What Is Leaky Gut Syndrome?

Angela Ryan Lee, MD
·6 min read
<p>artpipi / Getty Images</p>

artpipi / Getty Images

Medically reviewed by Jay N. Yepuri, MD

Leaky gut syndrome is a collection of symptoms attributed to the idea that the intestinal barrier is impaired, allowing toxins from the intestines (the "gut") to enter the bloodstream. While it's not currently a recognized medical diagnosis, the idea that increased intestinal permeability contributes to various symptoms and conditions has some scientific evidence with more research ongoing.

Various causes may contribute to increased gut permeability, including infection, stress, certain medications, and medical conditions. Leaky gut syndrome is proposed by some researchers and healthcare providers in the functional medicine space as a cause of symptoms ranging from gastrointestinal distress to allergies and inflammatory diseases.

This article will discuss the concept of leaky gut syndrome, as well as its symptoms, possible causes, diagnostic considerations, and proposed treatments.

Symptoms of Leaky Gut

It's important to note that symptoms of a "leaky gut" are nonspecific, meaning they can be caused by many other conditions. Symptoms attributed to leaky gut syndrome may include the following:

Because the symptoms overlap with other conditions, evaluation requires a workup by your healthcare provider to exclude other causes.

What Causes Leaky Gut?

Like the skin, the gastrointestinal (GI) tract, which is the digestive tube that runs from the mouth to the anus, is continuously exposed to external substances. It requires a specialized layer of defense to prevent the random passage of bacteria and toxins into the body.

This barrier defense includes a mucus layer, an epithelial layer, and immune cells. In between these cells are protein complexes called tight junctions that regulate what substance may pass between the cells. The GI microbiome—the population of microbes with beneficial effects living in our gut—also appears to play an important protective role.

Leaky gut is proposed to be caused by increased permeability of the GI lining. This may be due to injury to the mucosal surface, increased transport of substances across the inner lining, or disturbance of the microbiome. The resulting inflammation is considered to blame for multiple possible related conditions.

Risk Factors

Various stressors are believed to contribute to leaky gut, including medical conditions, diet, and certain medications. Proposed risk factors for leaky gut syndrome include:

  • Family history of gastrointestinal disorders such as inflammatory bowel disease or celiac disease

  • A diet high in sugar, fat, and processed foods

  • Infections, such as Helicobacter pylori (H. pylori)

  • Alcohol

  • Stress

  • Diabetes

  • Certain medications like non-steroidal anti-inflammatory drugs (NSAIDs) and antibiotics

Related: 15 Surprising Ways Stress Affects Your Body

Diagnosis

Unfortunately, there is no tried and true diagnostic test for leaky gut. Current tests involve consuming a "probe molecule," such as a large sugar molecule like lactulose, which the body doesn't normally absorb. The molecules are then measured in the urine to determine how much they've been absorbed. Unfortunately, there are no standards for this testing and normal results have not been determined.

Evaluation of gastrointestinal disease, in general, may include the following tests:

  • Laboratory studies, including a complete blood count (CBC) to look for anemia and signs of infection and a comprehensive metabolic panel to look for electrolyte abnormalities and to assess kidney and liver function.

  • Stool tests for ova and parasites, Clostridium dificile (C. diff) toxin, and white blood cells.

  • Imaging tests such as abdominal ultrasound or computed tomography (CT scan) to evaluate for gallbladder, liver, and pancreatic diseases.

  • Endoscopy, which is a test performed by a gastroenterologist (specialists who treat conditions of the GI system) that uses a probe to view the GI tract. An upper endoscopy can be used to evaluate the esophagus, stomach, and upper small intestine; and a colonoscopy is used to view the colon.

Treatments for Leaky Gut

Leaky gut is not a generally recognized clinical diagnosis at this time, and treatments to improve intestinal barrier function are under investigation. Some treatments and dietary modifications have been proposed to affect the intestinal lining, however, more research is needed.

Proposed therapeutic strategies include:

  • Stress avoidance

  • Dietary changes, such as avoiding excess sugar, limiting fats, and increasing fiber

  • Taking probiotics

  • Taking supplements such as arginine or glutamine

  • Consuming herbs, including ginger, peppermint, and tea

  • Consuming certain mushrooms, broccoli, berries, and yogurt

  • Avoiding certain medications such as NSAIDs

  • Consuming a low FODMAP diet: FODMAPs are fermentable oligo-, di-, monosaccharides and polyols, that are suggested to trigger symptoms. A low FODMAP diet limits wheat, dairy, legumes, and certain produce.

Prevention

While leaky gut is not a generally recognized clinical condition, there are some hypothetical ways to prevent impaired intestinal barrier. For example, we know that stress, infections, and some medications affect the gut lining. So you can consider the following to keep a healthy gut:

  • Managing stress

  • Avoiding NSAIDs

  • Avoiding excess sugar and processed foods

  • Limiting alcohol

  • Taking a probiotic

  • Practice proper hygiene when preparing foods to prevent GI illness

Related Conditions

Several conditions are proposed to have a link to leaky gut. A strong association has been found with intestinal disorders and certain other conditions. Studies have shown altered levels of various proteins and immune factors involved in the intestinal barrier in the following:

Proponents of leaky gut syndrome also suggest that the following conditions may be linked. However, studies are very limited or lacking evidence, and more research needs to be done before claiming that leaky gut syndrome causes them:

A Quick Review

Leaky gut is not a recognized diagnosis at this time, but it describes the phenomenon of increased intestinal permeability that is sometimes associated with certain gastrointestinal symptoms and illnesses. Proponents of leaky gut syndrome suggest that an association exists with autoimmune conditions, neuropsychiatric conditions, and some nonspecific symptoms such as abdominal bloating, fatigue, headaches, and joint pain.

There is no standard diagnostic test for leaky gut. In general, gut health can be supported by eating a balanced diet, limiting alcohol intake, and managing stress, among other lifestyle factors.

Frequently Asked Questions

What does leaky gut smell like?

There is no smell to detect leaky gut. Leaky gut is the idea that increased permeability of the intestine allows toxins and bacteria to enter the body, potentially leading to inflammation and other symptoms. Foul smelling stool may be due to what you ate or certain medications, or from poor absorption or infection.

What is the easiest way to tell if you have a leaky gut?

There is no currently validated diagnostic test for leaky gut syndrome. Some tests involve ingestion of a probe molecule that the body does not typically absorb, and then measuring it in the urine. However, there are no set values for normal or abnormal results, and researchers are still determining the most appropriate tests.

What are the worst things for leaky gut?

Leaky gut refers to an impaired intestinal barrier. This can be caused by stress, infection, and certain medications. NSAIDs, alcohol, and excessive sugar intake have been associated with increased intestinal permeability.

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