Probiotics for Leaky Gut

Probiotics decrease leaky gut and repair the gut lining.

Key Takeaways

  • Probiotics are a key approach to healing leaky gut.
  • Probiotics should be used alongside an anti-inflammatory diet for best results.

Probiotics are great for your gut health. They help improve the balance of organisms in your gut, reduce an overzealous immune response, and reduce inflammation.

Research shows that probiotics decrease intestinal impermeability. If you have symptoms of leaky gut, probiotics can play a key role in recovering your health.

Let’s take a look at what the research says about probiotics and gut permeability.

What is Leaky Gut?

Leaky gut syndrome, also known as intestinal permeability, is when undigested food particles or bacterial toxins get into your bloodstream through small leaks in your intestinal wall. These unwelcome intruders can trigger an immune system response, which can cause a wide range of symptoms, including digestive complaints, joint pain, fatigue, food sensitivities and food allergies.

Probiotics for Leaky Gut - leaky gut L

Who Has Leaky Gut and What Causes It?

Many health conditions are associated with increased intestinal permeability. These include:

Leaky gut isn’t a generally recognized diagnosis, but intestinal permeability is widely recognized in the scientific literature. If you have any of these conditions, chances are you have a leaky gut as well.

There are several causes of increased gut permeability:

Probiotics for Leaky Gut

Probiotics should be considered one key part of a holistic approach to healing leaky gut. This is because they simultaneously work to restore the gut environment while also helping rebalance the gut microbiota. Let’s take a look at how probiotic bacteria help restore the gut lining.

Probiotics Decrease Intestinal Permeability (Leaky Gut)

Several clinical studies have shown improvements in intestinal permeability from the use of probiotics.

  • In one study, a marker of intestinal permeability (zonulin) was significantly lower in the group who received a 14-week course of a multi-species probiotic. [20 Trusted SourcePubMedGo to source]
  • In a clinical trial, oral spore-based probiotic species reduced markers of intestinal permeability compared with placebo. [21 Trusted SourcePubMedGo to source]
  • In a randomized controlled trial, a seven-day trial of Lactobacillus rhamnosus showed biopsy-confirmed beneficial effects on the genes that regulate intestinal permeability. [22 Trusted SourcePubMedGo to source]
  • One small study found that probiotics helped to promote intestinal repair in the human gut. [23]
  • Another trial found positive effects of probiotics when used to treat intestinal impairment after a GI infection. [24 Trusted SourcePubMedGo to source]

Probiotics Help Rebalance the Gut Microbiome

Gut dysbiosis is an overgrowth of bad bacteria and organisms in your gut. The results of several studies suggest a connection between dysbiosis and leaky gut.

Since it’s likely that an imbalance of gut flora can cause leaky gut, we can make an inference that probiotics are helpful for healing gut permeability. We have very good science to show that probiotics are an effective treatment for gut dysbiosis:

  • A meta-analysis (the highest quality of science) summarizing 18 clinical trials concluded that probiotics are an effective treatment for small intestinal bacterial overgrowth (SIBO). [25 Trusted SourcePubMedGo to source] Specifically probiotics reduce bacterial overgrowths and hydrogen concentrations.
  • In a study of 181 infants, probiotics were as effective as Nystatin (a standard antifungal medication) in reducing fungal infection and improving food intolerances. [26 Trusted SourcePubMedGo to source]
  • Two studies show that probiotics can be more effective than standard antiparasitic drug treatment in Blastocystis hominis and Giardia infections. [27 Trusted SourcePubMedGo to source, 28 Trusted SourcePubMedGo to source]

In summary, we have good science to show that probiotics help to repair leaky gut. Probiotics can also improve imbalances of gut flora, one of the likely causes of leaky gut. Even better, probiotics do all this without side effects.

Using Probiotics for Leaky Gut

Choosing the right probiotics for leaky gut is as simple as picking one from each of the three types:

Using one type is good, but using all three together is often best for maximum benefit.

Each category of probiotics works as one leg of a three-legged stool. Without the other two legs, the stool can’t remain standing.

Probiotics for Leaky Gut - 3 PROBIOTICS FOR GUT BALANCE 1080x1080 L

Be sure to select a high-quality probiotic from a manufacturer who stands behind its label claims. For more on how to use probiotics, see our Probiotics Starter Guide.

Other Leaky Gut Support

Probiotics are just one part of a leaky gut healing strategy. It’s especially important to pay attention to lifestyle changes like improving your diet and getting enough sleep. Certain supplements can help, too.

