Did you know that the lining of your gut is only a single-cell layer thick? This is an undeniably beneficial feature for the proper absorption of nutrients, but stop and think...

This incredibly thin barrier is also a crucial part of our immune system. It’s designed to keep out the bad things just as much as let in the good things! Clearly, we rely heavily on the integrity of our pivotal gut lining! In fact, it is estimated that 70-80% of our immune system capacity lies within the gut!

Imagine the effects if this barrier was somehow compromised. These effects can not only manifest within our digestive system but also impact the overall strength and health of our immune system and entire body. This is exactly what brings us to the topic of “leaky gut,” a proposed condition related to the well-established phenomenon called “intestinal permeability."

Once a highly criticized idea by the conventional model, the term leaky gut is increasingly appearing in research as the importance and complexities of gut health become more widely explored. In this post, I hope to foster a deeper understanding of what leaky gut actually is, why you should care, how it happens and manifests, and ways to tackle this concern naturally.

What Is Leaky Gut?

Let’s set the stage for a better understanding of “leaky gut.” Our intestinal barrier is a “semi-permeable membrane” that is single-cell thick. These cells are held together by tight junctions (appropriately named, no?). When functioning normally, this barrier lets certain things in (our digested macronutrients and micronutrients) and keeps certain things out (undigested food, microbes, toxins, etc.).

When functioning abnormally, we call this relative “openness” of the space between cells intestinal permeability. Leaky gut is a proposed condition that says this loss of integrity of the intestinal barrier might let unwanted substances into the bloodstream. This situation is linked to dysfunctional absorption, inflammation, and immune responses.

Imagine your gut lining as a team of players in a game of Red Rover. Normally, the players (intestinal cells) stand strong, hand-in-hand, forming a tight line that only allows select participants (nutrients) to pass through when called. This keeps out unwanted players (toxins, bacteria, and undigested food particles).

In leaky gut, it's like some players (gut cells) have let go of their hands or are loosely connected. This creates gaps in the line, allowing not just the invited participants (nutrients) but also unwanted players (toxins, bacteria, and undigested food particles) to break through. These unwanted players can then wreak havoc on the other side, causing inflammation and various health issues.

Though leaky gut is currently not a conventionally recognized, stand-alone diagnosis, the existence of intestinal permeability is a well-known result of damage and inflammation in the gut. More time and research will reveal the answer to this question. Until then, let’s explore what causes damage to the gut lining and loss of integrity of these tight junctions!

What Causes Leaky Gut?

When we zoom out, we will see that the situation of leaky gut is largely a product of contemporary society. Our daily stressors, whether emotional, dietary, or environmental, become some of the common themes that result in intestinal permeability and leaky gut. Let’s explore some of the most common causes:

Standard American Diet

Perhaps one of the most direct causes of leaky gut and damage to the gut lining is through food. The Standard American Diet (SAD) is well-documented to promote widespread inflammation and negatively impact overall health. A diet high in refined carbs, processed foods, inflammatory fats, and low in plants, fiber, and micronutrients contributes to leaky gut.

Gluten

Gluten is obviously a hot topic in the wellness world, and its relationship to leaky gut and intestinal permeability is generally well-explored in the research. Even in those without celiac disease, gluten may play a role in damaging intestinal cells and prompting an immune response. This topic alone could take up a full post to explore or an entire blog!

Short-Term and Long-Term Emotional Stress

Both acute and chronic stress have demonstrated changes to gut health. Though many experience the link between stress and gut issues in real life, more research is always needed to continue to uncover the relationship between stress and intestinal permeability. One such area of study is the effect that cortisol, a primary “stress hormone,” has on the proteins and tight junctions of the gut lining.

Physical Trauma

Physical trauma can also be a potential trigger for leaky gut. There are studies especially in the area of concussion or traumatic brain injury (TBI) and its relationship to the gut. Shifts in the microbiome can be observed within hours after traumatic injury. This is a great area of focus in the two-way connection between the gut and brain, known as the gut-brain axis.

Toxins

It is well known that we’re all exposed to increasing levels of chemical and environmental toxins everyday. In fact, in 2004 the Environmental Working Group published findings of an average of 200 industrial chemicals and pesticides in the placenta of studied newborns. Phthalates (an ingredient in plastics) and glyphosate (a toxic ingredient in common pesticides) have known effects on gut health.

Infections (Apparent or Hidden)

Infections, whether acute or chronic, and apparent or hidden, can also lead to states of leaky gut. Whether you’ve recently had food poisoning, the stomach flu, or a hidden parasitic infection such as blastocystis hominis, infections and the inflammatory response can create intestinal permeability.

Medications

There are many classifications of medications that affect our gut health. The most common classes of drugs associated with leaky gut include the following:

• Over-the-counter NSAIDS such as ibuprofen and acetaminophen
• Acid-reducing medications such as proton pump inhibitors
• Antibiotics
• Oral contraceptive pills
• Steroid medications

Alcohol Consumption

It is also well-established that alcohol consumption leads to inflammation and is associated with increased intestinal permeability.

