Intestinal Permeability: Symptoms and Common Imbalances

What are the most common symptoms and signs associated with intestinal permeability?  When do we suspect it?  How do we test for leaky gut syndrome?

This is part 3 of a 5-part series on Intestinal Permeability (Leaky Gut)

Main points of this issue:

  • Symptoms of leaky gut vary significantly and have a varied presentation
  • Common Imbalances Associated with Leaky Gut
  • Malabsorption is Common in Leaky Gut
  • Lab Testing for Leaky Gut Syndrome

Symptoms of Leaky Gut

Symptoms of leaky gut vary significantly and have a varied presentation. There is a spectrum of severity of intestinal permeability from mild to severe forms.

Here is a list of the most common symptoms associated with intestinal permeability:

  • bloating
  • poor digestion
  • inflammation
  • food sensitivities
  • chronic pain
  • brain fog/poor memory
  • depression
  • fatigue

People with intestinal permeability will often react to certain types of foods, especially common food allergens such as wheat and dairy. Gluten sensitivity is very common with these patients. Digestive abnormalities such as bloating and food sensitivities are common symptoms of leaky gut.

On the other side of the scale are people who never have intestinal symptoms. Another very common presentation of leaky gut is chronic pain (systemic inflammation), depression and fatigue. These patients will have brain fog, fatigue, and depression. As clinicians, when we see patients that present with these symptoms, we have to consider intestinal permeability issues.

When patients come into our clinic with these sorts of complaints, it is important to assess their risk of having intestinal permeability problems. We will discuss lab testing for this condition below. In addition, their diet will clue the clinician in to their risk of having some degree of intestinal permeability. If someone has to follow a strict diet to manage or avoid symptoms of fatigue, depression or pain, then this could point to leaky gut issues. It is important to assess for leaky gut in these patients as well.

Common Imbalances Associated with Leaky Gut

There are a number of common imbalances that often occur together with leaky gut. This includes:

  • Malabsorption
  • Malnutrition
  • Bacterial overgrowth
  • Immune activation
  • Yeast overgrowth
  • Intestinal lining degeneration
  • Impaired intestinal immune integrity
  • Dysbiosis
  • Food sensitivities

Malabsorption is Common in Leaky Gut

Many of these leaky gut patients get malabsorption because the inflammation that occurs from the penetration of peptides causes mucus formation. The mucus makes it difficult for small micronutrients to penetrate. The larger molecular weight molecules are able to penetrate but not the smaller ones. So you get leaky gut usually with malabsorption and malnutrition. This becomes a serious issue. These people end up with bacterial overgrowths due to imbalances in acidity and lack of beneficial flora. One of the most common bacterial infections they get is H. pylori.

The leaky gut syndrome causes systemic immune activation and causes yeast overgrowths. Their intestinal lining continues to degenerate and they get further leaky gut. They have impaired intestinal immune integrity. Their secretory IgA get compromised and they get dysbiosis and multiple food sensitivities. The average person with leaky gut has bacterial overgrowths, yeast overgrowths, dysbiosis, a weak gut immunity and probably multiple bacterial and/or parasitic infections.

How do you test for leaky gut syndrome?
Cyrex Labs Panel 2: Intestinal Antigenic Permeability Screen

Cyrex Labs is the only lab test available in the country that offers immunologic testing for antibodies against the gut proteins that bind the epithelial cells together (occludin-zonulin and actin-myosin). If these are positive, we know there is a compromised gut barrier. This test also assesses for bacterial lipopolysaccharides (LPS). LPS should only be found in the GI tract, not the blood. If these antibodies are found in the blood, this also indicates a breached barrier system.

  • Bacterial endotoxin (LPS) IgG, IgM, IgA → permeability/dysbiosis
  • Actin-myosin network IgG → epithelial cell damage
  • Occludin/zonulin IgG, IgM, IgA → tight junction damage

The Intestinal Antigenic Permeability Screen costs about $200. For more information, visit Cyrex Labs.

Content provided by Datis Kharrazian, D.C., Breaking the Complex Web of Leaky Gut Syndrome, 2/10/11

In part 4 of this 5-part series, we answer the following questions:

  • What causes leaky gut?
  • What are the mechanisms involved in the development of leaky gut?

Continue to part 4 of series