Do you experience symptoms such as bloating, gas, cramps, food sensitivities, and aches and pains that aren’t associated with a medically diagnosed condition? If yes, you might be suffering from a condition called leaky gut syndrome—a diagnosis the integrative health world is quick to diagnosis, but that mainstream practitioners and researchers remain unsure of. While there’s debate between the two camps about the legitimacy of leaky gut diagnoses, one is for certain: The topic of digestive upset and intestinal permeability is all the rage these days and understanding the tenets of digestive and gut health is essential to championing your overall well-being.
What exactly is leaky gut?
According to Frank Lipman, MD, author and founder of Be Well and the Eleven Eleven Wellness Center in New York City, leaky gut syndrome, which is often referred to as intestinal permeability, is said to occur as the result of damage to the intestinal lining, making it more porous than it should be. When this happens, undigested food particles, bacteria, and toxins are then able to escape from the intestines and travel throughout the body via the bloodstream. Since these particles are not meant to leave your digestive tract, your immune system sees them as foreign invaders and fights back against them, creating an immune response that leads to inflammation, which can catalyze an array of symptoms and chronic health conditions. Lipman notes that the condition is exacerbated by an increase in zonulin, an inflammatory protein that regulates the openings between cells in the lining of the digestive tract. “Too much zonulin is not a good thing,” says Lipman. “For example, gluten happens to be a strong trigger of zonulin. So, a gluten-rich diet may be making our guts even more permeable, enabling inflammation to flourish system-wide and setting the stage for far more serious problems like heart disease, diabetes, cancer, and more down the road.”
Symptoms of Leaky Gut
Some of the most common symptoms of leaky gut according Raphael Kellman, MD, author of The Whole Brain: The Microbiome Solution to Heal Depression, Anxiety, and Mental Fog Without Prescription Drugs, include:
- Digestive issues—gas, bloating, diarrhea, irritable bowel syndrome, and heartburn
- An increase in allergies and/or food sensitivities
- Anxiety, depression, and mood swings
- Hormonal imbalances like premenstural syndrome and polycystic ovary syndrome
- Excessive fatigue
- Nutritional deficiencies
- Skin rashes, acne, eczema, and skin issues
- Joint pain
- Headaches, brain fog, and migraines
- A weakened immune system
- Autoimmune diseases such as celiac disease, Crohn’s, and rheumatoid arthritis
Causes of Leaky Gut
Digestive distress seems to be at an all time high. According to the National Institute of Diabetes and Digestive and Kidney Diseases, a whopping 60 to 70 million people are affected by digestive diseases on an annual basis. According to Lipman, these are some of the commonplae things that can contribute to leaky gut syndrome:
- Over-the-counter (OCT) nonsteroidal anti-inflammatory drugs (NSAIDs), like Advil, Aleve, and Motrin
- OTC products for acid reflux, like Maalox, Mylanta, and Rolaids
- Prescription medications (proton pump inhibitors, or PPIs) for acid reflux or gastroesophageal reflux disease (GERD), like Nexium and Prilosec
- Antibiotic use
- Habitual alcohol use or overuse
- Food sensitivities to things like gluten and dairy
- Low-fiber diets
- Diets high in processed foods
- Low-grade gut infections caused by yeast, bacteria, and parasites
- Diets high in sugar, which feeds bacteria growth
- Chronic stress
Other conditions such as small intestinal bacterial overgrowth—also known as SIBO—fungal dysbiosis, or parasitic infections are also said to potentially spur on the condition.
Health Conditions That Can Lead to the Discovery of a Leaky Gut (or Result From It)
Aditi Jha, MD, lead physician at JustDoc.com, notes that there are some common conditions that doctors see that can lead to a diagnosis of leaky gut. “In my practice, I see patients … suffering from IBS, inflammatory bowel syndrome (both Crohn’s and UC—Ulcerative Colitis) once a month at least in my clinic,” she says. “Other scenarios such as people with autoimmune disorders or kidney failure on immunosuppressive medications (steroids) can also develop a leaky gut,” she notes. Jha says that diarrhea is often the first symptom reported by these patients. Many health professionals, including Lipman, believe in the saying “Health is in your gut” and hypothesize that leaky gut may be the cause of many other ailments including common autoimmune diseases. Thus, it’s not uncommon for integrative health practitioners to see patients with arthritis, psoriasis, chronic fatigue syndrome, fibromyalgia, and similar conditions and conclude that leaky gut is the underlying cause of their diagnoses.
What do mainstream medical professionals actually think about leaky gut syndrome?
