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Dear Doctors: I went to urgent care with bad stomach cramps, and the doctor there talked about something called “leaky gut.” But when I asked my own doctor about it, he said it’s not really a thing. What do you know about leaky gut?
Dear Reader: Your doctor may have been referring to the fact that leaky gut is more of an umbrella term than a specific diagnosis. In fact, it’s commonly known as leaky gut syndrome. When something is characterized as a syndrome, it means that certain symptoms, when taken together, indicate that something is medically amiss. In the case of leaky gut syndrome, the cluster of symptoms centers on digestive issues such as abdominal pain, bloating, gas and diarrhea. There is also evidence of a link between leaky gut syndrome and mood imbalances, as well as a range of immune system disturbances.
Although the idea of a leaky gut has gained ground in recent years, the how and why remain a mystery. The syndrome is also the subject of an ongoing — and quite spirited — debate about which diseases and disorders can be attributed to it.
So what is a leaky gut? The word “gut” refers to the small and large intestines. These are the twisting tubes that reach from the bottom of the stomach to the anus. The function of the small intestine is to accept the contents of the stomach, complete digestion, absorb nutrients and water, and deliver them to the body. The small intestine gently and gradually moves its contents toward the large intestine, which absorbs the remaining water and nutrients from indigestible food. This requires numerous complex chemical interactions, as well as the transport of water and nutrients across the membranes of the gut.
Helping to regulate all of this is something known as the intestinal barrier. That’s a mucosal membrane that acts as a buffer. It covers an estimated 4,000 square feet within the small and large intestines and controls what crosses from the gut to the bloodstream.
The theory behind leaky gut syndrome, which is also known as increased intestinal permeability, is that holes, gaps or injuries have adversely affected the integrity of the intestinal barrier. As a result, substances such as partially digested food particles, bacterial flora and toxins are leaking from the gut and into the surrounding tissues. The result is inflammation, which may play a role in an array of symptoms and health problems. This abnormal permeability can also affect the health and makeup of the gut microbiome, which we now know plays a significant role in immune function. That’s at the root of the theory that some autoimmune conditions may arise as a result of, or are affected by, a leaky gut.
The cause of leaky gut syndrome isn’t fully understood, but poor diet, overconsumption of alcohol, smoking, stress and exposure to environmental contaminants are suspected to play a role. The best protection is a healthful diet high in natural fiber and low in added sugars and processed foods. It’s also important to go easy on the alcohol and to get daily exercise.
Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health. Send your questions to email@example.com, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.