Leaky gut, medically known as ‘Intestinal Permeability’, is a term given to describe inflammation of the gut lining. Our gut lining is a barrier that separates us from the environment[i], it is supposed to have tight junctions which fit together and have small gaps. These small gaps are for nutrients to pass through the digestive tract into the blood system. With leaky gut, these tight junctions have become loose, and therefore let larger particles, such as proteins, pass through into the blood system that shouldn’t be there[ii]. We will all experience leaky gut to some extent, but the problem is when this becomes chronic for someone.
Lots of factors affect the integrity of our gut lining, such as stress, genetics, food allergies[iii], gluten[iv], bacterial imbalance, alcohol, gut infections, Irritable Bowel Disease[v], overgrowth of yeasts, NSAIDS, antibiotics and other medications. For people with coeliac disease, the constant inflammation from eating gluten (pre diagnosis) often causes leaky gut and patients usually get much relief after just a few weeks of being gluten free.
There are lot of symptoms of leaky gut, the most common are bloating, gas, constipation, diarrhoea, brain fog, achy joints, mucous in stool, fatigue, nutrient malabsorption and some skin conditions such as acne, hives, eczema and psoriasis[vi]. Leaky gut has also been associated with the cause of conditions such as migraines and food allergies, chronic fatigue syndrome, autoimmune conditions[vii], mood changes[viii] and autism.
To reduce inflammation and toxic load, reduce or remove inflammatory agents in your diet and lifestyle. Examples are sugar, alcohol, improper use of NSAIDS and antibiotics, additives and products full of chemicals.
Additionally, consider lowering your gluten intake to only 3 times a week. Choose gluten foods which have nutrient value such as whole wheat pasta (good fibre and blood sugar balancing support) and sourdough bread (fermented so is partially digested for you before you eat it!) rather than white refined versions which offer no nutrient support at all. Rather than going for ‘gluten free’ products which tend to have hidden added sugars, familiarise yourself with naturally gluten free products such as buckwheat (noodles and bread), quinoa (looks like a grain but is actually a protein), lentils (you can get lentil pasta now too), chickpeas, gluten free oats and sweet potatoes.
Eat an anti-inflammatory diet which incorporates lots of vegetables and some fruit. Aim for 7 portions of vegetables and 2-3 portions of fruit a day. Additionally, ensure to have anti-inflammatory healthy fats on a regular basis such as extra virgin olive oil, oily fish, nuts and seeds, flaxseed oil, chia seeds and avocado. Have red meat only once a week, replace with lean meats like chicken and turkey and fish.
Probiotic foods such as sauerkraut, kimchi, miso and kombucha are full of good gut bacteria which help to defend against microbial imbalance and inflammation. Try introducing these into your diet, if you don’t usually eat them start with a small amount (1 tbsp) and build it up to 3 tbsp over a couple of weeks.
The medicinal mushroom Lions Mane contains prebiotics called beta glucans which are immune supportive, support the mucosal barrier and also feed good gut bacteria. For more information about Lions Mane click here.
Probiotics provide the digestive tract with beneficial bacteria which have multiple positive actions on health. One of their roles is to help keep the integrity of the gut lining by managing the mucosal layer. They also help to fight off pathogenic bacteria which reduces inflammation. We like Viridian Daily High Strength, Your flora Terrain and Wild Nutrition Multi-strain Biotic.
N-acetylcysteine (NAC) is a supplement which is the precursor to our master antioxidant, glutathione. In addition to its antioxidant status, it reduces endothelial dysfunction and inflammation in the digestive tract. (We like Viridian NAC and Pure Encapsulations Liver GI).
Molkosan is rich in a substance known as L+ lactic acid which is now known to support the growth of good gut bacteria.
The Intestinal Permeability Profile is a finger prick test that looks at serum Zonulin levels. Zonulin is a protein that is synthesized in intestinal cells and liver cells. It is a key biomarker for intestinal permeability. Zonulin is also addressed in the comprehensive stool sample so it may be beneficial to look at that test for a more comprehensive analysis of your digestive health.
