Talk:Leaky gut syndrome/Archive 1

Archive 1

References

Article needs references. This certainly is not my understanding of a leaky gut. NPOV is regarding the weasel words such as "A useful approach may be found in the thinking of doctors..." -- Samir धर्म 07:45, 13 June 2006 (UTC)

Samir, eliminating the passive voice in this sentences would help immensely. Antonrojo 01:48, 14 June 2006 (UTC)

I removed three references listed on this page for these reasons:

1. [1] The linked section is focused on a proposed treatment for the disease based in holistic/hypoallergenic medicine. After a brief and unreferenced description of the syndrome, various treatments are listed. I'm sure the various views on treatments have a place in the wiki article, however pointing the reader towards a particular one without any context or evidence in the article is confusing. Antonrojo 01:48, 14 June 2006 (UTC)
2. [2] This article is similar to the above link. The article makes several claims about the causes and treatment of the diseases, again proposing several holistic treatments and hypoallergenic dietary changes. Initially it appears well referenced, however none of the listed references are linked in the article. A search of the terms used in the causes page such as 'caffeine' and 'hormones' shows the references don't mention these terms. There does seem to be a few good references for alcohol which might be good to mention as a cause or aggrevator of the syndrome.
3. [3] This reference seems to be a good overview of the syndrome, unfortunately it currently has a broken link (at least at the moment). Antonrojo 01:48, 14 June 2006 (UTC)

I'm restoring the NPOV tag. A little Google finds that references are predominantly on alternative therapy, self-help and activism sites. A PubMed search finds only two references to "leaky gut syndrome". Currently the article treats the syndrome as established fact; it needs revising to make clear who believes in it, and provide a wider sysnthesis of the general medical view. Tearlach 19:52, 17 June 2006 (UTC)

Per the requests for references and citations, 150 + drawn upon by Galland, M.D. Res q68 02:29, 9 July 2006 (UTC)

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149. Gyory, C.P. and G.W. Chang, Effects of bran, lignin and deoxycholic acid on the permeability of the rat cecum and colon. J Nutr, 1983. 113: p. 2300-2307.

150. Shiau, S.Y. and G.W. Chang, Effects of certain dietary fibers on apparent permeability of the rat intestine. J Nutr, 1986. 116(2): p. 223-32.

151. Spaeth, G., et al., Food without fiber promotes bacterial translocation from the gut. Surgery, 1990. 108(2): p. 240-6.

152. Fukushi, T., Studies on edible rice bran oils. Part 3. Antioxidant effects of oryzanol. Rep Hokaido Inst Pub Health, 1966. 16: p. 111.

153. Yagi, K. and N. Ohishi, Action of ferulic acid and its derivatives as anti-oxidants. J Nutr Sci Vitaminol, 1979. 205: p. 127-135.

Uhh mmm

Pubmed "leaky gut syndrome" yields two papers. This article should clearly state that gut leakiness is an alternative medicine theory not quite supported by mainstream medicine in that form. JFW | T@lk 09:03, 9 July 2006 (UTC)

I have redone this article to actually state clearly that this is a diagnosis in alternative medicine. As the sections on diagnosis, treatment and actual signs and symptoms were not verifiable due to a lack of reliable sources I turn to other editors to supply these sources. The 153 references above are not themselves proof of how this condition should be diagnosed and treated. JFW | T@lk 19:20, 9 July 2006 (UTC)

Improve

Well now, science has moved on and there are now 12 references to this subject on Pubmed, so I intend to rewrite if no objections!

Also article so far seems to be focussed on autism, when leaky gut is implicated in a number of conditions that need mention.

Oh, and the science is shaping up to be a distinctly different condition to SBBOS Peerev (talk) 21:19, 8 April 2009 (UTC)

Citations

I am new to wiki and would appreciate discussion and reasoning on the recent reverts particually in relation to MEDRS as it seems to me some comply? Peerev (talk) 21:59, 23 April 2009 (UTC)

I'm guessing it was me. Just because something is peer reviewed doesn't automatically mean it can/should be included in wikipedia. Check out WP:MEDRS, WP:Fringe and other policies. Some of the refs you put in were problematic for various reasons. If you want to discuss any of the ones I reverted, just post the info here and I'll reply. --sciencewatcher (talk) 22:23, 23 April 2009 (UTC)

Thanks, it seems to me that this subject is not Alt Med as a check on Pubmed shows whilst there are only 12 hits for Leaky gut syndrome, there are 51 for 'leaky gut' including 21 reviews, where as there are 54 reviews for 'bowel permeability and tight junctions' So it seems that the science is there and probably no longer an 'alternative med' subject. However SBOS does not seem appropriate as only one cause among many possible. I will leave it to more experienced to decide. In the meantime the Article needs improvement.

