by Dr. Bill Rawls
One of the biggest roadblocks to feeling your absolute best is restoring good digestive health. This is true for even the healthiest among us, but especially for those coping with a chronic illness like chronic Lyme disease, fibromyalgia, or myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).
That’s because without normal digestion, the body’s ability to absorb healing nutrients and remove toxins that disrupt homeostasis suffers greatly. What’s more, this very complex system is connected to every other system in the body, so when digestion suffers, nothing works well.
With each year, awareness of the importance of digestive health increases, and I get more and more questions about it. One I hear more now than ever: “What’s the best treatment for healing leaky gut syndrome?” What’s interesting is that leaky gut, also known as intestinal permeability, isn’t a new problem. It’s long been associated with gastrointestinal (GI) diseases like Crohn’s and celiac disease.
But leaky gut is a growing problem, and one that extends far beyond the gut. Research suggests it may be linked with numerous serious symptoms and health concerns, including autoimmune, inflammatory, and neurodegenerative diseases such as lupus, multiple sclerosis, rheumatoid arthritis, and Alzheimer’s. As prevalence and concern grow, so does the number of remedies being offered by various health and wellness companies.
Unfortunately, as you may have already learned firsthand, most of these solutions don’t work. The reason: They don’t address the role that our modern lifestyle, technologies, and conveniences play in disrupting not only the GI system, but all of the body’s health systems. In other words, these so-called cures are only masking the symptoms, not treating the underlying factors – many of which are man-made.
Instead, healing leaky gut requires a multifaceted approach, one that restores healthy gut function, diminishes the cellular stress factors and system disruptors that damaged it in the first place, and offers much-needed symptom relief.
In this article, you’ll get the low-down on what you really need to know about overcoming leaky gut syndrome, including the signs and symptoms, causes, tests, and natural and herbal therapies, and lifestyle changes that can turn your gut and overall health around for good.
Leaky Gut, Explained
To understand why a gut becomes leaky, it helps to paint a quick picture of where in the body it occurs. Although some digestion begins in the mouth, most digestion and the absorption of nutrients occurs in the intestines, which also work to defend against foreign invaders like pathogens and toxins.
When functioning correctly, the cells that line the intestines, called the mucosa, are linked securely together with tight junction proteins that create a barrier and regulate the substances that pass into your bloodstream. Vital nutrients are let through; foreign substances such as toxins, microbes, and certain food components are mostly kept out. Those that do slip through are swiftly tagged by the immune system with antibodies to signal white blood cells to get rid of them.
But if an irregularity occurs in the mucosal cells, and the integrity of the protective barrier weakens, gaps and holes may develop, increasing intestinal permeability. Once the intestinal lining has been compromised, undigested foreign proteins, including food components not broken down by normal digestion, “leak” into the bloodstream in high concentrations. This is what’s commonly referred to as leaky gut.
These foreign substances overwhelm the immune system and create an inflammatory response that leads to problems in the digestive tract and throughout the entire body. Ultimately, a leaky gut has the potential to affect more than your bowels – it can set the stage for a long list of systemic problems.
For most people, the decline from normal digestion to digestive dysfunction and leaky gut is gradual. It starts with symptoms that are easy to ignore, such as mild indigestion and bloating, and then slowly progresses to ongoing intestinal discomfort. Add in chronic illness, chronic stress, and eating on the run, and the digestive situation goes from bad to worse. Here’s what to watch out for:
Symptoms of Leaky Gut
- Abdominal pain
- Digestive disturbances, including gas, bloating, belching, diarrhea, constipation, nausea, or indigestion
- Stomach ulcers
- Dietary concerns such as food allergies or sensitivities, nutritional deficiencies, or loss of appetite
- Chronic fatigue
- Arthritis or joint pain
- Weakened immune function
- Allergies or asthma
- Skin rashes and other skin problems like acne, eczema, and rosacea
- Depression and anxiety
- Mood swings
- Cognitive issues such as brain fog, memory loss, forgetfulness, confusion, or difficulty concentrating
- Hormone imbalances
- Weight fluctuations
You might think this list covers a pretty extensive set of symptoms — and, you’d be right. That’s how interconnected gut health is with the rest of your body. If your gut is leaky, other chemical processes, organs, and tissues in your body won’t function optimally either.
The 3 Modern Causes of Leaky Gut
As with most things, genetics have been shown to play a role in intestinal permeability, particularly with inflammatory bowel diseases. Certain microbes may also be a factor.
