Leaky Gut Syndrome – leaky gut as a cause of the disease?

Leaky Gut Syndrome – leaky gut as a cause of the disease

A “leaky gut” means a disrupted barrier function of the intestinal mucosa, which can occur due to an illness but is also associated with the development of various diseases. However, scientific evidence for this still needs to be provided. Nevertheless, there are numerous approaches to treating leaky gut syndrome, with nutrition playing an important role. We explain what you need to know about leaky gut syndrome, which symptoms should occur and what the therapy looks like.

What is Leaky Gut Syndrome?

Usually, the intestinal mucosa forms a barrier between the intestinal contents and the blood. It prevents undigested food components, toxic substances, fungi or bacteria from entering the blood. At the same time, however, nutrients can pass through the intestinal wall and thus get into the blood.

The so-called tight junctions (zonula occludens) play an essential role in the barrier function of the intestinal wall. These are bands of membrane proteins that connect the intestinal wall cells to each other and thus close the space between the cells. At the same time, they have the property of allowing specific molecules to pass through.

In the case of leaky gut syndrome, the barrier function is disturbed, and the permeability (permeability) of the intestinal wall is abnormally increased so that harmful substances can penetrate from the intestine into the bloodstream.

This may lead to inflammatory reactions via activation of the immune system, which in turn may increase the permeability of the intestinal mucosa.

Leaky Gut Syndrome is not a medically recognized term. Instead, it is a collective term commonly used for changes in the permeability of the intestine (permeability disorder). Colloquially, this is also called “holey intestine” in German.


Causes of Leaky Gut Syndrome

The permeability of the intestinal mucosa is naturally regulated by diet and is increased after meals to ensure nutrient absorption.

A pathologically increased permeability, as in leaky gut syndrome, could be caused by various influences: In addition to a genetic component, environmental influences, lifestyle and the bacterial intestinal flora are said to play a role. An excessive occurrence of the yeast fungus Candida is also said to damage the intestinal wall.

It has been proven that some diseases lead to a disruption in intestinal permeability. The following diseases can be associated with the development of leaky gut syndrome:

The following factors can also contribute to the development of a more porous intestinal wall:

  • frequent alcohol consumption
  • intensive endurance sports
  • chronic stress
  • Infections of the gastrointestinal tract
  • anti-inflammatory painkillers, such as ibuprofen or aspirin
  • Pancreatitis
  • Shock, for example, caused by primary operations or serious injuries or burns

Leaky Gut Syndrome: What symptoms are possible?

Increased intestinal wall permeability does not necessarily lead to symptoms or disease. However, a leaky gut can trigger the onset or outbreak of various diseases in people with the appropriate genetic predisposition.

Proponents of the thesis that leaky gut syndrome is an independent disease see it as causing a wide range of symptoms, from fatigue to joint pain and migraines to gastrointestinal complaints. It is suspected that leaky gut syndrome can cause these symptoms independently of another illness, but it is controversial.

Classically, there are no scientifically substantiated symptoms of leaky gut syndrome. Instead, leaky intestines are usually diagnosed in connection with diseases, which in turn have typical symptoms. These include, for example, stomach painflatulence and diarrhoea.

Some studies 1,2 have shown a connection with intestinal diseases such as Crohn’s disease, ulcerative colitis, irritable bowel syndrome and celiac disease (sprue).

A connection between leaky gut syndrome and the following diseases is also being discussed:

However, the causal direction of the connection is still unclear in many cases: In principle, it is possible that increased intestinal wall permeability occurs either as a result or as a trigger of an inflammatory disease.

There is currently no scientific evidence that one of the above-mentioned diseases occurs as a result of leaky gut syndrome.


Diagnosis: How is leaky gut syndrome diagnosed?

There are various methods for assessing the permeability of the intestinal mucosa. A lactulose-mannitol test is often used. This involves drinking certain amounts of lactulose and mannitol dissolved in water on an empty stomach and measuring their concentration in the urine after a few hours. Lactulose is mainly absorbed transcellularly, i.e. via certain endothelial cells, from the intestine into the blood, so that the value in relation to the mannitol value can provide information about the permeability of the intestine.

