How to Recognize Leaky Gut Syndrome

Because it is something of a mystery disease that can show itself as a bewildering array of other conditions, you could have leaky gut syndrome and not even realize it.

The reason is that leaky gut syndrome is one of the many concepts in medicine that cuts across the boundary lines of specific diseases.

It is a major example of an important medical phenomenon: distress in one organ causing disease in another.

Conditions That Can Signal Leaky Gut Syndrome:

• Arthritis
• Allergies
• Depression
• Eczema
• Hives
• Psoriasis
• Chronic fatigue syndrome, or fibromyalgia

If you have any or some of these symptoms, then you may also have leaky gut syndrome, because it causes or contributes to these conditions. That’s why getting a better understanding of leaky gut syndrome may help you find a more effective solution to your condition.

I am telling you about leaky gut syndrome because it is a vitally important but often undiagnosed condition that is key to recovering from many illnesses and regaining robust, good health.

An Integrated Approach to Leaky Gut Syndrome

I’ve been evaluating patients for leaky gut syndrome for over 20 years and have been writing about my integrated approach to this condition. My article “Leaky Gut Syndromes: Breaking the Vicious Cycles” is available at the Foundation for Integrated Medicine website.

Through my clinical experience and further research, I came to understand how gastrointestinal health in general and leaky gut syndrome in particular contribute to many seemingly unrelated conditions.

To share my knowledge and help my colleagues learn more about this important topic, I wrote a chapter titled “Integrative Approach to the Gastrointestinal System” for the textbook Integrative Medicine: Principles for Practice in 2004 and authored the booklength monograph Gastrointestinal Dysregulation: Connections to Chronic Disease in 2008.

I have found leaky gut syndrome especially relevant for many people with chronic fatigue syndrome.

Scientific Research Connects Leaky Gut With Chronic Fatigue and Depression

Recent research from Belgium confirms my observations about leaky gut syndrome and chronic fatigue syndrome and suggests a treatment plan that can alleviate chronic fatigue and also major depression.

The Belgian researchers found that people in their study with either chronic fatigue syndrome or major depressive disorder showed laboratory evidence of leaky gut syndrome when compared to a healthy control group.

More importantly, they demonstrated that treatment with diet and specific nutrients not only reversed laboratory signs of leaky gut syndrome, but also improved symptoms of fatigue, malaise and depression.

I’ll describe my approach to this condition and what lessons we can take away from the research from Belgium. But first, I want to give you some background on leaky gut syndrome and explain why the concept is still so controversial.

What Is Leaky Gut Syndrome?

Because it connects apparently unrelated disorders, leaky gut syndrome is one of the most misunderstood concepts in medicine today.

To begin with, it is not a single disease or syndrome; it’s a pathological condition that occurs as part of many different diseases and syndromes. The term refers to an abnormal increase in the permeability of the small intestine. Increased intestinal permeability is a component of many different disorders.

Leaky gut syndrome is associated with:

• Inflammatory and infectious bowel diseases
• Several types of arthritis
• Acne
• Psoriasis
• AIDS
• Chronic liver disease
• Pancreatic disease

It is also associated with numerous conditions triggered by food allergies, including eczema, hives and irritable bowel syndrome.

Why is increased small intestinal permeability such a problem? The small intestine is the largest organ in your body, and two-thirds of your immune system lies within its walls. The small intestine continuously activates itself by sampling the molecules that pass through the intestinal lining.

Leaky gut syndrome is increased permeability of this lining, and it alters the molecules that prime your immune system for action by allowing molecules that don’t ordinarily pass through the gut lining to get access to your immune system.

Sometimes leaky gut syndrome plays a primary role in the evolution of an illness. Crohn’s disease is a serious chronic intestinal disorder that affects almost a million people in the United States. People who develop Crohn’s disease may have a genetically induced increase in intestinal permeability that creates inflammation in the bowel. This predisposed leakiness can be found in close relatives of patients with Crohn’s diseases, suggesting that it precedes the development of inflammation.

Leaky gut syndrome can occur as a result of another disease. Celiac disease is an inherited intolerance to gluten, a group of proteins found in wheat, barley and rye. Celiac disease affects about one person in a hundred in North America and often goes undiagnosed, even when people have severe symptoms. The inflammation caused by active celiac disease causes the leaky gut, which in turn causes some of the complications associated with celiac disease.

Leaky gut syndrome can also be caused by the treatment for another disease. In rheumatoid arthritis, for example, drugs used to relieve pain and inflammation can damage the intestinal lining, leading to leaky gut syndrome within two weeks. Leaky gut syndrome, in turn, is associated with aggravation of arthritis.

For most conditions, the precise role of leaky gut syndrome remains unclear, but it seems to be part of a vicious cycle that makes the condition get worse over time. Allergic reactions to food, for example, cause a transient increase in intestinal permeability. If this happens frequently, it may increase the number or severity of food allergies.

In chronic fatigue syndrome and major depressive disorder, leaky gut syndrome activates the intestinal immune system to produce chemicals called cytokines that spread inflammation through your body.

Inflammation is an important trigger for symptoms like fatigue, malaise, pain and depression.

When should you suspect leaky gut syndrome? You should see a doctor if you have:

• pain in multiple joints
• a chronic skin condition
• chronic diarrhea or abdominal pain
• chronic fatigue
• chronic depression
• malaise
• a feeling of being infected but your doctor can’t find the infection

Recent research in animals has indicated that leaky gut syndrome may also be associated with difficulty losing or gaining weight, but its association with obesity is still under investigation.

How can the possibility of leaky gut syndrome be evaluated? There are only a few laboratories that test for leaky gut syndrome, and all require a doctor’s order. Talk to your doctor about what test might be appropriate. High levels of antibodies to common food proteins or to normal intestinal bacteria may indicate increased intestinal permeability. Many research studies have used a challenge test involving a special solution consisting of two sugars and seeing how much of each appears in urine. A blood test for celiac disease is essential.

Here are five steps to help heal leaky gut syndrome. Get rid of anything that might be causing or contributing to increased intestinal permeability:

1. Stop drinking alcohol for at least a month.
2. Stop using aspirin, ibuprofen, naproxen and other non-steroidal anti-inflammatory drugs (NSAIDS).
3. Have a stool test for intestinal parasites. There is extensive medical literature on intestinal parasites causing symptoms like fatigue, joint pain and skin disorders, without causing diarrhea. I discuss these in a chapter I wrote titled, “Intestinal Protozoan Infestation and Systemic Illness” for the Textbook of Natural Medicine, 3rd Edition, in 2005.
4. Adopt an anti-inflammatory dietary pattern. I explain the benefits of eating to reduce inflammation—and provide a plan to achieve that—in my book, The Fat Resistance Diet. The principles are simple to understand: Avoid foods with added sugar and refined starches made from white flour. Decrease consumption of saturated fat and most vegetable oils, using extra virgin olive oil instead. Eat at least nine servings of fruits and vegetables a day and at least four servings of fish per week.
5. Dietary supplements help the small intestine heal and restore its functional integrity. The most important of these are the amino acid L-glutamine and the amino sugar N-acetyl-glucosamine, which are readily available in health food stores.

These are but a few introductory steps toward an integrated approach to this condition. There is a vast amount of scientific literature on leaky gut syndrome, a sample of which appear in the references below from journals such as The Lancet, The British Medical Journal and The Annals of Internal Medicine.

Dr. Leo Galland is a board-certified internist who is internationally recognized as a leader in nutritional medicine. He has written several dozen scientific papers and textbook chapters and three highly acclaimed popular books, The Fat Resistance Diet, Power Healing and Superimmunity for Kids.