issue.
- Infections or exposures that were never resolved, such as traveler's diarrhea or a parasite.
- Chronic dysbiosis. Bad bacteria can secrete enzymes that destroy the "mortar" between the cells.
- Medications. These may include non-steroidal anti-inflammatory drugs (NSAIDs), medications such as ibuprofen and other prescriptions and even supplements which may irritate the gut lining and decrease protective mucus.
- Toxins such as those secreted by the yeast Candida. These can bind to part of the protective barrier, breaking it down.
- Alcoholism. Excess alcohol intake irritates the gut lining in addition to causing nutrient deficiencies.
Genetic testing can be helpful as a screening tool to learn if you possess variants associated with leaky gut. If you do find variants that may cause you to be at risk for gut issues, remember: genes are not necessarily the boss of you! The science of epigenetics looks at how diet and lifestyle can potentially switch genes on and off. You may have a choice in preventing dis-ease by developing a healthy diet, exercise, and stress-relief habits.
Your health professional can help you test and evaluate genetic variants that may influence gut issues associated with:
- Celiac disease. For example, 98% of people with celiac disease have either HLA-DQ2.5, HLA-DQ8.1 genes or both.
- Increased intestinal permeability
- Crohn's disease
- Decreased immune system function
- IBD, type 1 diabetes, rheumatoid arthritis and lupus
The gut is home to what we call the second brain, an ecosystem comprising some100 million neurons forming a mesh-like network that lines the entire digestive tract, and that can influence your mood more strongly than your thoughts. The second brain in our gut is where we feel stress responses like nervous butterflies, a fight-or-flight signal that is conveyed to our brain - not the other way around.
Specific ways in which our emotions impact our gut health include:
- Acute emotional or physical trauma. This may include cruelty and abuse; sexual trauma; battlefield experience; wounds, accidents, severe burns or surgery.
-Chronic stress. This suppresses the immune system, allowing pathogens to proliferate, increasing gut inflammation.
Nutritionist and dietitian Kathie Swift, MS, RDN, says, "When a patient of mine is diagnosed with the leaky gut syndrome, my first thoughts are of the mind-gut connection and food. I ask patients, Do you suspect any links between what you eat and how you feel? There are so many links between food, mood, and emotions. Treating my patients involves exploring those together".
Leaky gut is a condition caused by imbalances in our inner terrain, and by the invasion of pathogens and toxins from the world outside our bodies. Dramatic increases in both leaky gut and autoimmune diseases since World War II are associated with a whole host of environmental factors, such as chemical toxins in food, air, and water; heavy metals; pathogenic viruses, bacteria, parasites molds, fungi, and yeast.
One thing we know about healing leaky gut syndrome: one size does not fit all. The treatment of leaky gut syndrome is a process best understood by functional medicine, naturopathic and other holistic health professionals who work closely with their patients to create individual healing plans and support them along the way.
Dr. Blum says, "Leaky gut is NOT a quick fix. It's approximately a 6-month program, depending on how damaged the gut was at the start and involves transforming my patients? diets and lifestyles, addressing sleep, stress, and food. My patients have to make permanent changes in those things. Your gut is an ecosystem, susceptible to lifestyle habits. You have to balance your ecosystem, and stay with it for you and your gut to stay healthy".
Holistic healing programs will typically include:
Cleaning up your gut terrain.
The process starts with identifying and removing triggers: toxins and food you may be ingesting that are damaging; infections and pathogens that are overwhelming your immune system and preventing healing; and alcohol or medications that may be irritating the lining of your gut. An elimination diet may be recommended to pinpoint offending foods. These are then removed from your diet for a time to make way for healing.
Rebooting your gut.
Now that you've removed triggers, you move into the repair phase, which includes assessing the current status of your gut and making a custom healing plan including diet, supplements, stress reduction, physical activity, and improved sleep. You may also benefit from therapy or psycho-spiritual work to heal trauma and emotional triggers.
Maintaining a healthy gut for life.
