Leaky Gut Syndrome (Intestinal Permeability) Symptoms Causes and Treatment

Leaky Gut Syndrome (Increased Intestinal Permeability) has received increasing attention in recent years, particularly with the growing number of people experiencing digestive symptoms such as bloating, gas, changes in bowel habits, and abdominal pain.The term “leaky gut” generally refers to increased intestinal permeability, a condition in which the intestinal barrier—which normally helps regulate what passes from the digestive tract into the body—becomes more permeable than usual.Increased intestinal permeability may be associated with certain digestive, inflammatory, and other health conditions. However, many claims surrounding what is commonly referred to as “Leaky Gut Syndrome” go beyond what is currently supported by scientific evidence. Therefore, it is important to understand the condition accurately, recognize its possible causes and associations, and avoid assuming that any digestive symptom is definite evidence of increased intestinal permeability.In this article on Dalili Medical, we explore Leaky Gut Syndrome, its symptoms and possible causes, how intestinal permeability is evaluated, and the available approaches to managing associated conditions and supporting digestive health. We also highlight key medical information to help distinguish evidence-based facts from common misconceptions surrounding leaky gut.

What Is Meant by “Leaky Gut”?

The term “leaky gut” generally refers to increased intestinal permeability, meaning that the barrier separating the contents of the intestines from the surrounding tissues and bloodstream becomes more permeable than normal. Increased intestinal permeability is a real and well-studied biological phenomenon; however, the term “leaky gut syndrome” is sometimes used in ways that go beyond what is currently supported by scientific evidence.

Can IBS Cause Increased Intestinal Permeability?

Changes in intestinal permeability may be observed in some people with irritable bowel syndrome (IBS), but the relationship between the two is complex. Increased intestinal permeability does not necessarily mean that it is the only or direct cause of IBS, as multiple factors are involved in the development of the condition.

Can Increased Intestinal Permeability Cause Bloating and Gas?

Increased intestinal permeability cannot be considered a direct cause of bloating and gas. These symptoms are common and can result from a variety of causes, including irritable bowel syndrome, food intolerances, digestive disorders, changes in the gut microbiome, and other factors.

Can a Stool Test Detect “Leaky Gut”?

A stool test can help doctors identify certain infections, inflammation, or digestive disorders, but it is not, by itself, used to diagnose increased intestinal permeability. Therefore, evaluation depends on the symptoms, medical history, and appropriate tests recommended by a healthcare professional.

Can Probiotics Help Treat “Leaky Gut”?

Some types of probiotics may help improve certain digestive symptoms in some people. However, no single probiotic strain has been proven to generally treat “leaky gut syndrome.” The effects of probiotics vary depending on the strain, dosage, the person’s health condition, and the underlying cause of the symptoms.

Can the Gut Return to Normal?

Yes. Intestinal barrier function and intestinal permeability can improve in many cases, especially when the underlying cause is identified and treated, along with adopting a lifestyle and diet that support digestive health. However, the time required for improvement varies from person to person depending on the underlying cause and overall health, and there is no specific timeframe that applies to everyone.

Causes of Increased Intestinal Permeability (“Leaky Gut”)

Increased intestinal permeability occurs when changes develop in the function of the intestinal barrier, which consists of intestinal lining cells and the junctions that connect them. These changes may allow certain molecules and substances to pass from the intestinal lumen into the surrounding tissues to a greater extent than normal.

It is not attributed to a single cause. Instead, it may be associated with a combination of dietary, medication-related, medical, and lifestyle factors.

First: Dietary and Lifestyle Factors

Excessive consumption of certain unhealthy foods:
A diet high in highly processed foods, added sugars, and unhealthy fats may be associated with impaired gut health and increased inflammation, particularly when maintained over long periods.

Gluten:
Gluten can affect intestinal permeability in people with celiac disease, in which an immune response causes damage to the intestinal lining. However, in people who do not have celiac disease, there is insufficient evidence that gluten itself generally causes “leaky gut.”

