What is intestinal permeability (leaky gut syndrome)?

From the Guidelines

Leaky gut syndrome is a condition characterized by increased intestinal permeability, allowing harmful substances to pass through the gut lining into the bloodstream, potentially contributing to various health problems, including inflammation and immune system reactions, as supported by recent research 1. This condition is often associated with digestive issues, such as bloating, gas, and cramps, as well as fatigue, food sensitivities, headaches, and joint pain. The intestinal lining normally acts as a barrier, selectively allowing nutrients to pass while blocking harmful substances, but when this barrier is compromised, it may trigger inflammation and immune system reactions throughout the body. Some key factors that can contribute to leaky gut syndrome include:

• Gut dysbiosis, or an imbalance of the gut microbiota, which can lead to enhanced gut permeability and inflammation 1
• Chronic gastrointestinal tract inflammation, such as in inflammatory bowel disease (IBD), which involves ulcerative colitis and Crohn’s disease 1
• Stress, which can affect the hypothalamic-pituitary-adrenal (HPA) axis and modulate the stress response, potentially leading to increased gut permeability 1 Treatment for leaky gut syndrome typically focuses on improving gut health through:
• Dietary changes, such as eliminating inflammatory foods like gluten, dairy, and processed foods
• Taking probiotics to restore healthy gut bacteria
• Consuming bone broth, which contains collagen to help repair the intestinal lining
• Reducing stress, which can worsen gut permeability Some practitioners also recommend supplements like L-glutamine, zinc, and digestive enzymes to support gut healing, although scientific evidence for these interventions remains limited 1.

From the Research

Definition and Mechanisms of Leaky Gut Syndrome

• Leaky gut syndrome is a condition characterized by increased intestinal permeability, allowing harmful substances to pass through the intestinal epithelium and into the bloodstream 2, 3, 4.
• The intestinal barrier, composed of surface mucus, epithelial layer, and immune defenses, plays a crucial role in preventing the entry of toxic substances into the body 4.
• Factors such as stress, unhealthy diet, excessive alcohol consumption, antibiotics, and drug use can compromise the intestinal barrier function, leading to increased permeability 2, 5.

Clinical Implications and Associated Diseases

• Leaky gut syndrome is associated with various intestinal and extra-intestinal diseases, including inflammatory bowel disease, irritable bowel syndrome, heart disease, obesity, type 1 diabetes mellitus, and celiac disease 2, 3.
• The condition is also linked to multiple gastrointestinal symptoms, such as diarrhea, bloating, abdominal pain, and dyspeptic symptoms 3.
• Although leaky gut syndrome is not currently accepted as a formal medical diagnosis, it is widely recognized as a condition that requires attention and management 3.

Dietary Factors and Management Strategies

• Dietary factors, such as excessive consumption of simple carbohydrates, saturated fats, and processed foods, can contribute to dysbiosis and increased intestinal permeability 5, 6.
• On the other hand, diets rich in fruits, vegetables, nuts, and whole foods can help maintain a healthy gut microbiota and reduce the risk of leaky gut syndrome 5.
• The use of prebiotics, probiotics, omega-3 supplementation, and certain vitamins may also help modulate the intestinal microbiota and improve intestinal barrier function 5.