Best Health - - ADVICE - DR. TALIA ZENLEA is a gas­troen­terol­o­gist at Women’s Col­lege Hos­pi­tal, wom­en­shealth­mat­ters.ca, and au­thor of Belly Blog, belly­blog.ca Follow her on @WCHospi­tal


LEAKY GUT IS A CON­DI­TION THAT HASN’T been well de­fined, and it means dif­fer­ent things to dif­fer­ent peo­ple. We know that the gas­troin­testi­nal (GI) tract is full of mi­cro-or­gan­isms, such as bac­te­ria and fungi. These gen­er­ally stay in­side the gut be­cause of the in­tegrity of the wall of the GI tract – like how wa­ter stays in­side a gar­den hose. Some ex­perts have the­o­rized that those or­gan­isms can leak out un­der cer­tain cir­cum­stances and that this can have neg­a­tive con­se­quences.

Ul­cer­a­tive col­i­tis and Crohn’s dis­ease are ex­am­ples of inf lam­ma­tory bowel dis­ease (IBD) where this can hap­pen. In these cases, some­thing dis­rupts part of the gut wall that holds mi­cro-or­gan­isms in – like when the bricks and mor­tar of a wall have cracks or crum­bles. When these mi­cro-or­gan­isms seep out, the body rec­og­nizes them as for­eign and does what it’s sup­posed to do in the face of an en­emy, mount­ing a mas­sive in­flam­ma­tory re­sponse. This inf lam­ma­tory re­sponse drives the symp­toms of those dis­eases. Your in­flam­ma­tory re­sponse can be mea­sured – we can ac­tu­ally see inf lam­ma­tion when we do a scope and look in­side the gut or if we take a sam­ple and look at it un­der a mi­cro­scope. We can also usu­ally de­tect inf lam­ma­tory cells in blood and stool sam­ples.

When most peo­ple talk about leaky gut, what I’ve just de­scribed isn’t what they have in mind. It’s likely based on the gen­eral prin­ci­ple I de­scribed above, but peo­ple aren’t usu­ally re­fer­ring to some­one with Crohn’s dis­ease, ul­cer­a­tive col­i­tis or any other de­tectable or mea­sur­able in­flam­ma­tion of the GI tract.

The term “leaky gut” has been used as a blan­ket di­ag­no­sis for a whole host of symp­toms – from ab­dom­i­nal pain and bloat­ing to fa­tigue and rashes – with­out any clearly de­fined or di­ag­nosed syn­drome or any sci­en­tific ex­pla­na­tion as to how these symp­toms could be re­lated to each other or to some­thing leak­ing from the gut.

That said, the gut is a ma­jor im­mune or­gan in the body, so the con­cept isn’t to­tally im­pos­si­ble – it’s just not a con­di­tion we’ve stud­ied or de­fined yet. It has gained some In­ter­net pop­u­lar­ity, but it isn’t founded in sound sci­ence.

When you ask if you should worry about leaky gut, the short an­swer is no. That doesn’t mean you should dis­miss wor­ri­some symp­toms such as cramps, bloat­ing and ab­dom­i­nal pain, but it means that they will likely be in­ves­ti­gated ap­pro­pri­ately and at­trib­uted to a bet­ter­de­fined, bet­ter-un­der­stood syn­drome or con­di­tion.

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