This isn't one of those things where you can go back to eating junk food once you're better! Once you have cleaned up your inner terrain and repaired your gut lining, it's time to learn nourishing habits that will help you maintain a healthy gut for life. Bonus: not only will your gut will be happy, but you will also feel substantially better and potentially live longer.
Kathie Swift says, "Working with a patient with leaky gut is a process of discovery and experimentation - determining what works and what doesn't, what the patient tolerates and what they don't. The experiment includes exploring diet and lifestyle, emotions, and a growing self-awareness".
If she suspects a leaky gut problem, Dr. Blum suggests her patients start by taking the following 4-part self-assessment she created for her practice and has used successfully for many years in helping heal autoimmune disorders.
Dr. Susan Blum's Leaky Gut Self-Test
Give yourself one point for each question you answer with a "yes".
1. Did you uncover more than one food sensitivity from trying an elimination diet?
2. Did you score over a 10 on the Current Stressors Self-Assessment?
3. Did the Dysbiosis Self-Assessment reveal that you have dysbiosis?
4. Have you been diagnosed with an autoimmune disease?
Zero to 1 point: You don't have a leaky gut. But I do suggest that you take a probiotic daily if you want to strengthen your immune system because the good flora keeps your immune cells working at their best, which will make you more resilient if you get sick or very stressed.
2 or more points: Your treatment plan will include repairing the barrier function of your gastrointestinal tract. It is best not to reintroduce problem foods for at least six months, or even a year, to allow the immune system to recover, before reintroducing.
Your holistic health professional can advise you on the best laboratory tests for assessing leaky gut syndrome.
What we choose to put in our mouths results in health and healing or contributes to dis-ease. Consuming high amounts of refined sugars, processed foods, preservatives, refined flours, food dyes, and flavorings introduces chemicals that your body sees as toxic, which can cause inflammation. These foods may even cause leaky gut.
While every person is different, a diet designed to help you repair your gut is likely to include advice to remove harmful foods and triggers. You'll want to start by avoiding processed foods, refined sugars, artificial sweeteners, alcohol, dairy, gluten, grains and any problem foods you find that cause you digestive distress when you do an elimination diet. Eat colorful whole foods, chock full of vitamins, minerals, fiber, and phytonutrients, to promote gut healing and health. There are some foods with healing properties that may also help heal your leaky gut. Your holistic nutritionist can customize the right foods and recipes for you, and that will work well with your busy life!
What should you eat? Basically a nice, clean, whole foods diet with high-quality fats, oils, and proteins and a high quantity of plant foods.
Foods To Eat Often
- Omega-3 essential fatty acids and quality proteins.
- Healthy fats and oils.
- Avocado, olives and olive oil, coconut and coconut oil, ghee, grass-fed butter.
- Lightly-steamed vegetables.
- Dark leafy greens (arugula, kale, collard greens); cruciferous vegetables (broccoli, cauliflower, Brussels sprouts, cabbage); artichokes, asparagus, celery, cucumber, and zucchini.
- Fermented foods.
- Coconut yogurt, kombucha, fermented vegetables like kimchi and sauerkraut.
- Herbs and spices.
- Dandelion root tea, peppermint, ginger, and turmeric.
Foods to eat occasionally
- Starchy vegetables.
- Root vegetables and winter squash
- Natural sweeteners.
- Raw honey, maple syrup, poached apples, and pears.
Foods to avoid:
- Dairy products
- Unfermented soy (choose tempeh over tofu)
- Refined sugars and flours; preservatives, food dyes, and artificial sweeteners
- Grains *
- Legumes including peanuts *
- Packaged and processed foods
- Refined vegetable oils, such as canola, corn, peanut, safflower, soy, or sunflower
* These are essentially healthy foods which it may be possible to resume eating post-gut healing. Again, consult your holistic nutritionist to determine what's best for you.
