How Can You Tell if You Have Leaky Gut?

Leaks are never good news. They mean your car is losing oil, or that rain is falling inside the house instead of just outside. Leaky guts are much the same: something you want in one place is creeping through to another—and causing issues. And like the sensor that turns off your dishwasher when it detects water under the machine, a leaky gut might not be the cause of your problems—it might be a warning sign that something else is going on in your intestines, such as celiac disease or gluten sensitivity.

What is leaky gut syndrome?

Leaky gut syndrome isn't an actual medical diagnosis; it is a term that means increased intestinal permeability, or "hyperpermeability" of the intestinal lining. A healthy gut lining—the critical barrier that allows nutrients to pass from the digestive tract to the bloodstream—is like woven cotton fabric, well-packed with tiny gaps that are managed by the cells around them. In a leaky gut, the lining is like muslin or cheesecloth, with larger gaps that allow inflammatory substances, toxins, pathogenic microorganisms, and undigested proteins to pass through and enter circulation. This can cause inflammation, excess immune reactivity, and other health concerns. It's also an indicator that your gut flora, the microorganisms that make up your gut microbiome, may be out of balance. The inflammation from a leaky gut can contribute to—or be a sign of—other serious, chronic diseases, like Crohn's disease, ulcerative colitis and celiac disease.

What does a leaky gut feel like?

Leaky gut syndrome is a silent disorder. It doesn't feel like anything, so most people don't know they have it until their intestinal lining is badly diminished. Some people have symptoms related to celiac disease, inflammatory bowel disease (IBD) or autoimmune disease. But beyond that, there are no reliable symptoms of leaky gut syndrome.

8 signs of a leaky gut

Because leaky gut syndrome is a silent condition, the signs can be unclear. But the following conditions indicate a high likelihood of excessive intestinal permeability:

1. Celiac disease.

   Celiac disease is an autoimmune disease provoked by gluten in which the lining of the gastrointestinal tract gets eroded by the immune system. Anyone with a celiac disease diagnosis almost certainly has a leaky gut.

2. Inflammatory bowel diseases

   , such as ulcerative colitis or Crohn's disease. (This is not irritable bowel syndrome.) IBD is an autoimmune disease like celiac, in which the immune system also attacks the gut lining.

3. Autoimmune disease.

   In other autoimmune diseases, the gut lining might also be compromised, so that large molecules from food enter circulation and provoke an immune response.

4. Non-alcoholic fatty liver disease

   (NAFLD). There is a high incidence of gut dysbiosis in NAFLD patients. These "bad" bacteria can erode the intestinal wall and contribute to the liver dysfunction that marks NAFLD. (Probiotics that fight the bad bacteria and support the beneficial bacteria in your gut microbiome may help with this condition.)

5. A positive test for excessive gut permeability.

   Several tests for gut permeability have been developed, from tests that require the drinking of a specially formulated liquid solution to simple blood tests. If you test positive, you almost certainly have leaky gut syndrome.

6. Severe gastrointestinal infections.

   Shigellosis, which is an infection with Shigella bacteria, has been in the news lately, but any severe gastrointestinal infection may cause inflammation and intestinal damage and make the gut "leaky."

7. Severe illness.

   Severe illness stresses the digestive tract, especially when it requires extensive hospitalization or time in intensive care. Many factors can influence this, from medications, tube feeding and multiple infections to overall tissue loss (sarcopenia). When a person is really ill, all body systems suffer, including the gut.

8. Chemotherapy or radiation to treat cancer.

   The use of chemo or radiation puts cancer patients in a special category of severe illness. Chemotherapy specifically prevents the gut from healing or regenerating itself (as a result of preventing cancer cells from reproducing).

Some gastrointestinal problems, such as small intestinal bacterial overgrowth (SIBO) or microbiome dysbiosis, and even food sensitivities have been named as signs of leaky gut syndrome, but people can have these and not have a problem with a compromised gut lining.

Can you test for leaky gut?