While the condition is receiving more and more media attention, with it being a topic featured regularly in publications like The New York Times and The Washington Post, leaky gut is something that isn’t recognized by most traditional medical practitioners. “Intestinal permeability or so-called leaky gut syndrome is a distinct medical condition mostly claimed by nutritionist[s] and alternative medicine physicians,” says Rudolph Bedford, MD, a gastroenterologist at Providence Saint John’s Health Center in Santa Monica, California. “Within the traditional medical community this syndrome does not exist. It’s something of a medical mystery. From an MD’s standpoint, it’s a very gray area.” Mitchell Blume, a dietitian with EduPlated, notes that much of the confusion behind this condition stems from the fact that there is a lack of evidence and research surrounding the issue of intestinal permeability. “There is minimal research addressing treatment option[s] for this condition. Due to this, there aren’t any recognized medication, procedures, or recommendations that have been shown to help,” he explains. Blume, however, shares that while there are no scientifically-backed treatments out there, it has generally been found that diet may have an impact on symptomatology. Below is Blume’s list of diet and supplement recommendations, which may help:
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How to Change Your Diet and Lifestyle to Address Leaky Gut
According to integrative medicine approaches, a good first step in exploring your gut issues is to adhere to a two-week elimination diet. This will tame inflammation in the digestive system and eliminate any foods that may be triggering your symptoms. “The best remedy is to note the trigger foods, (everyone has a different trigger) and avoid them,” says Jared Koch, a New York City-based certified health coach, nutritional consultant, and founder of Clean Plates. “Common triggers I see in my patients are restaurant food, spicy food, oily foods, [and] junk such as white flour and burgers/hot dogs.” As Blume points out, sugar and high-fructose corn syrup are known to cause inflammation, as are trans fats, vegetable and seed oils, refined carbohydrates, excessive alcohol, and processed meats. It’s also a good idea to incorporate anti-inflammatory foods into your diet. Like Blume, Kellman recommends fish oil and healthy fats like coconut and olive oil, avocado, and flax seeds. Lipman adds that eating whole foods and forgoing anything processed is a good idea. He says that processed foods “offer few nutrients, lots of extra sugar, and chemical additives, as well as plenty of genetically modified ingredients, all of which can wreak havoc on your gut lining, making leaky gut and inflammation matters worse.” Other tips include adding leafy greens to your meals and taking a high quality probiotic to give your good bacteria a boost. “A daily serving of good gut bacteria will help keep your immunity strong, fend off pathogens, and protect the gut lining,” says Lipman. You also need to address any underlying infections that may be threatening the integrity of your immune system. Those who suspect they are suffering from leaky gut should prioritize eating plenty of high fiber foods and drinking adequate amounts of water every day, and can consider incorporating a daily dose of L-glutamine into their diet. Lipman corroborates Blume’s assertion that this amino acid helps repair the intestinal walls. “It can be purchased over the counter in health food stores and is plentiful in sources like grass-fed beef, asparagus, and broccoli,” he says. Bone broth enthusiasts, such as Osso Good Co., a company that ships out pre-packaged broth to its customers, claim that drinking collagen-rich bone broth can help to repair a compromised gut. Regardless of what you add into your diet, common allergens including cow’s milk, eggs, tree nuts, peanuts, shellfish, and wheat can be excluded to see if their absence gives you symptom relief.
Stress and Your Gut
Another important change to make is to reduce the amount of stress you experience on a daily basis. Since your digestive process is controlled by your nervous system, continuously spiking your cortisol levels, sending your body into “fight or flight” mode can wreak havoc on your digestion. In fact, studies show that stress can actually change the balance of the healthy bacteria in your gut, which can significantly impact your digestive function. To get a grip on stress, Patti Johnson, PsyD, a Los Angeles-based therapist, recommends deep breathing, meditation, exercise, watching a funny movie, spending time with friends, taking a relaxing bath, and taking a break from daily work and life stresses to unwind and recharge. Functional nutritionist Jennie Miremadi, MS, CNS, LDN, agrees that stress can strain your digestive system and makes a point of having her patients practice mindful eating. She says you need to thoroughly chew your food at every meal, as “all digestion begins in the mouth.” Her tips for eating mindfully include:
- Eating without distractions (i.e. avoid eating while driving, texting, or watching television)
- Only eating when you are physically hungry and not eating as a response to boredom or stress
- Taking a deep breath and exhaling slowly five to 10 times before you start eating your meal in order to calm your digestive system
- Chewing each bite slowly and carefully
- Staying fully present with your food and your hunger levels while eating
- Putting down your fork in between bites
- Stopping your meal before you are overly full, as this can burden your digestive system
How to Tell if You Have Leaky Gut Syndrome
First and foremost, if you suspect that you have leaky gut, you should talk to a health care professional so you can receive a proper diagnosis and medical treatment plan. Per Josh Axe, certified doctor of natural medicine, doctor of chiropractic, and clinical nutritionist, the following tests can help determine whether or not you may have leaky gut syndrome:
- An ELISA test that looks at your zonulin levels, as an abnormally high level of zonulin might suggest that your gut health is compromised
- An IgG food intolerance test, which can help you determine what types of foods you may be sensitive to; if you show intolerance to a lot of foods, that could mean your gut is compromised
- A stool test to check for yeast, parasites, and bacterial infections that can contribute to a leaky gut diagnosis
- Organic acid vitamin and mineral deficiency test to determine whether your body is struggling to digest food properly, which can also be a sign of intestinal permeability
Koch reiterates that when it comes to leaky gut, the medical community is on the fence. “From a medical perspective it is not a specific diagnosis and treatment, so it seems to be more of a grey area relating to digestive symptoms like gas, bloating, constipation, and or loose bowels that have no real clear cause. In the holistic health world it is generally meant that there [are] leaks in the intestines and therefore certain unwanted substances may be leaking into the bloodstream,” he says. Koch notes, however, that regardless of your diagnosis (or lack thereof), if you are having any sort of digestive upset, you should see a doctor to determine the best plan of action. “Find someone who can help you determine the root cause and then eliminate or reduce the culprits,” he says. Digestive upset is something that you shouldn’t have to live with and experts, including Kellman, note that conditions like leaky gut can definitely be reversed. Kellman recently worked with a patient who made major changes in her health by following his gut healing recommendations. “With[in] three weeks, she began to feel better. Within three months, most of her aches and pains were gone. After six months, she began to feel truly well, having regained optimal brain function.” Kellman’s recommendations include “eating a diet rich in high-fiber prebiotics and healthy fats that support cell integrity, avoiding inflammatory foods like soy, gluten, cow’s milk dairy, and processed foods, regulating … sleep patterns, in order to support [the] gut and microbiome, and addressing … stress.”
