What Is Leaky Gut, And How Do You Heal It?

Leaky gut, or increased intestinal permeability, occurs when the lining of your intestines becomes weakened (1). Under normal conditions, the gut lining acts like a protective barrier, allowing only certain things like nutrients and water to pass through into your bloodstream, while keeping out undigested food, microbes, and waste.

In the case of a leaky gut, tiny gaps form between the cells of the intestinal wall, allowing substances that shouldn’t be in your bloodstream, such as undigested food particles, to "leak" through (1). When this happens, the body may misidentify the food as an invader, which has the potential to trigger an immune response and can lead to inflammation. This in turn may contribute to health issues, such as digestive discomfort, food sensitivities, autoimmune reactions, and more (1,4).

To learn more about the inflammatory response, read this article: Understanding & Supporting A Healthy Inflammatory Response

These symptoms are quite broad and could be linked to many different health conditions, which is one of the challenges when it comes to identifying leaky gut. That said, if you are experiencing several of the above symptoms, particularly in combination with some of the lifestyle factors listed below, it may be worth looking into your gut health along with a trusted health practitioner.

Leaky gut can happen as a result of several factors, many of which are related to the modern lifestyle. Some potential contributors include:

1. Poor diet: A diet high in ultra processed foods, sugar, refined carbohydrates, and unhealthy fats can cause inflammation and damage to the gut lining (9).

2. Stress: Long-term stress can weaken the gut barrier (10). One of the ways this happens is triggered by the release of stress hormones, such as cortisol, which can disrupt digestion and immune function.

3. Medications: Overuse of antibiotics, nonsteroidal anti-inflammatory drugs (NSAIDs), and certain other medications can disrupt the gut microbiome (11,12) and contribute to intestinal permeability.

4. Toxins: Environmental toxins - like pesticides, heavy metals, and chemicals - in processed foods, cosmetics, and household products have the potential to irritate the gut lining (13).

5. Dysbiosis: An imbalance in gut bacteria, yeast overgrowth (like candida), and infections are thought to have the potential to contribute to leaky gut (14).

6. Gluten: For individuals sensitive to gluten, this protein can be particularly damaging to the gut lining, increasing permeability (15).

While leaky gut can cause a host of problems, the good news is that the gut can be healed (18). One approach to supporting gut health, is what we call the Four Rs - Remove, Replace, Re-inoculate, and Repair.

1. Remove

Step one involves removing the irritants that are contributing to gut irritation through eliminating (sometimes temporarily) certain foods and substances that are known to irritate the gut lining, such as gluten, dairy, and/or ultra processed foods. This is sometimes done by conducting an elimination diet. 

In addition to dietary changes, it is also recommended to avoid environmental toxins whenever possible. This might include switching to safer cleaning products, cosmetics, and skincare.

2. Replace

After removing irritants, the next step is to support digestion by encouraging the production of essential digestive components. Certain herbs can promote bile and digestive enzyme production, ensuring food is properly broken down and absorbed to prevent further irritation.

Herbs that support digestion include:

• Dandelion root: Dandelion root supports the body in digesting fats effectively. It also supports liver function, which is essential for overall digestive health (19).

• Ginger: A well-known digestive aid, ginger helps stimulate digestive motility, and it can also soothe inflammation in the gut (20).

• Oregon Grape Root: Oregon grape root is a bitter herb that supports healthy bile production (21).

3. Re-inoculate

After removing harmful substances and supporting digestion through the ‘Replace’ step, it's time to focus on rebuilding the population of beneficial bacteria in your gut. This step is called ‘Re-inoculate’ because it involves restoring and replenishing the healthy bacteria (probiotics) that are essential for maintaining a balanced gut microbiome.

To re-inoculate your gut, consider incorporating the following:

• Probiotic-rich foods: Fermented foods like sauerkraut, kimchi, kefir, yogurt, and kombucha are natural sources of probiotics that can help repopulate your gut with beneficial bacteria.

• Probiotic supplements: High-quality probiotic supplements can deliver concentrated doses of beneficial bacteria to help rebuild the microbiome. Look for a multi-strain probiotic with strains such as Lactobacillus and Bifidobacterium, which have been shown to support gut health and strengthen the intestinal lining (22).

• Prebiotics: Prebiotics are non-digestible fibers that feed and nourish beneficial bacteria in your gut (23), helping them thrive. Foods high in prebiotics include garlic, onions, asparagus, bananas, and oats.

To learn more about restoring the gut microbiota, read this article: Restoring Gut Health After Antibiotics: A Guide For Families.

4. Repair

The final step in the Four Rs approach is to repair the gut lining. This involves providing the body with the nutrients and compounds it needs to heal and regenerate the intestinal barrier.

Key nutrients, foods, and supplements that aid in the repair of the gut lining include:

• Bone Broth: Bone broth is rich in collagen, and provides essential amino acids like glycine and proline and l-glutamine that help rebuild and maintain the gut lining (24).

• Slippery elm and marshmallow root: These herbs are known for their mucilaginous properties, meaning they create a gel-like coating that coats and soothes the gut lining (25).

• Omega-3 fatty acids: Omega-3s promote a balanced inflammatory response (26), supporting a calm and healthy intestinal barrier.

• Zinc: Adequate zinc intake intake supports the health of the cells lining the gut (27)

• Vitamin A: Retinoic acid (RA), the active form of vitamin A, strengthens the gut barrier by enhancing tight junction function (28) and promoting the growth of beneficial bacteria like lactobacillus (28).

• Vitamin D: Vitamin D helps strengthen the gut barrier by supporting the integrity of the gut lining and regulating inflammation (29).

Restoring a leaky gut is not an overnight process. The timeline can vary depending on individual circumstances, such as the severity of symptoms and lifestyle factors. Some individuals notice improvement in symptoms within a few weeks, while others may require several months to notice changes. If your symptoms persist despite working on gut health, or symptoms become severe, it is time to see a doctor. 

To learn more about gut healing, read this article: How to Heal The Gut.

Leaky gut, or increased intestinal permeability, occurs when the gut lining becomes compromised, allowing harmful substances to pass into the bloodstream. A leaky gut is thought to have the potential to contribute to digestive issues, food sensitivities, chronic fatigue, autoimmune diseases, and systemic inflammation.

Conventional medicine remains somewhat skeptical about leaky gut as an official diagnosis, but emerging research confirms its role in various chronic conditions.

One approach to supporting the restoration of a healthy gut is the Four Rs approach: remove irritants, replace digestive components that might be imbalanced, re-inoculate the gut with probiotics and prebiotics, and repair the gut lining with nutrients and mucilaginous herbs. The process takes time, but caring for your gut health sets the scene for long term wellness and is always worth it!