Is There Really a Such Thing as “Leaky Gut?”

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Is there such a thing as increased intestinal permeability as a pathophysiological state (aka “leaky gut”)?

Based on my research, I must conclude that there is indeed such a thing as intestinal permeability, otherwise known as leaky gut.  According to the Current Opinion in Gastroenterology peer-reviewed journal (2016), intestinal permeability does indeed exist.   Intestinal permeability can be observed by sending a small probe into the digestive tract.  These probes are sterile, acid-resistant.  They are essentially swallowed and travel through the intestinal tract.  They allow doctors to see the actual epithelial wall, observe the mucosa, and also to observe areas of permeability (Arrieta, et. al., 2006).

Another interesting piece of information is that intestinal permeability seems to be very closely associated with autoimmune diseases.  Leaky gut in people with diabetes, multiple sclerosis, etc. is easily observable, but the causes seem to be greatly unknown, although associations with insufficient gut microbiota have been made (Arrieta, et. al. 2006).  Still, for me, this leaves more questions. 

Does dysbiosis within gut microbiota cause the autoimmune disease, or does the autoimmune disease cause dysbiosis?  Or does intestinal permeability cause all of the above?  Or does the autoimmune disease cause all of the above?  According to Fasono’s research (2012), autoimmune diseases are closely linked with the breakdown and damage of tissues, so is leaky gut disease just another manifestation?

Leaky gut is often associated with epithelial cells, however there may be more at work that contributes to leaky gut.  Microbiota in the gut, the GI mucosa, and gut inflammation are all factors that seem to contribute to leaky gut (Eamonn, 2016).

References

Arrieta, M.C., Bistritz, L., Meddings, J.B. (2006). Alterations in intestinal permeability. Gut, 55(10), 1512-1520.

Eamonn, Q.M. (2016). Leaky gut – concept or clinical entity? Current Opinion in Gastroenterology, 32(2), 74-79.

Fasano, A. (2012). Leaky gut and autoimmune diseases. Clinical review in allergy immunology. 42(10), 71-78.