Depression, re PMID 19085093 it is not a Review but as the edit is close to the article wording, it seems to comply with edits that rely on primary sources should only describe the conclusions of the source, In particular, this description should follow closely to the interpretation of the data given by the authors, PMID 18580840 may be better ref as it is secondary source from a reputable publisher will be written by an expert in the field and be editorially or peer reviewed. The author has some 242 pubmed articles on depression. The journal has a formal peer review process satisfactory to NIH, as shown here in 'instructions to authors[4] and published articles are distinct from 'letters to the editor' Peerev (talk) 21:58, 26 April 2009 (UTC)

As far as I'm aware, leaky gut is considered psueoscience. Number of hits on alt med does not prove anything (and 51 is very low for a recognised syndrome. Try searching for "chronic fatigue" and you'll get a lot more!) Both PMID 18580840 and 19085093 are hypotheses. --sciencewatcher (talk) 22:26, 26 April 2009 (UTC)

I said Pubmed not Alt med? Maybe a new Article, Leaky gut or Bowel permability appropriate? From Wiki article its not pseudoscience as it has a testable hypothesis, the fact that there are hypotheses in mainsteam journals attests that. Much of the published science also attests and 75 reviews is not trivial. Hypothesis yes, based on evidence thats why edits were placed in hypotheses section of Article!

Diabetes, PMID 18820210 is again a review in the journal 'Diabetes' ditto. Heart, PMID 18685461 is a review, to which can be added another review PMID 15980032. Hepatitis etc, PMID 18626795 is a review. Somatization and CFS, PMID 19127706 is another review, supported by PMID 19112401, which shows the hypothesis is testable. Peerev (talk) 21:31, 27 April 2009 (UTC)

Ok, it looks like you know more about this than me. Looking at these and other reviews there is genuine research into "leaky gut". The problem is that the "leaky gut syndrome" that is diagnosed by naturopaths isn't the same thing as the leaky gut that we see in the reviews. So you just need to be careful that you separate the "real" leaky gut from the quackery version.

Also, while hypotheses are fine in the hypotheses section, you just need to be careful about two things. First of all, don't give them too much WP:Weight. Generally one sentence max is sufficient for an untested hypothesis. Also you shouldn't be putting in anything too speculative even in the hypotheses section. For example, 19127706, which says "SUMMARY: 'Functional' symptoms, as occurring in CFS and somatization, have a genuine organic cause". That's a bit of a stretch, don't you think? He says "have a genuine organic cause", not "may have a genuine organic cause". Because of this, I'm now a bit suspicious about all of Maes' work. --sciencewatcher (talk) 22:25, 27 April 2009 (UTC)

From his website it seems Maes is a psychiatrist and researcher, this article is in journal 'Curr Opin Psychiatry' so opinion might be operative word? He has four published papers on Leaky gut and depression so it seems he possibly is refering to his own findings? Although not strictly MEDRS I agree with adding the word 'may' as you suggest.

The article title "Leaky gut' already redirects here, so I concur it is probably meant to cover both, but agree needs differentiating? Maybe constrasting these two in the lead might help, PMID 17182488, PMID 16092447. This Google scholar abstract might also be useful rerence [5] unless a better definition is possible, I will attempt a rewording?Peerev (talk) 21:51, 28 April 2009 (UTC)

Yes, just go ahead and improve the article, and I'll not revert unless there is an obvious issue. Sounds like you know what you're doing. --sciencewatcher (talk) 22:19, 28 April 2009 (UTC)

I recommend putting the material on "leaky gut", disruptions of tight junctions, into leaky gut rather than redirect. both articles linking to one another (and elsewhere) as necessary. There's plainly a difference between "leaky gut" per se on the one hand, and "leaky gut syndrome" on the other hand. If I understand the lay of the land correctly, the latter is asserted -- without much if any clear experimental evidence in support to date -- to be related to a cluster of symptoms so as to essentially constitute a defined spectrum disorder (i.e., "leaky gut syndrome") that is considered pseudoscientific. The former ("leaky gut") is still under experimental investigation without much of a clear understanding of its full implications within the medical community. IOW, best to split this new material into the title leaky gut. ... Kenosis (talk) 23:11, 1 May 2009 (UTC)

