Leaky gut – what is it exactly?
The term leaky gut, or what scientists call ‘increased intestinal permeability’, refers to a disorder in the protective barrier of the intestinal wall, primarily in the small intestine. As such, “leaky gut” therefore quite literally means a “leaky gut”. When the gut is “leaky”, incompletely digested protein (larger than they should be), bacteria and other toxins may find their way into the blood due to the excess permeability of the cell layer, which has been strongly associated with a wide range of autoimmune problems such as rheumatism1 or Hashimoto’s disease2. Leaky gut causes the weakening of adhesion of the cells that line small intestine, which can result from a stressful lifestyle, poor diet, certain medications (especially aspirin and nonsteroidal anti-inflammatory drugs), and environmental toxins.
Structure of the gut barrier
The gut’s protective function is upheld by various structures and intestinal cells. Its main parts are made up of intestinal cells, gut flora and intestinal mucosa, whose different functions all contribute to protecting the gut.
- Gelatinous first gut barrier to protect against pathogens
- Has trillions of gut bacteria for the protection of the gut
- Healthy gut flora wards off toxins and bacteria
- “Immune system of the gut”3
- Overgrowth of pathogens and yeast can degrade the protective function of the gut lining.
- Located beneath the mucus layer
- Held together by protein structures known as tight junctions, primarily consisting of a protein called ‘zonulin’
All three gut barriers are directly affected in leaky gut syndrome. Tight junctions, in particular, lose their effect, making the gut permeable to the invasion of bacteria and viruses, environmental toxins, and partially digested food products, potentially resulting in inflammation and illness.
Symptoms pointing to a leaky gut
Leaky gut can cause a number of symptoms which may vary from person to person, though some people have few if any symptoms associated with it. An imbalanced gut may lead to digestive problems such as flatulence, diarrhoea or constipation.4 As leaky gut syndrome can vary from person to person, those affected may not make the link between their digestive problems and leaky gut, instead believing the trigger of their discomfort to be inflammation. According to recent studies, it may also lead autoimmune problems5, such as rheumatoid arthritis6, rheumatism7 Hashimoto’s thyroiditis8, or even mental illness9.
Causes of leaky gut syndrome
Leaky gut syndrome is often caused by a hectic and stressful lifestyle. We can eat unhealthily during stressful times in our lives, and some may increase the consumption of sugary foods or alcohol. In principle, increased consumption (e.g. of alcohol, sugar and highly refined or processed products) may compromise overall health and physical wellbeing in every area and subsequently allow leaky gut syndrome to develop.10
Alongside a stressful lifestyle and an unhealthy diet, taking medication, such as non-steroidal anti-inflammatory drugs, may also affect the intestinal cells, leading to leaky gut.11 If there is an existing intestinal disorder, the gut may be more prone to leaky gut syndrome.
Diagnosis of leaky gut
In order to diagnose leaky gut, the protective function of the intestinal mucosa needs to be checked to see if it is intact. To determine abnormalities or irregularities, there are various approaches a doctor may take. First of all, however, it is always important to take a detailed history from the patient to determine exactly what the symptoms are and when they first developed. As with any illness, classic tests such as stool, blood or urine samples can shed some light initially as to the status of the patient’s intestinal mucosa and gut flora. The combined use of stool samples and blood tests has proved helpful in this regard.12 A zonulin test can be carried out to establish the presence of leaky gut syndrome. Zonulin is a protein that regulates the tight junctions in the intestinal wall and if zonulin moves from between the cells lining the small intestine into the blood, this may subsequently increase intestinal permeability. The protein is released with different stimuli by the intestinal mucosa. Zonulin is therefore a suitable marker to determine whether the gut is excessively permeable.13 If there is a high amount of zonulin in a blood sample, this may indicate the presence of leaky gut syndrome. Antibodies to zonulin in the blood can indicate that the condition has been present for a long time.
What can help with leaky gut?
