If you’re living with itchy, scaly skin from psoriasis, you may wonder what’s causing your skin condition. It’s not uncommon for friends and family to share information they’ve heard about potential triggers in an effort to support you.

Leaky gut syndrome is a topic that people are discussing as a possible cause of many conditions, including psoriasis. If you’ve heard that having a “leaky gut” might be causing your symptoms, there are some things you should know.

What Is Leaky Gut Syndrome?

Leaky gut syndrome, or increased intestinal permeability, is the term used to describe the extent to which substances in the intestines can make their way into the bloodstream. Although you want nutrients and other good things in your intestines to cross into the bloodstream, you also want your body to have protection against anything harmful that might end up in your gut. This function is an important part of your immune system.

A properly permeable membrane in your intestines should allow the good things through while keeping the bad ones in your intestines until they can be eliminated. A gut that is too permeable (leaky) allows too many substances out of the intestines and into your bloodstream.

How Should Your Gut Protect You?

The inside of your intestines is covered by cells called the epithelial barrier or the epithelium. These cells lie in a single layer and they control what can and cannot pass between the intestines and the bloodstream.

In order to form this protective layer, these cells are packed closely together. The outer layers of these cells join together to form a tight junction. These junctions add further protection and help regulate what moves from the intestines to the bloodstream and what does not.

These cells and the tight junctions have complex systems set up to allow good substances through the barrier while protecting you from bad substances.

What Happens When Your Gut Protection Fails?

Sometimes, the spaces between the cells widen so that tight junctions cannot form or work properly. This can lead to inflammation and affect the digestive tract’s naturally occurring bacteria. If this happens, it can have significant impacts on the gastrointestinal tract and the body as a whole. This increased intestinal permeability is what some practitioners refer to as “leaky gut syndrome.”

It’s important to note that the term “leaky gut syndrome” is usually used by complementary, alternative, or functional medicine practitioners. The syndrome is not currently recognized as a disease on its own.

The Relationship Between Increased Intestinal Permeability and Psoriasis

Intestines that allow substances into your bloodstream that they should not are linked to a number of chronic diseases, including type 1 diabetes and celiac disease. It is not clear whether a leaky gut causes these conditions or whether the conditions themselves cause the leaky gut. In fact, it has been proposed that certain health conditions may affect the intestines’ permeability, creating a leaky gut that allows bacteria, toxins, and other substances to enter the bloodstream.

Researchers have also suggested that having a leaky gut may also play an important role in the development of immune-related diseases like psoriasis.

Psoriasis is a pathology that can be associated with bowel disease. Studies have shown that people with psoriasis and leaky gut are more likely to have more severe disease activity and greater inflammation.

Does a Leaky Gut Cause Psoriasis?

No one knows exactly what causes psoriasis, though that doesn’t mean we don’t know anything about the topic.

Some people — particularly those with a family member who has psoriasis — are more likely to develop the condition.

If you already have a higher risk of developing psoriasis, having a leaky gut may allow substances that can trigger or worsen the disease to enter the bloodstream. This may be why some people with autoimmune diseases like type 1 diabetes or celiac disease experience a tight junction dysfunction in the spaces between the cells that line the intestines.

Research has also found that disease-causing bacteria can lead to a leaky gut and trigger the symptoms of certain autoimmune diseases, including celiac disease, lupus, and inflammatory bowel disease.

For these reasons, some researchers have suggested that the traditional understanding that environmental and genetic factors alone lead to immune-related disorders is incomplete.

They believe that a weaker intestinal barrier and the problems it can cause, including changes in the type of bacteria that live in your intestines (the gut microbiome, gut microbiota, or gut flora), may also play a role in the development of diseases like psoriasis.

What Causes Increased Intestinal Permeability in Psoriasis?

Researchers are not yet sure what causes increased intestinal permeability, either on its own or alongside psoriasis. The fact is that everyone’s intestines are permeable to a certain degree.

Several factors may cause more space between the protective cells in your intestines, including:

• Stress
• Certain infections
• Excessive alcohol consumption
• High-fat and high-sugar diets
• Burn injuries
• Autoimmune diseases

These factors may cause a leaky gut in people more sensitive to gastrointestinal tract problems.

There’s not enough evidence to show if leaky gut causes psoriasis or the other way around, but we do know that inflammation in our body can lead to leaky gut. So, if you have psoriasis, it’s important to keep it under control to make sure it doesn’t affect your gut health.

Diagnosing Leaky Gut Syndrome

Leaky gut syndrome is not an official medical diagnosis. However, you should talk to your doctor if you experience the following symptoms:

• New or worsening diarrhea
• Gas and bloating
• A burning feeling in your intestines
• Indigestion that burns or is otherwise painful
• Low energy

Certain tests may help determine if the intestines are not working as they should:

• Blood test — Looks for gut bacteria that would normally remain in your intestines
• Urine test — Tests for substances that should remain in your gut
• Tissue biopsy — Will determine what can get through
• Confocal endomicroscopy — Looks at your intestinal lining in detail

Depending on your symptoms, your doctor may make suggestions for other sorts of tests for other medical issues.

Treating Leaky Gut Syndrome

Research into treating leaky gut syndrome is ongoing. Currently, the best way to treat it is to treat any underlying conditions that may be causing it. If you have been diagnosed with celiac disease or inflammatory bowel disease, for example, finding effective treatments for these conditions can help heal your intestines and make them less permeable.

Note that research does not point to solutions from the other direction. Treatments aimed at healing the intestines directly do not heal these other conditions. They also do not prevent your gut from becoming permeable again once the treatment is complete.

Protecting Your Gut

If you are worried about leaky gut syndrome, there are things you can do to take care of your gut and improve overall gut health. These may not prevent leaky gut syndrome or heal it if you are already living with it, but they will help your overall intestinal health. Protective strategies for your gut include:

• Taking prebiotics
• Taking probiotics
• Eating a balanced diet
• Adding vitamin D and L-glutamine (an amino acid) to your diet
• Following a low FODMAP diet — “FODMAP” refers to certain types of hard-to-digest carbohydrates called fermentable short-chain carbohydrates.
• Consuming less dietary sugars and fats

Always talk with your doctor or a dietitian first before trying a new diet that may help with a health condition. Diets are not a treatment, but in combination with other management tips and with some adaptations, certain dietary changes could help you feel better.

Talk to Your Doctor

If you’re wondering about a possible connection between your gut and psoriasis, talk to your dermatology provider. They can help you understand the best way to take care of your psoriasis and help you determine if you need to seek treatment for gastrointestinal issues.

Talk With Others Who Understand

MyPsoriasisTeam is the social network for people with psoriasis and psoriatic arthritis and their loved ones. On MyPsoriasisTeam, more than 122,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis and psoriatic arthritis.

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