I've moved the new material over to Leaky gut, where it more appropriately belongs. TBH, it's far too much primary-source material-- please see also WP:Summary style. Nonetheless I've kept the just-added material intact for now at leaky gut, until one or more editors have a chance to deal with it and hopefully it can get sorted out so as not to confuse "leaky gut syndrome" with the more straightforward and far less speculative term "leaky gut". ... Kenosis (talk) 22:45, 3 May 2009 (UTC)

I will leave it to others to decide whether split is best. However most material in 'Leaky gut' complies with WP:MEDRS. If however you want please discuss specifics not generalise. Meanwhile i will add to 'leaky gut'Peerev (talk) 23:24, 3 May 2009 (UTC)

Misleading summary of Ming et al. 2008

I just now removed this text, as it is a greatly misleading summary of the cited paper:

"A more recent study 2008 has found autism is likely to occur together with other medical and psychiatric conditions including sleep disorders, epilepsy, food intolerance, gastrointestinal dysfunction, mood disorder, and aggressive and self-injurious behaviors, food allergies and food intolerance have been linked to 'leaky gut'(see above), treatment of associated conditions may benefit patients. "

The cited source says nothing about leaky gut syndrome. Nor does it say that autism is associated with food intolerance or gastrointestinal dysfunction. I am greatly puzzled as to why this paper was cited at all here" as per WP:MEDRS we should be preferring reviews to primary studies on this topic, and should not be using primary studies to dispute reliable reviews. Eubulides (talk) 20:59, 7 May 2009 (UTC)

References

No mention of Zonulin?

I was surprised to find that the wikipedia site on leaky gut hasn't been updated with the research into zonulin- the protein that can actually open up tight junctions (zonula occludens) in the gastrointestinal epithelium.

There was an 8 page article about leaky gut and celiac disease in the August 2009 edition of Scientific American.

There are already drugs in development that will prevent the effects of zonulin on the tight junctions. Shouldn't the wikipedia page be updated with this new mechanism that explains how leaky gut occurs?

Two articles sited by Scientific American were: "Mechanisms of Disease: The Roles of Intestinal Barrier Function in the Pathogenesis of Gastrointestinal Autoimmune Diseases," Fasano & Shea-Donohue in Nature Clinical Practice Gastroenterology & Hepatology, Vol.2, No. 9, pages 416-422, Sept 2005

"Diagnosis and Treatment of Celiac Disease" Sollid and Lundin, Mucosal Immunolgy,Vol 2, No 1, pages 3-7, January 2009

Kosovokelly (talk) 09:36, 27 May 2010 (UTC)

That would probably belong in the leaky gut article rather than here. --sciencewatcher (talk) 14:01, 27 May 2010 (UTC)

Removing inaccurate citation

I have removed the reference in the treatment section several times as the citation it refers to, regarding the treatments mentioned being ineffective, pertains only to Autism and not Leaky gut syndrome. If someone has an issue with Leaky gut not being a valid syndrome than I am not sure why there is a treatment section. How can one treat something that does not exist? 21:51, 1 October 2010 (UTC) —Preceding unsigned comment added by 76.168.8.59 (talk)

The sentence originally ended with "in the treatment of autism", but it was removed by someone a few weeks ago. It looks like you were the one who added those words in the first place. —Soap— 22:20, 1 October 2010 (UTC)

yes, but it sounded awkward so I removed the phrase altogether. 76.168.8.59 (talk) 22:28, 1 October 2010 (UTC)

By definition there cannot be a treatment for 'leaky gut syndrome' because it is not actually a valid diagnosis. Leaky gut syndrome is a proposed cause of autism, and the reference you removed is talking about 'so called' leaky gut syndrome, so it can be included (alternatively we may as well just delete the entire article using your logic!) --sciencewatcher (talk) 09:16, 2 October 2010 (UTC)

I've reworked the article a little to make it clearer that leaky gut syndrome is not a recognized medical condition, and renamed 'treatments' to 'proposed treatments'. If you think the removed study should go under the autism section instead of under treatment, go ahead and change it. --sciencewatcher (talk) 10:18, 2 October 2010 (UTC)

medical condition

We can't say it is a 'medical diagnosis' when that clearly isn't the case. Leaky Gut Syndrome is a pseudoscientific diagnosis that is not recognised by mainstream medicine. Therefore it is WP:POV to call it a 'medical diagnosis'. The morgellons article uses the term 'proposed condition' which is NPOV. I don't see how you can possibly say the 'unproven' or 'hypothetical' are weasel words or peacock - they are simply descriptive of the syndrome and backed up by the references. The lede should be a summary of the article, and 'hypothetical' and 'unproven' seem to be a fair summary, but I am open to discussion about alternatives. --sciencewatcher (talk) 20:49, 17 February 2011 (UTC)