But even bigger is the role of the typical Western diet – one that’s been cultivated for convenience, but is totally unnatural to our digestive system – and the stress that comes with living in a modern fast-paced world.
Here’s an overview of what’s most to blame for compromising the gut lining and causing leaky gut:
1. An Unnatural Diet
Today’s typical American diet hardly resembles what our ancient ancestors ate. For hundreds of thousands of years, the menu was dominated by roots, tubers, leaves, mushrooms, wild fruit, berries, bark, bird and reptile eggs, and game. Grains and beans were not digestible without the processing technology that we have today.
Flash forward to modern day, and we’ve learned that processing grains and soaking and boiling beans made it so we could digest them. And thanks to industrialized farming techniques, we can produce both cheaply and en masse. Unfortunately, all the ways we’ve found to grow and manipulate food have also flooded the Western diet with three key gut-disrupting components: lectins, gluten, and excessive carbohydrates.
Grains and beans – along with other common dietary staples like legumes, tree nuts, nightshade vegetables (tomatoes, potatoes, eggplant, etc.), and meat and dairy raised on corn and soybeans – are loaded with lectins. Lectins are plant proteins that bind to molecules in the cell membranes of the intestinal tract, irritate tissues, and cause tight junction proteins to malfunction. While our mucosal lining is designed to protect us from a certain level of lectins, excess lectins erode and compromise that barrier.
Once lectins start to flood the bloodstream, they can send the immune system into overdrive. This stimulates antibody production, activates cytokine cascades — inflammatory chemical messengers of the immune system — and initiates a histamine response that can cause inflammation and the slew of symptoms associated with leaky gut.
Besides lectins, other storage proteins in plants have a similar effect, the worst offender being gluten — found in wheat and related grains like rye and barley. Storage proteins are located in the inner parts of the seeds of grains (called the endosperm), and they’re designed to provide amino acids to the plant seed to help it grow.
But storage proteins are also resistant to digestion and can be very irritating to the gut. And like lectins, they can create gaps between cells in the gut lining, flood the bloodstream, overwhelm the immune system, and trigger symptoms.
One final, significant problem with the standard American diet is the sheer volume of processed food products we consume, most of which are loaded with carbohydrates in the form of starch and sugar — much more than the human body can use or absorb. This is great news for bacteria and yeast, as their favorite food is undigested carbs.
So while our highest concentration of bacteria is normally in the colon, excess sugar and starches allow bacteria and yeast to flourish in the small bowel (called small intestine bowel overgrowth, or SIBO). The resulting damage to the intestinal lining intensifies leaky gut symptoms and immune dysfunction.
2. Non-Stop Stress
Some stress comes with the territory of being human, and it can be a good thing: Occasional stress in the face of a serious threat slows the movement of food materials through the gut so the body can put its energy and resources elsewhere. It’s the old fight-or-flight response — a biological throwback to when we had to evade the occasional tiger in the wild.
But chronic stress — a pervasive problem in a world ruled by global commerce and a 24/7 workday mentality — basically signals to the body that you’ve got a tiger hot on your heels all day long. No surprise, this compounds the problems associated with leaky gut.
Chronic stress decreases the production of serotonin, a feel-good chemical that’s also important for peristalsis (the movement of food materials through the intestinal tract). As a result, food materials are left to sit in the stomach and intestinal tract, creating more opportunity for lectins, gluten, and carbs to wreak more havoc.
3. Gut-Disrupting Toxins
Toxins can enter the body via three routes. There are those we ingest, including artificial pesticides, herbicides, and mycotoxins from mold spores that grow on food. And there are those that make their way into our system through the air we breathe or through our skin, namely petroleum residues that come from driving cars, creating plastics, mining, and chemical plants.
All of these unnatural toxic substances disrupt cell membranes, plus they act like free radicals and cause serious inflammation. This, in turn, compromises your immune system, disrupts homeostasis, and allows bad bacteria to flourish and upset the balance of your microbiome.
Then, there are certain pharmaceutical drugs. Antibiotics are a key one: They alter our microflora and the biofilms (mucus layers filled with beneficial microbes) that protect the lower intestine and large colon, according to findings in the journal BMC Gastroenterology. Other drugs that play a similar role in leaky gut include nonsteroidal anti-inflammatories like ibuprofen (Advil, Motrin) and naproxen (Aleve), findings in the journal Gut reveal.
Testing and Diagnostics for Leaky Gut
Unfortunately, there’s no standard diagnostic test for detecting leaky gut syndrome. The most effective way to determine whether you have leaky gut is to eliminate (as best you can) all of the contributing factors you have the most control over – gut-disrupting foods, chronic stress, and toxins – and monitor your symptoms to see if they improve.
