This is a very common term that describes an intestinal tract that no longer has the ability to hold all of its contents inside and allows some to ‘leak through’ to the blood stream.  The medical term for this is intestinal barrier dysfunction.

It is becoming clearer that supporting intestinal health and restoring the integrity of the gut barrier will be one of the most important goals for doctors going forward. There are two closely related variables that determine our gut health: the intestinal microbes or “gut flora”, and the gut barrier. Let’s discuss each of them in turn.

The gut flora: a healthy garden needs healthy soil

As previously stated, our gut is home to approximately 100,000,000,000,000 (100 trillion) microorganisms. That’s such a big number our human brains can’t really comprehend it. One trillion dollar bills laid end-to-end would stretch from the earth to the sun – and back – with a lot of miles to spare. Do that 100 times and you start to get at least a vague idea of how much 100 trillion is.

We’ve only recently begun to understand the extent of the gut flora’s role in human health and disease. Among other things, the gut flora promotes normal gastrointestinal function, provides protection from infection, regulates metabolism and interfaces with more than 75% of our immune system. Imbalanced gut flora has been linked to diseases ranging from autism and depression to autoimmune conditions like Hashimoto’s, inflammatory bowel disease and type 1 diabetes.

Unfortunately, several features of the modern lifestyle directly contribute to unhealthy gut flora:

  • Antibiotics and other medications like birth control and NSAIDs

  • Diets high in refined carbohydrates, sugar and processed foods

  • Diets low in fermentable fibers

  • Dietary toxins like wheat and industrial seed oils that cause leaky gut

  • Chronic stress

  • Chronic infections

  • Lack of natural Sunlight

Antibiotics are particularly harmful to the gut flora. Recent studies have shown that antibiotic use causes a profound and rapid loss of diversity and a shift in the composition of the gut flora. This diversity is not recovered after antibiotic use without intervention.

We also know that infants that aren’t breast-fed and are born to mothers with bad gut flora are more likely to develop unhealthy gut bacteria, and that these early differences in gut flora may predict overweight, diabetes, eczema/psoriasis, depression and other health problems in the future.

 The gut barrier: the gatekeeper that decide what gets in and what stays out

Have you ever considered the fact that the contents of the gut are technically outside the body? The gut is a hollow tube that passes from the mouth to the anus. Anything that goes in the mouth and isn’t digested will pass right out the other end. This is, in fact, one of the most important functions of the gut: to prevent foreign substances from entering the body.

When the intestinal barrier becomes permeable (i.e. “leaky gut syndrome”), large protein molecules escape into the bloodstream. Since these proteins don’t belong outside of the gut, the body mounts an immune response and attacks them. Studies show that these attacks play a role in the development of autoimmune diseases like Hashimoto’s and type 1 diabetes, among others.

In fact, experts in mucosal biology like Alessio Fasano now believe leaky gut is a precondition to developing autoimmunity:

This new theory holds that the intestinal barrier in large part determines whether we tolerate or react to toxic substances we ingest from the environment. The breach of the intestinal barrier (which is only possible with a “leaky gut”) by food toxins like gluten and chemicals like arsenic or BPA causes an immune response which affects not only the gut itself, but also other organs and tissues.

This is a crucial point to understand: you don’t have to have gut symptoms to have a leaky gut. Leaky gut can manifest as skin problems like eczema or psoriasis, heart failure, autoimmune conditions affecting the thyroid (Hashimoto’s) or joints (rheumatoid arthritis), mental illness, autism spectrum disorder, depression and more.

Researchers have identified a protein called zonulin that increases intestinal permeability in humans and other animals. This led to a search of the medical literature for illnesses characterized by increased intestinal permeability (leaky gut). Imagine their surprise when the researchers found that many, if not most, autoimmune diseases – including celiac disease, type 1 diabetes, multiple sclerosis, rheumatoid arthritis and inflammatory bowel disease – are characterized by abnormally high levels of zonulin and a leaky gut. In fact, researchers have found that they can induce type 1 diabetes almost immediately in animals by exposing them to zonulin. They develop a leaky gut, and begin producing antibodies to islet cells – which are responsible for making insulin.