Anti-Inflammatory Diet

Eating an anti-inflammatory diet that is right for your body is a key strategy to improve leaky gut symptoms. An anti-inflammatory diet also helps maintain a healthy gut microbiome and intestinal wall. Your main leaky gut diet goal is to reduce gut inflammation by eating healthy, whole foods and to avoid the processed foods that cause gut inflammation.

Include clean protein, healthy fatty acids, and fruits, veggies, nuts, and seeds as a source of carbs. Foods like bone broth and curcumin are especially healing for the gut.

Pay attention to the foods your body tolerates and doesn’t tolerate. Everyone is unique in this respect and there’s no one right diet for everyone.

Probiotics for Leaky Gut - AdobeStock 58775535 L

Probiotic Foods for Leaky Gut

While probiotic foods, such as kimchi and kefir, provide general gut health benefits, probiotic foods generally do not have enough colony-forming units (CFUs) to provide a clinical effect on leaky gut or other digestive system disorders. Include fermented foods, but also include quality probiotic supplements with CFUs in the billions. See a comparison of probiotic amounts in fermented foods versus probiotic supplements here.

Prebiotics for Leaky Gut

Prebiotics are starchy fibers that feed the bacteria in your gut, so they can produce important gut healing compounds, like butyrate. Prebiotics can be included as a supplement, but the best source of prebiotics is a diet rich in fiber. Including fruits and vegetables, whole grains and legumes (if tolerated), and nuts and seeds should provide plenty of food for your good bacteria. However, prebiotics should be used with caution, as they can flare digestive symptoms for some. If you want to try a prebiotic supplement, your best bet is to start with a very small dose and increase slowly to tolerance.

Other Key Leaky Gut Supplements

Digestive supports like digestive enzymes and stomach acid support can help encourage gut healing. Several other supplements can also be helpful for resolving leaky gut.

  • L-glutamine: Supplementation with L-glutamine, and amino acid, can help speed the repair of the intestinal lining, decrease intestinal permeability, and reduce inflammation. [29 Trusted SourcePubMedGo to source]
  • Vitamin D: Some studies indicate that low vitamin D is associated with greater gut lining permeability and worse outcomes for people with IBD, while increasing vitamin D reduced irritable bowel syndrome (IBS) symptoms. [30 Trusted SourcePubMedGo to source, 31 Trusted SourcePubMedGo to source, 32 Trusted SourcePubMedGo to source]
  • Deglycyrrhizinated Licorice (DGL): Soothing herbs like deglycyrrhizinated licorice (DGL) can help coat and soothe an irritated gut lining. [33] DGL combined with L-glutamine can super-charge your gut-healing protocol.

The Bottom Line

Probiotics are a key approach to healing leaky gut. They should be used alongside an anti-inflammatory diet for best results. Probiotics help rebalance your gut flora, restore your intestinal wall, and decrease intestinal inflammation.

More on Probiotics:

