Leaky gut syndrome: Causes and Diagnosis

*by Dr. Aikaterini Raka

“All disease begins in the gut”. “Death sits in the bowel”. Through these words, 2000 years ago, Hippocrates described the necessity of having a healthy digestive system as well as its mucous protective “mantle”, for the good of all organs within our body.

In recent years, many chronic diseases for which the scientific community has not found their definite cause, develop symptoms which make the everyday life difficult for the patient. Additionally, scientific studies on digestive system, and more specifically on the intestine, have shown that these symptoms emerge when the mucous membrane which consists of one or more layers of epithelial cells overlying a layer of loose connective tissue, begins to leak, either due to enlargement of the intercellular spaces, or due to perforation of the cells themselves. The epithelial cells of the mucous membrane which, like soldiers, are lined up next to each other and they sit on their supportive structure, the basement membrane, which connects them with the lamina propria, are responsible for the nutrients’ absorption. The nutrients are coming from the digestion of the low molecular-weight food, which after digestion, circulates into the bloodstream for the body’s energy, maintenance, and damage repair.

However, these “tight junctions”, may start loosening. As a result, the intercellular spaces become bigger and therefore, higher molecular-weight elements like undigested food, bacteria, fungi, parasites, drugs and heavy metals pass through, into the bloodstream, and then, to the liver. The liver is the second in the row filtering organ, which separates the “good” elements from the “bad” ones – however, not always. When these high molecular-weight elements are in abundance, the liver fails to filter all of them. Consequently, they disperse throughout the body where the immune system, by triggering the T-lymphocytes, attacks them, as though they were antigens. The T-lymphocytes in turn, produce cytotoxic proteins which create an environment of chronic inflammation within the body.

All these are related to the syndrome of increased permeability of the intestinal mucosa also known as the leaky gut syndrome.

The etiology of leaky gut syndrome lies:

  • In the poor diet (high consumption of red meat, diary, sugar, salt, and alcohol)
  • In the overuse of medicine such as antibiotics and non-steroidal anti-inflammatory drugs
  • Stress
  • In the disruption of the gut’s normal flora (microbiome) – increased colonization of pathogens
  • In autoimmune diseases such as Systemic Lupus Erythematosus (SLE), Type 2 Diabetes and more

It is worth noting that may be misdiagnoses on developing several autoimmune diseases when in fact, the real culprit is the leaky gut syndrome. These diseases are:

  • The Irritable bowel syndrome (IBS)
  • Crohn’s disease
  • Celiac disease
  • Diabetes
  • Chronic liver disease (cirrhosis) (maybe due to liver’s reduced ability of filtration)
  • Food, fungal, bacterial, and heavy metal allergies which the leaky gut fails to filter
  • Endocrine disorders such as Polycystic Ovary Syndrome (PCOS)
  • Diseases such as autism or other diseases of neurological etiology, which we do not know if they are triggered by leaky gut syndrome or if they themselves may cause it, thus raising the question of whether the leaky gut syndrome is a cause or symptom of those.

So, the aforementioned provide an answer to a series of chronic symptoms for the patient, which the classical medicine and treatment it provides, cannot effectively solve. These symptoms are:

  • Chronic diarrhea, constipation, flatulence
  • Nutrient deficiencies
  • Chronic fatigue
  • Headache
  • Confusion and difficulty concentrating
  • Dementia
  • Overstimulation and catatonia
  • Skin problems (acne, eczema, rashes)
  • Arthralgias, myalgias, tendonitis
  • Diffuse inflammation and more

Although the leaky gut syndrome has not been officially included in the accepted medical syndromes by the global medical community, at least so far, we cannot ignore its association with chronic not-resolved diseases through traditional medical methods.

Is there a way for the clinician to move diagnostically so to solve these problems? The answer is positive as there are test panels that provide information about the intestinal microbiome and its pH, and they detect pathological substances in the feces based on lesions on the intestinal mucosa, such as zonulin, some antitrypsins and other fecal proteins.

Therefore, we can be optimistic for the improvement of the intestinal health, always looking for the guidance of specialist doctors. Proper diagnosis, though, is a must.


– Consumption of probiotics to maintain the normal and beneficial microbiome

– Consumption of food rich in fiber such as vegetables, fruits and whole grains

– Restriction of red meat and dairy products

– Avoid consumption of sugar, artificial sweeteners, salt, and alcohol

– Adequate sleep

– Physical exercise

– Restriction of stress

– Restriction of antibiotics and other drugs

– Smoking cessation.

In summary, at a time of the pandemic that is affecting us on one way or another, we need to maintain a healthy immune system to fight infections and focus on the health and well-being of the digestive system, our organs’ “mother”. It is the key of our wellbeing. Let’s provide the care and respect it deserves.

* MD, Medical Biopathologist / Microbiologist at Yiannoukas Medical Laboratories – BIOIATRIKI Healthcare Group