There are different ways to support the health of the gut: getting enough movement, reducing stress levels and also having a healthy diet. Many nutrition researchers have looked into which foods have a bearing on mental health, and by extension, how the right diet can contribute to stress reduction.14
Consuming the right minerals, such as zinc, which can contribute to the normal function of the immune system, may also help in this regard. This is because gut health is closely linked with the health of the entire body.15 When dealing with leaky gut and the corresponding dietary advice, a low-gluten and low-sugar diet has been seen to play an important role time and time again. It is also recommended to eat as little processed food as possible to prevent leaky gut.16
The right amount of exercise
Regular exercise is an important part of a healthy lifestyle and contributes to a healthy immune system.17 Make exercise part of your daily routine, for example, by going jogging or cycling. Exercise out in the fresh air can particularly help to encourage blood flow.18 With sufficient exercise, the blood circulation in the gut can also be stimulated and constipation and flatulence can be prevented.
Preventing leaky gut with the right diet
“Through our diet and by consuming certain nutrients, we can help the body to rejuvenate, repair, and therefore recover from leaky gut. The body can repair the leaky gut itself, but we have to give it what it needs to do this and remove any interfering factors”,
A leaky gut can be prevented or gut health promoted through healthy eating. If you find out that you do, in fact, have leaky gut, you may benefit from a low-lectin diet, at least for a certain period of time. Lectins are a family of proteins that are in many foods, in particular in grains, legumes (beans) and pulses, some of which break down when pressure cooked.19 Although lectin-containing foods aren’t necessarily bad, they may slow down the healing process of a patient affected by leaky gut if consumed in large quantities. This is because consuming lectins may lead to the protective barrier of the gut being attacked. If you choose to change your diet, this should be monitored by a practitioner with experience in nutrition, and knowledgeable about leaky gut repair.
Aloe vera strengthens and soothes
Many people value the positive impact of aloe vera gel for skin problems. The plant can help with healing the skin when irritated or sunburnt. According to Dr Dwight McKee, this positive effect can also be transferred to the intestinal mucosa, and may help alleviate the symptoms of leaky gut.
“Aloe vera is one of the best healers of the skin. And the digestive tract lining is our inner skin and an epithelial tissue.”
Other tips to help treat leaky gut syndrome
We should pursue a holistic approach to alleviate the symptoms of leaky gut syndrome. The gut should always be provided with enough fluids in the form of water. Those affected should also consider changing their diet to contain many foods rich in nutrients that promote healing and few highly processed or sugary foods.20 Getting enough sleep and avoiding stress is just as important as having the right diet and exercising regularly. Taking medication frequently, especially antibiotics and non-steroidal anti-inflammatory drugs, may also have a negative impact on the health of the gut flora.21 Medication should therefore only be taken when necessary after consultation with a doctor in order to prevent putting the gut under unnecessary stress.
Risks of leaky gut
Leaky gut syndrome can have different effects on the entire body. Leaky gut can result in toxins, normally filtered by the gut and taken away, entering the bloodstream. If there is a pre-existing illness or there are further risk factors, autoimmune issues such as rheumatism22 or Hashimoto’s disease23 may develop in some circumstances.
If you suspect you might have leaky gut, you should see a doctor, who is knowledgeable about this condition, as soon as possible. This way leaky gut can be quickly spotted and the microbiota boosted to promote the gut’s regeneration.
Preventing leaky gut: establishing a healthy gut flora
A healthy lifestyle can help keep the gut healthy and prevent the development of leaky gut syndrome. It’s important to have a balanced diet both for gut health and general wellbeing. Having a healthy diet not only impacts on our physical wellbeing but also our mental health. Using a holistic approach consisting of exercise, diet and relaxation, gut health can be achieved or improved and the overall feeling in our bodies enhanced.
11Dr Amy Myers (2016) Die Autoimmun-Lösung: Ein gesundes Immunsystem beginnt im Darm. https://books.google.de/books?vid=ISBN978-3424153101
12The Physiological Society. “New, noninvasive test for bowel diseases.” ScienceDaily. www.sciencedaily.com/releases/2019/06/190626200318.htm
18Claudia Voelcker-Rehage (2013) Gehirntraining durch Bewegung: wie körperliche Aktivität das Denken fördert. S. 23f. https://books.google.de/books?vid=ISBN9783898997959