Several years ago, we were at a small conference attended by some very thoughtful physicians. The overall theme of the discussions focused on the concept of empowered patients. These doctors were totally committed to patient-centered health care. Over lunch, one of the primary care physicians brought up the subject of leaky gut syndrome. He thought it was a crock and dismissed the idea outright. To our surprise, most of the other medical doctors doubted that there was such a thing as leaky gut syndrome. None of them had learned about it in medical school. But gastroenterologists have begun to acknowledge something called intestinal permeability. It’s a more scientific way of describing leaky gut syndrome. This reader wants to know how to diagnose this condition.
How Do You Test for Leaky Gut Syndrome?
Q. My daughter took a wide-spectrum antibiotic for years to control acne. She developed IBS and then an autoimmune condition. I suspect that the long-term use of antibiotics changed the ecology of her digestive tract and contributed to leaky gut syndrome.
One doctor we consulted suggested that fragments of proteins escape from the intestines into the bloodstream and mess up the immune system. Another doctor dismissed the whole concept of leaky gut as a fad. Is there any way to test for leaky gut?
What Is Leaky Gut Syndrome or Intestinal Permeability?
A. We understand why many medical doctors cringe at the term leaky gut syndrome. It does not sound very scientific. But if you put “intestinal permeability” into a search of PubMed (The US National Library of Medicine), you will discover thousands of references.
A review article in the highly respected journal, BMC Gastroenterology (online, Nov. 18, 2014), is titled “Intestinal permeability – a new target for disease prevention and therapy.” This international panel of experts notes in classic medicalese:
“Why do we need a gut barrier? The intestinal barrier covers a surface of about 400 m2 [square meters] and requires approximately 40% of the body’s energy expenditure. It prevents against loss of water and electrolytes and entry of antigens and microorganisms into the body while allowing exchange of molecules between host and environment and absorption of nutrients in the diet…Experimental data showed that disruption of the peaceful co-existence with intestinal symbionts at early life, and possibly even later in life, results in severe immunodeficiency and risk of disease. Such findings support the hypothesis that the breakdown of intestinal barrier control mechanisms means danger and possibly disease.”
The authors point out that:
“intestinal barrier dysfunction has been found to play a pathogenic role not only in IBD [inflammatory bowel disease], but also in IBS [irritable bowel syndrome]. Most importantly, there is evidence now that increased intestinal permeability is related to low-grade inflammation, visceral hypersensitivity and pain in IBS.”
The panel concludes its overview:
“In summary, intestinal permeability, which is a feature of intestinal barrier function, is increasingly recognized as being of relevance for health and disease, and therefore, this topic warrants more attention.”
An article in the World Journal of Gastroenterology (May 21, 2014) agrees:
“Defects in intestinal barrier function characterized by an increase in intestinal permeability contribute to intestinal inflammation. Growing evidence has shown that an increase in intestinal permeability has a pathogenic role in diseases such as inflammatory bowel disease (IBD) and celiac disease, and functional bowel disorders such as irritable bowel syndrome.”
What Happens with Leaky Gut Syndrome?
Whether you call this condition intestinal permeability, intestinal barrier disruption or leaky gut syndrome, there are negative consequences. People with celiac disease (an autoimmune reaction to gluten) experience damage to the lining of the small intestines. This leads to inflammation and intestinal permeability. Celiac disease can lead to nausea, diarrhea, flatulence, indigestion, poor absorption of nutrients, anemia, osteoporosis, joint pain, headache, fatigue, itchy skin rashes and occasionally lymphoma.
We had the opportunity to interview Susannah Meadows about her son’s terrifying experience with juvenile idiopathic arthritis. The doctor she consulted believed that his leaky gut syndrome contributed to an overactive immune system which in turn led to his excruciating joint pain. You can listen to this free podcast at this link. Just click on the green arrow or download the free mp3 file.
How to Test for Leaky Gut Syndrome?
One test of intestinal permeability involves a urine test. The patient fasts for eight hours and then provides a urine specimen before swallowing the sugars mannitol and lactulose. Urine is collected over the next six hours and tested for those sugars.
Another test looks for something called zonulin. This protein affects the junction between cells in the digestive tract. We have had the honor to interview the researcher who discovered zonulin, Dr. Alessio Fasano (Show 964: Should You Go Gluten Free?). Here is a link to his research about zonulin (Annals of the New York Academy of Sciences, July, 2012).
At-Home Testing for Leaky Gut Syndrome:
There is an organization (Verisana Lab) that provides a number of home gut health tests. They include a Zonulin Test, a Leaky Gut Test, and a Gut Flora and Biome Analysis among others. These and other home tests can be found at this link.
FULL DISCLOSURE: The German Company, Verisana Lab, and its cousin organization, Kaya Biotics, underwrite our nationally syndicated radio program. That means we are not impartial observers. That said, we have been impressed with their attention to quality. Their certified organic probiotics are created in German laboratories that are inspected by regulatory authorities. That is much more than can be said for companies in other countries (including the US) where regulators are lax about inspections of dietary supplement manufacturers.
You can save 20% off all purchases of Verisana Lab home tests or Kaya Biotics products by using the promo code PEOPLE.
Share your own experience with intestinal permeability or leaky gut syndrome below in the comment section. Have you found probiotics to be helpful?