That it is a diagnosis is fact. So the question becomes, is it a "medical" diagnosis. I'm not familiar with the pseudoscience articles on Wikipedia but I don't think a particular organization or philosophy has a monopoly on the term "medical". I think that by beginning - literally - by hammering the reader over the head with "it's fake! it's not proven! pseudoscience!" that we're doing a disservice to the reader. We aren't respecting them. It's similar (if I may) to Nagorno-Karabakh Republic. We inform the reader in the first sentence that, yes, it's unrecognized, but we don't badger them with "it's illegal! it's part of Azerbaijan!" even though, from certain (and even majority) points of view, these statements may be accurate. I'm not necessarily saying that "if Morgellons doesn't have it, we shouldn't", I was simply looking at it as a guideline since that's a much more well-known "disorder." You don't have to hammer in all the negative terms in the first sentence to make your point, is all I'm saying. --Golbez (talk) 22:54, 17 February 2011 (UTC)

I just have a problem with calling it a 'medical diagnosis' in the first sentence (it clearly isn't). In wikipedia we use the scientific mainstream viewpoint as described here and that viewpoint is that leaky gut syndrome is not a recognised medical diagnosis. Please suggest an alternative wording that you are happy with. --sciencewatcher (talk) 00:08, 18 February 2011 (UTC)

Diagnosis is a technical term with a particular meaning in this context, which leaky gut does not satisfy. Does this satisfy, at least as a basis for discussion? The wording should be tightened and the grammar examined, but I think that it at least conveys the important points in summarizing the article. - 2/0 (cont.) 06:23, 18 February 2011 (UTC)

Looks okay to me. --sciencewatcher (talk) 15:27, 18 February 2011 (UTC)

Autism

The claim in the autism section that there is no evidence connecting intestinal permeability to autism is not accurate. That may be the conclusion of the paper cited, but this 2010 reference says otherwise. [6] J Pediatr Gastroenterol Nutr. 2010 Oct;51(4):418-24. — Preceding unsigned comment added by 50.129.181.171 (talk) 05:31, 20 April 2012 (UTC)

Merge with Small bowel bacterial overgrowth syndrome

This seems to me to be exactly the same topic as SBBOS, so I think they should be merged and appropriate redirects placed. Arthurrh 10:21, 12 August 2007 (UTC)

It seems to me that perhaps SBBO is a condition similar to leaky gut - the difference being that one is "treated" using conventional medicine and the other is treated using "alternative" methods such as diet. Go to http://www.albatherapeutics.com/ - that's all the proof you need that leaky gut is a "real" medical condition.

And..... what about gut dysbiosis? Nevertheless, the most common terminology used by far, at least in the U.S., is leaky gut syndrome Friarslantern (talk) 10:24, 22 January 2008 (UTC)

• No, because one is about permeability, and the other is about bacteria. Two seperate issues; two separate articles. Softlavender (talk) 03:54, 5 March 2013 (UTC)

Merge proposal?

It is again being proposed that Leaky gut syndrome and Intestinal permeability be merged (I think). I would oppose that proposal. Alexbrn ^{talk|contribs|COI} 14:44, 7 February 2014 (UTC)

Hearing, no more and in lieu of discussion, I'm removing the tags from the articles in question ... Alexbrn ^{talk|contribs|COI} 17:43, 27 March 2014 (UTC)

I also oppose this, good call Alexbrn - it seems that a link from this article to Intestinal permeability would be helpful though so that readers can see the difference and the relation. Smartedits5 (talk) 18:12, 9 November 2014 (UTC)

I am pretty shocked reading this article on wikipedia. Wikipedia should be objective, there are enough studies supporting leaky gut syndrome and related ailments to it. It should be definitely rewritten. — Preceding unsigned comment added by 79.231.74.173 (talk) 15:01, 16 April 2014 (UTC)

Please post them. I just had a quick look on google scholar and didn't find a single review. --sciencewatcher (talk) 17:27, 16 April 2014 (UTC)

TheLeakyGutSyndrome Book

This page is to discuss about Theleakygutsyndrome book. — Preceding unsigned comment added by Pranavalwar (talk • contribs) 14:14, 16 January 2015 (UTC)

Why should Wikipedia be used to advertise an unnotable book promoting this health scam? That's not our purpose. -- Brangifer (talk) 15:51, 16 January 2015 (UTC)

