Your gut does much more than digest food. Its lining helps absorb nutrients while forming a barrier between the contents of your bowel and the rest of your body. When that barrier becomes more permeable than usual, researchers call it increased intestinal permeability. You may have heard it called “leaky gut”.
It is a real area of research, but “leaky gut” is a broad description, not a diagnosis that explains every digestive symptom. If you are struggling with bloating, pain, changes in your bowel habits or food reactions, the useful question is: what is happening in your gut, and what support do you need?
What does “leaky gut” mean?
Imagine your gut lining as a fine sieve. It lets nutrients from your food pass through into your body, while helping to keep things like germs on the other side. If that sieve becomes less selective, substances that would usually be kept back may get through and come into contact with your immune system. This is called increased intestinal permeability.
It does not mean that bits of food are falling through holes in your gut. And while it may play a part in some food reactions, it is not the cause of every food intolerance.
What can affect the gut barrier?
Your gut lining is constantly renewing itself. Its health can be affected by illness, inflammation, diet, medicines, trauma and many other factors. Increased permeability has been studied in conditions including coeliac disease and inflammatory bowel disease. Researchers are still working out when a change in permeability contributes to symptoms and when it is a consequence of an underlying condition.
This is why I prefer to look at the whole person. We can explore your symptoms, food patterns, bowel habits, sleep, stress, medicines and medical history rather than assuming that one explanation fits everyone.
What might you notice?
People who are concerned about their gut often describe:
- Bloating or excess wind
- Abdominal discomfort
- Constipation, diarrhoea or a mixture of both
- Feeling that many foods do not agree with them
- Changes in appetite or energy
These symptoms deserve attention, but they cannot tell us on their own whether the gut barrier is more permeable. They can occur for many reasons, some of which need specific assessment or treatment.
What are researchers saying?
Researchers have studied how the cells of the intestinal lining maintain the gut barrier, how permeability can be measured, and what those measurements may mean in practice. Their work has brought careful attention to a subject that is often oversimplified online.
One important point is that a test result must be interpreted carefully. Some commercial tests marketed as “leaky gut tests”, particularly certain zonulin tests, have problems with what they actually measure. I would not want anyone to spend money on a panel and feel that it has given them a definite diagnosis when it has not.
How do functional medicine practitioners approach it?
Some functional medicine practitioners approach gut health by looking at possible triggers, digestion, nutrition, the gut microbiome, and rest and recovery. These ideas can help organise a personal plan, although there is no single protocol that suits everyone.
Here is how I would turn those ideas into practical starting points.
1. Find out what needs attention
Keep a simple record of your meals, symptoms and bowel movements. Note when symptoms began and whether they followed an illness, a change in medicine, a stressful period or a change in eating habits.
Persistent symptoms may need assessment for a condition such as coeliac disease, inflammatory bowel disease or another digestive problem. If coeliac disease is a possibility, speak to your doctor about testing before removing gluten, as changing your diet first can affect the result.
2. Eat enough, and build variety where you can
Regular, satisfying meals give your body the nutrients it needs. Depending on what you tolerate, include a variety of vegetables, fruit, protein foods, wholegrains, nuts, seeds and healthy fats.
Fibre supports the gut microbiome, but a sudden large increase can make bloating worse. Start with what feels manageable and adjust gradually. If your diet has become very restricted because you are frightened of symptoms, you deserve help to make eating feel easier again.
There is no single “leaky gut diet”. You do not need to remove a long list of foods automatically. Social media does not know everything about you. A short, carefully planned food trial may sometimes be useful when there is a clear reason for it, followed by a thoughtful reintroduction.
3. Review what may be irritating your gut
Alcohol and some medicines can affect the digestive tract. If you regularly take anti inflammatory painkillers or have concerns about a prescribed medicine, discuss them with the clinician who advises you. Do not stop prescribed treatment on your own.
Stress and poor sleep can really affect how the gut feels and functions. A calm meal, time to chew, regular sleep and space to respond to the urge to open your bowels are worthwhile parts of a digestive health plan.
4. Be selective with supplements
Functional medicine plans often mention probiotics, prebiotics, glutamine, zinc and herbs. Some of these are being studied, but none is a universal solution.
For example, a trial found that glutamine helped a specific group of people with diarrhoea predominant irritable bowel syndrome after an infection and measured increased permeability. That does not mean everybody with digestive symptoms needs glutamine. Research on probiotics also varies by product, person and condition.
If you are considering supplements, it makes sense to check your medicines, medical history and the exact product first. Add one meaningful change at a time so you can tell whether it actually helps you.
When should you seek medical advice?
Please arrange an assessment if you have persistent or worsening symptoms, unexplained weight loss, blood in your stool, ongoing diarrhoea, significant abdominal pain, or a family history that raises concern. These symptoms should not simply be put down to “leaky gut”.
My approach
I believe digestive support should be personal. Two people may have the same bloating but need very different plans. We can start by listening to your story, looking at what you eat and how you feel, and deciding which changes are realistic for your life.
This guide is for general education. It cannot diagnose a condition or replace individual medical advice.
Would you like a plan tailored to you?
If you would like to work on your digestive health with me, please reach out. I offer a comprehensive, individualised programme tailored to your body, symptoms, needs and goals. Together, we can look at food, lifestyle, supplements and herbs, and consider whether any further testing or medical referral would be appropriate for you.
To ask about a consultation, email me at lisa@evolvefemalewellness.com.
Lisa Cahill
Evolve Female Wellness