We now know, more than ever, that our gut plays a key role in our overall health. But can our guts become leaky? Let’s find out more about this trend.
As someone who suffers from a digestive condition, I’ve been intrigued by the idea of “leaky gut”. I’ve seen articles and blog posts about it, where it’s made out to be an extremely common condition that causes a myriad of health problems.
I will also say, nice and early on, that this condition is discussed by a lot of natural health and functional medicine practitioners but I’d never heard of it when studying biomedical science at university.
Therefore, it’s fair to say that I’m also somewhat skeptical.
What is leaky gut?
Let’s start with a description of the gut. Technically, our digestive tract starts at the mouth and ends at the anus (literally in one end and out the other).1 But let’s focus on ‘the gut’ which is the small and large intestine (the colon).
The lining of the gut is a single layer of cells, and is the most rapidly renewing tissue in adult mammals.2 So as a barrier that needs to hold the contents of what we eat and the billions of microbes that help with digestion, it’s literally slim.
There are also a lot of well known conditions that affect this layer of cells, including coeliac disease, ulcerative colitis and Crohn’s disease.3
So… onto what leaky gut may or may not be. Advocates of the condition define it as compromised permeability of this lining, which allows toxins, antigens and bacteria into the blood, which then pass through the body.4 This means that environmental factors, like diet, can cause chronic inflammation and autoimmune disease.4 What’s more, advocates state that leaky gut is the cause of the coeliac disease, Crohn’s and colitis.4
What’s the evidence?
Well, a functional medicine practitioner will argue that there’s lots of evidence, but I decided to do a good old fashioned medical literature search. I searched for “leaky gut” on PubMed and filtered results into randomised clinical trials and meta-analyses.
I’ll tell you now, I didn’t find much. I also didn’t find it as a listed disease or condition on MedicineNet.
Hmm. This doesn’t bode well for the rest of this article.
Cause, or result?
Without any randomised clinical trials, I had to go a good ol’ fashioned internet search.
In this 2017 article on Healthline, Becky Bell explains that while leaky gut proponents will argue that leaky gut is the cause of a variety of conditions, the evidence is mixed. For example, animal studies show that intestinal permeability occurs before the onset of type 1 diabetes or IBS.5–7 But then, another study showed that 87% of coeliac patients had improved permeability after cutting out gluten.8
So… do I have a leaky gut?
As someone with chronic IBS (like, 20+ years with it), I may have increased intestinal permeability. That being said, if large numbers of bacteria were making it into my body and potentially my blood… wouldn’t I know about it?
Bacteraemia is a problem after all (and sometimes very mild, such as bleeding when brushing your teeth) and in some cases can lead to sepsis and septic shock. In my research on the topic however, it’s never really mentioned.
At this point, I’m doubting the validity of chronic leaky gut. But that doesn’t mean that I’m not taking gut health seriously.
Leaky or not, take care of your gut
Whether or not leaky gut is a bona fide, real condition, proponents seem to have generally jumped onto the ‘gluten is bad, dairy is bad, sugar is bad’ bandwagon.
But remember, only around 1% of people actually have coeliac disease, and it’s an autoimmune condition.9 Therefore, you don’t necessarily need to go gluten free if you want to improve your gut health.
As for lactose and sugar, lactose intolerance is common but I haven’t found any evidence for the link between the condition and intestinal permeability. And sugar? Let’s face it, most of us could cut down on our intake of processed sugars, but natural sugars like fruit and whole grains are fine.
I’d like to finish this post by simply saying this: take care of your gut. Enjoy a rich variety of foods, mostly healthy, that nourish the bacteria within you. If you take care of them, then they can take care of you.
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- MedicineNet. Definition of Digestive System. Available at: https://www.medicinenet.com/script/main/art.asp?articlekey=2994. Accessed July 2020.
- Harvard Health Publishing. Leaky gut: What is it, and what does it mean for you? Available at: https://www.health.harvard.edu/blog/leaky-gut-what-is-it-and-what-does-it-mean-for-you-2017092212451. Accessed July 2020.
- NHS. “Leaky gut syndrome”. Available at: https://www.nhs.uk/conditions/leaky-gut-syndrome/. Accessed July 2020.
- Mind Body Green. This is how you can heal leaky gut with diet & foods you should avoid. Availble at: https://www.mindbodygreen.com/articles/what-to-eat-to-heal-leaky-gut. Accessed July 2020.
- Meddings JB, et al. Am J Physiol. 1999;276(4):G951-7.
- Odenwald MA and Turner JR. Clin Gastroenterol Hepatol. 2013;11(9):1075–1083.
- Hall EJ and Batt RM. Gut. 1991;32(7):749–753.
- Deurksen DR et al. Dig Dis Sci. 2005;50(4):785–790.
- Coeliac UK. Key facts on coeliac disease. Available at: https://www.coeliac.org.uk/document-library/25-key-facts-and-stats/. Accessed: July 2020.