Healing Leaky Gut Syndrome

Written by Institute for Natural Medicine Staff

Medically Reviewed by Sarah Hung, ND, MSOM, LAc

Published January 20, 2026
Last Updated February 5, 2026

A healthy intestinal lining is like a sturdy hose, transporting food and nutrients through the digestive tract. If this funnel starts to crack, allowing undigested food particles, bacteria, and other toxins to seep into the bloodstream, it may lead to a compromised intestinal barrier, known as leaky gut syndrome.¹^,²

Leaky gut is associated with a host of inflammatory conditions, including gastrointestinal disorders like celiac disease and ulcerative colitis,² autoimmune diseases, obesity, and heart disease.

Leaky gut symptoms & risk factors

A healthy digestive lining has tight junctions that prevent proteins from leaking into the bloodstream before they break down into amino acids. When the immune system detects these proteins, it mounts an inflammatory attack.

“The immune system does not like to see proteins in the blood,” says Mark Davis, ND, a doctor at Foundational Medicine who specializes in treating inflammatory bowel disease (IBD). “If food proteins enter the bloodstream, it may create an inflammatory response to certain foods. If bacterial proteins enter the bloodstream, the immune system might start attacking healthy gut bacteria, which can cause dysbiosis. Sometimes, the inflammatory response is general and just keeps certain tissues swollen or painful when they don’t really need to be. [This causes] other chronic and acute health concerns, which is how leaky gut can contribute to a variety of systemic health issues.”

Leaky gut symptoms range widely and may overlap with other conditions. Food intolerance or sensitivities and digestive upset (bloating, cramps) are common.³

Multiple factors increase the risk of intestinal permeability, including poor diet, chronic stress, alcohol, antibiotics and other drugs, and infections.⁴

Testing for intestinal barrier dysfunction

Diagnosing leaky gut syndrome is complicated and typically requires a combination of symptom evaluation and laboratory tests.⁵

“I treat all of my IBD patients as if they have a leaky gut,” says Dr. Davis. “Tests can be great for family members because people who have a first-degree relative with IBD are more likely to eventually develop IBD themselves, and when this condition is caught early, outcomes are improved.”

For a medical diagnosis, Dr. Davis prefers the lactulose–mannitol test. After drinking a solution with the two sugars, the ratio of the two is measured in the patient’s urine or serum. A high lactulose-to-mannitol ratio suggests dysfunction within the gastrointestinal lining.⁶

Elevated levels of zonulin, a protein that regulates tight junctions throughout the intestines, indicate an increased risk of permeability and associated inflammation.¹

“Zonulin is a natural signaling molecule that makes guts leakier, and occludin is a protein that keeps guts from getting leaky,” adds Dr. Davis. “Testing one or both proteins can be helpful when diagnosing small intestine hyperpermeability.”

Conventional treatment options

Conventional medicine doesn’t officially recognize leaky gut syndrome as a distinct diagnosis. Treatments focus on addressing underlying conditions or specific symptoms through dietary modifications, lifestyle changes, and targeted medications. These may include antibiotics, steroids, or immunosuppressants for autoimmune or inflammatory bowel conditions.

Although antibiotics and steroids (like prednisone) are commonly prescribed for IBD, these drugs can negatively affect the gastrointestinal tract, even increasing intestinal permeability with prolonged use.⁷ Tumor necrosis factor (TNF) inhibitors, which block a specific inflammatory protein, show promise in treating some symptoms connected with leaky gut. However, many patients find TNF blockers don’t help, and for those who do benefit, there is only partial restoration of the GI lining.⁸

“Presently, there are not a lot of effective pharmaceutical options that can help reverse intestinal hyperpermeability,” notes Dr. Davis. “That’s why utilizing a comprehensive natural approach is so important when treating leaky gut.”

Healing leaky gut naturally

The ultimate goal with intestinal permeability is to reduce digestive symptoms by improving GI function and healing related underlying issues.

“Treating the cause or causes can be complicated and can often include lots of layers,” Dr. Davis says, “but the closer you get to the cause, the better outcomes you will have. For example, someone who has leaky gut related to celiac disease may have improved intestinal barrier function by removing wheat and other gluten grains, but there may be a deeper cause as to why they developed celiac in the first place.”

Diet, dietary supplements, and lifestyle factors

Nutrition is a key strategy for reversing intestinal permeability and strengthening the gut lining, and dietary guidance can be highly individualized. “Some patients may need to avoid high-fructose corn syrup and trans fatty acids to resolve leaky gut, while others may need to adopt a healthy Mediterranean diet,” notes Dr. Davis. “Others may need to restrict individualized food sensitivities.”

