The condition of “leaky gut” has gained significance in the medical community. It refers to a disorder where the lining of your intestines becomes more permeable, usually after some type of environmental, bacterial, viral, stress, or food trigger. This condition of increased permeability may be the root cause of various health problems and is gaining traction with increasing scientific evidence.

Our digestive tract is essentially a long tube starting from our mouth and ending at our rectum. Food starts the journey with chewing then is passed to the stomach for enzymatic preparation. After leaving the stomach, it passes into the small intestine where an important barrier exists. This barrier allows nutrients to pass through to our bloodstream but blocks bacteria, viruses, toxins and other undesirable substances.

A special layer of cells line the small intestine. This cell lining would extend more than 300 square feet if it were stretched out. It consists of tightly packed cells. The space between the cells is referred to as a “tight junction.” These cells and the tight junctions are responsible for allowing the good stuff in and keeping the bad stuff out.

When the protective barrier is disrupted and the junctures open, harmful substances and partially digested food is allowed to get into our bloodstream. This is called LEAKY GUT. The professional term for leaky gut is intestinal permeability. Intestinal permeability can reduce the absorption of essential nutrients and affect our health.

Leaky gut activates our immune system and can lead to inflammation, food reactions (sensitivities and allergies), and increase the likelihood of disease. Some studies have shown that leaky gut may be the underlying cause of migraines, depression, and various autoimmune diseases such as Celiac and Rheumatoid arthritis.

The causes of intestinal permeability are varied. Some possible causes include viral and bacterial infections, antibiotics and other medications, toxins, stress, inflammation, food intolerances, and imbalances of gut bacteria (usually not enough “good” bacteria).

Evaluation for leaky gut is personalized and may involve an exam, journaling, and lab tests. Treatment for gut restoration can be summarized by 5 Rs:

Remove the things that negatively affect the gastrointestinal tract,

Replace the necessary digestive secretions,

Reinoculate with pro- and prebiotics,

Repair the lining with key nutrients, and

Rebalance with important lifestyle changes to reduce stress and improve restorative sleep. Most cases of leaky gut can be managed without pharmaceuticals or medical procedures.

HOW CAN FUNCTIONAL MEDICINE HELP?

Identifying Root Causes:

Food Sensitivities: Functional medicine practitioners can identify food sensitivities that trigger inflammation and gut dysfunction through testing and elimination diets.
Gut Infections: We may test for and treat bacterial overgrowth, parasites, or fungal imbalances that disrupt the gut microbiome.
Stress Management: Chronic stress disrupts gut function. Functional medicine can offer stress reduction techniques like meditation, prayer, yoga, or breathing exercises to promote gut healing.

Healing and Repair:

Dietary Changes: An elimination diet may be used to identify and remove trigger foods, followed by a reintroduction phase. A practitioner can also guide you towards a gut-friendly diet rich in prebiotics and probiotics.
Supplements: Certain supplements like L-glutamine, an amino acid that supports intestinal lining repair, or probiotics to replenish healthy gut bacteria, may be recommended.
Lifestyle Modifications: Getting enough sleep and regular exercise are crucial for overall health and gut function.

Functional medicine focuses on:

Individualized Plans: Creating a personalized plan based on your specific needs and triggers, unlike a one-size-fits-all approach.
Addressing the Root Cause: We help to identify and address the underlying issues that contribute to leaky gut, not just manage symptoms.
Long-Term Solutions: Help you reach your goal to promote long-term gut health and prevent future problems.

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REFERENCES

1. König J, Wells J. Intestinal barrier function in health and disease. Clin Transl Gastroenterol. 2016 Oct 20;7(10):e196. doi:10.1038/ctg.2016.54.

2. Farré R, Fiorani M. Intestinal permeability, inflammation and the role of nutrients. Nutrients. 2020;12(4):1185. doi:10.3390/nu12041185.

3. Helander HF, Fändriks L. Surface area of the digestive tract - revisited. Scand J Gastroenterol. 2014 Jun;49(6):681-9. doi:10.3109/00365521.2014.898326.

4. Turner JR. Molecular basis of epithelial barrier regulation: from basic mechanisms to clinical application. Am J Pathol. 2006;169(6):1901-1909. doi:10.2353/ajpath.2006.060681.

5. Visser J, Rozing J. Tight junctions, intestinal permeability, and autoimmunity: celiac disease and type 1 diabetes paradigms. Ann N Y Acad Sci. 2009;1165:195-205. doi:10.1111/j.1749-6632.2009.04037.

6. Bischoff SC, Barbara G. Intestinal permeability- a new target for disease prevention and therapy. BMC Gastroenterol.2014;14:189. doi:10.1186/s12876-014-0189-7.

7. Karl JP, Margolis LM. Changes in intestinal microbiota composition and metabolism coincide with increased intestinal permeability in young adults under prolonged physiological stress. Am J Physiol Gastrointest Liver Physiol. 2017 Jun 1;312(6):G559-G571. doi: 10.1152/ajpgi.00066.2017.

What is Leaky Gut?

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