What makes you think this is a health scam? I myself have suffered from this and got out of it by advise given in the book. There are people dying because of this disease and you think this is a scam? — Preceding unsigned comment added by Pranavalwar (talk • contribs) 16:48, 16 January 2015 (UTC)

Because the theory that increased intestinal permeability causes any sort of disease is vague and largely unproven; and, as documented in the article, there is no evidence that the remedies marketed for treating it bring the benefits they claim, despite personal anecdotes such as yours. WP must maintain a neutral point of view, which means that we have to go with the scientific data, not anecdotes. Also, please sign your posts on talk pages. DoctorJoeE ^{review transgressions}/_{talk to me!} 17:25, 16 January 2015 (UTC)

Redundant article?

Seems like this article was written by and for the benefit of the Quackwatch (QW) fans - some of the loudest participants I've seen on Wikipedia (W).

The article on intestinal permeability (IP) seems to cover the same info and symptoms (et al), but with better info and leaving out all the stuff by the QW kooks. The fewer articles that refer to QW or contain content from their acolytes, the better for W. (It's a sad statement that they qualify as a reliable source.) Intestinal permeability is not fake or a fake condition and I don't know what benefit anyone sees (aside from Quackwatch-ites) in this article which promotes the idea that it is fake. Product marketers exaggerating the benefits of their products is expected and is just as common - or more - with FDA/PHRMA meds, which often have national or international marketing budgets. I'd personally like to see a little more worry thrown in this direction where the problem is actually significant to a lot of people.

Is there any reason that this article can't be flushed and simply become a redirect to the intestinal permeability article? There's almost nothing currently redeeming about this article except the link to the IP article anyway.

Also, could there be any more weasel words in one sentence: "Skeptics and mainstream scientists [who are all unidentified] generally agree [when do they not agree?] that most [exceptions, please?] marketing of treatments for leaky gut syndrome is, at best, misguided, and at worst, an instance of deliberate health fraud."

No mentions of health fraud or anything even close in the citation. Mccabem (talk) 06:55, 13 July 2015 (UTC)

"Leaky gut syndrome" is a fringe claim that excessive permeability causes pretty much everything that is not otherwise explained with enough money chasing "treatments". There is no doubt presented here or at intestinal permeability that permeability is real. There is substantial doubt that excessive permeability causes everything from autism to late car payments.

In situations such as this, the question of a merge is best answered as follows: What do WP:MEDRS sources have to say? When a WP:FRINGE topic has minimal coverage in reliable sources, WP:WEIGHT explains why we typically offer little more than a small section in the article on the mainstream topic. If there is sufficient coverage in independent MEDRS sources, an independent article makes sense.

Substantial discussions at the reliable sources noticeboard and arbcom have repeatedly found that Quackwatch is a reliable, if strongly worded, source.

As for the "weasel" issue, the sentence seems to have been pieced together and needs a bit of work to bring it back to the source.

• "Skeptics and mainstream scientists generally agree" seems to be a mirror image of "Exponents of 'leaky gut syndrome' – largely nutritionists and practitioners of complementary and alternative medicine – believe". Without some digging, I can't really tell how much this has been massaged by both sides. One side is probably trying to say that science says this is bullshit. The other side is probably trying to play on absurdly negative connotations of "skeptics" and "mainstream".
• "most marketing of treatments for leaky gut syndrome is...misguided (or) deliberate health fraud" - you ask for exceptions. The source does not provide exceptions so we do not provide exceptions. This particular source does not say the claimed treatments are misguided or fraud. We will need a source for that. However, the source does repeatedly refer to them as "treatments". With little evidence to suggest the grab-bag of conditions are caused by a leaky gut, the "treatments" are, of course, supported by even less evidence. We need to present this information fairly but clearly. - SummerPhD^v2.0 13:41, 13 July 2015 (UTC)

Stephen Barrett

Referencing Stephen Barrett as an expert anything is embarrassing to Wikipedia. This entire article has a tone of condescending annoyance that is inappropriate at best. Clean it up. How hard is it to look and see that there are published articles, studies, and books on this topic that far outway Mr. Barrett's unqualified opinions and obvious bias to all things he doesn't view as "conventional" medicine?