One of the main reasons we don’t want to eat wheat and other gluten-containing grains is that they contain a protein called gliadin, which has been shown to increase zonulin production and thus directly contribute to leaky gut.

But what else can cause leaky gut? In short, the same things I listed above that destroy our gut flora: poor diet, medications (antibiotics, NSAIDs, steroids, antacids, etc.), infections, stress, hormone imbalances, and neurological conditions (brain trauma, stroke and neurodegeneration).

Leaky gut = fatigued, inflamed and depressed

Here’s the takeaway. Leaky gut and bad gut flora are common because of the modern lifestyle. If you have a leaky gut, you probably have bad gut flora, and vice versa. And when your gut flora and gut barrier are impaired, you will be inflamed. Period.

This systemic inflammatory response then leads to the development of autoimmunity. And while leaky gut and bad gut flora may manifest as digestive trouble, in many people it does not. Instead it shows up as problems as diverse as heart failure, depression, brain fog, eczema/psoriasis and other skin conditions, metabolic problems like obesity and diabetes and allergies, asthma and other autoimmune diseases.


Silent suffering- that is what most people with chronic digestive problems go through.  They are discouraged by their inability to control their symptoms and how unpredictable their condition is. Many people are embarrassed to even speak with their doctor about their symptoms; cramping, bloating, intermittent or constant diarrhea or constipation. Many people will find themselves on the internet searching for answers. Even after seeing a doctor, the prognosis and treatment do not hold much hope for people.

Many people who have been diagnosed with Irritable Bowel Syndrome (IBS), chronic constipation or Colitis are given some options; be put on medications to slow down or speed up GI function or  learn “to live with it.”

IBS, colitis, reflux or GERD, diarrhea and constipation are all considered functional gastrointestinal disorders. This means that there is a problem with the function of the system, not the structure.   As a result, common testing like endoscopy and colonoscopy are usually negative. But just because your doctor doesn’t ‘see’ anything wrong with your intestines, something is horribly wrong. According to the International Foundation for Functional Gastrointestinal Disorders, these disorders are the most commonly presented GI illnesses seen by doctors in primary care or gastroenterology.

Functional GI and motility disorders generally cannot be diagnosed in a traditional way. No inflammatory, infectious, or structural abnormality can be seen by commonly used examination, x-ray, or laboratory test. Gastrointestinal motility is defined by the movements of the digestive system, and the transit of the contents within it.

Symptoms commonly include:

  • pain

  • heartburn

  • abdominal distension

  • nausea

  • vomiting

  • bloating

  • constipation

  • diarrhea

Problems occur when an imbalance begins in the digestive tract. The entire system functions from north to south, so if there is a problem in the stomach, eventually there will be a problem in the intestines. These areas are all depending on each other for normal function. For example, if you have reflux or constant burning after eating, your doctor might prescribe a medication to reduce the amount of acid your stomach produces. These medications are among the most widely prescribed drugs in the world. But in many cases, they cause more damage that you can believe. This is because not everyone with burning or reflux has too much stomach acid! The doctor didn’t test your acid levels, he/she prescribed that drug based on your symptoms! Believe it or not, a LOW stomach acid condition called hypochlorhydria causes the same burning symptoms and reflux as high stomach acid.

Let’s say you have burning in your stomach and chest and it is caused by low stomach acid and your doctor recommends an acid blocker or PPI drug like Prilosec, Zantac, Pepsid, Tagamet, the Little Purple Pill, or you just take Maalox or TUMS every day to deal with the discomfort.  You can be creating a long term nightmare! If your stomach acid is low (which it is 60% of the time), you are now making it EVEN LOWER with these drugs.

Your stomach acid is a critical barrier that protects you from infection (from bacteria and parasites that are constantly getting into your mouth) and is the first step in all protein digestion! If you lower it, your digestion becomes poor (and you can suffer from protein malabsorption) and you open yourself up to bacterial, yeast and parasite infections!

“You can’t fix and environmental or functional problem with a drug.” – Dr. Mike