GI Effects is a comprehensive stool analysis test which identifies the microbiome population, digestive enzymes, inflammatory markers and pathogenic bacteria, yeasts, parasites and viruses. The results from this test can be used to devise a personalized protocol based on your own ecosystem to help improve microbial balance and restore health there.
SIBO which stands for Small Intestinal Bacteria Overgrowth, happens when bacteria which should reside in our large intestines, actually end up in our small intestines (where they shouldn’t really be). This can cause symptoms of IBS including chronic diarrhea. The SIBO test is a breath test which measures hydrogen and methane levels which can determine if and which type of bacteria are in your small intestine. The practitioner can then devise a specific protocol to help eradicate the bacteria in the small intestine.
Coeliac and Gluten Sensitivity Panel: this test looks at the immune antigens associated with gluten sensitivity and coeliac disease – two common reasons for chronic diarrhea.
Other testing options are the Food Sensitivity Test.
[i] Mu, Qinghui et al. “Leaky Gut As a Danger Signal for Autoimmune Diseases.” Frontiers in immunology vol. 8 598. 23 May. 2017, doi:10.3389/fimmu.2017.00598
[ii] Dulantha Ulluwishewa, Rachel C. Anderson, Warren C. McNabb, Paul J. Moughan, Jerry M. Wells, Nicole C. Roy, Regulation of Tight Junction Permeability by Intestinal Bacteria and Dietary Components, The Journal of Nutrition, Volume 141, Issue 5, May 2011, Pages 769–776, https://doi.org/10.3945/jn.110...
[iii] Järvinen KM, Konstantinou GN, Pilapil M, Arrieta MC, Noone S, Sampson HA, Meddings J, Nowak-Węgrzyn A. Intestinal permeability in children with food allergy on specific elimination diets. Pediatr Allergy Immunol. 2013 Sep;24(6):589-95. doi: 10.1111/pai.12106. Epub 2013 Aug 2. PMID: 23909601; PMCID: PMC3774110.
[iv] Drago S, El Asmar R, Di Pierro M, Grazia Clemente M, Tripathi A, Sapone A, Thakar M, Iacono G, Carroccio A, D'Agate C, Not T, Zampini L, Catassi C, Fasano A. Gliadin, zonulin and gut permeability: Effects on celiac and non-celiac intestinal mucosa and intestinal cell lines. Scand J Gastroenterol. 2006 Apr;41(4):408-19. doi: 10.1080/00365520500235334. PMID: 16635908.
[v] Gecse K, Róka R, Séra T, Rosztóczy A, Annaházi A, Izbéki F, Nagy F, Molnár T, Szepes Z, Pávics L, Bueno L, Wittmann T: Leaky Gut in Patients with Diarrhea-Predominant Irritable Bowel Syndrome and Inactive Ulcerative Colitis. Digestion 2012;85:40-46. doi: 10.1159/000333083
[vii] Fasano A. Zonulin and its regulation of intestinal barrier function: the biological door to inflammation, autoimmunity, and cancer. Physiol Rev. 2011 Jan;91(1):151-75. doi: 10.1152/physrev.00003.2008. PMID: 21248165.
[viii] Maes M, Kubera M, Leunis JC. The gut-brain barrier in major depression: intestinal mucosal dysfunction with an increased translocation of LPS from gram negative enterobacteria (leaky gut) plays a role in the inflammatory pathophysiology of depression. Neuro Endocrinol Lett. 2008 Feb;29(1):117-24. PMID: 18283240.
Please note that the information contained within this website does not and should not replace medical advice, and is not intended to treat or diagnose. We always recommend you consult with your doctor. Our Nutritional Therapy team is highly trained and we offer one to one Nutritional Therapy Consultations, which are designed to be complementary to any medical treatment from a functional medicine approach, as well as offering a preventative & optimal health focus.