20:07, 28 September 2006 (UTC)20:07, 28 September 2006 (UTC)20:07, 28 September 2006 (UTC)20:07, 28 September 2006 (UTC)20:07, 28 September 2006 (UTC)20:07, 28 September 2006 (UTC)20:07, 28 September 2006 (UTC)20:07, 28 September 2006 (UTC)20:07, 28 September 2006 (UTC)20:07, 28 September 2006 (UTC)20:07, 28 September 2006 (UTC)20:07, 28 September 2006 (UTC)~

The last two links are extremely suspect. Does anyone else agree? Isopropyl 20:58, 5 April 2006 (UTC)

I'm far from an expert, but I removed the one to askshelley.com. I noticed it'd been removed before also. Friday (talk) 21:42, 5 April 2006 (UTC)

I agree. "Leaky gut" is just a simpler way of saying "intestinal hyperpermeability". I is most certainly a recognized condition, pubmed yields numerous results. —Preceding unsigned comment added by 85.229.114.228 (talk) 12:53, 1 January 2011 (UTC)

I agree this article is very embarrassing to Wikipedia. Also, however, I find the lack of recognition of leaky guy, or intestinal permeability, by traditional Western medicine to also be embarrassing. A great contributor to this health condition is the glyphosate sprayed on Monsanto's GMO crops. For much more accurate and up-to-date information, see the Institute for Responsible Technology. — Preceding unsigned comment added by 2602:30A:2CEA:9650:D0D4:D867:5745:64B7 (talk) 04:37, 12 March 2016 (UTC)

Jeffrey M. Smith (a.k.a. the "Institute for Responsible Technology") is not a reliable source for this article. "Traditional Western medicine" sources (a.k.a. WP:MEDRS sources reflecting current knowledge) are required for all biomedical topics. - SummerPhD^v2.0 05:33, 12 March 2016 (UTC)

Biased Article

This article is written in a biased way, by people who do not believe in the "leaky gut" hypothesis, although there is a growing amount of litterature that proves that it actually exist:“We don’t know a lot but we know that it exists,” says Linda A. Lee, MD, a gastroenterologist and director of the Johns Hopkins Integrative Medicine and Digestive Center.

Several times, I have suggest more neutral edits, taking into account state-of-the-art medical literature. They were deleted. This article should be rewritten in a neutral way. — Preceding unsigned comment added by 87.66.76.207 (talk) 15:26, 13 July 2015 (UTC)

There are two distinct things: what is commonly called "Leaky Gut Syndrome" (an altmed scam), and the phenomenon of intestinal permeability and associated research (which has its own article). It's important not to try confuse the two separate topics. If there is serious content to add about a hypothesis, it belongs in the IP article and not here. Alexbrn (talk) 15:30, 13 July 2015 (UTC)

Treating leaky gut as an "altmed scam" does not take into account recent medical literature: Wallace et al. Imaging the leaky gut. Gastroenterology 2014 , and other related articles. This is misleading for the user. The article should be rewritten in a neutral way, and inform the user that the topic is still debated. One cannot let the Science for the article about intestinal permeability, and the (debated) scam for this one, whereas the 2 issues are obviously linked.

References

Facepalm THIS ARTICLE IS NOT ABOUT LEAKY GUT. Leaky gut is disambiguated to two articles, one of which is the Intestinal permeability article (for legitimate science). The article is about the scam commonly known as Leaky Gut Syndrome. You have removed the template making this clear and edit-warred content in. Alexbrn (talk) 15:45, 13 July 2015 (UTC)

A syndrome is not necessarily a scam. Do you also believe that irritable bowel syndrome is a scam ? There is growing evidence that leaky gut syndrome, although poorly understood, is not a scam. The article is written in a biased way for the user. In place of editing what I wrote, you deleted it. Please edit the article in order to make it neutral. — Preceding unsigned comment added by 87.66.76.207 (talk) 16:02, 13 July 2015 (UTC)

A syndrome is not necessarily a scam ← obviously. But this one is. If you have sources that specifically refer to the altmed belief known as "leaky gut syndrome" that proposes leaky gut causes autism, etc, and can be treated with dietary supplements -- then bring them forth. Alexbrn (talk) 16:06, 13 July 2015 (UTC)

Not to pile on, but just in the interest of clarification: Neither the paper by Fritscher-Ravens, et al nor the editorial by Wallace, et al make any reference at all to the leaky gut syndrome. They do address (peripherally) the subject of intestinal permeability (IP), which, as Alexbrn pointed out, is a different phenomenon, covered by its own article. It is unfortunate that Wallace and Vazquez-Roque chose to refer to IP as "the leaky gut" in the title of their editorial, and I'm sure they would have titled it differently had they known that it would lead to this sort of confusion. Still -- and this has been discussed here at length in the past -- there is a distinct difference between "leaky gut", which is an actual, observed phenomenon, and "leaky gut syndrome", an entirely hypothetical condition that some individuals have attempted (often unscrupulously) to link with a variety of conditions of thus-far unknown cause. Regarding your allegation of "bias" in the article, I would only add that neutral point of view should never be confused with your point of view. DoctorJoeE ^{review transgressions}/_{talk to me!} 17:02, 13 July 2015 (UTC)

