How to Test For Leaky Gut

Increased intestinal permeability, also known as leaky gut, occurs when the barrier between the gut and the bloodstream (mucosal membrane) fails to prevent potentially harmful molecules from entering the bloodstream. These molecules include large fat particles, toxins, and bacteria, which may cause bowel dysfunction and a generalized inflammation in the body, which in turn contributes to chronic health problems such as heart disease, cancer, and dementia. Leaky gut is a syndrome or group of symptoms, not a disease.


The Leaky Gut Test


Testing for leaky gut is relatively new. The “lactulose mannitol ratio” test or challenge is also known as the Intestinal Permeability Assessment and is used to uncover disorders characterized by changes in gut permeability.


During the test, you will be asked to drink a solution containing two sugars, lactulose and mannitol. Urine is collected over a period, up to 24 hours, and then tested in a lab. Lactulose is a large molecule that is normally unable to cross the gut-blood barrier, so if your gut is healthy, there should be little or no lactulose in your urine. But if your gut is leaky, levels will be high.


Mannitol, on the other hand, is a small molecule that is normally able to cross the barrier. Low levels in the urine suggest a problem with absorption of small molecules. In the lab, technicians will look at both urine levels and calculate their ratio.


Your doctor will interpret the results and may recommend further testing. Some testing uses rhamnose rather than mannitol and others give a dose of aspirin before the test.


Other Tests for Leaky Gut and Bowel Dysfunction


Your doctor will interpret the results and discuss the need for other tests. The lactulose mannitol ratio only assesses gut permeability; it does not help diagnose the cause. Your doctor may recommend other investigations including:


  • Blood tests
  • Stool examination
  • Bowel imaging with a plain x-ray, ultrasound, computed tomography scan (CT), CT enterography or magnetic resonance (MR) or magnetic resonance imaging.


Endoscopy is essential for diagnosing more severe conditions such as Crohn’s or ulcerative colitis. Here a fiberoptic scope or tube is introduced into the gut, so that it can be examined visually and biopsies taken. Your doctor may refer you for a colonoscopy to look at the colon and ileum, and/or a gastroscopy to look at the stomach and duodenum.


Symptoms of Leaky Gut: Who Needs the Leaky Gut Test?


Most people are unaware that they have a leaky gut, because symptoms are often vague and progress slowly. Symptoms include:


  • Change in bowel habit, including diarrhea, constipation, bloating, or flatulence.
  • Fatigue for no reason.
  • Headaches, poor concentration, brain fog, and memory decline.
  • Rashes such as acne, rosacea, and eczema.
  • Weak immune system. You may notice that you catch every cold or tummy bug that is doing the rounds.
  • Craving sugar and carbohydrates.
  • Aches and pains in muscles and joints.
  • Depression, anxiety, and ADHD.
  • Nutritional deficiencies. These may be detected on a routine blood test.
  • Autoimmune diseases like rheumatoid arthritis, Ankylosing spondylitis, and thyroid disease.


Risk Factors for Leaky Gut


Leaky gut can affect almost anyone, but experts say there are some factors that increase the risk:


  • Alcohol abuse
  • Bowel infections: Food poisoning, parasites, bacterial overgrowth
  • Gut conditions, including gastritis, colitis, and Crohn’s disease
  • Eating disorders, notably anorexia.
  • Medical shock, trauma, burns, or surgery
  • Cancer and cancer treatment
  • Chronic hepatitis and chronic pancreatitis
  • Medications including NSAIDS
  • Rheumatoid arthritis
  • Environmental toxins: Heavy metals, organic pollutants, solvents, endocrine disruptors
  • Psychological distress: This is a major one as stress is such a huge problem today.


Leaky Gut Syndrome is one of the regenerative medicine treatments offered at Integrative Telemedicine. Our physicians will perform a comprehensive evaluation of your condition in order to determine which treatment might be best for you. They will explain your options so that you can make a decision you’re most comfortable with.

If you have any questions or would like to schedule a consultation, call our friendly staff today at (520) 396-4866 or fill out our online request form. We look forward to being your healthcare partner.

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