Leaky Gut Syndrome

Definition-what is leaky gut syndrome?

The "Leaky Gut Syndrome“As a translation from English means something like“ Syndrome of the leaky bowel ”. In patients there is thus an increased permeability (Permeability) of the intestinal mucous membrane for numerous substances with which our digestive tract comes into daily contact. There are numerous "transporters" (precisely controlled transport proteins) in the intestinal mucosa, as well as systems for "sealing" the intestine, which decide what is absorbed into the bloodstream and in what quantity. For example, the end strips ("Tight junctions“) Normally, as dense cell-cell connections, for adequate protection so that bacteria, toxins and inadequately digested food components are not absorbed. One reason for the leakage of the mucous membrane is assumed to be an insufficient function of the end strips. Since the filter function for the passage into the blood is disrupted, inflammatory processes or immune reactions can be triggered.


The so-called "intestinal microbiome" (the "intestinal flora") describes the totality of germs, especially bacteria, that colonize the digestive tract. This flora is of essential importance for the immune system, which is largely located in the intestine. An exactly functioning barrier of the intestinal mucosa is also dependent on an intact milieu in the intestine.

The cause of a leaky gut syndrome can be an incorrect colonization of the intestine, i.e. an increased / decreased occurrence of certain types of bacteria. Intolerance / allergies to certain food components such as gluten, histamine or lactose can lead to an immune reaction that has a negative effect on the barrier of the intestinal mucosa. Chronic inflammatory bowel diseases such as ulcerative colitis or Crohn's disease can also increase the permeability of the intestine, as the mucous membrane is severely impaired. Inflammation of the pancreas (Pancreatitis) can also favor this.

An unhealthy diet high in alcohol, coffee, sugar, white flour and smoking is blamed. Consumption of preservatives, flavorings and food additives is also seen as unfavorable. Frequent use of medication such as antibiotics or painkillers affects the entire digestive tract via various mechanisms, including the intestinal flora, the tightness of the intestine and thus the immune system. Stress, operations and, in particular, previous radiation therapy (in general and especially in the area of ​​the abdomen) can promote a leaky gut syndrome.


To make a diagnosis, a detailed and thorough medical history (medical history) should always be taken at the beginning. For complaints that affect the gastrointestinal tract, a travel history (asking about stays abroad) is also useful. A physical examination can then provide valuable information about the underlying disease and decide which tests and other measures can be meaningfully supplemented afterwards. Various stool and blood tests can confirm or refute the relevant diagnosis.

What tests are there?

If leaky gut syndrome is suspected, a stool examination can be carried out first. Here, on the one hand, the presence of pathogenic (pathogenic) intestinal germs, for example Clostridium difficile, Shigella etc. tested. On the other hand, an examination of the intestinal microbiome (the "intestinal flora") takes place. Here the ratio of the different intestinal germs is determined, i.e. whether there are enough “good / healthy” types of bacteria.

In addition, specific tests should be carried out if food intolerance is suspected, for example an H2-lactose breath test for lactose intolerance.

If there are indications of an underlying inflammatory process in the intestine, calprotectin in the stool can be useful as a marker. Blood tests for so-called "inflammation parameters" such as CRP (C-reactive protein), the number of leukocytes or a BKSG (sedimentation rate) can also be helpful.

A specific test for increased intestinal permeability is the lactulose-mannitol test. The basis for this test is that both sugars are not metabolized and can therefore be measured unchanged in the urine of healthy people. As mannitol is absorbed through the cells it becomes lactulose paracellular, that is taken up between the cells. Leaky gut syndrome primarily affects the terminal ridges, which limit the transport between the cells. Therefore, compared to mannitol, lactulose appears more in the urine of those affected. The quotient of lactulose and mannitol in the urine after drinking a solution with both substances is therefore indicative of a disturbance in the permeability of the intestine. In addition, secretory immunoglobulin A can be determined in the stool. It is formed by the plasma cells in the intestine and is primarily responsible for the defense against mucosal surfaces.

All of the above tests should definitely be carried out by a doctor depending on the symptoms and after advice on the necessity.

These doctors treat leaky gut syndrome

It is advisable for patients with corresponding complaints to first turn to their general practitioner or specialist in internal medicine, who will also provide general practitioner care. Following the anamnesis and physical examination, the doctor can decide to what extent an appointment with a gastroenterologist is useful. A specialist in gastroenterology focuses on all diseases of the gastrointestinal tract and, if necessary, can offer further diagnostic and therapeutic measures.

