Leaky gut syndrome symptoms are due to excessive intestinal permeability and are often thought of as candida symptoms (I will discuss this further later as well as investigations and treatment). It has also been linked to IBS or the Irritable Bowel Syndrome.
It is debatable whether symptoms of are due to a true syndrome as the features are also encompassed in a variety of different gut diseases and is therefore somewhat controversial in medical circles.
It is probably better to think of it as a classification for many different diseases of the gut and I will discuss this further here.
All cells are joined together by adhesion proteins on their cell membranes. These are known as desmosomes and can be thought of as the ‘glue’ that binds cells together.
If the desmosomes are disturbed, the gaps between the cells widen and it is thought this allows substances to leak between them thus increasing intestinal permeability.
In the gut, the cell adhesion prevents gut contents to seep through. This is important as the gut has many toxic substances present including trace metals, bacteria, viruses, yeasts such as candida, drugs, undigested foods, complex proteins, carbohydrates and fats that are not in digestible forms. The syndrome occurs when these substances pass through, allowing access into the lymphatic and blood system.
It is thought that the above toxic substances act either directly or as a result of an antibody response to them. This in turn can result in ever increasing intestinal permeability and subsequent damage resulting in leaky gut syndrome.
There are many symptoms that have been attributed to the condition. These can be non-specific such as excessive tiredness, lethargy, anorexia (off food), muscle aches and pains, rashes, hair loss, recurrent infections, poor memory, mood swings and depression.
Candida is sometimes blamed, a fungal infection called candida albicans which is more common in diabetics, steroid users, immune suppressed, antibiotic users and more.
Candida symptoms include many if the above including fatigue, low mood, sore throat, itchy genitalia and skin.
No one knows the cause for the syndrome, but it has been linked to poor diet, low socioeconomic groups, high alcohol intake, smoking, low fitness levels , stress drugs and environmental factors.
Not surprisingly leaky gut syndrome has been linked to most gut conditions where there is increased intestinal permeability including coeliac disease, inflammatory bowel disease, IBS, gastroenteritis, pancreatic failure and liver diseases.
It is this fact that makes this condition more likely to be just a label for a group of symptoms caused by these conditions. However, it has also been linked with conditions such as candida symptoms and infection, allergy, asthma, eczema and autoimmune diseases such as hyperthyroidism, diabetes, rheumatoid arthritis and pernicious anaemia.
The main way of diagnosing the syndrome is a Mannitol/Lactulose test. This involves giving a mixture of Mannitol, a monosaccharide which is easily absorbed with Lactulose, a largely non-absorbable polysaccharide that is normally used as a laxative. In a normal person, the Mannitol is absorbed but not much of the Lactulose.
When there is a leaking gut, both substances are absorbed due to increased intestinal permeability and these can be found in a urine collection sample. If the issue is one of malabsorption, both of these substances will be low in the urine as neither can be absorbed and no leakage occurs in theory.
Other tests that can be done include candida testing when candida symptoms are present, allergy tests and investigations similar to other bowel complaints including colonoscopy, stool analysis, CT and much more.
Treatment of leaky gut syndrome is mainly directed at treating the underlying condition causing it such as Inflammatory Bowel Disease or IBD (Crohns and Ulcerative Colitis, Coeliac disease etc).
However lifestyle changes are also thought to be helpful including leaky gut diet advice and maintaining fitness, keeping well hydrated, not to smoke and keep alcohol intake to a minimum.
Diet advice is very similar to an IBS diet. However, the important things to avoid are substances that increase bacterial fermentation in the bowel which are mainly sugars and complex carbohydrates including fruits and berries.
Dairy products, Chocolate, fizzy drinks, acidic substances such as vinegar and caffeine containing drinks can all make symptoms worse. You can find out more on diets by going to the diet section. Some people find dietary supplements and vitamins help too.
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