Living with a Leaky Gut

By Aliza Beer MS, RD, CDN

Leaky gut syndrome is a digestive condition where there is an increase in permeability of the intestinal lining, which allows bacteria and toxins into the bloodstream, causing an inflammatory response. While it is not an official medical diagnosis, numerous symptoms may occur which may dramatically impact quality of life. Symp - toms may include chronic diarrhea, constipation or bloating, fatigue/confusion, poor skin health, and joint pain, as well as widespread inflammation and nutritional deficiencies. Although there is no cure for leaky gut syndrome, symptoms may be managed through lifestyle interventions, including nutrition, which may reduce its impact.

While there is no one specific cause of leaky gut syndrome, certain conditions, drugs, and lifestyle choices may increase intestinal permeability. Factors include poor nutrition, alcohol consumption, infections, autoimmune disorders (IBD, Celiac disease, Lupus), diabetes and stress. Eliminating or managing these risk factors through protecting your gut health may help to eliminate or lessen the impact of leaky gut syndrome.

Probiotics, the “Good Bacteria”

Probiotics (or good bacteria) may help to reduce symptoms associated with leaky gut. Leaky gut is often correlated with an imbalance of gut bacteria. The makeup of the gut microbiome is closely related to the gut barrier integrity. Introducing healthy gut bacteria into the digestive tract can help to heal intestinal permeability. Probiotics are effective in that they simultaneously work to reverse leaky gut and improve digestive health, while reducing the body’s inflammatory response.

Sources of probiotics include supplements and food. Supplements may be beneficial when attempting to populate the gut with numerous types of bacteria. While foods that we consume may contain one or two types of bacteria, for individuals with severe leaky gut they may additionally benefit from supplements. When consuming supplements, ensure they are clinically approved, such as Culturelle, and are not high in additives that may further insult your microbiome. Select multi-strain probiotics and combine this with an anti-inflammatory diet for the best results. Probiotics are best kept refrigerated.

While supplements may enable for a more immediate diversity and greater control over the types of bacteria being consumed, they lack the nutritional benefits of whole foods. Many whole foods, such as probiotic yogurt or kefir, tempeh, sourdough, fermented foods (kimchi, miso, sauerkraut), as well as certain cheeses (swiss, cottage, edam) contain probiotics. These foods also contain many other important nutritional properties such as protein and antioxidants which contribute towards a healthy diet. When purchasing probiotic foods, ensure the bacteria are alive at the time of consumption. This may be challenging due to storage, however, here are a few tips. Do not assume yogurt contains live probiotics; instead, read the label and select those that say live or active cultures. Pasteurization typically kills bacteria so choose unpasteurized products. Select pickles made without vinegar, as these do not contain probiotics.

Prebiotics

While probiotics are beneficial bacteria found in certain foods or supplements, prebiotics are types of fiber that feed friendly bacteria in the digestive system. Feeding the positive gut bacteria enables these bacteria to multiply and produce additional gut healing compounds. By enabling good bacteria to flourish, it helps to control the acidity of the stomach to further fight off the “bad bacteria” in your microbiome.

Prebiotics foods are typically high in fiber such as fruits, vegetables (with the skin), whole-grains, nuts and legumes. A diet high in simple sugar and fat and low in prebiotic fiber increases intestinal per- meability. Prebiotics may be easily added to your diet by adding berries to your yogurt or not peeling the skin off your carrots. Select whole-wheat bread over white, and add some chia or flax seeds to your salad. These small steps can help improve the health of your microbiome.

FODMAPS Diet

Adopting a low FODMAP diet may reduce gas production, which may alleviate the digestive discomfort brought by leaky gut syndrome. FODMAPS are made of fermentable carbohydrate proteins of plant-based foods, that when metabolized by the gut increase gas production and cause intestinal dysmotility. Fructose, lactose, and polyols are examples of FODMAPS. Examples of foods high in FODMAPS are dairy-based products, wheat products (cereal, bread, crackers), beans and lentils, some vegetables (artichokes, asparagus, onions and garlic) and some fruits (apples, cherries, pears, peaches).

The low FODMAP diet is a temporary eating plan that is restrictive, however, it may help to determine which foods contribute towards symptoms. While some may cause symptoms, others may not, and keeping a food journal to identify the types of foods that trigger symptoms will enable you to customize your diet to best improve the quality of life.

The low FODMAP diet works by first stopping to eat certain (high FODMAP) foods and then slowly reintroducing them to determine which causes issues. Lastly, once you are able to identify which cause issues, you can avoid them! The elimination period should range from two- may include eggplant, potatoes, tomatoes, cucumbers, and zucchini. Examples of fruits to eat are grapes, oranges, berries, and pineapple.

Foods to Caution

Avoiding certain foods may help to improve your gut health. Foods that have been shown to cause inflammation may switches such as ensuring the bread is not high in sugar and that the yogurt is a Greek yogurt high in protein and low in fat can go a long way to improve your gut health. Select plant-based oils such as olive oil or avocado oil over coconut oil or sesame oil. These are lower in saturated fat and are higher in unsaturated heart health fats which are anti-inflammatory. Overall, while there is no one cure for leaky gut, being mindful about the foods that we eat can go a long way to eliminating symptoms and improving the quality of life. Consume a diet that is low in processed/high fat/sugar products and focus on fiber. Include more prebiotic and probiotic foods and figure out which foods are most triggering for your symptoms. Implementing these changes are the best ways to eliminate the symptoms of leaky gut and improve your overall microbiome health. six weeks, and it is critical to work with a dietitian who can help you effectively manage this.

When following a low FODMAP diet, foods should be based around protein such as eggs, meat, fish, certain cheeses; switch cow’s milk for plant-based milk such as almond milk and include grains such as rice, quinoa and oats. Vegetables promote the growth of unhealthy bacteria. Foods that may trigger symptoms and promote the growth of harmful bacteria include processed meats, baked goods, artificial sweeteners, alcoholic beverages, refined oils, and foods that are high in added sugar or fat. When selecting products at the supermarket, be sure to read the nutrition facts label. Making small

Aliza Beer is a registered dietitian with a master’s degree in nutrition. She has a private practice in Cedarhurst, NY. Patients’ success has been featured on the Dr. Oz show. Aliza can be reached at alizabeer@gmail.com, and you can follow her on Instagram at @alizabeer