7 questions to ask to help you heal your leaky gut

Leaky gut is one of the biggest drivers of poor health I see in my patients. Whether you are experiencing gut specific issues, or you are struggling with a foggy brain, hormonal imbalances, food sensitivities or anxiety, you need to consider the health of your gut as part of what’s driving these issues. Leaky gut can affect anyone!

Unfortunately, leaky gut is still one of the most misunderstood and overlooked health issues.

To help you understand a bit more about leaky gut, I am answering seven questions you need to ask yourself to help make your gut healing journey easier.

1.What is an unhealthy gut?

People frequently use the term unhealthy to describe their gut when they believe something is 'wrong' or 'not working properly'. I get it. It's hard to understand what is going on inside, let alone describe it accurately. Also, there are multiple things happening that are contributing to your symptoms and words like 'unhealthy' or 'bad' are just easier to say.

So when these terms are said, perhaps one or more of the following could be happening:

Leaky gut which is the name given to an increased intestinal permeability (1).
Immune dysfunction such as allergies, intolerances, autoimmunity and inflammation) (2)
By-products created by bacteria. Are there beneficial short chain fatty acids being produced or harmful byproducts?
Dysbiosis, which is characterized by having a reduction in microbial diversity and an increase in pro-inflammatory and/or pathogenic species. (3)
Structural and mechanical issues like slow stomach emptying or 'weak' sphincters (4)
Insufficient acid, bile or enzymes required for food breakdown (5).

2. What are the symptoms of a leaky gut?

Due to the gut-everything connection, you may find that the symptoms of a gut in need of healing extends beyond obvious gut symptoms. With this in mind here are gut specific and whole body symptoms which may indicate there is a gut in need of some support and healing.

Gut specific symptoms:
Food intolerances and allergies (6)
Constipation, diarrhea or alternating bowel motions
Excessive bloating (7)
Abdominal pain, indigestion and discomfort
Excessive burping or flatulence (8)
Blood, mucus or undigested food in stools (9, 10)
Reflux (11)

Whole body symptoms and conditions* that may indicate the gut is involved include:

Mental health concerns such as anxiety and depression (12)
Autism and spectrum conditions (13)
Any autoimmune condition including Graves disease and Hashimoto's (14, 15)
Low immunity, recurrent and/or chronic infections (16)
Allergies and hay fever (17)
Skin concerns such as eczema, rosacea and acne (18, 19, 20)
Respiratory conditions such as asthma (21)
Headaches and migraines (22, 23)
Nutritional deficiencies such as iron and B12 (these can also cause other symptoms like low energy) (24)
Inflammatory joint pain (25)

*None of these things are cause and effect as health is a product of many things (diet, genetics, stress, chemical exposure etc). This is merely suggesting there may be a gut component involved.

3. What causes an 'unhealthy' or leaky gut?

There are many causes of an 'unhealthy' or leaky gut, and each of us will have different drivers. Some may be easier to identify than others and how they may have influenced your health. Here is what some of the evidence has linked to unfavourable changes to your gut and its microbiome.

Diets that are low fibre (26) , gluten containing (for some people) (27), high saturated fat, contain sulfates, high protein, especially animal and/or high refined sugar and carbohydrates (28).
Eating foods contaminated with Roundup - essentially this mean most non-organic foods (29)
Eating foods you are allergic, intolerant or have autoimmunity to. This can be any food, but commonly thought of is gluten, dairy and fructose (30, 31, 32)
Alcohol (33)
Stress (28)
Medications such as PPIs and antipsychotic medications (34)
Antibiotics (28)
Infections, including H. pylori, SIBO and gastroenteritis infections (food poisoning and travelers diarrhea) (35)

4. What foods can help heal your leaky gut?

As you can see by now, food is only one part of the picture. Whilst it is important to have a diet that is supportive of your goals, this is still very individual and can be quite tricky to navigate on your own.
The following list is a very general and evidence based list. This does not take into account conditions like Small Intestinal Bacterial Overgrowth (SIBO) or Irritable Bowel Syndrome (IBS) and any individual complexities and circumstances.

Avoiding foods you have a known allergy, autoimmune response or intolerance to
Avoid known dietary drivers of gut dysbiosis including refined sugar and carbohydrate, animal protein, sulphates and alcohol.
Consuming high fibre 40g or more per day can increase microbiota richness and stability (36). If fibre causes bloating, check out the free quiz ‘what’s causing your bloating?’
Prebiotic and high FODMAP foods that contain fructooligosaccharides (FOS) and inulin, and galactooligosaccharides can beneficially modulate gut bacteria, assist with many gut conditions, are anti-inflammatory (37)
Polyphenols can enhance the growth of beneficial bacteria and inhibiting the growth of pathogens, thus exert prebiotic-like effects (38)
Fermented foods can provide sources of lactic acid bacteria which can improve the health of your intestinal tract health, enhance the immune system, synthesizing and enhancing the bioavailability of nutrients and reduc prevalence of allergy in susceptible individuals (39) (Not advised for anyone with histamine issues).
A long term diet that is highly diverse can help support microbiome diversity. Aim for 40+ different plant-based foods per week (40)

There are many other foods that have the potential or theoretically assist general gut health. One example is bone broth which I often encourage people to enjoy (not helpful in histamine issues) and a part of a healthy diet.

5. Can you test for a leaky and ‘unhealthy’ gut?

Yes, absolutely!

Aside from the medical procedures of a colonoscopy or endoscopy that would identify structural damage and significant inflammation. There are lots of functional tests that trained practitioners can use to assess the health of your gut. These include:

Urine tests that can test for leaky gut
Stool tests which can test for bacterial, fungal, parasites, inflammatory and immune markers, enzymes and bacterial byproducts. Not all stool tests are the same - make sure you choose the right one for your health needs.
Breath tests which can assess for SIBO, Helicobacter pylori and other food intolerances such as fructose
Blood tests to assess for Coeliac genes and other generalised inflammatory markers.

6. Can stress, anxiety and depression affect your gut?

There are so many studies confirming that the mind can affect the health of your gut. Studies have linked stress with dysbiosis, reflux, indigestion, Inflammatory Bowel Disease, IBS and leaky gut (41, 42, 43, 44, 45).
Supporting your mental health is incredibly important in the gut healing process, perhaps just as important as any food or probiotic you take.

7. Can you heal your leaky gut on your own?

The body has the power and ability to heal and with that said, yes you can heal your gut on your own. However, healing on your own may not be the most efficient or effective solution for everyone. I'm sure you can see that there is a lot more to healing your gut than taking bone broth and glutamine.

If you can relate to any of the following, perhaps it's time you joined my Bloated to Body Confident course where I share all of my gut expert advice.

You haven't identified or find it difficult to identify your causes or drivers for an unhealthy gut
There is a long history of health issues, (it's of a chronic nature)
Your health is complex, as in there isn't just one issue playing out for example there is hormonal, mental health, immune or low energy happening as well
You experience food intolerances and allergies. Intolerances and certain immune responses to food can often be addressed with the potential of consuming them without pain or bloating etc.
You take medications. For your safety, these need to be monitored as your health changes and contraindications for foods, nutrients and herbs must be assessed.
You are managing your health, but it requires restriction and there are limitations to your day for you to feel normal (there is no leeway).