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Leaky gut isn't as literal as it sounds. Our intestinal lining is quite large (covering over 4000 sq feet of surface area) and usually it's marvelously in control of what enters it.1 However, if your gut is unhealthy it's thought that it might start to become more permeable. This means it can become less controlled: potentially allowing nutrients to slip through it more easily.
This is a problem. Undigested food particles 'leaking' through the net - along with toxins and bugs - can eventually seep into the bloodstream. Once there, the immune system may react to these particles and confuse them for pathogens (a nasty microorganism which can cause disease) and 'attack' the body,2 which is why getting to the root cause of leaky gut in the first place is so important.
Understanding leaky gut means we need to look at our health as a whole. There's no one clear cause or trigger, which is why truly getting to the root requires a bit of digging rather than a quick fix.
Firstly, our gut flora - the community of bacteria that live in our gut - plays a huge part. This complex community can help support the barrier in our intestines, so if it gets out of sync, perhaps after taking antibiotics, it can become compromised in supporting the lining which can ultimately cause permeability to develop.3
There's a little hero protein called zonulin which is involved in helping regulate our gut permeability. Bacteria in the intestines have been found to trigger it, which could suggest there is a link between regulation and topping up on your good gut bacteria.4
Diet is also thought to be a factor that can cause leaky gut syndrome. For instance, high sugar intake and excessive alcohol consumption may potentially damage the barrier, whilst a lack of nutrients can also contribute to this.5 Vitamins such as vitamin D may play a role in maintaining the gut's impermeable barrier in this instance.6
It's thought that gluten, most commonly found in bread and pasta, may too be involved in triggering zonulin and therefore could be linked to how permeable our gut is.7
The term 'leaky gut' is becoming more widely recognised in the health and nutrition sphere but this still remains controversial. Why? One reason is that it's almost impossible to be able to zoom in close enough to truly see these tight junctions in our gut. Even with a colonoscopy leaky gut would not be detected. On top of this, it's particularly difficult to diagnose, since its many symptoms can be attributed to a number of different conditions.
That's not to say it doesn't exist - in fact, the medical profession tend to agree that in some chronic illnesses, such as Crohn's disease, an increase in how permeable the intestines are is definitely observable.8
Unfortunately, there are several other conditions that share a number of similar symptoms to leaky gut syndrome.
For instance, autoimmune diseases such as coeliac disease, a condition in which the immune system reacts to gluten particles, or Inflammatory Bowel Disease, a wider term for Crohn's disease or Ulcerative Colitis, might both cause similar symptoms to leaky gut. With so many possibilities, it's important to speak to your GP. Though they might not be able to diagnose you with leaky gut, they could help to rule out these other more serious digestive conditions.
Another potential condition that shares similar symptoms is lactose intolerance - which is an inability to digest lactose. In people who are affected, eating dairy can lead to symptoms such as pain, bloating and diarrhoea. With the support of a nutritionist, it therefore might help to eliminate lactose foods for two weeks, in order to see whether your symptoms subside, and thus bringing you one step closer to either ruling out or diagnosing leaky gut.
It's not just food that can cause these symptoms, medication like antibiotics and contraceptives can cause a range of digestive issues.13 In these instances, it's best to check the medication you're taking carefully and chat to your doctor if you suspect they are causing side effects.
If your GP has ruled out other conditions and you think you do have leaky gut, then the first step is to keep a food diary. This will help you keep track of how your body reacts to different foods and help you identify potential triggers. Ideally, in conjunction with this you should follow an elimination diet, with the support of a dietician. This involves eliminating different foods and reintroducing them one at a time, whilst monitoring for potential reactions. It may well be worth monitoring your moods alongside your diet to see whether there's a possible connection between your mood and your gut.
A healthy gut flora is vital for anyone suffering with leaky gut. Taking a probiotic with at least 5 billion healthy bacteria can help reintroduce good gut bacteria into your gut. Vitamin D is another key nutrient that's thought to play a part in intestine permeability. Additionally, it might also be worth considering taking a collagen supplement which contains amino acids, that are potentially helpful in repairing a damaged gut lining.
If you'd like to read more about the benefits of keeping a healthy gut, as well as find more information on how you can promote good gut health, select Digestion from the Your health menu above.
Nothing beats a healthy, balanced diet to provide all the nutrients we need. But when this isn't possible, supplements can help. This article isn't intended to replace medical advice. Please consult your healthcare professional before trying supplements or herbal medicines.
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6Assa, A., Vong, L., Pinnell, L. J., Avitzur, N., Johnson-Henry, K. C., and Sherman, P. M. (2014). Vitamin D Deficiency Promotes Epithelial Barrier Dysfunction and Intestinal Inflammation. The Journal of Infectious Disease 210(08).
7Fasano, A. (2012). Zonulin, regulation of tight junctions, and autoimmune diseases. Annals of the New York Academy of Sciences 1258(01).
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9NHS Choices. (2018). Leaky Gut Syndrome. NHS.
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13Khalil, H., Higuchi, L. M., Ananthakrishnan, A. N., et al. (2013). Oral contraceptives, reproductive factors and risk of inflammatory bowel disease. Gut 62(08).