The sources offered discuss "food-associated changes in the intestinal mucosa of patients with irritable bowel syndrome". This article is about an unrecognized syndrome that allegedly causes autism, diabetes, lupus, multiple sclerosis, bad hair days, the Mondays, the Star Wars prequels, etc. If you believe the sources provide support for the fringe theory being discussed in this article, you will need to wait until reliable sources say that. If you believe this information is being suppressed by Big Pharma Inc., the FDA, the Knights Templar and the Stonecutters, you are absolutely right, but wasting your time (Wikipedia is a wholly owned subsidiary of the Stonecutters).

Until such time as independent reliable sources state that "leaky gut syndrome" is not an idea falling between misinformed hypothesis and outright scam, this article falls under WP:FRINGE. While we may present the beliefs of proponents, we will not present the beliefs as though they are equal to the mainstream views. They aren't. - SummerPhD^v2.0 17:18, 13 July 2015 (UTC)

Google Leaky gut NIH and look at the peer reviewed pubs validating leaky gut. — Preceding unsigned comment added by 67.198.123.240 (talk) 02:54, 5 October 2015 (UTC)

I agree that this article is not written properly and seems to be biased. Statements such as "Skeptics and mainstream scientists generally agree [...]" have no place in an encyclopaedia. 62.195.45.181 (talk) 21:45, 12 December 2015 (UTC)

When I search for leaky gut syndrome reviews there are only 3 results in total, only one of which might satisfy MEDRS. It says "Proponents claim that barrier restoration will cure underlying disease, but this has not been demonstrated in clinical trials". How exactly is this validating leaky gut syndrome? With all due respect, I think perhaps you don't know how to use that google thingy. --sciencewatcher (talk) 23:07, 12 December 2015 (UTC)

I happened upon this page as I was looking for info on leaky gut for myself. I am NOT a big alternative medicine fan, but I am OFFENDED by the unbalanced feel of this article as it was written by someone who has a bone to pick with alternative medicine, i.e., sciencewatcher. Unfortunately, their bad experience in turn reflects in their writing and in their personal attempts to dissuade others from seeing the issue in any other way. And yes, sciencewatcher, I found several other sceintific articles and sites supporting the concept of leaky gut syndrome. Using terms like "psuedoscience" and "fraud" is clearly a poor choice. In terms of resources, I quickly found mainstream scientific articles that actually support the concept. sciencewatcher, while you may espose any belief you choose, you cannot say that it's an objective one. I'm a new editor, though, and I can't seem to get my edits to stick. It's not worth my time to duke it out here, so I ask you: who is going to make this joke of an article more balanced? It makes Wikipedia and mainstream medicine look bad. There is far more to intestinal permeability than what has been written here. Please. — Preceding unsigned comment added by Les5889 (talk • contribs) 17:01, 7 June 2016 (UTC)

As a new editor you need to learn to WP:FOC. This page is about a fake condition which is NOT the same as intestinal permeability, which has its own article. Alexbrn (talk) 17:14, 7 June 2016 (UTC)

This article is about a fringe medical claim, "leaky gut syndrome". Reliable sources make it clear that the fringe claim ("OMG! It causes everything from autism to brain cancer! And 99.9% of the world's doctors are conspiring to cover it up!") is a fringe claim, wildly extrapolated from intestinal permeability. Yes, this article is slanted toward mainstream medicine vs. alternatives to medicine. This saves us the trouble of figuring out whether all diseases should be treated with foot massages, back rubs, random pin pricks or sugar water with one simple trick: WP:MEDRS. Is mainstream science wrong? Frequently. It's almost the worst system in the world for figuring anything out, second only to everything else. - SummerPhD^v2.0 00:46, 8 June 2016 (UTC)

Okay, I'll say this nicely. I don't want to learn the rules, because I don't want to stay around. If mainstream medicine were the answer to everything, we wouldn't have thalidomide babies or malpractice suits, of which I am an aggrieved party to right now. Mainstream medicine causes further problems in simple situations that alternative approaches may remedy in a less invasive (and far less expensive) way. Tell that to the Ph.D.s and pharmaceutical reps, though. Feel free to keep the article biased...it's not worth the drama. — Preceding unsigned comment added by Les5889 (talk • contribs) 01:41, 9 June 2016 (UTC)

Wikipedia is biased; openly, proudly biased toward what reliable sources say. If you choose to believe that illnesses are caused by mysterious micro misalignments of the spine, eating food from outside your climate, evil spirits or whatever, we don't care. If you want to treat yourself with magic pebbles, blood sacrifices, magnetic shoes, etc., we say go for it. If, however, you want to have Wikipedia say that your favorite subset of those beliefs is true, we will ask, "Says who?"

