Leaky gut syndrome, also known as intestinal permeability, is a term used to describe a condition where the inner lining of the intestinal tract becomes more permeable or “leaky” than normal. In a healthy gut, the lining of the intestines acts as a barrier, allowing nutrients to be absorbed while preventing harmful substances, such as toxins and undigested food particles, from entering the bloodstream. This barrier is formed by tightly packed cells held together by specialized proteins.

In leaky gut syndrome, this barrier becomes compromised, allowing larger molecules, bacteria, food particles, and other substances to pass through the intestinal lining and enter the bloodstream. This triggers an upregulation of the immune response and creates inflammation in the body, as the immune system recognizes these substances as foreign invaders.

There are many potential causes of leaky gut syndrome. When I am treating patients for this condition at Thrive GI, the most important thing I need to do is identify and treat the underlying cause for each specific person. While I also use a combination of supplements that can soothe and heal the mucosal barrier, if the underlying cause has not been addressed, these patients will either show limited symptom improvement, or they will improve but then experience a relapse in symptoms once the supplements are discontinued.

What are the most common underlying causes of leaky gut syndrome? Here are the triggers that I see most often:

  1. Diet: Certain dietary factors, such as food intolerances and/or allergies, a high intake of processed foods, sugar, and refined carbohydrates, as well as a lack of fiber, can potentially contribute to gut inflammation and increased permeability.
  2. Dysbiosis: An imbalance in the gut microbiota (the community of microorganisms residing in the intestines) can lead to inflammation and compromise the integrity of the gut lining. I see this often with SIBO (small intestinal bacterial overgrowth) patients.
  3. Medications: Long-term use of non-steroidal anti-inflammatory drugs (NSAIDs), antibiotics, and other medications may affect the gut lining and contribute to leaky gut.
  4. Chronic Stress: Chronic stress can impact gut health and increase the risk of inflammation.
  5. Infections: Infections and certain gastrointestinal disorders can damage the gut lining and contribute to increased permeability.
  6. Genetics: Some individuals may be genetically predisposed to developing leaky gut syndrome. While we can’t test for every genetic condition, it can be helpful to test for total IgA levels in patients as some people are genetically prone to low IgA levels (which means they will always experience decreased immune function in the gut and a propensity for developing leaky gut syndrome).

The symptoms of leaky gut syndrome can vary widely and may include:

  • Digestive issues, such as bloating, gas, diarrhea, or irritable bowel syndrome (IBS) symptoms.
  • Multiple food sensitivities or allergies.
  • Significant environmental allergies
  • Fatigue.
  • Joint pain.
  • Skin issues, like eczema or acne.
  • Brain fog and difficulty concentrating.
  • Autoimmune conditions, as leaky gut has been hypothesized to contribute to certain autoimmune disorders.

In patients with suspected leaky gut syndrome, it is important to get a proper medical workup before attempting to treat. Often we need to rule out more serious conditions like IBD (inflammatory bowel disease), Celiac disease, intestinal infections, or SIBO. Some patients need to be tested for deficiencies in nutrients like iron and B12, as these substances are more difficult to absorb when the gut lining is compromised. And as always, a comprehensive treatment plan that includes temporary avoidance of all food intolerances, intestinal anti-inflammatories, and treatment of any underlying condition is the key to restoring long-term intestinal health.

Dr. Katie Nuckolls is a naturopathic physician and owner of Thrive GI: Natural Digestive Medicine in Vancouver, Washington. She currently sees patients that live in Washington, Oregon, and Arizona using telemedicine. For more information, visit our contact page or schedule a free 15-minute consultation online. 

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