Leaky gut syndrome

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Leaky gut syndrome is a hypothetical and medically unrecognized condition. [1] [2]

Unlike the scientific phenomenon of increased intestinal permeability ("leaky gut"), [1] [3] claims for the existence of "leaky gut syndrome" as a distinct medical condition come mostly from nutritionists and practitioners of alternative medicine. [1] [4] [5] Proponents claim that a "leaky gut" causes chronic inflammation throughout the body that results in a wide range of conditions, including chronic fatigue syndrome, rheumatoid arthritis, lupus, migraines, multiple sclerosis, and autism. [1] [4] There is little evidence to support this hypothesis. [1] [6]

Stephen Barrett has described "leaky gut syndrome" as a fad diagnosis and says that its proponents use the alleged condition as an opportunity to sell a number of alternative-health remedies – including diets, herbal preparations, and dietary supplements. [5] In 2009, Seth Kalichman wrote that some pseudoscientists claim that the passage of proteins through a "leaky" gut is the cause of autism. [7] Evidence for claims that a leaky gut causes autism is weak and conflicting. [8]

Advocates tout various treatments for "leaky gut syndrome", such as dietary supplements, probiotics, herbal remedies, gluten-free foods, and low-FODMAP, low-sugar, and/or antifungal diets, but there is little evidence that the treatments offered are of benefit. [1] None have been adequately tested to determine whether they are safe and effective for this purpose. [4] The U.K. National Institute for Health and Care Excellence (NICE) does not recommend the use of any special diets to manage the main symptoms of autism or leaky gut syndrome. [1]

See also

Related Research Articles

<span class="mw-page-title-main">Coeliac disease</span> Autoimmune disorder that results in a reaction to gluten

Coeliac disease or celiac disease is a long-term autoimmune disorder, primarily affecting the small intestine, where individuals develop intolerance to gluten, present in foods such as wheat, rye and barley. Classic symptoms include gastrointestinal problems such as chronic diarrhoea, abdominal distention, malabsorption, loss of appetite, and among children failure to grow normally. Non-classic symptoms are more common, especially in people older than two years. There may be mild or absent gastrointestinal symptoms, a wide number of symptoms involving any part of the body, or no obvious symptoms. Coeliac disease was first described in childhood; however, it may develop at any age. It is associated with other autoimmune diseases, such as Type 1 diabetes mellitus and Hashimoto's thyroiditis, among others.

<span class="mw-page-title-main">Irritable bowel syndrome</span> Functional gastrointestinal disorder

Irritable bowel syndrome (IBS) is a "disorder of gut-brain interaction" characterized by a group of symptoms that commonly include abdominal pain, abdominal bloating and changes in the consistency of bowel movements. These symptoms may occur over a long time, sometimes for years. IBS can negatively affect quality of life and may result in missed school or work or reduced productivity at work. Disorders such as anxiety, major depression, and chronic fatigue syndrome are common among people with IBS.

<span class="mw-page-title-main">Herbal medicine</span> Study and use of supposed medicinal properties of plants

Herbal medicine is the study of pharmacognosy and the use of medicinal plants, which are a basis of traditional medicine. With worldwide research into pharmacology, some herbal medicines have been translated into modern remedies, such as the anti-malarial group of drugs called artemisinin isolated from Artemisia annua, a herb that was known in Chinese medicine to treat fever. There is limited scientific evidence for the safety and efficacy of many plants used in 21st-century herbalism, which generally does not provide standards for purity or dosage. The scope of herbal medicine sometimes include fungal and bee products, as well as minerals, shells and certain animal parts.

<span class="mw-page-title-main">Diverticulosis</span> Condition of the wall of the intestine

Diverticulosis is the condition of having multiple pouches (diverticula) in the colon that are not inflamed. These are outpockets of the colonic mucosa and submucosa through weaknesses of muscle layers in the colon wall. Diverticula do not cause symptoms in most people. Diverticular disease occurs when diverticula become clinically inflamed, a condition known as diverticulitis.

<span class="mw-page-title-main">Fructose malabsorption</span> Medical condition

Fructose malabsorption, formerly named dietary fructose intolerance (DFI), is a digestive disorder in which absorption of fructose is impaired by deficient fructose carriers in the small intestine's enterocytes. This results in an increased concentration of fructose. Intolerance to fructose was first identified and reported in 1956.

<span class="mw-page-title-main">Malabsorption</span> Medical condition

Malabsorption is a state arising from abnormality in absorption of food nutrients across the gastrointestinal (GI) tract. Impairment can be of single or multiple nutrients depending on the abnormality. This may lead to malnutrition and a variety of anaemias.

Functional gastrointestinal disorders (FGID), also known as disorders of gut–brain interaction, include a number of separate idiopathic disorders which affect different parts of the gastrointestinal tract and involve visceral hypersensitivity and motility disturbances.

Food intolerance is a detrimental reaction, often delayed, to a food, beverage, food additive, or compound found in foods that produces symptoms in one or more body organs and systems, but generally refers to reactions other than food allergy. Food hypersensitivity is used to refer broadly to both food intolerances and food allergies.

<span class="mw-page-title-main">Intestinal pseudo-obstruction</span> Medical condition

Intestinal pseudo-obstruction (IPO) is a clinical syndrome caused by severe impairment in the ability of the intestines to push food through. It is characterized by the signs and symptoms of intestinal obstruction without any lesion in the intestinal lumen. Clinical features mimic those seen with mechanical intestinal obstructions and can include abdominal pain, nausea, abdominal distension, vomiting, dysphagia and constipation depending upon the part of the gastrointestinal tract involved.