High-fiber, anti-inflammatory diets, such as the Mediterranean, may increase beneficial bacterial species and gut-protective compounds known as short-chain fatty acids.⁹ Research shows that the Mediterranean diet also supports intestinal integrity.¹⁰ Consuming more fermented foods and fewer processed foods can also enhance digestive health and reduce inflammation.¹¹^,¹²

Probiotics strengthen the intestinal barrier and tame systemic inflammation, which could help reverse dysbiosis.¹³

A 2025 analysis of 41 randomized clinical trials on probiotics, prebiotics, and synbiotics (a blend of the two) noted significant improvements in gut permeability markers.¹⁴

Targeted dietary supplements may also lower the risk of leaky gut or jump-start the reversal process. Vitamins A and D, glutamine, arginine, polyphenols like resveratrol, berberine, and curcumin, and mushrooms (maitake, shiitake, lion’s mane) all contain gut-fortifying properties.⁵

“I like to use zinc, glutamine, colostrum, and other supplements to help my patients with leaky gut,” says Dr. Davis. “But if, for example, they are a person with celiac still eating gluten, all those supplements aren’t really going to help.”

From a lifestyle perspective, Dr. Davis encourages patients to get enough recuperative sleep and manage day-to-day stress. Research links chronic stress to a higher risk of leaky gut.¹⁵

It’s more than possible to repair a damaged GI lining and restore optimal digestive health. A comprehensive treatment plan balancing nutrition, positive lifestyle changes, and curated supplements takes a whole health approach to resolve leaky gut and its root inflammatory causes.

Footnotes

1
Fasano A. All disease begins in the (leaky) gut: role of zonulin-mediated gut permeability in the pathogenesis of some chronic inflammatory diseases. F1000Res. 2020;9:F1000 Faculty Rev-69. https://doi.org/10.12688/f1000research.20510.1
2
Guemes-Gonzalez AM, Arriga-Pizano LA, Chacon-Salina R, et al. Regulation of intestinal permeability in health and disease: possible therapeutic applications. Arch Med Res. 2026;57(3). https://www.sciencedirect.com/science/article/pii/S0188440925001419
3
Macura B, Kiecka A, Szczepanik M. Intestinal permeability disturbances: causes, diseases and therapy. Clin Exp Med. 2024 Sep 28;24(1):232. https://doi.org/10.1007/s10238-024-01496-9
4
Aleman R, Moncada M, Aryana KJ. Leaking gut and the ingredients that help treat it: a review. Molecules. 2023;28(2). https://doi.org/10.3390/molecules28020619
5
Compare D, Sgamato C, Rocco A, et al. The leaky gut and human diseases: ‘Can’t fill the cup if you don’t plug the holes first.’ Dig Dis. 2024;42(6):548-566. https://karger.com/ddi/article/42/6/548/910640/The-Leaky-Gut-and-Human-Diseases-Can-t-Fill-the
6
Mishra A, Makharia GK. Techniques of functional and motility test: how to perform and interpret intestinal permeability. J Neurogastroenterol Motil. 2012;18(4):443-447. https://doi.org/10.5056/jnm.2012.18.4.443
7
Totleben L, Thomas J, Austin D. Drug-mediated disruption of the aging gut microbiota and mucosal immune system. Front Aging. 2025 Oct 13;6:1603847. https://doi.org/10.3389/fragi.2025.1603847
8
Ciccia F, Dussias N, Gandolfo S, et al. The effect of anti-TNF drugs on the intestinal microbiota in patients with spondyloarthritis, rheumatoid arthritis, and inflammatory bowel diseases. Rheumatol Immunol Res. 2024;5(1):27-33. https://doi.org/10.1515/rir-2024-0003
9
Barber TM, Kabisch S, Pfeiffer A, Weickert MO. The effects of the Mediterranean diet on health and gut microbiota. Nutrients. 2023;15(9). https://doi.org/10.3390/nu15092150
10
Vilar E, Oliva S, Penades BF, et al. Mediterranean diet effect on the intestinal microbiota, symptoms, and markers in patients with functional gastrointestinal disorders. Microorganisms. 2024;12(10). https://doi.org/10.3390/microorganisms12101969
11
Lim E, Yu W, Lim C. Integrative gut health: how fermented foods bridge ancient Eastern wisdom and modern microbiome science. J Tradit Chin Med Sci. 2025;12(4):499-508. https://www.sciencedirect.com/science/article/pii/S2095754825000766
12
Rondinella D, Raoul PC, Valeriani E, et al. The detrimental impact of ultra-processed foods on the human gut microbiome and gut barrier. Nutrients. 2025;17(5). https://doi.org/10.3390/nu17050859
13
Zheng Y, Zhang Z, Tang P, et al. Probiotics fortify intestinal barrier function: a systematic review and meta-analysis of randomized trials. Front Immunol. 2023;14. https://doi.org/10.3389/fimmu.2023.1143548
14
Ghorbani Z, Shoaibinobarian N, Noormohammadi M, et al. Reinforcing gut integrity: a systematic review and meta-analysis of clinical trials assessing probiotics, synbiotics, and prebiotics on intestinal permeability markers. Pharmacol Res. 2025;216. https://www.sciencedirect.com/science/article/pii/S1043661825002051
15
Leigh SJ, Uhlig F, Wilmes L, et al. The impact of acute and chronic stress on gastrointestinal physiology and function: a microbiota-gut-brain axis perspective. J Physiol. 2023 Oct;601(20):4491-4538. https://physoc.onlinelibrary.wiley.com/doi/pdfdirect/10.1113/JP281951

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