Episode 9: Is Leaky Gut Real?

Leaky gut… it’s the sexy topic that is all over the internet. But, is it real?

This episode breaks down what leaky gut really is, the myths and truths that are out there, and what you can do if you think you have it.

You can check out the podcast on iTunes here, Spotify here, and on YouTube here! Below is a full transcript of the episode if you prefer to read through it or want notes.

Don’t forget to connect to others in The GUT Community, a Facebook group for those with IBS and digestive disorders to support one another and dive deeper into each episode together.

Welcome back to The Gut Show! I'm so excited that you're here, and I'm thrilled for this episode because this is a sexy topic that a lot of people are talking about and a lot of people ask me about. The question is: is leaky gut real? Ooohh, what are we going to say? It's gonna get really exciting!

So first, before we get into what leaky gut actually means, let's talk about what the gut barrier is. So our gut actually includes anything from our mouth when you swallow all the way down to your anus, where you let everything out. So everything in between is almost like a long connected tube of sorts. And this tube has a lining and a barrier that separates the things inside the tube from the things outside the tube. So because this is all in your body, the things outside the tube are going to be every part of your body, so the fluid between all of your organs, your organs, blood systems, all those other systems are outside of your body. The major roles of our digestive system include digestion and absorption. So we want to pull in the things that we need, so that our body can take, you know all those little pieces and utilize them, like our carbohydrates, our proteins, our fats, our micronutrients, our water, all those different things, we also want to make sure that the things that would do harm to the body stay inside the tube, and get flushed out with our feces or through the urine.

So we want to make sure that things either stay out or can get pulled in. So this tube and this barrier are really important because at different stages of the digestive tract, the barrier changes a little bit and has a different function in terms of if it's pulling things into the body or keeping things out of the body. So our small intestine is where this starts to really happen. The small intestine is where we start to actually digest and absorb our micronutrients, which is really incredible. So that's where we typically do most of our absorption, we're also going to be utilizing some of our carbs, fats and proteins during that time. Our fats kind of have their own little channel, but that is for another day.

After the small intestine, and this happens fairly quickly, everything moves to the large intestine or colon, and this is where the majority of our microbes live. So whenever we're talking about leaky gut, and whenever we're going to be talking about the gut barrier from here to the end of this conversation, we are focusing on our large intestine for the most part. So our large intestine is where we absorb and reabsorb water. It's also where we have our gut bacteria that ferment our fiber, those nondigestible pieces of our plants. So we don't digest them, we don't absorb them, we don't really break them down fully our bacteria, they're able to ferment them, they eat them, and they produce byproducts that are beneficial to our health. So there's a lot going on in the large intestine. That's also where we are packing stool down and getting ready to eliminate it.

So whenever we're looking at the gut barrier, I want you to think about, if you're watching the YouTube video, you're going to see this, if you're on podcast, imagine this with me, think about putting your hands together, weaving your fingers together. So whenever you look at your palms, if you're squeezing your hands together, you shouldn't really see much space between your fingers, it should be pretty solid. So this is what our gut barrier is kind of like, if you kind of open and separate your hands just a little bit, okay, we're going to allow water back in the body and nutrients, and then we're going to close it back. So allow some out, then close it back. That's kind of how the barrier works. Whenever the gut barrier is not strong, and we're going to talk about each layer of that of what that might look like, what can happen is if you pull your hands apart slightly, and they stay there, there is little holes in there, little gaps. And so that means that the gut has now become more permeable, meaning things are able to permeate the gut barrier and the gut lining, making their way either from the body into the gut or out of the gut into the body. That is what we refer to as leaky gut!

And so leaky gut in and of itself is not real, it's not a real diagnosis of intestinal permeability, increased intestinal permeability, that is an actual symptom. And they're basically the same thing. leaky gut is just a little bit sexier. So leaky gut is what has been marketed. It's what people usually refer to increase intestinal permeability is what's going to be used among the medical world. And it's actually a lot better of a term because it describes exactly what is happening, leaky can be a little bit misleading.