Some doctors may still recommend a number of tests, some of which might help you better understand and address your gut dysfunction. Even so, these likely aren’t a necessary expense if your symptoms are mild to moderate and respond to appropriate dietary and lifestyle changes.
But if your symptoms are unmanageable or severe, such as severe abdominal pain or chronic diarrhea, testing can help you and your doctor determine the best course of action. In this case, consider the following:
- Food sensitivity testing: Specific food sensitivity testing can be helpful for defining the presence of leaky gut and identifying problematic foods. Of all the tests on this list, it’s the one that might provide the most useful information — though you could also learn the same information through an elimination diet. Note, too, that food sensitivity testing is not absolute and does not check for lectin sensitivities; the two can occur simultaneously. Lectin sensitivities often do not show up on food sensitivity panels.
- Stool culture and stool evaluation for parasites: Testing is indicated for persistent or bloody diarrhea. This is especially important in cases of loose stools associated with traveling abroad. (A lot of people suspect worms, but these aren’t much of a problem in the United States.)
- Liver function: Routine blood testing is readily available for evaluating the functional capacity of the liver; some conditions may impact how well the liver works.
- Testing for celiac disease: Simple blood tests are available for celiac disease, but know that wheat intolerance commonly occurs in the absence of true celiac disease. You can determine whether symptoms are related to gluten sensitivity on your own by avoiding gluten products for several weeks to see how you feel.
- Urinary oxalates: This test involves a 24-hour urine collection to measure levels of oxalates, a plant substance in certain foods that can leak across the intestinal barrier and increase your risk of kidney stones (70% of kidney stones are calcium oxalate).
- Comprehensive stool analysis: This type of testing is expensive (several hundred dollars or more) and rarely worth the cost. It may be valuable when symptoms do not respond to the recommended dietary and lifestyle changes.
- Liver and gallbladder ultrasound: Ultrasound is a noninvasive test for evaluating liver size and the occurrence of stones in the gallbladder. This test is only necessary if your symptoms are serious or don’t respond to therapy.
- Colonoscopy or upper endoscopy: Scoping the colon or stomach can help determine the degree of dysfunction and rule out serious concerns such as colon cancer. As with a liver and gallbladder ultrasound, colonoscopy and upper endoscopy aren’t necessary unless symptoms are serious or unresponsive to therapy.
Of course, anything out of the ordinary, including vomiting, vomiting blood, the passage of blood from the rectum, severe cramping, or any other severe symptoms should be immediately reported to your healthcare provider.
How to Restore a Healthy Gut, Naturally
Likely the best way to heal a leaky gut is to go back to eating and living the way our ancient ancestors did, and spend your days foraging for food in the form of roots, leaves, berries, bark and the occasional egg or wild animal you manage to take down. This is what our digestive systems were designed to thrive on, and they haven’t changed much (if at all) in the last few hundred thousand years.
But let’s be honest: None of us want to live that way, nor is it even realistically possible. Perhaps best of all, it’s not necessary.
Instead, you can overcome leaky gut by making some calculated changes to your day-to-day diet and lifestyle to minimize the worst of the risk factors that accompany modern life. Some of the key steps are easy, such as taking supportive herbal remedies; others, like nixing added sugars and being truly dedicated to reducing stressors in your life, are admittedly harder.
While you can’t eradicate all threats to your digestive function, you can minimize stress factors enough to restore a healthy gut lining. And that allows your immune system functions to normalize so that it can resume dealing with any threats that do slip through the cracks.
How long you have to stick with the program really depends on the degree of your dysfunction. If you have a chronic illness, gut restoration will likely be a major part of your overall recovery process. No matter where you are, the necessary steps are doable — and the results are well worth the effort. Here’s how to get your gut back on track:
1. Apply Herbal and Natural Therapy.
Taking herbal and natural supplements is an easy and effective way to support your gut health and accelerate your recovery*. Essentially, you’re offering your gut the beneficial plant chemicals it was designed to rely on hundreds of thousands of years ago — and that design hasn’t changed.
Herbs and other plants also carry potent antimicrobial and detoxifying compounds that help fend off pathogens and eliminate toxins. These benefits are transferred to us upon consumption — the key word being consumption: You have to take them to get the perks.
