Leaky gut syndrome
Increased intestinal permeability is a measurable mechanism rather than a diagnosis, so treating it without finding the cause gives only temporary results.
"Leaky gut" is popular shorthand for increased intestinal permeability, which is genuinely documented in celiac disease, inflammatory bowel disease, and a range of autoimmune and metabolic conditions. What it is not is a standalone diagnosis that explains every symptom. It is a mechanism with causes, and the causes are what get treated.
Dysbiosis and loss of protective commensal populations. NSAIDs, which impair the barrier directly and are the most overlooked cause. Alcohol. Repeated antibiotic exposure. Chronic stress physiology, which measurably increases permeability. Untreated celiac disease. Intense endurance exercise. And inflammation already present in the gut.
The cause first, since barrier repair without it is temporary. Then the barrier itself: glutamine, zinc carnosine, colostrum, short-chain fatty acids and polyphenols, alongside nutrition that feeds commensal populations rather than starving them. NSAID and alcohol exposure addressed honestly. Stress physiology and sleep, which are not optional here.
Zonulin and lipopolysaccharide-binding protein as permeability markers, understanding that these are indicative rather than definitive. Stool analysis for dysbiosis, inflammation and short-chain fatty acid production. Calprotectin. Celiac serology, which must be excluded first. And nutrient status, since malabsorption follows a compromised barrier.
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