References (click to expand)
  1. Mujagic Z, Ludidi S, Keszthelyi D, Hesselink MA, Kruimel JW, Lenaerts K, Hanssen NM, Conchillo JM, Jonkers DM, Masclee AA. Small intestinal permeability is increased in diarrhoea predominant IBS, while alterations in gastroduodenal permeability in all IBS subtypes are largely attributable to confounders. Aliment Pharmacol Ther. 2014 Aug;40(3):288-97. doi: 10.1111/apt.12829. Epub 2014 Jun 18. PMID: 24943095. Trusted SourcePubMedGo to source
  2. Canakis A, Haroon M, Weber HC. Irritable bowel syndrome and gut microbiota. Curr Opin Endocrinol Diabetes Obes. 2020;27(1):28‐35. doi:10.1097/MED.0000000000000523 Trusted SourcePubMedGo to source
  3. Michielan A, D’Incà R. Intestinal Permeability in Inflammatory Bowel Disease: Pathogenesis, Clinical Evaluation, and Therapy of Leaky Gut. Mediators Inflamm. 2015;2015:628157. doi: 10.1155/2015/628157. Epub 2015 Oct 25. PMID: 26582965; PMCID: PMC4637104. Trusted SourcePubMedGo to source
  4. Lee SH. Intestinal permeability regulation by tight junction: implication on inflammatory bowel diseases. Intest Res. 2015 Jan;13(1):11-8. doi: 10.5217/ir.2015.13.1.11. Epub 2015 Jan 29. PMID: 25691839; PMCID: PMC4316216. Trusted SourcePubMedGo to source
  5. Drago S, El Asmar R, Di Pierro M, Grazia Clemente M, Tripathi A, Sapone A, Thakar M, Iacono G, Carroccio A, D’Agate C, Not T, Zampini L, Catassi C, Fasano A. Gliadin, zonulin and gut permeability: Effects on celiac and non-celiac intestinal mucosa and intestinal cell lines. Scand J Gastroenterol. 2006 Apr;41(4):408-19. doi: 10.1080/00365520500235334. PMID: 16635908. Trusted SourcePubMedGo to source
  6. Chang J, Leong RW, Wasinger VC, Ip M, Yang M, Phan TG. Impaired Intestinal Permeability Contributes to Ongoing Bowel Symptoms in Patients With Inflammatory Bowel Disease and Mucosal Healing. Gastroenterology. 2017 Sep;153(3):723-731.e1. doi: 10.1053/j.gastro.2017.05.056. Epub 2017 Jun 8. PMID: 28601482. Trusted SourcePubMedGo to source
  7. Morris G, Berk M, Carvalho AF, Caso JR, Sanz Y, Maes M. The Role of Microbiota and Intestinal Permeability in the Pathophysiology of Autoimmune and Neuroimmune Processes with an Emphasis on Inflammatory Bowel Disease Type 1 Diabetes and Chronic Fatigue Syndrome. Curr Pharm Des. 2016;22(40):6058-6075. doi: 10.2174/1381612822666160914182822. PMID: 27634186. Trusted SourcePubMedGo to source
  8. Utzeri E, Usai P. Role of non-steroidal anti-inflammatory drugs on intestinal permeability and nonalcoholic fatty liver disease. World J Gastroenterol. 2017 Jun 14;23(22):3954-3963. doi: 10.3748/wjg.v23.i22.3954. PMID: 28652650; PMCID: PMC5473116. Trusted SourcePubMedGo to source
  9. Graham DY, Opekun AR, Willingham FF, Qureshi WA. Visible small-intestinal mucosal injury in chronic NSAID users. Clin Gastroenterol Hepatol. 2005 Jan;3(1):55-9. doi: 10.1016/s1542-3565(04)00603-2. PMID: 15645405. Trusted SourcePubMedGo to source
  10. Bjarnason I, Hayllar J, MacPherson AJ, Russell AS. Side effects of nonsteroidal anti-inflammatory drugs on the small and large intestine in humans. Gastroenterology. 1993 Jun;104(6):1832-47. doi: 10.1016/0016-5085(93)90667-2. PMID: 8500743. Trusted SourcePubMedGo to source
  11. Vanuytsel T, van Wanrooy S, Vanheel H, Vanormelingen C, Verschueren S, Houben E, Salim Rasoel S, Tόth J, Holvoet L, Farré R, Van Oudenhove L, Boeckxstaens G, Verbeke K, Tack J. Psychological stress and corticotropin-releasing hormone increase intestinal permeability in humans by a mast cell-dependent mechanism. Gut. 2014 Aug;63(8):1293-9. doi: 10.1136/gutjnl-2013-305690. Epub 2013 Oct 23. PMID: 24153250. Trusted SourcePubMedGo to source
  12. Costa RJS, Snipe RMJ, Kitic CM, Gibson PR. Systematic review: exercise-induced gastrointestinal syndrome-implications for health and intestinal disease. Aliment Pharmacol Ther. 2017 Aug;46(3):246-265. doi: 10.1111/apt.14157. Epub 2017 Jun 7. PMID: 28589631. Trusted SourcePubMedGo to source
