“Leaky gut syndrome” has been a topic of much interest, with symptoms such as bloating, gas, cramps, food sensitivities, and aches and pains. However, it remains somewhat of a medical enigma.
“From an MD’s standpoint, it’s a very gray area,” says gastroenterologist Donald Kirby, MD, director of the Center for Human Nutrition at the Cleveland Clinic. “Physicians don’t know enough about the gut, which is our biggest immune system organ.”
While “leaky gut syndrome” isn’t a diagnosis taught in medical school, it is something that needs to be explored further, according to Kirby. “You hope that your doctor is a good-enough Sherlock Holmes, but sometimes it is very hard to make a diagnosis,” he says.
Dr. Linda A. Lee, a gastroenterologist and director of the Johns Hopkins Integrative Medicine and Digestive Center, acknowledges that much about leaky gut remains unknown. “In the absence of evidence, we don’t know what it means or what therapies can directly address it,” she explains.
One potential cause of leaky gut is increased intestinal permeability or intestinal hyperpermeability.
This can occur when tight junctions in the gut, which control what passes through the lining of the small intestine, malfunction. This could allow substances to leak into the bloodstream.
People with celiac disease and Crohn’s disease frequently experience this. “Molecules can get across in some cases, such as Crohn’s, but we don’t know all the causes,” Lee says. Whether hyperpermeability is more of a contributing factor or a consequence is still unclear.
But why or how this would happen in someone without those conditions is not fully understood.
There is little known about other potential causes of leaky gut not associated with certain types of drugs, radiation therapy or food allergies.
Leaky gut symptoms are not unique and are also associated with other conditions. Diagnosis often remains elusive, leaving patients untreated.
Finding a doctor who will take the time to listen and take concerns seriously is key, according to Kirby. “You may have leaky gut and we may be able to treat what causes it,” he says. “If you have something going on, it is incumbent upon the medical community to listen to you.”
Dr. Lee shares that, unfortunately, not all doctors make the effort to get to the root of the problem, leading many patients to seek alternative treatments.
In her clinic, Lee combines conventional medicine with evidenced-based complementary therapies. But when it comes to leaky gut, she expresses that full evidence is still needed to fully understand its causes and treatments, noting that this is something that is essential for patients to understand.
“We are in the infancy of understanding what to do,” Lee says.