Alcohol:
Chronic excessive alcohol consumption may be associated with disruption of the intestinal barrier and inflammation of the digestive system. Therefore, avoiding or limiting alcohol is an important part of maintaining digestive health.

Second: Medication-Related and Medical Causes

Nonsteroidal anti-inflammatory drugs (NSAIDs):
Examples include ibuprofen and aspirin. Frequent or prolonged use of some of these medications may irritate or damage the gastrointestinal lining and increase intestinal permeability in some people.

Antibiotics:
Unnecessary or repeated use of antibiotics may alter the composition of bacteria in the gut, which can affect the balance of the microbiome and digestive functions.

Proton pump inhibitors (PPIs):
These include some medications used to treat acid reflux and stomach ulcers. These medications may affect the composition of the gut microbiome in some people. However, their medically appropriate use does not necessarily mean that they cause “leaky gut,” and they should not be discontinued without consulting a doctor.

Chemotherapy and radiation therapy:
Some types of chemotherapy and radiation therapy, particularly when targeting the abdominal or pelvic region, can affect rapidly regenerating cells in the gastrointestinal lining and may cause inflammation and changes in intestinal barrier function.

Third: Infections and Changes in the Gut Microbiome

Intestinal infections:
Certain bacterial, viral, or parasitic infections may cause inflammation and temporary damage to the intestinal lining, which may affect intestinal permeability.

Imbalance in the gut microbiome:
Some changes in the composition of intestinal bacteria may be associated with alterations in intestinal barrier function. Small intestinal bacterial overgrowth (SIBO), however, is a different condition from “leaky gut.” It may occur alongside certain digestive disorders, but it should not be considered a confirmed cause of increased intestinal permeability in all cases.

Fourth: Psychological, Immune, and Inflammatory Factors

Chronic stress and psychological pressure:
Chronic stress can affect digestive function, intestinal motility, and the gut microbiome. Research suggests that it may also be associated with changes in intestinal barrier function. However, the relationship is complex, and stress alone cannot be considered a direct cause of “leaky gut.”

Inflammatory and immune-mediated intestinal diseases:
Certain conditions, such as celiac disease, Crohn’s disease, and ulcerative colitis, are associated with inflammation and changes in intestinal barrier function.

What Are the Symptoms of “Leaky Gut Syndrome”?

There is no specific set of symptoms that can reliably diagnose “leaky gut syndrome,” and increased intestinal permeability itself may not cause noticeable symptoms. However, certain digestive disorders or conditions associated with altered intestinal barrier function may occur alongside a range of symptoms, including:

First: Digestive Symptoms

Bloating and gas:
Some people may experience bloating and excessive gas. These are common symptoms that can be associated with digestive disorders, irritable bowel syndrome, food intolerances, or changes in the gut microbiome.

Abdominal pain and cramps:
Recurring abdominal pain or cramps may occur in people with digestive disorders. However, these symptoms are not specific to increased intestinal permeability and can have many causes.

Diarrhea or constipation:
Diarrhea, constipation, or alternating between the two may result from various disorders affecting intestinal motility or digestion. These symptoms alone cannot be considered evidence of “leaky gut.”

Indigestion and a feeling of fullness:
Some people may experience fullness, heaviness after eating, or indigestion. These symptoms can be associated with a variety of digestive disorders.

Second: Neurological and Psychological Symptoms

Difficulty concentrating or “brain fog”:
Some people report difficulty concentrating, forgetfulness, or mental fatigue. However, these symptoms are nonspecific and may result from insufficient sleep, stress, certain vitamin deficiencies, or other conditions. There is not enough evidence to consider them a direct result of “leaky gut.”

Anxiety and mood disorders:
There is a complex relationship between the digestive system and the brain known as the gut-brain axis. This relationship can be influenced by multiple factors, including stress, the microbiome, and nervous system function. However, it cannot be concluded that “leaky gut” is a direct cause of anxiety or depression.

