Leaky Gut Syndrome

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Leaky gut syndrome refers to a clustering of symptoms such as bloating, gas, cramps, various food sensitivities, and nonspecific aches and pains. It is not a specific medical diagnosis, but rather an indication that an intestinal disorder is present and needs to be diagnosed. One aspect of leaky gut syndrome that makes it difficult to study is the fact that its symptoms overlap with those of a variety of other conditions.

Although researchers do not know what causes leaky gut syndrome, one theory suggests that the lining of the small intestine may be defective, thereby allowing substances to leak into the bloodstream. This type of intestinal dysfunction (often referred to as intestinal permeability) is common among individuals who have celiac disease and Chrohn’s disease.

Unfortunately, there is a lack of research and evidence regarding the causes of leaky gut syndrome, as well as how best to treat it. However, for individuals who have known, underlying conditions, such as Chrohn’s disease or celiac disease, treating the underlying condition may help to resolve the symptoms associated with leaky guy syndrome. For those who have no known associated conditions, there is little evidence to support any particular type of treatment. Nevertheless, many experts agree that dietary counseling from a gastroenterologist who is trained in nutrition can be beneficial, and effective stress management can also be helpful. Some popular therapies for treating leaky gut include glutamine supplementation, but there is a lack of scientific evidence to support its use, although research is gaining momentum (Rapin & Wiernsperger, 2010).

Research

There is a lack of research in general pertaining to leaky gut syndrome, and no studies have been conducted that specifically examine an association between leaky gut syndrome and fibromyalgia. However, leaky gut syndrome has been investigated in several narrowly-focused studies of conditions that are commonly associated with fibromyalgia, including depression, irritable bowel syndrome, and chronic fatigue syndrome.

A recent study by Maes et al. was conducted to further examine the researchers’ previous observations that depressed individuals have increased immune responses to naturally-occurring bacteria in the gut. The 2012 study measured blood levels of various immune cells that were directed at various intestinal bacteria in 112 depressed patients and 28 non-depressed control subjects. In addition, the researchers also measured the fatigue and systemic symptoms commonly associated with depression. After data analysis, the researchers found that depressed individuals had significantly higher levels of immune system activation against gut bacteria when compared to controls. As a result, the researchers suggest that bacterial translocation (meaning, bacteria that leak from the intestines) may play a role in the development of depression. (Maes et al., 2012).

Slightly earlier research by Maes & Leunis (2008) investigated the causal relationship between leaky gut syndrome and chronic fatigue syndrome. These authors studied patients with chronic fatigue syndrome who were treated over a 10-14 month period with various anti-inflammatory and anti-oxidant supplements, as well as dietary modifications. Similar to the depression study described above, the researchers measured immune system activation in each patient prior to and after the treatment period. The study found that as many as two dozen patients experienced significant clinical improvement in their leaky gut and chronic fatigue syndrome symptoms following this particular course of treatment, and the authors concluded that this particular regimen is a useful treatment for chronic fatigue patients who also suffer from leaky gut syndrome (Maes & Leunis, 2008). Previous research by Maes and colleagues has also resulted in similar findings (Maes et al., 2007).

Leaky gut syndrome has also been studied in patients with other conditions that are frequently co-morbid with fibromyalgia, including irritable bowel syndrome and ulcerative colitis (Gecse et al., 2012), as well as in heart disease (Krack et al., 2005) and certain pediatric illnesses (Liu et al., 2005).

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References

1.        McMillan M. Leaky gut syndrome. What is it?  Reviewed on July 8, 2011; Accessed June 12, 2012.

2.        Maes M, Kubera M, Leunis JC, Berk M. Increased IgA and IgM responses against gut commensals in chronic depression: Further evidence for increased bacterial translocation or leaky gut. J Affect Disord. 2012 Mar 11.

3.        Gecse K, Róka R, Séra T, Rosztóczy A, Annaházi A, Izbéki F, Nagy F, Molnár T, Szepes Z, Pávics L, Bueno L, Wittmann T. Leaky gut in patients with diarrhea-predominant irritable bowel syndrome and inactive ulcerative colitis. Digestion. 2012;85(1):40-46.

4.        Rapin JR, Wiernsperger N. Possible links between intestinal permeability and food processing: A potential therapeutic niche for glutamine. Clinics (Sao Paulo). 2010 Jun;65(6):635-643.

5.        Maes M, Coucke F, Leunis JC. Normalization of the increased translocation of endotoxin from gram negative enterobacteria (leaky gut) is accompanied by a remission of chronic fatigue syndrome. Neuro Endocrinol Lett. 2007;28(6):739-744.

6.        Krack A, Sharma R, Figulla HR, Anker SD. The importance of the gastrointestinal system in the pathogenesis of heart failure. Eur Heart J. 2005;26(22):2368-2374. Review.

Liu Z, Li N, Neu J. Tight junctions, leaky intestines, and pediatric diseases. Acta Paediatr. 2005;94(4):386-393.

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