Leaky Gut is a syndrome shrouded in mystery. Some practitioners refuse to acknowledge it while others believe it is at the core of resorting digestive health.

Yum was given the opportunity to ask world-renowned paediatric gastroenterologist and research scientist Dr Alessio Fasano some key questions on Leaky Gut Syndrome. Dr Alessio Fasano will be presenting to healthcare practitioners at the 4^th BioCeuticals Research Symposium in Sydney, 22-24 April at Sheraton on the Park.

Yum: What are common symptoms of Leaky Gut Syndrome?

Dr. Fasano:

Common symptoms of conditions associated with increased intestinal permeability, sometimes called “leaky gut syndrome,” are often gastrointestinal in nature. They include abdominal bloating, cramps, chronic constipation and diarrhea, along with joint pain and skin rash.

Food allergies, food sensitivities and autoimmune conditions such as celiac disease and Crohn’s disease are associated with increased intestinal permeability.

We have strong scientific evidence for how the protein zonulin loosens tight junctions between intestinal cell walls, leading to increased intestinal permeability. This can allow a host of unwelcome bacteria or other invaders to move into the bloodstream, causing symptoms to develop.

Yum: How can you be diagnosed with Leaky Gut Syndrome?

Dr. Fasano:

There are currently no diagnostic criteria for “leaky gut syndrome,” which is not a term recognized or acknowledged by most medical practitioners. Identifying what underlying condition (Crohn’s disease, celiac disease, Irritable Bowel Disorder, food allergy or sensitivity) is causing the increased intestinal permeability is the challenge for the medical practitioner. Tests like the lactulose/mannitol test are the only available but not validated tool to assess gut permeability. Other tests are currently in development but not yet available.

Yum: Can a leaky gut be healed?

Dr. Fasano:

Without a proper cause identified, a diagnosis secured and, therefore, a course of treatment based on solid evidence, this is still a misnomer—we cannot really heal a leaky gut. However, in a condition such as celiac disease or Irritable Bowel Disorder, many patients do respond to treatment with reduced symptoms and improved intestinal permeability.

Yum: Do you believe there is a connection between gluten sensitivity and leaky gut?

Dr. Fasano:

Although we don’t yet have definitive evidence on what causes gluten sensitivity, there seems to be a mechanism similar to celiac disease that results in increased intestinal permeability. Much more research is needed in this area to determine how gluten sensitivity develops. We do know that people with gluten sensitivity do not show the same kind of intestinal damage that we see in people with celiac disease. Therefore, the increased gut permeability in gluten sensitivity is related to a functional defect of the gut barrier rather than being secondary to a structural damage as in celiac disease and Crohn’s disease.

Yum: What are the next steps in diagnosis and treatment of leaky gut syndrome?

Dr. Fasano:

Research into intestinal permeability or “leaky gut” is in its infancy. Without identifying diagnostic biomarkers about what specific molecular mechanism causes this condition, we still have a long way to go in terms of diagnosis and treatment, and ultimately, the prevention of what some practitioners call “leaky gut syndrome.” We also need to have accurate and reliable methods of measuring intestinal permeability that will translate into diagnostic tools for the use of clinicians.

The next phase in the diagnosis and treatment of this condition are in the research laboratory and clinical trials. Although there are some promising candidates for reducing intestinal permeability, randomized double-blind trials are needed to investigate the safety and efficacy of therapeutic interventions.