There are many specific supplements that can assist in repairing the gut and intestinal lining. Your knowledgeable health professional can prescribe the best options for you, such as:
- Probiotics: repopulates the gut with good bacteria
- L-Glutamine: repairs and fuels cells of the gut lining
- Enzymes: aids digestion
- Quercitin: improves the seal of the gut lining
- DGL Licorice Root: maintains the mucosa protecting the intestinal wall
- Antifungals: helps balance good and bad bacteria
Lifestyle change can be a powerful component of leaky gut healing, especially:
- Movement and exercise.
- Gentle exercise, such as tai chi, qi gong, or walking, promote healthy digestion and gut health. Gentle exercise can help decrease stress and inflammation, stimulate your immune system, lift your mood, increase your energy, and improve both detoxification and sleep. Be aware of the effects of your exercise program. Do you feel energized afterward? You are on the right track. Do you feel depleted, instead? You are overexerting, which will diminish rather than improve your health. Watch for the right balance for beneficial results.
- Wonderful sleep: Sleep can be elusive for many people, but regularly obtaining quality sleep is like depositing gold in the bank for healing. The repair that occurs during sleep is crucial for healthy digestion, brain functioning, and emotional health. Dine early, don't drink liquids after 9 pm, and turn off those screens for a truly, deep, healthy night's sleep. Sufficient gentle exercise earlier in the day, lowering the lights as the evening wanes and a 20-minute epsom salts bath (1 1/2 cups Epsom salts, 1/2 cup baking soda, 4-6 drops of lavender essential oil) before bedtime can encourage and support sleep.
- Stress reduction: What do you do to reduce stress? We know that over-stress is a significant cause of leaky gut syndrome and that healing will involve reducing your level of stress. Some examples of great solutions for reducing stress include meditation, guided imagery, laughing, playing with your puppy or child, walking in nature, a gratitude practice or journaling. Establishing even a 10-minute daily meditation practice has been shown to not only reduce stress but increase joy. An excellent investment in you.
- Mindful eating: Gulping down food is not good for the gut! Kathie Swift advises her patients to take three breaths before eating. This simple step, that even the busiest people can take time for, helps calm the parasympathetic nervous system to promote healthy digestive functioning. Take a moment. Take three breaths.
What therapies might help heal leaky gut syndrome? When we asked physician Susan Blum and dietitian Kathie Swift how their leaky gut patients do, both said emphatically, "Very well!"
Functional medicine and naturopathic physicians are fully trained to help you assess and repair leaky syndrome. Because food plays such a central role in leaky gut healing, a functional or integrative nutritionist would also be a great choice. Meditation teachers, therapists, acupuncturists, and other professionals can also help you with stress and emotional healing that is integral to the process. Emotional freedom technique (EFT) is a powerful healing technique that can be used for self-healing or with the guidance of a certified practitioner to reduce stress and alleviate emotional pain.
The following experts reviewed and contributed to this article:
Susan Blum, MD, MPH, Functional Medicine Doctor and Author
Kathie Swift, MS, RDN, Integrative and Functional Medicine Nutritionist, Author and Educator.
How to Heal a Leaky Gut
Catherine Guthrie, Experience Life Magazine.
What is Leaky Gut Syndrome? + Causes & Symptoms
Includes an explanation of genetic factors that influence intestinal permeability.
Zonulin and its regulation of intestinal barrier function: the biological door to inflammation, autoimmunity, and cancer.
Physiological Review, 2011
Leaky gut and autoimmune diseases.
Clinical Reviews in Allergy & Immunology, 2012
Autoimmunity and the Gut.
Andrew W. Campbell
Autoimmune Diseases, 2014
Susan Blum, MD, MPH, The Immune System Recovery Plan: A Doctor's 4-Step Program to Treat Autoimmune Disease. NY, Scribner, 2013.
Kathie Swift, MS, RDN, The Swift Diet: 4 Weeks to Mend the Belly, Lose the Weight, and Get Rid of the Bloat. NY, Hudson Street Press (Penguin Group), 2014.
Gerard Mullin, MD and Kathie Swift, MS, RDN, The Inside Tract: Your Good Gut Guide to Great Digestive Health. Rodale Books, 2011.