  13. Canakis A, Haroon M, Weber HC. Irritable bowel syndrome and gut microbiota. Curr Opin Endocrinol Diabetes Obes. 2020 Feb;27(1):28-35. doi: 10.1097/MED.0000000000000523. PMID: 31789724. Trusted SourcePubMedGo to source
  14. Tripathi A, Lammers KM, Goldblum S, Shea-Donohue T, Netzel-Arnett S, Buzza MS, Antalis TM, Vogel SN, Zhao A, Yang S, Arrietta MC, Meddings JB, Fasano A. Identification of human zonulin, a physiological modulator of tight junctions, as prehaptoglobin-2. Proc Natl Acad Sci USA. 2009;106:16799–804.
  15. El Asmar R, Panigrahi P, Bamford P, Berti I, Not T, Coppa GV, Catassi C, Fasano A. Host-dependent zonulin secretion causes the impairment of the small intestine barrier function after bacterial exposure. Gastroenterology. 2002 Nov;123(5):1607-15. doi: 10.1053/gast.2002.36578. Erratum in: Gastroenterology 2003 Jan;124(1):275. El Asmar Rahzi [corrected to El Asmar Ramzi]. PMID: 12404235. Trusted SourcePubMedGo to source
  16. Ciccia F, Guggino G, Rizzo A, Alessandro R, Luchetti MM, Milling S, Saieva L, Cypers H, Stampone T, Di Benedetto P, Gabrielli A, Fasano A, Elewaut D, Triolo G. Dysbiosis and zonulin upregulation alter gut epithelial and vascular barriers in patients with ankylosing spondylitis. Ann Rheum Dis. 2017 Jun;76(6):1123-1132. doi: 10.1136/annrheumdis-2016-210000. Epub 2017 Jan 9. PMID: 28069576; PMCID: PMC6599509. Trusted SourcePubMedGo to source
  17. Tripathi A, Lammers KM, Goldblum S, Shea-Donohue T, Netzel-Arnett S, Buzza MS, Antalis TM, Vogel SN, Zhao A, Yang S, Arrietta MC, Meddings JB, Fasano A. Identification of human zonulin, a physiological modulator of tight junctions, as prehaptoglobin-2. Proc Natl Acad Sci USA. 2009;106:16799–804.
  18. El Asmar R, Panigrahi P, Bamford P, et al. Host-dependent zonulin secretion causes the impairment of the small intestine barrier function after bacterial exposure [published correction appears in Gastroenterology 2003 Jan;124(1):275. El Asmar Rahzi [corrected to El Asmar Ramzi]]. Gastroenterology. 2002;123(5):1607‐1615. doi:10.1053/gast.2002.36578 Trusted SourcePubMedGo to source
  19. Feng Y, Huang Y, Wang Y, Wang P, Song H, Wang F. Antibiotics induced intestinal tight junction barrier dysfunction is associated with microbiota dysbiosis, activated NLRP3 inflammasome and autophagy. PLoS One. 2019 Jun 18;14(6):e0218384. doi: 10.1371/journal.pone.0218384. PMID: 31211803; PMCID: PMC6581431. Trusted SourcePubMedGo to source
  20. Lamprecht M, Bogner S, Schippinger G, Steinbauer K, Fankhauser F, Hallstroem S, Schuetz B, Greilberger JF. Probiotic supplementation affects markers of intestinal barrier, oxidation, and inflammation in trained men; a randomized, double-blinded, placebo-controlled trial. J Int Soc Sports Nutr. 2012 Sep 20;9(1):45. doi: 10.1186/1550-2783-9-45. PMID: 22992437; PMCID: PMC3465223. Trusted SourcePubMedGo to source
  21. McFarlin BK, Henning AL, Bowman EM, Gary MA, Carbajal KM. Oral spore-based probiotic supplementation was associated with reduced incidence of post-prandial dietary endotoxin, triglycerides, and disease risk biomarkers. World J Gastrointest Pathophysiol. 2017 Aug 15;8(3):117-126. doi: 10.4291/wjgp.v8.i3.117. PMID: 28868181; PMCID: PMC5561432. Trusted SourcePubMedGo to source
  22. Mujagic Z, de Vos P, Boekschoten MV, Govers C, Pieters HH, de Wit NJ, Bron PA, Masclee AA, Troost FJ. The effects of Lactobacillus plantarum on small intestinal barrier function and mucosal gene transcription; a randomized double-blind placebo controlled trial. Sci Rep. 2017 Jan 3;7:40128. doi: 10.1038/srep40128. PMID: 28045137; PMCID: PMC5206730. Trusted SourcePubMedGo to source
  23. McFarlin BK, Henning AL, Bowman EM, Gary MA, Carbajal KM. Oral spore-based probiotic supplementation was associated with reduced incidence of post-prandial dietary endotoxin, triglycerides, and disease risk biomarkers. World J Gastrointest Pathophysiol. 2017;8(3):117‐126. doi:10.4291/wjgp.v8.i3.117