So here’s what I recommend taking for overcoming leaky gut and other gut dysfunction – all of which can be found in my holistic gut health protocol*:
Herbs with mucilage, a demulcent that acts like the mucus barrier in your gut. These can help serve as a barrier to foreign substances until you’re able to rebuild your mucosa. My favorite mucilage-containing herb is slippery elm.
Natural ingredients that help balance the gut microbiome and suppress the overgrowth of microbes in the small intestine. Berberine, a compound in foraged plants, is active in the gut and helps promote a healthy microbiome.
Chlorella. It’s a freshwater green algae with potent detoxifying powers, thanks to its rich stores of the pigment chlorophyll. Chlorophyll in chlorella binds to toxins in the GI tract and holds them there, preventing them from being absorbed into your tissue. These toxins include organic-type ones such as herbicides, pesticides, and possibly mycotoxins from molds, as well as heavy metals and plastics such as BPA and phthalates, which are being studied as possible endocrine disruptors and carcinogens.
Digestive enzymes. If your digestive system is compromised due to leaky gut or any other chronic condition, it’s likely you’re not naturally producing the digestive enzymes you need to break down food sufficiently, which means food is able to park in your gut longer and do more damage. Taking an assortment of enzymes (such as protease, amylase, alpha-galactosidase, lipase, and others) can help your body digest protein, fat, and carbs until it’s able to restore normal enzyme levels.
Bitter herbs. We have bitter receptors throughout our GI tract, and they are still programmed to respond to all those bitter things our ancient ancestors used to eat back in our food-foraging days — leaves, stems, barks, roots. Bitter flavor activates the release of saliva, enzymes, and bile to break down food. But we’ve all but eliminated bitter herbs and foods from our modern diet because, well, they don’t taste as good as sweet and salty ones.
Again, there’s no need to actually return to our foraging days. Swallowing capsules with bitter herbs activates the bitter taste receptors; look for berberine and andrographis, a plant native to India that helps support bacterial flora in the gut.
Aromatic bitters (bitter herb extracts in an alcohol base) have become a popular ingredient in craft cocktails, but you’ll get more bang for your bitter by squeezing a dropperful or two on the back of your tongue before every meal. Look for bitters that contain herbs known for helping digestion. That includes burdock, dandelion, and gentian root, as well as fennel seed and ginger.
Learn more about Dr. Rawls’ Gut Health Protocol »
2. Nourish Your Body with the Right Diet.
Follow this plan closely for at least two weeks, and beyond that, until you notice all nagging GI discomfort and other symptoms you’ve been experiencing are gone. Only then should you begin slowly adding foods back to your diet. Sugar and processed foods should always be minimized.
Step 1: Eliminate Gut-Disrupting Foods
The first and most important step is minimizing or even totally avoiding all foods that can potentially disrupt digestive dysfunction to give your gut the freedom to heal. You don’t have to swear off all these foods forever — again, how long it takes really depends on the level of your gut dysfunction.
Below is a working list of top gut offenders to avoid. It’s by no means conclusive, but it’s a great place to start. If you find yourself experiencing a surge of symptoms after eating a food you don’t see on the list, cut it out, too, and see if your symptoms subside.
Foods high in lectins, gluten, and other storage proteins, including:
- Grains, especially whole grain wheat and wheat relatives*
- Legumes, including soybeans, kidney beans, and peanuts
- Tree nuts, such as almonds, pecans, walnuts, cashews, hazelnut, Brazil, pistachios, and pine nuts
- Nightshade vegetables, including tomatoes, potatoes, eggplant, peppers, okra, and tomatillos
- Dairy from cows raised on corn and soybeans
- GMO seeds (corn, soy)
* White rice is actually very friendly to the digestive system. The lectins and storage proteins in rice don’t seem to be as damaging as other grains and are mostly broken down by steaming or boiling. Also, the carbohydrates in white rice are completely broken down and absorbed and therefore do not contribute to SIBO.
Sweeteners and high-sugar fruits and beverages, including:
- Table sugar
- Organic cane sugar
- Canned pineapple (high oxalate and sugar)
- Soft drinks
- Fruit drinks
- Beer, wine, other alcohol containing drinks
Finally, I want to reiterate that it is nearly impossible to absolutely avoid all offending foods, especially all at one time. The objective is to minimize reactive foods until healing can occur and to identify the foods causing the most problems for you.
Step 2: Rebuild Your New Gut-Friendly Diet
Once any nagging discomfort and symptoms subside, you can carefully reintroduce foods that have the potential to cause reactions but are otherwise healthful one at a time. It may take months (or longer) to reach this point, so be patient with yourself and listen to your body.