Similar tests with other types of sugar are used specifically for different parts of the gastrointestinal tract. However, the significance of these tests is limited because the result can be influenced by various factors – such as kidney function or individual intestinal activity. There is currently no officially recognized test for diagnosing leaky gut syndrome.

In addition, the presence of diseases that can cause increased permeability of the intestinal wall should always be checked as part of the medical examination.

Zonulin: Controversial marker protein

Zonulin is a protein that occurs in the intestinal mucosa and is said to influence intestinal permeability, more precisely that of the tight junctions. An increased level in the blood can be an indication of leaky gut syndrome.

However, the relevance of zonulin in the diagnosis of leaky gut syndrome is controversial because, in addition to zonulin, many other substances affect the permeability of the intestinal mucosa, which limits the informative value of the zonulin value. Studies in this regard should be viewed with caution as there may be economic interests behind them. Just like the test kits based on sugar measurement, the Zonulin test is not a health insurance service and must be paid for yourself.

Treating Leaky Gut Syndrome

Leaky Gut Syndrome is not an official medical condition. That’s why there are no specific therapy recommendations. Read below to find out which options can still be used.


Therapy with medication

Since increased permeability of the intestinal mucosa has no disease value in itself, treatment with medication for leaky gut syndrome should only take place in the context of a manifest secondary illness and on medical advice. There are no medicines that cure leaky gut syndrome – such advertising promises should be viewed with skepticism. But what can be done to treat leaky gut syndrome?

Treating Leaky Gut Syndrome: Probiotics Can Help

Considering the fact that the microbiological balance of the intestine has been proven to play an important role in the development and treatment of intestinal diseases, the use of probiotics in the treatment of leaky gut syndrome seems sensible. According to study results3, for example, Lactobacillus casei could prevent a disturbed intestinal barrier.

Dietary supplement for a healthy gut

There is evidence that certain dietary supplements can strengthen the intestinal barrier. The intake of butyric acid (butyrate) for inflammatory bowel diseases and irritable bowel syndrome was examined. Zinc also appears   to have a positive influence on intestinal permeability.

However, high-dose dietary supplements should only be taken after consulting a doctor, as some nutrients can cause side effects if overdosed.


Beware of dubious offers

Leaky Gut Syndrome is a clinical picture that is controversial from the perspective of conventional medicine. Promises of healing and expensive treatment methods from “specialists” should therefore be assessed extremely critically. To date, there is no scientific evidence that measures to improve or restore the intestinal barrier have an influence on the development or progression of a disease.

What can you eat? Nutrition for Leaky Gut Syndrome

You can find countless nutritional tips, nutrition plans and recipes related to Leaky Gut Syndrome. Since there is still little research into the condition, there are no scientifically proven recommendations on what you should eat if you have leaky gut syndrome.

Which foods are generally recommended to support the balance of intestinal bacteria and thus a healthy intestinal flora and intestinal mucosa? Foods rich in fiber such as whole grain products, vegetables and legumes are useful, as the bacterial decomposition of fiber in the intestine produces butyric acid, which can under certain circumstances improve increased intestinal wall permeability.

You can also follow the following five nutritional tips:

  1. Zinc can also help strengthen the intestinal barrier. The trace element is found, for example, in seafood,  nuts  and beef.
  2. The amino acid glutamine is suspected of positively influencing the function of tight junctions and preventing inflammatory processes in the intestines. Glutamine is found in soybeans, spelt flour and peanuts, among other things.
  3. Artificial additives in industrially produced foods, such as flavour enhancers and emulsifiers, are suspected of increasing the permeability of the intestinal mucosa. 4 Therefore, try to eat as unprocessed foods as possible.
  4. Some guides advocate elimination diets that eliminate foods suspected of causing allergies or detoxification programs to cure leaky gut syndrome. Apart from the questionable effectiveness, one-sided diet plans are not recommended because they can lead to a nutrient deficiency in the long run. A balanced diet, on the other hand, contributes to a healthy balance in the digestive system.
  5. Avoid alcohol, as regular consumption can contribute to damage to the intestinal wall.

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