Living Gluten-Free
by Tricia Thompson, MS, RD, The Gluten-Free Dietitian

Google the term "leaky gut" and many websites containing an abundance of information come up.

To help separate the accurate from the not so accurate information, Daniel Leffler, MD, MA, Director of Clinical Research at The Celiac Center at Beth Israel Deaconess Medical Center in Boston graciously agreed to answer some questions.

What exactly is meant by the term "leaky gut?"
The cells lining the intestine are linked together by a complex of proteins known as "tight junctions." These exist throughout the entire intestinal tract but cells are bound more tightly together in some areas.

These barriers are important ways that your body regulates what comes in and out of the intestinal lining. It has been suggested that if these tight junctions are not working well, proteins and even microorganisms might be able to get into the body past the intestinal lining causing disease or symptoms. This is what is referred to as "leaky gut" or increased intestinal permeability.

What causes leaky gut?
Many things have been shown to weaken tight junctions including gastrointestinal infections, medications such as aspirin or ibuprofen, systemic illnesses such as liver disease, pancreatitis or severe infections, and of course gastrointestinal inflammatory disorders such as inflammatory bowel disease, celiac disease and some types of irritable bowel syndrome.

What diagnostic tests are available for leaky gut?
Currently there are no clinically available proven tests for leaky gut. Testing is sometimes done as part of research studies, but there is currently no good evidence that testing clinically is reliable or helpful.

What is the treatment of leaky gut?
There is no specific treatment for leaky gut other than when possible removing the underlying cause of the dysfunction. Medications are being tested that may help tight junction function.

However, it is important to remember that it is not at all clear whether leaky gut is a cause of illness, a complication of illness or a just a result of illness. For example in celiac disease, we do not know whether a problem with tight junctions leads to the development of celiac disease and possibly other autoimmune disorders (cause of illness), occurs ...    Continue

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