So let's look at the gut barrier on a deeper level. The gut barrier has about four different major layers. On the innermost layer interacting with the things moving through is your gut microbiota. These are the microbes that make up your gut, your microbiome or microbiota. So they're like the guards basically of the lining of the barrier. The second layer is the mucus layer, this is a pretty thick layer, and this is the layer of protection. So the mucous layer is kind of like, if you think about jello, if you were to try to move through, let's say a doorway that's covered in jello, like you could get through, it's gonna be harder, you might get a little stuck, right? Or like, you know, things that are smaller, like ants or bugs, like they're gonna get stuck, they might not make it all the way through. So a thick strong mucus layer provides extra protection, so things aren't going to get through like they need to. There's also a lot of things in that mucus layer that are going to be helpful for the different roles of the gut, which is really important.

Next is the epithelial lining. The epithelial lining is a single-celled semi-permeable lining. So it is meant to be partially permeable, because things have to move in and out. So after that mucous layer, we have this semi-permeable lining that's just single-celled smaller, where things can move in and out. So the guards and the mucous layer are already there for protection, and then you have this semi permeable layer where things can kind of move back and forth as they need to. And then the last layer is the lamina propria. This is the house basically, of your immune system, this is where our immune system lives. So we talked about the gut being the immune system, we break that down, sometimes in a more generalized way to say that your microbiome, your microbiota, that's your immune system, it's part of it, they're the guards, this layer of the gut barrier is truly your immune system. And that is there to like, really make sure that okay, things aren't moving in and out that don't need to be, and that protects against chronic and systemic inflammation, which is important to know.

So we know that there is increased intestinal permeability with certain conditions, especially those that involve inflammation of the gut, like IBD (inflammatory bowel disease), celiac disease, those can definitely contribute to this. We also think that there could be an increased intestinal permeability with IBS (irritable bowel syndrome), which is not really marked by inflammation. But in knowing that, there are currently no validated tests to study gut permeability. These are being studied, there are markers that we are starting to see in research, but right now the research is not there for there to be tests to directly identify your level of intestinal permeability. This also means that there's no validated, scientifically validated treatment for increased permeability, no matter what the Guru's and the ads are telling you, there is no validated treatment for “leaky gut,”

Now, that doesn't mean that there's nothing you can do about it, it doesn't mean that it doesn't exist, because we know that increased intestinal permeability does exist. We know that some of the things that we're finding with inflammation, and what we're seeing with the health of the gut is very true. And it's central to a lot of these conditions that we're working with, especially in my practice that focuses on digestive disorders and GI conditions. And what we want to make sure that we make clear is that some of the tests that are marketed, some of these, like superfood supplements, things that are supposed to treat and cure your leaky gut, these are not validated. And so if you want to try them, and they're safe for you, great, but be really careful what you allow in as a belief, because it may not actually be backed up by true science and research. And when those do come out, believe me, I will scream it from the rooftops and I can't wait to share it. But we just don't have it yet. And so we're going to sit and we're going to wait and then one day we will have it.

What we do know from our studies and from looking at the gut barrier is that there are some things that can actually impact gut barrier function. So we know that nutrition can play a role in this, specifically fiber phytochemicals from our plants, those can actually improve gut barrier function likely and we'll talk about why. Alcohol may have a negative impact, some medications can have a negative impact, stress, smoking, those can have a negative impact. And then outside of those lifestyle pieces, we know that there's a genetic component here, there are environmental factors, and certain disease states can contribute to an altered gut barrier function.