A lab test is the best way to identify excessive intestinal permeability. Life Extension has a convenient and innovative finger stick test with a reliable and comprehensive methodology to determine if leaky gut syndrome may be a concern. Its Gut Barrier Panel tests for key markers involved with regulating intestinal barrier function: zonulin, occludin, and Candida albicans:

• Candida albicans.

  Immune system response toward Candida albicans may indicate heightened intestinal permeability and can be an early sign of leaky gut syndrome.

• Zonulin.

  Zonulin is a protein involved with regulation of intestinal permeability through its effects on intestinal tight junctions. Positive reactivity toward zonulin suggests excess gut permeability, typically at an intermediate level of leaky gut syndrome.

• Occludin.

  Occludin is an enzyme involved with stabilization of intestinal tight junctions. Because occludin does not typically enter circulation, detecting occludin suggests a deterioration of the intestinal wall. Typically, it reflects a later stage and/or chronic leaky gut syndrome.

How can you heal your leaky gut?

• Eat a healthy diet that is high in fruits, vegetables and legumes, such as the Mediterranean diet. Plant nutrients and high-fiber foods support a healthy microbiome. Just remember to increase your fiber consumption gradually. Too much at once can cause digestive issues. Also, plan your meals to avoid lectins and to be mindful of any food sensitivities you may have, such as gluten or dairy.
• Manage stress and get enough sleep. Regular, restful sleep gives your body the time it needs to recharge and repair the body and your digestive system. Chronic stress damages our health, increasing the risk for serious health concerns and ongoing inflammation.
• Avoid unnecessary antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs). Antibiotics and NSAIDs are ineffective for viral infections and have been shown to induce gut damage.
• Support a healthy gut with targeted nutrition. These nutrients have been studied to support a healthy intestinal lining:
• L- Glutamine. Ten active men received glutamine or a placebo before intense exercise, to study gastrointestinal permeability differences post-exercise. Those taking glutamine had decreased gastrointestinal permeability compared to those in the placebo group.
• Vitamin E. Vitamin E's ability to restore the intestinal barrier and improve the gastrointestinal tract may be linked to the prevention and treatment of rheumatoid arthritis.
• Probiotics. These health-promoting bacteria help rebalance the gut microbiota and support intestinal health.
• Prebiotics. Prebiotic food sources help to fuel the healthy flora in your intestines. They may support better sleep as well as gut health.
• Zinc. Zinc is associated with tissue healing and has been proposed for excessive intestinal permeability.

How to prevent leaky gut

As with healing a leaky gut, to prevent this condition from occurring in the first place, you want to eat a healthy diet that avoids most added sugar, manage your stress and get enough sleep. All of these are factors in good intestinal health. In addition, follow these tips:

• Be wary of antibiotics.

  Specifically, don't take antibiotics for a viral infection. Many sore throats, and much of what we usually think of as colds and flus, are viral infections that aren't helped by antibiotics, and their use may affect your gut health.

• Work up a sweat.

  Exercise is important to overall wellbeing, weight loss and maintenance, and gut health.

• Support your gut microbiome.

  Live probiotics and prebiotics can help promote a healthy gut flora in your intestines.

References

• Actis, Giovanni C., et al. "Antibiotics and non-steroidal anti-inflammatory drugs in outpatient practice: indications and unwanted effects in a gastroenterological setting." Curr Drug Saf. 2014. https://pubmed.ncbi.nlm.nih.gov/24446890/
• Kou, H, et al. "Effect of vitamin E supplementation in rheumatoid arthritis: a systematic review and meta-analysis." European Journal of Clinical Nutrition. April 2022. https://www.nature.com/articles/s41430-022-01148-9
• Marasco G, et al. "Probiotics, Prebiotics and Other Dietary Supplements for Gut Microbiota Modulation in Celiac Disease Patients." Nutrients. September 2020. https://pubmed.ncbi.nlm.nih.gov/32887325/
• "Antibiotics Aren't Always the Answer." CDC. https://www.cdc.gov/patientsafety/features/be-antibiotics-aware-infographic.html