by Dr. Nikki Bundy


What in the World is Leaky Gut and Why is it Important?


If you have been following medical blogs or hot health topics covered in popular press, chances are you have come across the term “leaky gut”.  For years thought to be the stuff of alternative medicine at best, and even “quack medicine” by some, leaky gut has now grabbed the attention of mainstream medicine and is an exciting, promising area of research with potential implications for a staggering number of diseases.  But what does leaky gut really mean and what are its implications?


A brief tour of your gut

Your intestines are an incredible organ. Far from just a tube that digests food and helps absorb nutrients, the gut performs myriad functions critical to your health. Yes, the gastrointestinal (GI) tract is where food is broken down into usable forms of energy, vitamins, and minerals.  But the gut also contains 70 percent of your body’s immune cells.  Furthermore, your intestines are home to trillions (yes, trillions) of microorganisms (mostly bacteria but also viruses, fungi and other “bugs”, together often referred to as the gut “flora” or the gut “microbiome”).  These “friendly” gut bacteria are essential to your good health. They help you digest food, defend against “unfriendly” bacteria (those that can make you sick), play a role in keeping the lining of your gut healthy, and are pivotal in training and maintaining a healthy immune system.  It is not an overstatement to say that a happy, healthy gut is absolutely critical to your overall good health.


Let’s take a closer look at the normal function of the intestines and then how it can go wrong in leaky gut.  Obviously the intestines must allow parts of the food you eat to cross the intestinal wall and enter your body to be used as fuel. In a healthy gut, this is a very selective, highly regulated process.  Any unusable parts of the food you eat should stay inside the gut until they are eliminated (ie pooped out…to be technical). Likewise, other potentially harmful substances, such as “unfriendly” bacteria and toxins, should not be allowed to cross the gut wall.  The intestines accomplish this “gatekeeping” or barrier function through complicated mechanisms that involve a host of proteins and lots of signaling between cells. When the barrier is not functioning correctly, substances that should stay in the gut for ultimate elimination are allowed to cross the intestinal wall into your body – this is referred to as “leaky gut” (also referred to in medical literature as “increased intestinal permeability”).


Why is leaky gut bad?

When foreign substances cross the gut wall, they are exposed to an army of cells (your immune system) meant to defend your body against invaders (remember that 70 percent of your immune cells reside in and around your gut).  If a substance is perceived as dangerous, your immune cells jump into action, setting off a host of reactions that ultimately lead to inflammation. It stands to reason then that a leaky gut is a set-up for overactivation of your immune system.  In fact, researchers have now linked leaky gut to a number of inflammatory diseases [among them certain forms of arthritis, celiac disease, asthma, inflammatory bowel disease (Crohn’s and ulcerative colitis), multiple sclerosis, and type 1 diabetes).  Studies also suggest that several diseases not typically thought to be inflammatory may also be associated with leaky gut (including autism, irritable bowel syndrome, fibromyalgia, chronic fatigue syndrome, and obesity/insulin resistance), although the exact nature of this association is not yet clear.   


What causes leaky gut?

While the understanding of leaky gut is far from complete, there is a growing body of research pointing to a long list of things that may compromise the barrier function of your intestines.  Top on this list is the standard American diet (high in sugar and processed foods and low in fiber and nutrient-rich foods). Stress, excessive alcohol, and infections can also lead to leaky gut.  Of particular interest is the recent finding that gluten (a protein component of wheat) is a common cause of leaky gut, and while eating gluten may not cause problems for many people, in others it can negatively affect gut health.


How can you tell if you have leaky gut?

The concept of leaky gut is still relatively new in the medical world.  And while there is increasing recognition of the importance of this problem across medical specialties, some doctors may know very little about it.  However, medical providers who practice Integrative or Functional Medicine will be well-versed in leaky gut. They will be aware that there are tests available to help diagnose leaky gut, although it often remains a condition that is diagnosed clinically (ie based on your current health, medical history and physical exam).    


The good news!

Leaky gut can be fixed! A number of doctors and scientists are working hard to understand how to restore normal barrier function in patients with leaky gut.  It has become clear that changes in diet and lifestyle can heal a leaky gut wall, leading to profound improvements in your health and well-being.  Changing how you eat and making other lasting lifestyle changes can be extraordinarily difficult, as anyone who has tried to make meaningful, lasting changes in diet and lifestyle can attest to.  But there are resources to help guide and support you, many of them right here in our Bexley community. Close supervision from a registered dietitian can be enormously helpful. Stress reduction (think yoga, acupuncture, massage, and mindfulness) is an essential part of healing a leaky gut.  Getting regular exercise and enough good quality sleep are also important. Overwhelmed? Often times a health coach can help you put together a thoughtful, personalized, doable plan to get you on the road to optimal health.  Take control of your health and live your best life!


The understanding of leaky gut is a rapidly evolving, exciting area of medicine.  This brief overview is meant to give you a basic understanding of the “ins and outs” of leaky gut.  For more thorough coverage of intestinal health, including leaky gut, I recommend reading “The Inside Tract: Your Good Gut Guide to Great Digestive Health” by Dr. Gerard Mullin and Kathie Swift, MS, RD and/or “Eat Dirt: Why Leaky Gut May Be the Root Cause of Your Health Problems and 5 Surprising Steps to Cure It” by Dr. Josh Axe.