So there's some things that could be slightly in control, as well as some things that may be out of control. And whenever we're looking at your health as a whole, and we talked about what gut health means in a previous episode, this is the reason why we want to talk about that, because your health is so much more than the exercise you do, it's more than the disease state you do or do not have. It's more than the nutrition that you're taking in. And there's so much involved, when we're talking about health, and there's so many different determinants of health that we have to take into account whenever we're looking at this. And what I will say is that some of the misinformation that's going around, especially around leaky gut, really discriminates against some of these communities that might be at a higher risk, but it's out of their control, and so they need resources that are more applicable and more available to them and addressed to them versus this like sensationalized you know, group that isn't actually providing validated information. I'm really passionate about this because I think that there's a lot of harm that might be done in the ads and in the, you know, influencers and in some of these businesses even, that aren't actually looking at the true condition, what's truly going on for each person.

So let's get back to fibers, let's come down to nutrition. I'm a dietitian, I care about the food and the nutrition, and this is something that I have definitely been interested in myself as well as in my practice. So there are animal studies that have shown that a fiber poor diet, one that does not feed the microbes, because the microbes, remember, they feed on fiber, so they're not being fed, that this might actually lead to the microbes eating the mucous layer of the barrier. So remember, the microbes are on the innermost layer, and there's that thick mucus barrier. And so if the microbes are eating our mucus barrier, then that means that there's going to be a weakened barrier, and that could lead to a quote unquote, leaky gut, more permeability, less protection, more chronic inflammation. So there's a chance that that might be what's happening, we've only seen this in animal studies. And so this would actually mean that more fiber is probably the key to making sure that we have a strong, healthy, thriving gut barrier in the absence of disease and damage that needs to be, you know, healed and recovered from of course. So the good thing about this is that fiber is actually known to have so many different positive effects on the body, it's known to help improve the diversity and the quantity of our gut bacteria, which means more of those beneficial byproducts that can lead to better health and that can lead to better overall energy and also improve symptoms for those with IBS and other digestive disorders. And so we know that fiber helps already, fiber might be one of the keys to improve gut barrier function. And so it's likely a win-win of health or for health overall.

So all that to say, leaky gut, is it real? Yes, and no, in and of itself, you know, it is a symptom, it's not a condition. There's a lot of information going around that says that leaky gut is the cause of everything. leaky gut is a symptom, increase intestinal permeability, which is, you know, the actual term, is a symptom. It's not the underlying condition, it might be leading to other symptoms, but it's not the underlying condition. And so what we want to make sure that we're understanding here is that there's a lot that can impact gut barrier function, there's no way to truly test your gut barrier function at the moment, we can look at your body look at some of these other symptoms that are coming up to see if we might be able to really work on improving the health of your microbiome. Fiber might be a key to this whole puzzle, which means more quantity, more diversity for a thriving healthy microbiome, which then hopefully will lead to a thriving healthy mucus layer. And then there is a need for personalization in this puzzle, because we have to understand what might be leading to this issue. And then how do we really get to the root of it on a person-by-person basis. So with IBS specifically, what I found is that, you know, we do know that there's probably some increased intestinal permeability, and we know that as we strengthen the microbiome, as we combat the dysbiosis, which is that unideal makeup of bacteria, then we might be able to actually improve symptoms at a higher degree while including more variety and diversity in the diet. And this is what we do in our practice at Gutivate!

So my encouragement is if you think that you may have leaky gut, if you think that you may have increased intestinal permeability, be careful with what you see out there. Be careful with the ads that are probably popping up on your feed day after day. Find a specialized registered dietician that can work with you in your diet, your lifestyle factors with you in mind to be able to put together a plan that might help you. And then also make sure that we're following the research so that as more information does come out of the studies that are being done now that are being talked about, that we can all follow that and get even further together. So I would love to hear what you thought about this episode. Go over to our Facebook community, The Gut Community, join if you haven't already and just let us know what you thought. What was your takeaway? What questions do you have? Let's continue the conversation over there so that we can chat more and go deeper into our gut barrier function. Have an amazing day! I hear you, I see you and I can't wait to be with you on the next episode.