Headaches or migraines:
Some people may experience headaches or migraines alongside digestive symptoms. However, this association does not provide evidence of increased intestinal permeability.

Third: Skin Symptoms

Certain skin and inflammatory conditions may occur alongside digestive problems or changes in intestinal barrier function, but the relationship is not necessarily directly causal.

Eczema and skin rashes:
Eczema and skin rashes can result from multiple factors, including allergies, immune responses, genetic factors, and environmental triggers.

Rosacea and acne:
Research has investigated the relationship between digestive health and certain skin conditions. However, current evidence does not support considering “leaky gut” a direct cause of rosacea or acne.

Psoriasis:
Psoriasis is a chronic inflammatory condition associated with immune system dysfunction. There may be a relationship between inflammatory diseases and gut health, but increased intestinal permeability cannot be considered a confirmed cause of psoriasis.

Fourth: Immune- and Allergy-Related Symptoms

Food intolerance or food allergy:
Some people experience symptoms after consuming certain foods. However, food allergies involve specific immune mechanisms, and experiencing symptoms after eating does not necessarily indicate increased intestinal permeability.

Immune and inflammatory diseases:
Certain conditions, including celiac disease, Crohn’s disease, and ulcerative colitis, are associated with changes in intestinal barrier function. However, the relationship between increased permeability and these diseases is complex, and this does not mean that “leaky gut” is the direct cause of these conditions.

Allergies and recurrent inflammation:
Immune system function can be influenced by many factors, including genetics, environmental factors, infections, and nutritional status. Therefore, allergies or recurrent inflammation cannot be attributed solely to “leaky gut.”

Fifth: Fatigue and Nutritional Deficiencies

Fatigue and exhaustion:
Fatigue is a common and nonspecific symptom. It may result from insufficient sleep, anemia, thyroid disorders, deficiencies of certain nutrients, or many other conditions.

Obesity and Non-Alcoholic Fatty Liver Disease

Some studies suggest an association between increased intestinal permeability, changes in the gut microbiome, obesity, and non-alcoholic fatty liver disease (NAFLD). The movement of certain bacterial components from the gut into the portal circulation may contribute to inflammatory responses in the liver in some people.

However, the relationship between these factors is complex, and increased intestinal permeability cannot be considered a direct or sole cause of obesity or fatty liver disease.

Allergies and Skin Conditions

There may be a relationship between intestinal barrier health and certain inflammatory and immune-mediated conditions, including eczema and psoriasis. Research suggests that changes in the gut microbiome and intestinal barrier function may be associated with some of these conditions. However, the evidence does not support the idea that the body eliminates “toxins” through the skin because the intestines are unable to remove them.

Asthma and Seasonal Allergies

Research is investigating the relationship between the gut microbiome, intestinal barrier function, and the immune system and certain allergic conditions, including asthma and allergic rhinitis. However, increased intestinal permeability cannot be considered the direct cause of asthma or seasonal allergies, as multiple genetic, environmental, and immune factors contribute to these conditions.

How Is “Leaky Gut Syndrome” Diagnosed?

Diagnosing what is commonly referred to as “leaky gut syndrome” can be challenging because it is not considered a standardized, independent medical diagnosis. Instead, the term is generally used to describe increased intestinal permeability, a phenomenon that may be associated with certain digestive, inflammatory, and other medical conditions.

Therefore, doctors generally do not rely on a single test to diagnose “leaky gut.” Instead, they begin by evaluating the patient’s symptoms and medical history and then order appropriate tests to investigate possible underlying causes and rule out conditions that may cause similar symptoms.

First: Intestinal Permeability Tests

Lactulose–Mannitol Test:
This is one of the tests used in research to evaluate intestinal permeability. The person consumes a solution containing lactulose and mannitol, and the amounts of these substances excreted in the urine are then measured. The test can provide information about intestinal permeability; however, its use in routine clinical practice varies, and it is not considered a general diagnostic test for “leaky gut syndrome.”

