Permeabilitatea intestinala, cauze si recomandari

Intestinal permeability, causes and recommendations

The most frequent symptom in the case of people with intestinal permeability disorders is associated with diarrhea. In fact, many diseases associated with intestinal permeability occur mainly with diarrhea.

Other common symptoms associated with intestinal permeability are:

  • fatigue
  • bloating
  • joint pain
  • flatulence
  • constipation
  • muscle pain
  • abdominal pain etc.

The influence of intestinal permeability in chronic fatigue syndrome and irritable bowel is currently being investigated. In fact, in people with irritable bowel syndrome who present with diarrhea, a different microbiota has been observed in patients with this syndrome associated with constipation. The intestine of these patients shows a change in the diversity of the intestinal microbiota, especially a decrease in butyrate-producing bacteria.

It is known that, as in other diseases such as atopic dermatitis, the decrease in short-chain fatty acid leads to some degree of inflammation.

Butyrate has the following main functions:

  • Produces energy for enterocytes
  • Decreased inflammation
  • It contributes to the maintenance of the intestinal barrier

Some of the people who show changes in permeability develop greater sensitivity to some foods (intolerances) and even allergies.

The increase in intestinal permeability seems to be related to many factors such as: stress, substances we ingest with food (toxic, metals, dyes, etc.) or ingested drugs.

All of these cause inflammation of the intestinal mucosa, such as antibiotics or anti-inflammatories. These substances can pass into the blood in larger quantities due to a change in the intestinal barrier and can alter the immune, endocrine, nervous, etc. systems. and causing numerous digestive symptoms.

More and more people complain about these types of symptoms, especially diarrhea, and the fact that they are not diagnosed correctly.

The intestinal barrier concept

The intestinal barrier is a functional concept that refers to a set of cellular and extracellular elements present in the intestine that act in a coordinated manner.

Its coordinated action prevents the passage of antigens, toxins and pathogenic bacteria. Therefore, intestinal permeability is a property that the intestinal barrier has to allow the passage of nutrients from the diet, blocking the passage of toxic substances and microorganisms that can damage the body.

The main functions of this barrier are:
  1. It prevents the passage of antigens, toxins and microbial products
  2. Maintain tolerance function of dietary antigens and gut microbiota.

Alteration of intestinal barrier function has been associated with the development of inflammatory diseases in the digestive tract, which can cause an increased permeability syndrome.

The intestinal barrier is composed of a single layer of cells (enterocytes) covered by a layer of mucus, where the intestinal microbiota (microbiota) and immunoglobulins of the Ig A type, which have a defense role, are found.

It selectively regulates the passage of substances between the intestinal lumen and the bloodstream. This passage of substances is carried out by two mechanisms:

  1. The transcellular mechanism, i.e. through enterocytes
  2. Or the paracellular mechanism, that is, in the union of enterocytes.

Enterocytes are linked by intercellular proteins, which act as filters and allow the passage of small molecules (no more than 50 angstroms). When this paracellular pathway is altered, increased permeability syndrome occurs.

What is the cause of intestinal permeability?

There are many causes that can produce an alteration of intestinal permeability and, moreover, not all of them are clearly known.

  • Stress
  • Dermatological pathologies such as atopic dermatitis, etc.
  • Rheumatological diseases such as rheumatoid arthritis, spondylitis, etc.
  • Tumors
  • Infections (bacteria, viruses, fungi) that usually cause diarrhea
  • Inflammatory diseases such as Crohn's disease and ulcerative colitis, which can also lead to diarrhea
  • Irritable bowel syndrome especially with diarrhea
  • Celiac disease
  • Acute pancreatitis
  • Medicines such as anti-inflammatories, antibiotics, antivirals, etc.
  • Radiotherapy and chemotherapy
  • Heavy metals, alcohol and tobacco.
  • Asthma
  • Multiple sclerosis
  • Diabetes, obesity and metabolic syndrome
  • Changes in the intestinal microbiota (dysbiosis)
Recommendations for improving intestinal permeability

There are a number of measures that can be applied to try to avoid changes in intestinal permeability. It should not be forgotten that these types of changes must be evaluated by a specialist doctor, as it is necessary to establish a correct diagnosis.

These measures consist of:

  • balanced diet, rich in fiber and polyphenols, avoiding irritating, refined and processed products.
  • Assess mood and stress
  • Vitamin B6 and zinc, very useful elements for these patients.
  • Maintain adequate hydration
  • Probiotic supplementation can be effective, probiotics and prebiotics improve intestinal permeability.
  • Drinks (coffee, tea, alcohol) and tobacco should be suppressed.
  • Supplements with amino acids such as L-glutamine and arginine can be useful, it should not be forgotten that L-glutamine is an important element of intestinal connective tissue and improves cellular recirculation and energy intake. On the other hand, arginine is important for the formation of glutathione. (antioxidant). Both glutamine and arginine can be supplemented through dietary supplements or along with probiotics.
  • Avoid proton pump inhibitors, some NSAIDs, antidepressants and statins, they can induce intestinal dysbiosis and increase intestinal permeability.
  • Finally, new research has found that a monoclonal antibody (tofacitinib) useful in the treatment of ulcerative colitis and rheumatoid arthritis recently approved by the FDA has been shown to be able to repair intestinal defects that cause increased intestinal permeability in some patients.


    • Salvo-Romero, E., Alonso-Cotoner, C., Pardo-Camacho, C., Casado-Bedmar, M., & Vicario, M. (2015). Intestinal barrier function and its implication in digestive diseases. Revista Española de Enfermedades Digestivas, 107(11), 686-696.
    • Pozuelo, M., Panda, S., Santiago, A., Mendez, S., Accarino, A., Santos, J., … & Manichanh, C. (2015). Reduction of butyrate- and methane-producing microorganisms in patients with Irritable Bowel Syndrome. Scientific reports, 5(1), 1-12.
    • Spalinger, MR, Sayoc-Becerra, A., Ordookhanian, C., Canale, V., Santos, AN, King, SJ, … & McCole, DF (2021). The JAK inhibitor tofacitinib rescues intestinal barrier defects caused by disrupted epithelial-macrophage interactions. Journal of Crohn's and Colitis, 15(3), 471-484.

Back to blog

Leave a comment