The absence of intestinal and systemic symptoms for several days indicates that a food is okay for you, and you can move on to reintroducing the next food on your list. This reintroduction phase may take several months, depending on the number of adverse reactions to food you experience.
Start by slowly adding foods that contain lectins and storage proteins one by one back to your diet. Processed and refined foods high in carbohydrates should stay on your avoid list; sugar in small doses as an occasional treat is fine.
One other thing to consider adding to your diet is prebiotics, found in fermented foods like kimchi and sauerkraut. These non-digestible carbohydrates feed the good bacteria that help keep bad ones in check. Many experts also recommend taking probiotics to help restore microbiome balance, and research suggests multi-strain ones may be beneficial for leaky gut syndrome as well.
3. Manage Your Stress Levels
I know that easing stress is easier said than done — but it’s vital for keeping digestion moving at a healthy pace (not to mention a laundry list of other health benefits). Dedicate some time every day to finding calm and putting the proverbial tiger in a cage: exercise, laugh, nap, or do whatever works for you to ease tension. I’m even happy to prescribe a half-hour of your favorite (light-hearted) Netflix show a day, if it means your brain gets the chance to unwind and focus on something besides your to-do list and other pressures from the outside world.
Keep in mind, the time frame for how quickly your leaky gut resolves depends on the degree of dysfunction and how rigorously you follow the steps outlined above. Most people will notice significant improvements in energy and symptom reduction after only a few weeks. Complete healing, however, can take months.
In the meantime, be patient with yourself and your body. Your digestive tract simply wasn’t built to tolerate the modern foods and stressors that are thrown at it each day, and the resulting damage will take some time to repair. But if you stick with the plan — minimize gut-disrupting foods, reduce stress, and embrace the right restorative therapies — a healthy gut is within your reach.
Dr. Rawls is a physician who overcame Lyme disease through natural herbal therapy. You can learn more about Lyme disease in Dr. Rawls’ new best selling book, Unlocking Lyme.
You can also learn about Dr. Rawls’ personal journey in overcoming Lyme disease and fibromyalgia in his popular blog post, My Chronic Lyme Journey.
1. Bischoff SC, Barbara G, Buurman W, et al. Intestinal permeability – a new target for disease prevention and therapy. BMC Gastroenterology. 2014; 14:189. doi: 10.1186/s12876-014-0189-7
2. Buhner S, Buning C, Genschel J, Kling K, Herrmann D, Dignass A, Kuechler I, Krueger S, Schmidt HH, Lochs H. Genetic basis for increased intestinal permeability in families with Crohn’s disease: role of CARD15 3020insC mutation? Gut. 2006 Mar;55(3):342-7. doi: 10.1136/gut.2005.065557
3. Camilleri M. Serotonin in the Gastrointestinal Tract. Current Opinion in Endocrinology, Diabetes, and Obesity. 2009 Feb; 16(1): 53–59. doi: 10.1097/MED.0b013e32831e9c8e
4. Chaiyasut C, Sivamaruthi BS, Lailerd N, Sirilun S, Khongtan S, Fukngoen P, Peerajan S, Saelee M, Chaiyasut K, Kesika P, Sittiprapaporn P. Probiotics Supplementation Improves Intestinal Permeability, Obesity Index and Metabolic Biomarkers in Elderly Thai Subjects: A Randomized Controlled Trial. Foods. 2022 Jan 19;11(3):268. doi: 10.3390/foods11030268
5. Leaky gut: What is it, and what does it mean for you? Harvard Health Publishing website. https://www.health.harvard.edu/blog/leaky-gut-what-is-it-and-what-does-it-mean-for-you-2017092212451
6. Majee SB, Biswas GR. Exploring plant lectins in diagnosis, prophylaxis, and therapy. J Med Plant Res. 2013;7(47):3444-3451. doi: 10.5897/JMPR2013.5289
7. Mu Q, Kirby J, Reilly CM, Luo XM. Leaky Gut As a Danger Signal for Autoimmune Diseases. Frontiers in Immunology. 2017; 8: 598. doi: 10.3389/fimmu.2017.00598
8. Sigthorsson G, Tibble J, Hayllar J, Menzies I, Macpherson A, Moots R, Scott D, Gumpel MJ, Bjarnason I. Intestinal permeability and inflammation in patients on NSAIDs. Gut. 1998 Oct;43(4):506-11. doi: 10.1136/gut.43.4.506
9. What is Oxalate? Low Oxalate Diet website. http://www.lowoxalate.info/