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For many of my patients, especially those dealing with digestive and autoimmune problems, what stands between them and feeling great is an insidious but fixable problem we in the integrative health world call ‘leaky gut,’ or gut ‘permeability.’

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If low-grade ills are dragging you down, leaky gut should probably be on your radar… even though it’s probably not on your primary care doc’s. Likely, it’s up to you to start repairing your gut -- ‘plugging up the leaks’ -- before the doctor whips out the prescription pad and loads you up with a suitcase full of pharmaceuticals that will mask rather than fix the problem, and quite possibly make it worse.

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So, how to take on leaky gut and win? Here’s a topline on what you need to know– and how to jumpstart the healing process:

How do I know if my gut’s leaky?

If you’ve got one or two or a laundry list of chronic ills that never seem to go away, suspect the gut is involved. Classic clues include digestive problems like gas, bloating, constipation, diarrhea (the “umbrella” term is IBS), as well as food sensitivities and allergies. But that’s just for openers. Symptoms can pop up anywhere: mood disorders, brain fog, skin problems like acne and rosacea, joint pain and muscle aches, fatigue, weight issues. And leaky gut can help drive even more threatening conditions: a weakened immune system, autoimmune diseases, asthma, possibly even diabetes and obesity.

How did my gut get this way?

There are no shortage of ways a gut can go off the rails. A lot of the problem is driven by the not-so-great by-products of modern life. Let’s tick off a few: highly-processed and genetically-engineered foods; toxic chemical exposure; hyper-hygiene; chronic stress; poor sleep; lack of exercise. Other routes? Falling short on fiber which starves the good bacteria in the gut so they can’t do their job of keeping the lining of the gut wall intact. (And eating lots of sugar and refined foods feeds unhelpful bacteria which also keeps the good bugs down.) Gluten can trigger a sensitive gut. Other gut-destabilizers? Medications like non-steroidal anti-inflammatory drugs (NSAIDs), proton pump inhibitors (or PPIs) and antibiotics.

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For any or all of these reasons, the all-important balance of the bacteria living in the gut, the microbiome, is thrown out of whack. The result? The gut wall’s one-cell-thick lining begins to lose its integrity. Microscopic spaces open up, letting partially digested food particles and toxins slip through into the bloodstream. This triggers an overreaction by the immune system, systemic inflammation that makes you feel bad now and, if left unchecked, potentially a lot worse down the road.

How can I ‘plug the leaks’ and start healing my gut?

Protect your gut microbiome and reverse the gut dysfunction responsible for chronic or recurring bouts of unwellness. Take a multi-pronged approach, incorporating diet, supplements, and stress reduction—no prescription pad required. The good news is that the microbiome is a flexible, living ecosystem that changes constantly, and the cells in the intestinal lining replace themselves every three to six days, which means you can rebuild your gut and start turning your health around in just a few weeks.

Try my repair program to fast-track your gut healing.

One of the best ways to implement this repair program is to use a formula called the ‘5Rs’: remove, replace, reinoculate, repair and relax. From these key elements, you’ll create your own month-long repair protocol:

1) Remove the most common sources of irritation.

• DIETARY TOXINS: These include sugar and processed foods, factory-farmed animal products, pesticide-laden foods, artificial sweeteners, and GMOs.
• FOODS THAT TRIGGER SENSITIVITIES: Identify the culprits by trying a gut-calming elimination diet to delete the most common leaky-gut triggers from your plate, such as gluten, dairy, soy, corn and sugar.
• GASTRIC IRRITANTS: Think alcohol and caffeine. With your doctor’s supervision, limit or eliminate the NSAID and PPI drugs.
• CHRONIC, LOW-GRADE INFECTIONS: Small intestinal bacterial overgrowth (SIBO), yeast/candida overgrowth, and parasites living in the intestines are extremely common. A knowledgeable healthcare provider can help diagnose and treat them with herbal antimicrobials (and, occasionally, medications when necessary).

2) Replace what may be lacking.

• FIBER… helps eliminate toxins and food by-products. Without fiber, your bowels move slowly, allowing waste to reenter the system and create inflammation and toxicity throughout your body. To ‘keep things moving,’ eat an array of colorful non-starchy vegetables, berries, nuts, seeds, and some legumes, and/or supplement with 1 to 2 tablespoons of freshly ground psyllium seeds, flaxseeds or soaked chia seeds.
• HYDROCHLORIC ACID… starts the digestive process. If your body isn’t producing as much as it used to, natural “bitters” before meals can help stimulate gastric juices. Or you can add a tablespoon of apple cider vinegar to a glass of water, but do so under a health professional’s supervision.
• DIGESTIVE ENZYMES… help to break down food and make nutrients easier to absorb. The more food is broken down, the fewer problems your system will have with inflammation-provoking partially-digested food particles.

3) Reinoculate with beneficial bacteria to restore a healthy balance of microflora.

• DAILY PROBIOTICS… are super-helpful for your gut. They support and rejuvenate the microbiome to rebalance, assist with digestion, help your body make vitamins, aid in the absorption of minerals, strengthen the immune system, improve metabolism and help boost mood.
• FERMENTED FOODS… are excellent food sources of probiotic bacteria.
• PREBIOTIC FOODS … act as fertilizer for the helpful bacteria, feeding the good guys.
• ‘PHAGES’… short for bacteriophages, they’re included in some of the latest probiotic blends. Phages are beneficial viruses that infect and kill microbes, help the beneficial bacteria to reproduce, and even protect the epithelial layer in the gut by concentrating in the mucus layer that protects that lining.

4) Repair the gut lining with the good building blocks it needs.

• GLUTAMINE POWDER… support immunity and digestion by fueling the cells that line the small intestine.
• OMEGA-3 FATTY ACIDS… from a well-sourced supplement help the gut rebuild healthy cell walls and improve the “tight junctions” between the gut lining’s cells.
• A GOOD MULTIVITAMIN… helps fill in the nutrient gaps that commonly accompany leaky gut syndrome, even in those eating a healthy whole-food diet.
• BONE BROTH… a cup of this gut-healing stuff is loaded with soothing nutrients like collagen and gelatin.
• A DIVERSE WHOLE-FOODS DIET replete with non-starchy vegetables, healthy proteins, and good fats delivers the enzymes, vitamins, minerals, fatty acids, amino acids, and phytonutrients needed to repair damage and rebuild healthy new tissue. Include a diverse array of health-building foods to encourage a robust microbiome that can act as your reliable blockade against infection and disease.

5) Relax every day!

• Though it may seem challenging at times, practice some form of stress-reduction – like meditation, mindfulness, restorative yoga. All support gut health, whereas unchecked stress has the opposite effect, leading to bacterial overgrowth, leaky gut and inflammation.
• Get enough good, quality rest. Ideally, get 7 - 8 hours nightly to help keep your gut (and the rest of you) on an even keel and your immunity high.