Zonulin Tests:
Zonulin is a protein involved in regulating the junctions between intestinal lining cells. Its levels have been studied as a potential marker of changes in intestinal permeability. However, commercially available zonulin tests in blood or stool are currently not considered sufficiently reliable as stand-alone diagnostic tests for determining whether someone has “leaky gut.”

Second: Tests to Identify Conditions Associated With the Symptoms

Celiac Disease Testing:
When celiac disease is suspected, a doctor may order appropriate blood tests, particularly IgA tissue transglutaminase antibodies (tTG-IgA), along with an assessment of total IgA when necessary. Other tests may also be used depending on the individual case.

Blood Tests:
A doctor may order a complete blood count, iron studies, vitamin B12, folate, and other tests when anemia, nutritional deficiencies, or malabsorption is suspected.

Stool Tests:
Certain stool tests can be used to detect infections, inflammation, bleeding, or some digestive disorders. One example is fecal calprotectin, which can help assess whether there is intestinal inflammation, but it does not diagnose “leaky gut.”

Third: Testing for Small Intestinal Bacterial Overgrowth (SIBO)

A hydrogen and methane breath test may be used when small intestinal bacterial overgrowth (SIBO) is suspected. The test measures gases produced after consuming a specific substance and may help evaluate certain cases of bloating, gas, and bowel habit disturbances.

It is important to distinguish between SIBO and increased intestinal permeability. They are different conditions, and having one does not necessarily mean that the other is present.

Fourth: Clinical Evaluation and Medical History

Evaluation usually begins with a comprehensive review of the patient’s symptoms, including their duration and factors that worsen or relieve them, as well as the patient’s medical, dietary, and medication history.

The doctor may also ask about the use of certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and antibiotics, as well as any history of digestive or immune-related diseases.

Fifth: Ruling Out Organic Diseases

Because symptoms such as bloating, diarrhea, constipation, and abdominal pain can occur with many different conditions, the doctor may order additional tests depending on the symptoms. These may include blood tests, imaging studies, or upper gastrointestinal endoscopy and colonoscopy when clinically indicated.

These tests are intended to identify or rule out conditions such as celiac disease, Crohn’s disease, ulcerative colitis, intestinal infections, and certain malabsorption disorders, among others.

Is There a Single Definitive Test for “Leaky Gut”?

There is currently no single validated test that can definitively diagnose “leaky gut syndrome.” Some commercial tests marketed for diagnosing leaky gut or “poor gut health” also do not have sufficient accuracy or clinical validation to diagnose the condition on their own.

Therefore, the most appropriate approach is to evaluate the symptoms, identify the underlying cause, and perform appropriate tests based on the individual’s condition, rather than relying on a single test or self-diagnosis.

Medical Treatment for “Leaky Gut Syndrome”

There is currently no specific approved medication for treating “leaky gut syndrome” as an independent disease. Treatment primarily focuses on identifying and managing the underlying cause of increased intestinal permeability, while addressing associated symptoms when necessary.

First: Treating the Underlying Cause

If increased intestinal permeability is associated with a specific disease or disorder, the doctor focuses on treating the underlying condition.

Antibiotics:
Certain antibiotics, such as rifaximin, may be used in specific situations, including some cases of small intestinal bacterial overgrowth or certain digestive disorders, as determined by a doctor. Rifaximin is not used simply because someone has “leaky gut,” and unnecessary antibiotic use may cause side effects and alter the gut microbiome.

Antiparasitic or Antifungal Medications:
These medications are not routinely used to treat “leaky gut.” The appropriate medication is prescribed only when a confirmed parasitic or fungal infection is present and requires treatment.

Anti-inflammatory and Immunomodulatory Medications:
If increased intestinal permeability is associated with an inflammatory or immune-mediated disease, such as Crohn’s disease or ulcerative colitis, a doctor may prescribe medications specifically intended to treat the underlying disease. These may include corticosteroids for limited periods, immunomodulatory medications, or biologic therapies, depending on the severity and location of the disease.

