What is Leaky Gut?
Leaky Gut Syndrome vs leaky gut
Leaky gut syndrome (LGS) is a well-publicized but medically unrecognized condition that is separate and distinct from the scientific phenomenon of leaky gut (aka, increased intestinal permeability), a known factor in diseases such as celiac and Crohn’s disease.
The hypothesis of leaky gut syndrome is that when the junctions in our intestinal lining are malfunctioning, the intestines become hyperpermeable. This then allows harmful substances through the intestinal wall into the bloodstream. Proponents of LGS claim that a host of maladies – from bloating to autism – are caused by the immune system reacting to germs, toxins or other substances that have been absorbed into the bloodstream via a dysfunctionally porous (“leaky”) bowel.
In contrast, leaky gut/increased intestinal permeability occurs in concurrence with diagnosable gastrointestinal disorders as a result or contributor, allowing uncontrolled passage of potentially harmful substances (eg, bacteria, gliadin protein in celiac disease, etc.) from the intestinal lumen into the bloodstream. The body responds with subsequent immune and/or inflammatory reactions.
- LGS is a hypothetical condition, used to explain a wide range of physical discomforts; with no proven causes, symptoms, or effective treatments.
- Leaky gut/increased intestinal permeability is a symptom (not a cause) of known ailments tied to malfunction of the intestinal lining.
Intestinal Barrier - An Overview
The gastrointestinal (GI) tract is a totally separate environment from the rest of your innards – a tube from your mouth to your rectum that is a necessarily distinct and specialized domain in which food is ingested, digested, and excreted. For the purpose of discussing Leaky Gut Syndrome, we are interested in the lining of your small and large intestines, which is made up of a mucosal boundary between partially digested food in your intestines (ie, your “gut”) and the rest of your body. The intestinal lining therefore is a dynamic and semipermeable barrier that allows the absorption of nutrients, but also protects us from bacteria, large food molecules, etc. that are found inside the gut (think gastric acid, bacteria in food, chunks of chicken, etc.) but can cause damage if in the bloodstream and tissues.
Is Leaky Gut Syndrome Real?
The quick answer is … probably not. If you want to know why, read on:
LGS supposedly causes bloating, gas, cramps, inflammatory bowel disease (IBD), as well as fatigue, food sensitivities, joint pain, moodiness, irritability, sleeplessness, autism, and skin problems like eczema and psoriasis. That’s quite a list!
- The above symptoms occur in a large number of other health conditions that are not related to the GI tract.
- There is no reliable diagnostic test for LGS (and beware of a practitioner who tries to convince you otherwise).
- There is no evidence that intestinal permeability causes any disease – we all have permeable intestines, and to varying degrees.
In summary, the symptoms of LGS are wide-ranging among other health conditions, there’s no valid research proving the existence of LGS, and there is no diagnostic test or criteria for LGS.
Do I Have Leaky Gut Syndrome?
No, because it’s not a real thing.
You may have leaky gut, or increased intestinal permeability, in which case your doctor or GI specialist can assist you with further diagnosis and treatment of the underlying condition.
If you are currently paying an alternative health practitioner for supplements and/or to treat your LGS, I would urge you to investigate exactly what and why you’re being treated, and definitely get a second opinion from either a registered dietitian or MD. Actually, I would suggest you stop spending money on LGS treatment immediately.
As mentioned above, common suggested treatments for LGS include elimination diets, in which “offending” foods or food groups are removed from the diet. Briefly, the problems with this approach are:
- If you don’t have an allergy or intolerance to a particular food, there is no reason this will work,
- Elimination diets usually remove the unhealthiest of foods (think soda, donuts, etc.) first, which will cause a person to feel better overall but have no real impact on the intestine itself.
- These diets can be extremely difficult to maintain for any period of time, ultimately setting up the patient for failure (to follow).
A practitioner may also suggest taking supplements to “heal” your gut – zinc, fiber, probiotics (and probably some we’ve never heard of) may be prescribed. Not that these supplements have not been approved for the treatment of LGS (remember LGS isn’t a recognized diagnosis) and that they are likely not regulated by the FDA for purity or efficacy. Furthermore, many of these supplements can easily be added to your diet using real food. Buyer beware.
It is important to actively question a diagnosis that isn’t backed by scientific evidence, especially if it includes pricy supplements or excludes entire food groups.
Big questions about LGS remain, such as, why is there no research evidence of LGS, why are alternative medicine practitioners so quick to diagnose the disorder, and why is the only treatment to take unproven supplements or eliminate multiple food groups?
Although I haven’t been able to find any research on it yet, another question I have is: Why does LGS disproportionately impact wealthier, health-conscious individuals?
The Real Harm - Defrauding Patients & No Health Benefit
- People are diagnosed and treated for a fictitious condition and may feel better for a bit (hello, placebo effect); while their actual ailment goes untreated.
- Patients invest significant time and money into treatments that offer no real benefit to the condition they wish to or believe they are treating. Sure, eliminating donuts and soda while getting eight hours of sleep every night will likely cause you to feel better, but making those changes are free of charge.
NHS Choices, NHS, www.nhs.uk/conditions/leaky-gut-syndrome/.
Camilleri, Michael, et al. “Role for Diet in Normal Gut Barrier Function: Developing Guidance within the Framework of Food-Labeling Regulations.” American Journal of Physiology-Gastrointestinal and Liver Physiology, vol. 317, no. 1, 2019, doi:10.1152/ajpgi.00063.2019.
Campos, Marcelo. “Leaky Gut: What Is It, and What Does It Mean for You?” Harvard Health Blog, 24 Oct. 2019, www.health
“Debunking the Myth of ‘Leaky Gut Syndrome’.” Gastrointestinal Society, 4 Nov. 2019, badgut.org/information-centre/a-z-digestive-topics/leaky-gut-syndrome/.
“Intestinal Permeability.” Wikipedia, Wikimedia Foundation, 16 Feb. 2020, en.wikipedia.org/wiki/Intestinal_permeability.
Murray, Joseph, and Samantha A. Scanlon. “Update on Celiac Disease – Etiology, Differential Diagnosis, Drug Targets, and Management Advances.” Clinical and Experimental Gastroenterology, 2011, p. 297., doi:10.2147/ceg.s8315.
Quigley, Eamonn M.m. “Leaky Gut – Concept or Clinical Entity?” Current Opinion in Gastroenterology, vol. 32, no. 2, 2016, pp. 74–79., doi:10.1097/mog.0000000000000243.
Disclaimer: I am not a doctor. The information I provide is based on my personal experience, education and study of dietetics, human nutrition, and biochemistry; and my experience as a runner and athlete. Any recommendations I may make about exercise, nutrition, supplements or lifestyle; or information provided to you in person or on this website are for information purposes only and do not take the place of professional medical advice.