Is Leaky Gut Syndrome a Real Diagnosis?

Here’s why your doctor is unlikely to diagnose you with leaky gut syndrome.

If you're struggling with gastrointestinal distress and take a spin through social media, you'll likely find "leaky gut syndrome" within a few clicks. For example, the hashtag #leakygut on Instagram has nearly half a million posts. But is this condition a real diagnosis?

The short answer is no, because you're unlikely to have this jotted down on your medical chart, says Nayana George, MD, a gastroenterologist at Orlando Health Digestive Health Institute in Florida.

"Leaky gut syndrome is not a medical diagnosis," she says. "Instead, it's a popular term that's often used to describe symptoms that tend to align with inflammatory bowel disease (IBD)" or irritable bowel syndrome (IBS).

Think of your intestine as a mesh-lined, flexible channel rather than a steel pipe that simply shuttles substances like blood, water, and food from one place to the next. Normally, that mesh is small enough to block toxins while still allowing nutrients and electrolytes to pass into your bloodstream.

But with so-called leaky gut, that mesh is believed to be expanded due to inflammation, and that allows the bad stuff to get into your blood, too. This is an idea called intestinal permeability, or hyperpermeability. Basically, the mucus lining of the intestine may be "leaking" bacteria and other infectious agents into areas where it shouldn't, which is thought to trigger symptoms such as:

Burning sensation in the gut
Diarrhea
Fatigue
Gas and bloating, caused by overgrown bacteria
Painful indigestion
Nausea or vomiting

More research is still needed to solidify the idea of intestinal permeability. "Right now, 'leaky gut' is just a theoretical cause for inflammation in the gut. It's not considered an absolute phenomenon," says Pratima Dibba, MD, a gastroenterologist with Medical Offices of Manhattan in New York City. Part of that comes from lack of any standard test to measure intestinal permeability directly.

It's likely that "leaky gut" as a term was popularized because it's catchy — after all, "intestinal permeability" isn't much of a hashtag — and also because it's easy to understand, says Dr. George. Basically, it simplifies the complexity of intestinal lining function in a way that provides insight into how intestinal barrier issues could impact your health.

Whatever you're calling it, issues with your intestinal lining can have a real impact on your digestive health and can also be a warning sign of a bigger problem.

"While most physicians don’t view leaky gut syndrome as a proven condition, many patients with these symptoms are eventually diagnosed with other medical issues," says Caroline Soyka, DO, a gastroenterologist at Baptist Health in Jupiter, Florida. "These can include IBS, functional dyspepsia, small intestinal bacterial overgrowth, celiac disease, Crohn’s disease, fibromyalgia, or less commonly, autoimmune or neurological conditions."

At some point, leaky gut syndrome may actually become a diagnosis, but the data just isn't there yet, says Dibba.

More research is needed to validate routine testing and establish how impaired the intestinal lining has to be to allow bacteria and toxins to pass into the bloodstream, says Dr. Soyka.

"There's limited scientific evidence currently to support this theory, which is why doctors don't recognize leaky gut as an official medical diagnosis," she says.

Experiencing occasional digestive issues like bloating, gas, changes in bowel movements, and indigestion is common and happens to nearly everyone at some point, says Dr. Dibba.

However, if these symptoms linger for more than a couple weeks, it's a good idea to get them checked out by your healthcare provider, especially if they're worsening and impacting your everyday life, she says. The more serious symptoms that are sometimes linked to leaky gut syndrome — such as severe diarrhea or vomiting — should prompt you to visit your doctor sooner rather than later.

Although leaky gut syndrome is not a recognized medical diagnosis, that doesn't mean your symptoms are psychosomatic — it just implies there may be issues with your gastrointestinal system that need more investigation for an actual diagnosis, says Soyka.

For example, what you believe to be leaky gut symptoms could turn out to be a form of IBD, celiac disease, or IBS, she says. All of these conditions have symptoms that overlap, but they're treated in different ways, so it's crucial to understand what you actually have, says Soyka.

Leaky gut syndrome is a theory that suggests impairment in the lining of the intestines, which can negatively affect the barrier that keeps toxins and bacteria from getting into the bloodstream.
There's no routine test to measure intestinal permeability, but in research, it has been suggested to occur in patients with digestive conditions like irritable bowel syndrome. More research is still needed to solidify this.
As leaky gut syndrome is not a recognized medical diagnosis, continued gastrointestinal symptoms should prompt a doctor's visit if they're prolonged or worsening.

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