Leaky gut syndrome in the general clinical practice

Abstract

Leaky gut syndrome is a pathological state characterized by the reduced barrier gut function and translocation of gut flora in the blood flow, that results in the onset of symptoms on the part of various organs and systems. Leaky gut syndrome is a problem not only for the general practitioners, internists or gastroenterologists, but also this is a multisystem problem, concerning medical practitioners of other specialties (dermatologists, neurologists etc.). Despite the established relationships between leaky gut syndrome and various diseases (depression, chronic fatigue syndrome, autism), there are still many unresolved issues regarding mechanism of the leaky gut syndrome development. The clear standardized tests do not exist, that enable confirmation of the presence of this syndrome, in particular, reveal of the markers of epithelial dysfunction and intestinal permeability. Methods, used for leaky gut syndrome diagnosis, have many shortcomings, that limit their application in the everyday practice. This encourages doctors to use the empirical principle of treatment, using different types of drugs, which sometimes do not improve, but worsen, the prognosis of such patients. The main reason to suspect the leaky gut syndrome for a doctor is the non‑specific clinical picture: combination of one or multiple symptoms (flatulence, pain, diarrhea, constipation) with the dermatological; problems, disturbances in the functional liver tests, immunological disorders. The article presents new concepts on the leaky gut syndrome etiology and pathogenesis. The modern methods and basic principles of the leaky gut syndrome diagnosis and treatment have been elucidated. The search for the effective specific etiotropic treatment is ongoing. With account of the existing data, a patient can be assisted with the use of pathogenetic approach to the therapy: anti‑inflammatory, antibacterial, probiotic and prebiotic treatment, correction of functional, inflammatory and dysbiotic intestinal states.