An Integrated Approach to Leaky Gut Syndrome

I’ve been evaluating patients for Leaky Gut Syndrome for over twenty years, and have been writing about my integrated approach to this condition. My article “Leaky Gut Syndromes: Breaking the Vicious Cycle“ is available online at the Foundation for Integrated Medicine.

Through my clinical experience and further research I came to understand how gastrointestinal health in general, and Leaky Gut Syndrome in particular, contributes to many seemingly unrelated conditions.

To share my knowledge and help my colleagues learn more about this important topic I wrote a chapter titled “Integrative Approach to the Gastrointestinal System” for the textbook Integrative Medicine: Principles for Practice in 2004 and coauthored the book-length monograph Gastrointestinal Dysregulation: Connections to Chronic Disease, in 2008.

I have found Leaky Gut Syndrome especially relevant for many people with chronic fatigue syndrome.

What is Leaky Gut Syndrome?

Because it connects apparently unrelated disorders, Leaky Gut Syndrome is one of the most misunderstood concepts in medicine today.

To begin with, Leaky Gut is not a single disease or syndrome; it’s a pathological condition that occurs as part of many different diseases and syndromes. The term refers to an abnormal increase in the permeability of the small intestine. Increased intestinal permeability is a component of many different disorders.

Leaky Gut Syndrome is associated with:

as well as numerous conditions triggered by food allergy, including eczema, hives, and irritable bowel syndrome.

Sometimes, Leaky Gut Syndrome plays a primary role in the evolution of an illness.

Crohn’s disease is a serious chronic intestinal disorder that effects almost a million people in the United States. People who develop Crohn’s disease may have a genetically induced increase in intestinal permeability that creates the inflammation in the bowel. This predisposing leakiness can be found in close relatives of patients with Crohn’s diseases, suggesting that it precedes the development of inflammation.

Leaky Gut Syndrome can also be caused by the treatment for another disease.

In rheumatoid arthritis, for example, the drugs used to relieve pain and inflammation can damage the intestinal lining, leading to Leaky Gut Syndrome within two weeks. Leaky Gut Syndrome, in turn, is associated with aggravation of arthritis.

For most conditions, the precise role of Leaky Gut Syndrome remains unclear, but it seems to be part of a vicious cycle that makes the condition get worse over time. Allergic reactions to food, for example, cause a transient increase in intestinal permeability. If this happens frequently, it may increase the number or severity of food allergies.

In chronic fatigue syndrome and major depressive disorder, Leaky Gut Syndrome activates the intestinal immune system to produce chemicals called cytokines that spread inflammation through your body.

Inflammation is an important trigger for symptoms like fatigue, malaise, pain, and depression.

When should you suspect Leaky Gut Syndrome?

If you have:

or if you use aspirin or anti-inflammatory drugs on a regular basis, or if you’re a heavy drinker of alcohol.

Recent research in animals has indicated that Leaky Gut Syndrome may also be associated with difficulty losing or gaining weight, but its association with obesity is still under investigation.

Five Steps to Help Heal Leaky Gut Syndrome

Get rid of anything that might be causing or contributing to increased intestinal permeability:

• Stop using aspirin, ibuprofen, naproxen and other non-steroidal anti-inflammatory drugs (NSAIDS). I wrote about the side effects of these common pain relievers in a recent Huff Post article “Why Medication Can Be Dangerous to Your Health.“

• Have a stool test for intestinal parasites. There is extensive medical literature on intestinal parasites causing symptoms like fatigue, joint pain and skin disorders, without causing diarrhea. I discuss these in a chapter I wrote titled, “Intestinal Protozoan Infestation and Systemic Illness”, for the Textbook of Natural Medicine, 3rd Edition, in 2005.

• Adopt an anti-inflammatory dietary pattern. I explain the benefits of eating to reduce inflammation, and provide a plan to achieve that, in my book, The Fat Resistance Diet. The principles are simple to understand: avoid foods with added sugar and refined starches, made from white flour. Decrease consumption of saturated fat and most vegetable oils, using extra virgin olive oil instead. Eat at least 9 servings of fruits and vegetables a day and at least 4 servings of fish per week.

These are but a few introductory steps toward an integrated approach to this condition. There is a vast amount of scientific literature on Leaky Gut Syndrome, a sample of which appear in the references below from journals such as The Lancet, The British Medical Journal and The Annals of Internal Medicine.