  24. Sindhu KN, Sowmyanarayanan TV, Paul A, Babji S, Ajjampur SS, Priyadarshini S, Sarkar R, Balasubramanian KA, Wanke CA, Ward HD, Kang G. Immune response and intestinal permeability in children with acute gastroenteritis treated with Lactobacillus rhamnosus GG: a randomized, double-blind, placebo-controlled trial. Clin Infect Dis. 2014 Apr;58(8):1107-15. doi: 10.1093/cid/ciu065. Epub 2014 Feb 5. PMID: 24501384; PMCID: PMC3967829. Trusted SourcePubMedGo to source
  25. Zhong C, Qu C, Wang B, Liang S, Zeng B. Probiotics for Preventing and Treating Small Intestinal Bacterial Overgrowth: A Meta-Analysis and Systematic Review of Current Evidence. J Clin Gastroenterol. 2017;51(4):300‐311. doi:10.1097/MCG.0000000000000814 Trusted SourcePubMedGo to source
  26. Demirel G, Celik IH, Erdeve O, Saygan S, Dilmen U, Canpolat FE. Prophylactic Saccharomyces boulardii versus nystatin for the prevention of fungal colonization and invasive fungal infection in premature infants. Eur J Pediatr. 2013;172(10):1321‐1326. doi:10.1007/s00431-013-2041-4 Trusted SourcePubMedGo to source
  27. Dinleyici EC, Eren M, Dogan N, Reyhanioglu S, Yargic ZA, Vandenplas Y. Clinical efficacy of Saccharomyces boulardii or metronidazole in symptomatic children with Blastocystis hominis infection. Parasitol Res. 2011;108(3):541‐545. doi:10.1007/s00436-010-2095-4 Trusted SourcePubMedGo to source
  28. Besirbellioglu BA, Ulcay A, Can M, et al. Saccharomyces boulardii and infection due to Giardia lamblia. Scand J Infect Dis. 2006;38(6-7):479‐481. doi:10.1080/00365540600561769 Trusted SourcePubMedGo to source
  29. Shu XL, Yu TT, Kang K, Zhao J. Effects of glutamine on markers of intestinal inflammatory response and mucosal permeability in abdominal surgery patients: A meta-analysis. Exp Ther Med. 2016;12(6):3499‐3506. doi:10.3892/etm.2016.3799 Trusted SourcePubMedGo to source
  30. Luthold RV, Fernandes GR, Franco-de-Moraes AC, Folchetti LG, Ferreira SR. Gut microbiota interactions with the immunomodulatory role of vitamin D in normal individuals. Metabolism. 2017;69:76‐86. doi:10.1016/j.metabol.2017.01.007 Trusted SourcePubMedGo to source
  31. Abbasnezhad A, Amani R, Hajiani E, Alavinejad P, Cheraghian B, Ghadiri A. Effect of vitamin D on gastrointestinal symptoms and health-related quality of life in irritable bowel syndrome patients: a randomized double-blind clinical trial. Neurogastroenterol Motil. 2016;28(10):1533‐1544. doi:10.1111/nmo.12851 Trusted SourcePubMedGo to source
  32. López-Muñoz P, Beltrán B, Sáez-González E, Alba A, Nos P, Iborra M. Influence of Vitamin D Deficiency on Inflammatory Markers and Clinical Disease Activity in IBD Patients. Nutrients. 2019;11(5):1059. Published 2019 May 11. doi:10.3390/nu11051059 Trusted SourcePubMedGo to source
  33. Aly AM, Al-Alousi L, Salem HA. Licorice: a possible anti-inflammatory and anti-ulcer drug. AAPS PharmSciTech. 2005;6(1):E74‐E82. Published 2005 Sep 20. doi:10.1208/pt060113

Need help or would like to learn more?
View Dr. Ruscio’s additional resources

Get Help

Discussion

I care about answering your questions and sharing my knowledge with you. Leave a comment or connect with me on social media asking any health question you may have and I just might incorporate it into our next listener questions podcast episode just for you!

One thought on “Probiotics for Leaky Gut

  1. Very timely article for me. I have T1 diabetes and mild Hashimoto’s hypothyroidism for which I take 25 mcg’s of Synthroid daily. I am certain I have leaky gut and SIBO but my gastroenterologist doesn’t “believe” in SIBO and thinks permeable gut isn’t a big deal—so many tone-deaf Doctors! I tried l-glutamine based on my own research and it adversely affected my thyroid. I have taken probiotics off and on because they are pricey and tried kefir but it bloated me uncomfortably. I’m going back on probiotics after reading this so thank you!

Leave a Reply

Your email address will not be published. Required fields are marked *