Second: Nutritional Supplements

Certain nutrients and supplements are being studied for their potential role in supporting intestinal lining health. However, the evidence for using them to treat “leaky gut” is not strong enough to recommend them routinely for all patients.

L-Glutamine:
Glutamine is an important energy source for intestinal lining cells. Some studies have shown promising effects on intestinal barrier function, but clinical evidence remains insufficient to consider it a standard treatment for increased intestinal permeability.

Zinc Carnosine:
This compound has been studied for its potential role in supporting and protecting the gastrointestinal mucosa. However, its use specifically for treating “leaky gut” requires further evidence.

Digestive Enzymes:
Digestive enzymes may be used in certain situations where there is an established enzyme deficiency or insufficiency. However, they are not a proven treatment for increased intestinal permeability and are not routinely necessary for healthy individuals.

Third: Probiotics and Prebiotics

Certain probiotics may help improve specific digestive symptoms in some people, and their effects vary depending on the strain and the individual’s health condition. However, no single probiotic has been proven to generally treat “leaky gut syndrome.”

Prebiotics, which are fibers and compounds that help support the growth of certain beneficial gut bacteria, may contribute to a healthy gut microbiome. However, increasing their intake too quickly may cause bloating and gas in some people.

IV. Medications Used to Relieve Symptoms

Your doctor may prescribe certain medications to manage associated symptoms, depending on the underlying cause and the nature of the symptoms.

• Antispasmodics: Certain antispasmodics, such as mebeverine, may be used to relieve abdominal cramps and pain in some patients, especially when functional bowel disorders are present.

• Treatment for Constipation or Diarrhea: If a patient suffers from constipation or diarrhea, the doctor can choose the appropriate treatment based on the cause and health status, rather than treating these symptoms as proof of "leaky gut" in themselves.

• Magnesium: Certain magnesium salts may be used in specific cases of constipation or when a documented deficiency exists. However, there is insufficient evidence that magnesium directly treats "leaky gut" or restores the intestinal barrier to normal.

What is the Most Important Treatment?

The most critical factor is not treating "leaky gut" in isolation from the underlying cause. If the cause is celiac disease, treating celiac disease is fundamental. If there is inflammatory bowel disease, it must be treated. If the issue is linked to a medication, infection, or a specific digestive disorder, the cause is handled according to a physician's evaluation.

Additionally, following a balanced diet, getting enough fiber based on personal tolerance, getting good sleep, engaging in physical activity, and avoiding smoking and excessive alcohol consumption are all factors that generally help support digestive health.

It is not recommended to use antibiotics, antifungals, or dietary supplements with the aim of treating "leaky gut" without a clear diagnosis and medical supervision.

Treatment of Leaky Gut Syndrome via Surgery and Procedures

There is no specific surgery designed to treat "leaky gut syndrome" or increased intestinal permeability by itself, as this condition is not an independent surgical disease that can be treated by stitching or patching the intestinal wall. Furthermore, increased permeability occurs at a microscopic level in the intestinal barrier, not as a hole or tear that can be surgically repaired.

Therefore, if a patient requires surgical intervention, the goal is to treat the disease or complications that led to intestinal damage, rather than directly treating increased permeability.

When Might Surgery Be Necessary?

A patient may need surgery when severe complications or organic diseases do not respond to medical treatment. Prominent conditions include:

• Crohn’s Disease: Advanced cases of Crohn's disease may necessitate surgical intervention when severe strictures, intestinal obstruction, fistulas, abscesses, perforations, or severe damage to a segment of the intestine occur and fail to respond to appropriate medical therapy.

• Severe Ulcerative Colitis: Surgery may be performed in severe cases that do not respond to medical treatment or when dangerous complications occur, such as severe bleeding, toxic megacolon, or a perforated colon.

