All roads to health seem to lead back to gut health. And if things are amiss with your digestion, how do you make them better? If you want to enjoy your best health, you’ll want to know how to repair leaky gut. Here’s a clue: it is not about following a fad diet.
Gut health is a bit like fitness: it is something that you always have the opportunity to improve upon. We are never done cultivating our best fitness levels or gut health!
What is leaky gut?
Leaky gut is also known as increased intestinal permeability to doctors and medical researchers. The lining of our intestines SHOULD be permeable… to a point. This is how water and nutrients from our food make their way to our blood stream and eventually to our cells.
With leaky gut, instead of being able to carefully screen what gets absorbed into our body, undigested food particles and pathogens can slip through the cracks. These rouge particles can cause inflammation and your immune system to rev up in response – not good!
Having leaky gut can increase your risk of disease, including autoimmune conditions and IBS.
You may be wondering: how do you know if your gut is, in fact, leaky? Not everyone with digestive symptoms has leaky gut and not everyone with leaky gut has digestive symptoms.
What Causes Leaky Gut
One of the main causes of leaky gut is the standard American diet (SAD, for short), which is typically low in fiber and high in processed foods. These foods do not nourish your microbiome, which is the collection of good gut bacteria in the colon. We want to keep these guys happy and well-fed!
In addition, chronic stress, too much alcohol, certain medications, allergens, and even bacterial infections like food poisoning and traveler’s diarrhea, can cause leaky gut.
Any of these factors can cause inflammation, which may lead to the damage of intestinal gatekeepers, known as tight junctions. They are not able to not regulate what gets in, and what stays out, during digestion.
Enter leaky gut: these gatekeepers are not able to do their jobs. Undigested food particles and unwanted toxins and pathogens have gotten into your body and are causing a ruckus.
How to diagnose leaky gut
The gold standard to test gut barrier function is the lactulose/mannitol urine test. This is a non-invasive test, thank goodness. Your role is to drink a sweet solution that contains two types of sugars – lactulose and mannitol and then to collect a urine sample. Then the lab will test your urine to see which of those sugars show up.
When your gut is healthy – i.e. – not leaky – lactulose is too big to be absorbed directly by the lining of your small intestine. However, if your gut function is compromised, the lactulose sugar can sneak through and be absorbed, kind of like your puppy sneaking through a loose board in the fence. More lactulose present in the urine signals a more leaky gut.
The mannitol is absorbed by the gut lining, but if the gut is damaged, it is not able to absorb as much of the sugars. So in this case, less mannitol means more damaged gut tissue and less surface area.
Together, the ratios of sugars present in your urine after drinking the sugar solution lets your doctor know how well your gut is functioning; is it leaky or is the surface area in good condition to absorb the nutrition from your food? (1).
So, what does it feel like to have leaky gut? You may experience digestive symptoms, which is probably expected, but what may surprise you is that not everyone with increased intestinal permeability has digestive symptoms.
In addition, you can have symptoms of leaky gut that impact your entire body. Each of our body’s systems are intertwined.
Digestive symptoms of leaky gut
Since these symptoms are not unique to leaky gut, it is important to work with a practitioner to have an accurate diagnosis of your symptoms to be able to have an effective solution.
If you have leaky gut, you may be struggling with changes in your bowel habits, bloating, abdominal pain and gas. You might have constipation, diarrhea, or (drumroll please) both. Ack!
Other symptoms of leaky gut
In addition to the digestive symptoms listed above, leaky gut might cause other symptoms, too (2). Leaky gut might cause:
- Brain fog
- Joint pain
- Difficulty focusing
- Skin issues, such as acne and eczema
How to repair leaky gut
Now that we know what leaky gut is and what it might feel like, let’s get to the good stuff: how to repair leaky gut.
First, we’ll talk about the 5-R protocol to systematically change your eating plan to effect healing in your gut and then we’ll talk about the best lifestyle habits to start adopting, stat!