I recognize leaky gut syndrome by these symptoms

In the leaky gut syndrome there is no single symptom that occurs specifically only in this clinical picture, but a multitude of possible symptoms that can be an indication of a leaky intestine when viewed together. On the one hand, the immune system is massively challenged by the increased penetration of harmful substances. On the other hand, detoxification via the liver and excretion via the kidneys must take place in parallel. This manifests itself as reduced performance, tiredness and fatigue. The development or progression of inflammatory bowel diseases is promoted by the damage to the mucous membrane. This damage can also lead to diarrhea, gas, and weight loss. The immune system can also turn against the own body due to harmful substances penetrating into the blood and the ingestion of only partially digested food and thus favor autoimmune diseases or food intolerance.

Read more on the topic: unwanted weight loss

Irritable bowel syndrome

The so-called irritable bowel syndrome ("Irritable colon“) Can occur as part of a leaky gut syndrome and is generally very common in patients with gastrointestinal complaints. This is an exclusion diagnosis, which means that all other diseases of the gastrointestinal tract must be excluded before the diagnosis is made. This is because irritable bowel syndrome can be viewed as harmless and has a good prognosis.

Symptoms include changes in bowel movements with diarrhea (Diarrhea) or constipation (Constipation). In the case of diarrhea, an admixture of mucus can be observed and the feeling of an "urge to defecate" and an incomplete bowel movement is described. Diffuse abdominal pain throughout the gastrointestinal tract can also occur.

Read more on the topic: Abdominal pain and diarrhea

In terms of therapy, anticonvulsant medication can be useful in the short term, but in the longer term autogenic training, the intake of probiotics (e.g. yoghurt preparation with viable microorganisms) or a change in diet make more sense.

Read more on the topic: Anti-flatulence drugs

Warnings that speak strongly against irritable bowel syndrome include diarrhea at night, fever, blood in the stool, or weight loss. The presence of these warnings requires urgent medical clarification.

Treatment / therapy

A causal (Specific) treatment for Leaky Gut Syndrome is not available. On the one hand, any underlying diseases (e.g. chronic inflammatory bowel disease) should be given the best possible medical treatment.

On the other hand, avoiding triggering factors, for example in the case of proven food intolerance, can provide relief. A medical consultation should take place here in order to optimally treat intolerances. In addition, the respective lifestyle plays an absolutely crucial role. Excessive alcohol consumption, smoking or a diet high in white flour or sugar should be avoided.

If the intestine is badly colonized with a change in one's own milieu, an intestinal rehabilitation with the addition of certain intestinal bacteria preparations can be useful. This should only be done in a targeted manner and with medical advice. A diet rich in fiber can help the mucous membrane to recover. A sufficient supply of vitamins, minerals, trace elements and amino acids should be ensured. In addition, the supply of so-called probiotics (drugs with viable microorganisms) can support the reconstruction of the intestinal mucosa.

Read more on the topic: Diet for diarrhea or a healthy diet

Healing earth

Healing earth is obtained from a type of clay (loess) and is mixed in small amounts in water and drunk for internal use. There is no scientific evidence of its effectiveness. The effect of leaky gut syndrome is mediated by binding harmful substances and then excreting them. This is intended to support the rehabilitation / recovery of the intestine.

Duration / forecast

The duration is individual for everyone and strongly depends on various factors such as existing underlying diseases, age and lifestyle. The duration can be anywhere from a few weeks to two years. The cooperation of the patient is essential here, for example with the diet and a change in lifestyle.

Course of disease

There are no scientifically proven findings about the specific course of the leaky gut syndrome. It is crucial to treat the cause of the increased permeability of the intestine, for example an incorrect colonization, a previous antibiotic therapy or a chronic inflammatory bowel disease. If the triggering causes are eliminated and the therapy started promptly, the course can be favorably influenced and healing occurs. If the cause is inadequately treated and / or the patient does not cooperate, a leaky gut syndrome can occur again even after successful treatment.

Can leaky gut syndrome be cured?

Leaky gut syndrome can be cured. However, it depends on decisive factors. For example, whether the triggering causes can be eliminated and the cooperation of the patient in the therapy. In addition, other existing illnesses or necessary radiation or operations have an impact on the chances of recovery.