• Diverticulitis and its Complications: Complex cases of diverticulitis may require surgical intervention, especially upon the occurrence of an intestinal perforation, a large abscess, or severe abdominal inflammation.

• Intestinal Obstruction or Perforation: Surgery may be necessary in certain cases of bowel obstruction or perforation, depending on the cause and severity of the condition.

Types of Surgical Procedures Used

The choice of surgical procedure depends on the cause of the problem, the location of the lesion, the extent of intestinal damage, and the patient's general health status.

1. Laparoscopic Surgery: Laparoscopy is considered a minimally invasive surgical approach that can be used for many appropriate bowel operations.

   • How it is performed: The surgeon makes several small incisions in the abdominal wall, then inserts a camera and specialized micro-instruments to access the intestines and perform the operation.

   • The goal: It can be used to resect the diseased segment of the intestine or manage certain complications, depending on the nature of the disease. Laparoscopy does not mean it treats the increased intestinal permeability itself; rather, it treats the organic problem that necessitated the surgical intervention.

2. Open Abdominal Surgery (Laparotomy): In some cases, a surgeon may need to perform an open procedure through a larger incision in the abdominal wall for direct access to the intestines and abdominal organs. This method may be used in emergency or complex situations, such as a large intestinal perforation, severe intra-abdominal inflammation, complex adhesions, or when laparoscopy is unsuitable or unsafe.

3. Resection and Anastomosis (Removal of the Diseased Intestinal Segment and Connection of Healthy Ends): The surgeon removes the diseased or damaged part of the intestine, then connects the two healthy ends together to restore the continuity of the digestive tract. Connection may be performed using surgical sutures or surgical staplers, according to the location of the procedure, tissue condition, and the surgeon's judgment.

4. Stoma / Ostomy (Bowel Diversion): In some cases, it may not be safe to directly connect the two ends of the intestine immediately after removing the diseased portion, particularly in the presence of severe inflammation, intra-abdominal contamination, or poor tissue healing. In this instance, the surgeon brings out one end of the intestine through an opening in the abdominal wall known as a stoma, collecting waste in a special pouch outside the body. The stoma may be temporary until the intestines heal and re-connection becomes safe, or it may be permanent in some cases, depending on the nature of the disease and the extent of the damage.

Does Surgery Treat Leaky Gut?

No, surgery is not a direct treatment for increased intestinal permeability. It is utilized when an underlying disease or complication requires surgical repair, such as an obstruction, perforation, abscess, or severe intestinal damage. Addressing increased intestinal permeability primarily relies on identifying and treating the underlying cause, alongside symptom management and supporting digestive health according to medical evaluation.

When Do Bowel Symptoms Call for Urgent Intervention?

Immediate medical evaluation must be sought when severe symptoms appear, such as sudden or severe abdominal pain, severe bloating accompanied by an absence of gas or stool passage, frequent vomiting, obvious bleeding, a high fever, or a rapid deterioration in general health. These symptoms may point to complications requiring prompt intervention.

Prevention Tips for Increased Intestinal Permpetuity (Leaky Gut)

No single method guarantees the prevention of increased intestinal permeability in all cases. However, digestive health and barrier function can be supported by adopting a healthy lifestyle and a balanced diet, alongside treating diseases that may affect the intestines and avoiding the unnecessary use of certain medications.

First: Improving Diet

• Focus on whole foods rich in fiber: It is preferable to consume a diverse range of vegetables, fruits, legumes, and whole grains, according to individual tolerance. Dietary fiber helps support the gut microbiome, and certain beneficial bacteria produce compounds like short-chain fatty acids that contribute to gut lining health.

• Limit added sugars and highly processed foods: Reducing sugary drinks, sweets, and ultra-processed foods improves overall diet quality and may support digestive and metabolic health.

• Avoid foods that cause confirmed symptoms or allergies: If an individual suffers from a food allergy or specific food intolerance, it is best to avoid that food after an appropriate medical evaluation. It is not recommended to eliminate entire food groups, such as gluten or dairy, without a clear medical reason.