Lastly, we’ll cover a few supplements you may wish to consider.
The 5-R protocol is a systematic process to heal gut function, including repairing leaky gut. The five-step protocol includes remove, replace, repopulate, repair and rebalance.
Remove any food, medication, supplement, infection or pathogen that may be causing irritation in the gut. This also applies to removing stress.
Replace what’s lacking to help improve digestion and nutrient status (ex: digestive enzymes).
Repopulate the microbiome with the gradual expansion of the diet, fermented foods and perhaps, targeted probiotics.
Repair the gut by providing specific nutrients to promote healing, for example, foods rich in vitamin C, zinc and anti-inflammatory omega-3 fatty acids..
Rebalance your lifestyle to promote gut health, including a good night’s sleep and stress management.
Stress puts your body in fight or flight mode. And if your body is working to evade physical danger, you’re not prioritizing digestion. While we all have some stress, if your stress is significant and ongoing, your digestion will suffer. Enter: leaky gut.
Reducing stress and having outlets to manage stress helps your whole body to feel and function better. Less stress lowers your risk of leaky gut!
And the best homework we can assign? Getting a good night’s sleep as often as possible. A good night’s sleep is your body’s opportunity to actively repair your gut tissue from the day’s efforts. Better sleep means better digestion, fewer cravings for simple sugars and a better, more relaxed mood.
There are some supplements to consider as part of your program for healing leaky gut. But please keep in mind that there are high and low-quality supplements available and it can be tricky to know if the brand is a good one because supplements are not regulated in the US.
And, supplements are never a substitute for healthy eating, sleep and stress management; they’re just one piece of the puzzle of how to repair leaky gut.
L-glutamine is an amino acid that is very important to the maintenance of the lining of your digestive tract. It is not considered to be an essential amino acid, but in the case of impaired digestion, supplementing L-glutamine may help to repair leaky gut (3).
Vitamin D status is inversely related to your risk of developing leaky gut and autoimmune conditions. The lower your vitamin D level dips, the greater your risk of having issues.
If your digestion is impaired, you cannot absorb as much vitamin D from your diet. And if you’re stressed, you’re using more vitamin D (hey there, cortisol!). Vitamin D supplementation can help to reduce your cortisol levels and repair leaky gut (4).
There are as many species of probiotics as there are animals in the zoo. Our microbiome, the collection of organisms living in our digestive tract, feels and functions best when we have a diverse population of organisms.
Taking care of your microbiome is a bit like having a pet; when we are well hydrated, eating healthy foods, go on walks and get a good night’s sleep, our microbiome also thrives. And a healthy microbiome takes great care of our health: it’s a mutually beneficial relationship!
If you choose the right probiotics and the right dose, your gut health may improve. In addition, you can consider including fermented foods such as sauerkraut, kimchi, miso paste, yogurt, and fermented pickles, to further boost the colony on an ongoing basis.
Omega-3 fatty acids
Fish oils contain a few different kinds of omega-3 fatty acids. These fatty acids are essential to have in our diets because our bodies cannot make them.
If you are not consistently eating fish, walnuts, chia seeds, flax seeds and other rich sources of omega-3s, it’s time to have them more often. The benefits of omega-3s include their ability to reduce inflammation (good for the gut, among other things) and interestingly, the supplements can improve the population of the probiotics living in your gut (5).
Key takeaways: how to repair leaky gut
Leaky gut is real and a risk factor for discomfort at a minimum and autoimmune conditions and diseases at the worst.
There is no quick fix for leaky gut, but improvements in diet, including the 5-R protocol, reducing stress and a few supplements can go a long way towards cultivating your best health, including your gut health.
And if you’re ready to work with a professional, give us a call.
Sara Kahn, MS, CNS, CDN is a board-certified nutritionist specializing in digestive health conditions like SIBO, IBS, acid reflux and more. She’s the founder of Belly Bliss Nutrition and the Solving SIBO Program.