Gut Imbalances Such as Dysbiosis and SIBO

Microbiome imbalances such as the overgrowth of some organisms or the invasion of opportunistic bacteria and other pathogens are associated with leaky gut. This is a state known as dysbiosis. Small intestine bacterial overgrowth, or SIBO, is another situation that leads to such gut inflammation.

Signs and Symptoms of Leaky Gut

What makes a leaky gut such a tough situation to tackle is that the symptoms can vary widely from person to person. There are no “hallmark” symptoms of leaky gut. However, because the occurrence of intestinal permeability is intertwined with many conditions, symptoms may vary widely.

In fact, it may come as a surprise, but the symptoms of leaky gut may go far beyond gut-related symptoms. Let’s explore some of the possible experiences associated with leaky gut.

Digestive Associations:

• Indigestion
• Bloating, excessive gas production
• Acid-reflux
• Loose bowel movements or constipation
• Stomach pain and cramping
• Overweight and obesity

Non-digestive Associations:

• Linked with autoimmune conditions such as Hashimoto’s thyroiditis and celiac disease
• Brain fog, difficulty concentration
• Fatigue
• Body aches, joint pain, and headaches
• Skin issues
• Chemical and food sensitivities
• Increased allergies
• Mental health concerns such as anxiety and depression

Why Should I Care About Leaky Gut?

Looking at the wide variety of symptoms and associations above, we should highlight that leaky gut is often an insidious situation. Sometimes stark symptoms are absent or not gut-related, and this makes it notoriously difficult to tackle in a world where the conventional model and patients often wait for symptoms to appear to intervene!

That said, leaky gut may be associated with the development of chronic disease and dysregulation of the immune system. Your gut function and integrity of the intestinal barrier is a pivotal first-line defense. Attention to this area of your gut health can help set you up for an increased quality of life by looking at these important changes that underlie most of the chronic illness that plagues our society.

How to Test for Leaky Gut?

There are several methods for directly and indirectly assessing whether leaky gut is present. It’s important to consult with a health professional for personal testing recommendations, but here are a few of the most common tests that look for leaky gut.

1. The lactulose-mannitol test: This is the current “gold standard” test for leaky gut. It measures the absorption and excretion rates of differently sized sugar molecules to see if bigger molecules are getting through the gut lining that shouldn’t be.
2. Zonulin testing: This test is commonly used, though highly criticized, for its lack of reliability and specificity to leaky gut. Nonetheless, it is sometimes used as a supportive marker.
3. Functional stool testing: Looking at the gut microbiome and other markers of gut inflammation can be used to deduce the likelihood that leaky gut is present.
4. Tissue biopsy and endomicroscopy: These tests are expensive and less commonly used. They visualize the gut lining through magnification to assess tight junction integrity.

Despite all of these testing options, I like to pose this question. “Is it even worth testing for leaky gut?”

Because of its connection to many other inflammatory conditions, you can almost assume that a degree of intestinal permeability is present. This includes the Inflammation in the gut caused by stress, alcohol, inflammatory foods, and any of the other causes we explored earlier!

My question goes back to the idea that a leaky gut may not be an independent disease “entity.” So it may be more beneficial to prioritize testing for the causes of leaky gu, like dysbiosis and autoimmunity, rather than for leaky gut alone. Time will tell!

Natural Ways to Support Healing Leaky Gut

You can look at the many causes of leaky gut to understand the solutions to treating and avoiding it. Here are some of the main approaches to support your intestinal lining:

1. Avoid the underlying causes of leaky gut when possible - This may include minimizing or eliminating alcohol, inflammatory foods, and unnecessary medications.
2. Stress reduction, mindfulness, and meditation - Strengthening the immune system and the integrity of your gut can be supported through stress reduction techniques.
3. Support the strength and balance of your microbiome - Consume more plant-based foods, increase vegetables of all colors in your diet, and incorporate fermented foods.
4. Consider working with a gut health practitioner - Gain insight into your microbiome and digestive function with functional medicine lab testing and targeted treatment programs. The timing of treating leaky gut can be important and unique to your situation too. For example, as long as the underlying cause (hidden infection, inflammatory diet, etc.) is present, it doesn’t make sense to treat the leaky gut because it’ll just come right back.
5. Consider daily supportive supplements like Cielo’s Horizon with soothing ingredients such as marshmallow root, aloe vera, and ginger.

Conclusion

Understanding and addressing leaky gut is helpful for understanding how gut health affects overall health and the occurrence of chronic disease. By exploring the causes, symptoms, and testing methods for this condition, you can take proactive steps to support your gut health.

Whether through dietary changes, stress management, or working with a gut health expert, there are many ways to strengthen your gut lining, immune system, and quality of life.

If you have any questions or need further guidance on your journey to better gut health, feel free to reach out. Stay connected with Cielo and Dr. Kenny on Instagram for more insights, tips, and wellness support!