Leaky gut syndrome
The world of alternative medicine has a certain fondness for inventing conditions in order to be able to sell a “cure” that medicine cannot offer. morgellonsW and chronic Lyme diseaseW are two of the better known. Another, particularly beloved of nutritionists, is leaky gut syndromeW.
Often there is an overlap with reality: in morgellons the condition is delusional parasitosisW, patients preferring the alternative because they repudiate the psychological cause; in chronic Lyme there is a genuine condition (post-Lyme syndrome) though many self-diagnosed sufferers show no evidence of borrelia burgdorferi, the cause of Lyme disease.
In the case of “leaky gut syndrome” there is some substance to the idea that the gut wall can become more permeable in those suffering from inflammatory bowel diseaseW but the crossover between this and the alternative diagnosis of “leaky gut” happens early. However, the idea of a leaky gut syndrome, particularly as the cause of autism, CFS and even multiple sclerosisW, is entirely speculative and not supported by credible evidence.
As an example, the website leakygutcure.com uses the illustration at right. This shows: top left, a normal gut wall; top right, villous atrophy, a diagnostic sign of coeliac diseaseW, and bottom, vague references to food and unspecified “toxins”.
I am not aware of any credible pathological findings of undigested food in the blood, as this suggests, nor is any such objective test proposed for “leaky gut”. Instead the diagnosis is one of – well, guesswork: usually exclusion diets, but with the nutritionist’s favourite bête noire always in the mix, and (it seems) always found to be the One True Cause.
Comparison with coeliac is illustrative. Coeliac is an autoimmune disorder where the immune system attacks the gut wall where the proteins in gluten are absorbed. Diagnosis is by blood tests for tissue transglutaminase (tTG) antibodies, possibly confirmed by duodenal biopsy, which typically shows exactly the features seen at top right in the picture: blunting of the villi, enlargement of the crypts and invasion of the crypts by lymphocytes (white blood cells).