• Consume fermented foods if tolerated: Fermented foods like yogurt, kefir, and certain fermented vegetables can be part of a diverse diet and may supply beneficial microorganisms. However, these foods may not suit everyone, particularly those with certain digestive disorders.

Second: Rational Medication Use

• Avoid overuse of Nonsteroidal Anti-inflammatory Drugs (NSAIDs): Frequent use of medications like ibuprofen and aspirin can irritate or damage the gastrointestinal lining in some individuals. It is best to use them according to the dose and duration prescribed by a doctor, especially with frequent use.

• Do not use antibiotics without a prescription: Antibiotics are effective for treating certain bacterial infections, but they do not help viral infections, and their unnecessary use can disrupt the balance of the gut microbiome. They should only be used when there is a clear medical need. There is no general recommendation to routinely take probiotics with every course of antibiotics, as benefits vary depending on the antibiotic type, health status, and strain used.

Third: Focusing on Lifestyle

• Manage stress and psychological pressure: Chronic stress can negatively impact digestive functions and the gut-brain axis. Regular physical activity, deep breathing, relaxation, and meditation practices can help improve stress-coping abilities.

• Get sufficient, regular sleep: Quality sleep supports general health and regulates numerous vital functions, including immune and metabolic functions. Most adults need around 7–9 hours of sleep per night.

• Maintain good hydration: Consuming adequate fluids supports bodily functions and digestive motility. Water requirements vary from person to person based on weather, physical activity, health status, and diet.

• Engage in physical activity: Regular physical activity supports overall health, digestive function, and metabolism, making it an essential component of a healthy lifestyle.

Dietary Approach for Gut Health

No single standardized diet is proven to treat "leaky gut syndrome" for everyone. It is best to focus on a diverse, balanced diet that supports digestive health while respecting individual food tolerances.

Foods to Increase

• Vegetables and fruits: Such as spinach, broccoli, carrots, zucchini, leafy greens, and various fruits, selecting quantities and types that suit the digestive system.

• Whole grains and legumes: Such as oatmeal, brown rice, quinoa, lentils, and beans, if well-tolerated.

• Healthy protein sources: Such as fish, poultry, eggs, legumes, and relatively lean meats, while diversifying protein sources.

• Healthy fats: Such as olive oil, nuts, seeds, avocados, and omega-3 rich fish.

• Probiotic-containing foods: Such as yogurt, kefir, and select fermented foods, if suitable and symptom-free.

• Dietary fiber: Obtain adequate fiber from vegetables, fruits, whole grains, and legumes, increasing it gradually if current intake is low to prevent excessive gas and bloating.

Foods to Limit

• Ultra-processed foods: Such as fast food, processed meats, and ready-made meals containing large amounts of salt, sugar, or fats.

• Added sugars: Such as sweetened sodas, sweets, and high-sugar drinks; best consumed in moderation.

• Trans fats and unhealthy fats: Especially those found in fried and processed foods, favoring unsaturated fats like olive oil, nuts, and fish.

• Alcohol: Excessive alcohol consumption can negatively affect the digestive system and intestinal barrier function; it is best avoided or limited based on health status.

Should Gluten Be Eliminated? Not necessarily. There is no general recommendation to avoid gluten for individuals who do not have celiac disease or another condition requiring its omission. Those diagnosed with celiac disease must follow a gluten-free diet under proper medical and nutritional supervision.

Should Dairy Products Be Avoided? Most people do not need to avoid dairy products simply out of fear of a "leaky gut." They can be consumed if well-tolerated without causing symptoms. In cases of lactose intolerance or milk allergy, appropriate alternatives should be selected following an evaluation of the condition.

Does Bone Broth Treat Leaky Gut? Bone broth can be part of a diet, but it is not a proven treatment for increased intestinal permeability, nor is there sufficient evidence making it a necessary cure to repair the intestinal barrier.