Intestinal permeability is a term describing the control of material passing from inside the gastrointestinal tract through the cells lining the gut wall, into the rest of the body. The intestine normally exhibits some permeability, which allows nutrients to pass through the gut, while also maintaining a barrier function to keep potentially harmful substances from leaving the intestine and migrating to the body more widely. In a healthy human intestine, small particles can migrate through tight junction claudin pore pathways, and particles up to 10–15 Å can transit through the paracellular space uptake route. There is some evidence abnormally increased intestinal permeability may play a role in some chronic diseases and inflammatory conditions. The most well understood condition with observed increased intestinal permeability is celiac disease.

The specific carbohydrate diet (SCD) is a restrictive diet originally created to manage celiac disease; it limits the use of complex carbohydrates. Monosaccharides are allowed, and various foods including fish, aged cheese and honey are included. Prohibited foods include cereal grains, potatoes and lactose-containing dairy products. It is a gluten-free diet since no grains are permitted.

Postcholecystectomy syndrome (PCS) describes the presence of abdominal symptoms after a cholecystectomy.

<span class="mw-page-title-main">Gluten-related disorders</span> Set of diseases caused by gluten exposure

Gluten-related disorders is the term for the diseases triggered by gluten, including celiac disease (CD), non-celiac gluten sensitivity (NCGS), gluten ataxia, dermatitis herpetiformis (DH) and wheat allergy. The umbrella category has also been referred to as gluten intolerance, though a multi-disciplinary physician-led study, based in part on the 2011 International Coeliac Disease Symposium, concluded that the use of this term should be avoided due to a lack of specificity.

FODMAPs or fermentable oligosaccharides, disaccharides, monosaccharides, and polyols are short-chain carbohydrates that are poorly absorbed in the small intestine and ferment in the colon. They include short-chain oligosaccharide polymers of fructose (fructans) and galactooligosaccharides, disaccharides (lactose), monosaccharides (fructose), and sugar alcohols (polyols), such as sorbitol, mannitol, xylitol, and maltitol. Most FODMAPs are naturally present in food and the human diet, but the polyols may be added artificially in commercially prepared foods and beverages.

Non-celiac gluten sensitivity (NCGS) or gluten sensitivity is a controversial disorder which can cause both gastrointestinal and other problems.

<span class="mw-page-title-main">Environmental enteropathy</span> Disorder of chronic intestinal inflammation

Environmental enteropathy is an acquired small intestinal disorder characterized by gut inflammation, reduced absorptive surface area in small intestine, and disruption of intestinal barrier function. EE is most common amongst children living in low-resource settings. Acute symptoms are typically minimal or absent. EE can lead to malnutrition, anemia, stunted growth, impaired brain development, and impaired response to oral vaccinations.

Serum-derived bovine immunoglobulin/protein isolate (SBI) is a medical food product derived from bovine serum obtained from adult cows in the United States. It is sold under the name EnteraGam.

<span class="mw-page-title-main">Intestinal mucosal barrier</span>

The intestinal mucosal barrier, also referred to as intestinal barrier, refers to the property of the intestinal mucosa that ensures adequate containment of undesirable luminal contents within the intestine while preserving the ability to absorb nutrients. The separation it provides between the body and the gut prevents the uncontrolled translocation of luminal contents into the body proper. Its role in protecting the mucosal tissues and circulatory system from exposure to pro-inflammatory molecules, such as microorganisms, toxins, and antigens is vital for the maintenance of health and well-being. Intestinal mucosal barrier dysfunction has been implicated in numerous health conditions such as: food allergies, microbial infections, irritable bowel syndrome, inflammatory bowel disease, celiac disease, metabolic syndrome, non-alcoholic fatty liver disease, diabetes, and septic shock.

A low-FODMAP diet is a person's global restriction of consumption of all fermentable carbohydrates (FODMAPs), recommended only for a short time. A low-FODMAP diet is recommended for managing patients with irritable bowel syndrome (IBS) and can reduce digestive symptoms of IBS including bloating and flatulence.

References

  1. 1 2 3 4 5 6 7 "Leaky gut syndrome". NHS Choices. 26 February 2015. Archived from the original on 2018-02-11. Retrieved 15 August 2016.
  2. "Debunking the Myth of 'Leaky Gut Syndrome'". Inside Tract. Canadian Society of Intestinal Research (187). 2013.
  3. Bischoff SC, Barbara G, Buurman W, Ockhuizen T, Schulzke JD, Serino M, et al. (2014). "Intestinal permeability--a new target for disease prevention and therapy". BMC Gastroenterol (Review). 14: 189. doi: 10.1186/s12876-014-0189-7 . PMC   4253991 . PMID   25407511.
  4. 1 2 3 Odenwald, Matthew A.; Turner, Jerrold R. (2013). "Intestinal Permeability Defects: Is It Time to Treat?". Clinical Gastroenterology and Hepatology. 11 (9): 1075–83. doi:10.1016/j.cgh.2013.07.001. PMC   3758766 . PMID   23851019.
  5. 1 2 Barrett, Stephen (14 March 2009). "Be Wary of "Fad" Diagnoses". Quackwatch . Retrieved 24 October 2013.
  6. Quigley EM (2016). "Leaky gut - concept or clinical entity?". Curr Opin Gastroenterol (Review). 32 (2): 74–9. doi:10.1097/MOG.0000000000000243. PMID   26760399. S2CID   40590775.
  7. Kalichman, Seth C. (2009). Denying AIDS: Conspiracy Theories, Pseudoscience, and Human Tragedy. Springer. p.  167. ISBN   9780387794761.
  8. Rao M, Gershon MD (2016). "The bowel and beyond: the enteric nervous system in neurological disorders". Nat Rev Gastroenterol Hepatol (Review). 13 (9): 517–28. doi:10.1038/nrgastro.2016.107. PMC   5005185 . PMID   27435372.