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 is not a recognized medical condition. The term “leaky gut syndrome” is usually used by complementary, alternative, or functional medicine practitioners.

The idea of leaky gut syndrome is based on intestinal permeability. Intestinal permeability is the term used to describe the extent to which substances in the intestines can “leak” 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. This can lead to digestive and other health problems.

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.

Tight junction proteins seal the spaces between the epithelial cells. These proteins are critical for regulating what moves from the intestines to the bloodstream and what does not.

What Happens When Your Gut Protection Fails?

Sometimes, the spaces between the cells widen so that tight junctions cannot form or work properly. It’s possible that this might 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 complementary, alternative, or functional medicine practitioners refer to as “leaky gut syndrome.”

Does a Leaky Gut Cause Psoriasis?

Psoriasis is caused by a combination of genetic and environmental factors. Risk factors include a family history of psoriasis, certain infections, and smoking.

Researchers are working to better understand how your gut and your skin are connected. Studies have found that psoriasis and gut inflammation are linked, but exactly how needs more research. One key question is whether increased intestinal permeability causes inflammation or if it occurs because of inflammation. Inflammation is a key feature of psoriasis.

Studies about how increased intestinal permeability affects psoriasis have been mixed. One study comparing people with psoriasis with an impaired gut barrier to those without any gut issues found that those with the impaired barrier had more severe symptoms. They also had more stomach issues than the other group.

Research shows that people with psoriasis often have an imbalance in gut bacteria. This can weaken the gut lining and make it “leakier,” which may trigger the immune system and worsen psoriasis symptoms.

Another study following a different methodology didn’t find a relationship between increased intestinal permeability and psoriasis severity, though it did conclude that psoriasis and gut inflammation are linked.

Does a Leaky Gut Cause Other Diseases?

Research supports a link between impaired intestinal function and certain health conditions, including:

• Functional dyspepsia (chronic indigestion)
• Inflammatory bowel disease (IBD)
• Irritable bowel syndrome (IBS)
• HIV
• Type 1 diabetes

This doesn’t necessarily mean that a “leaky gut” causes these conditions, just that there is a relationship.

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 damage your intestinal barrier, including:

• Stress
• Certain health conditions, such as IBD or celiac disease
• Excessive alcohol consumption
• High-fat and high-sugar diets
• Cancer treatments like chemotherapy or radiation
• Long-term overuse of medications that can harm the gut, such as ibuprofen

Both IBD and celiac disease are associated with psoriasis.

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
• Stomach bloating and gas
• A burning feeling in your intestines
• Indigestion that burns or is otherwise painful
• Low energy

For now, no validated tool exists to accurately diagnose leaky gut syndrome. Certain tests may help determine if the intestines are not working as they should:

• Urine test — Tests for substances that should remain in your gut
• Blood test — Looks for gut bacteria that would normally remain in your intestines
• Intestinal 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 a Leaky Gut

Research into treating a leaky gut 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 inflammatory bowel disease, for example, finding effective treatments 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 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 the health of your gut, there are things you can do to improve overall gut health. Some are associated with improved psoriasis outcomes, but none are guaranteed cures. 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 (avoiding certain types of hard-to-digest carbohydrates)
• Eating less sugar and fat

Always talk with your doctor or a dietitian 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

On MyPsoriasisTeam, people share their experiences with psoriasis and psoriatic arthritis, get advice, and find support from others who understand.

Have you wondered if a leaky gut is linked to psoriasis? Let others know in the comments below.