Leaky gut syndrome - a problem when things go wrong

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What is it?

Leaky gut means that substances which should be held in the gut leak out through the gut wall – this causes many problems! Hydrogen ions (ie acid) cannot be concentrated in the stomach (hypochlorrhydria). This causes malabsorption of minerals and vitamin B12. Hypochlorrhydria is a major risk factor for fermenting gut since acid helps to sterilise the upper gut. It also is an essential part of protein digestion. Leaky gut causes allergy.

Normally one expects foods to be completely broken down into amino acids (from protein) essential fatty acids and glycerol (from fats) and single sugars or monosaccharides (from carbohydrates). The undigested foods stay in the gut and the small digested molecules pass through the gut wall into the portal blood stream and on to the liver where they are dealt with.

However leaky gut means food particles get absorbed before they have been properly digested. This means large food molecules get into the blood stream. These large molecules are "interesting" to the immune system who may mistake them for viruses and/or bacteria. In this event it may attack these harmless molecules either with antibodies or directly with immune cells. This causes inflammation. Inflammation in the gut causes diseases of the gut. Inflammation elsewhere can cause almost any symptom you care to mention. It may switch on allergy and/or auto-immunity, i.e. it is potentially a disease amplifying process.

Another problem with small digested molecules or polypeptides getting in to the bloodstream is that these molecules may be biologically active. Some of them act as hormone mimics which can effect levels of glucose in the blood or blood pressure. This is akin to throwing a handful of sand into a finely tuned machine - it makes a real mess of homeostatic mechanisms of controlling body activities.


To diagnose leaky gut, we look at levels of Short chain polypeptides. This test now replaces a PEG test.

Causes of leaky gut

A positive short chain polypeptide profile is often very useful to explain inexplicable symptoms particularly with respect to blood sugar control or blood pressure. It clearly shows that there is gut pathology. This makes it a useful screening test to show that there is something wrong with the gut but because it doesn't narrow down the diagnosis very much I don't often request this test.

Causes of leaky gut include:

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