That said, this page is for discussing improvements to the article about "Leaky gut syndrome". If you wish to further discuss Wikipedia's policies and guidelines, this is not the appropriate venue. You might consider Wikipedia_talk:Identifying_reliable_sources_(medicine) or the Village pump. - SummerPhD^v2.0 02:55, 9 June 2016 (UTC)

I suppose what matters most is winning and being rude. Not necessarily being right. Have at it. Not much in the document will change, and I am not impressed. — Preceding unsigned comment added by Les5889 (talk • contribs) 02:32, 10 June 2016 (UTC)

Oh, sorry, was I rude? As a "narrow-minded and pompous...cynical stooge (who is) tiresome, spiritless, and frightfully deficient in humor, creativity, and likability"[7] I'm usually too busy making "mind-numbing comments"[8] to be polite.

This page is for discussing improvements to the article about "Leaky gut syndrome". If you wish to further discuss Wikipedia's policies and guidelines or me and my "cynical stooges", this is not the appropriate venue. - SummerPhD^v2.0 03:12, 10 June 2016 (UTC)

Okay, this "polite" pissing contest has run its course, yes? Let's define the 2 basic (and very common) confusions, and then move on, shall we?

• First — and this has been discussed here at length in the past — there is a distinct difference between "leaky gut", which is an actual, observed, verifiable phenomenon that is covered in its own article, and "leaky gut syndrome", an entirely hypothetical condition that some individuals have attempted (often unscrupulously) to link with a variety of conditions of thus-far unknown cause, with zero credible scientific support.
• Second, situations such as this, where the verifiable facts conflict with your personal beliefs, do not constitute "bias". Beliefs are neat; cherish them, but don't share them like they're the truth; and don't bring them to WP. Our personal beliefs are not relevant here; only reliable sources are. A basic WP reality is that neutral point of view is not necessarily your point of view; and if you cannot make that distinction, then WP is not your kind of place. DoctorJoeE ^{review transgressions}/_{talk to me!} 13:59, 10 June 2016 (UTC)

There is an overlap in the claims made by intestinal permeability and leaky gut syndrome, they are not completely distinct. By poo-pooing leaky gut syndrome so categorically, some collateral damage may occur in the reader's mind, so they may come to believe there is no correlation whatsoever between, say, rheumatoid arthritis and intestinal permeability. Just because a sham science makes a claim, it isn't necessarily then a false claim. I'm not sure the disambiguation at the top of the page is enough. A few "whereas" clauses to point the reader toward the actual science may help.Mongreilf (talk) 21:11, 26 July 2016 (UTC)

The correlation between RA and intestinal permeability is covered in the intestinal permeability article (along with the fact that a cause/effect relationship has not been established). Inclusion of that information in this article will create precisely the sort of confusion that you seek to avoid. The two articles were separated for exactly that reason -- to avoid confusing intestinal permeability (which is real) with leaky gut syndrome (which is hypothetical). DoctorJoeE ^{review transgressions}/_{talk to me!} 21:58, 26 July 2016 (UTC)

Updated of National Health Service England (NHS) source

Old version, prior to the latest revision - February 24, 2015:

There is little evidence to support this theory, and no evidence that so-called 'treatments' for 'leaky gut syndrome', such as nutritional supplements and a gluten-free diet, have any beneficial effect for most of the conditions they are claimed to help.

Current version (Page last reviewed: 26/02/2015):

While it's true that some conditions and medications can cause a "leaky" gut (what scientists call increased intestinal permeability), there is currently little evidence to support the theory that a porous bowel is the direct cause of any significant, widespread problems. There is also little evidence that the "treatments" some people claim help to reduce bowel "leakiness", such as nutritional supplements and herbal remedies, have any beneficial effect for most of the conditions they supposedly help.

I will adjust.

Best regards. --BallenaBlanca (talk) 11:56, 15 August 2016 (UTC)

You forgot to mention the gluten-free food included in the source. Have rectified and turned the mega-quotation into a paraphrase. Alexbrn (talk) 14:29, 15 August 2016 (UTC)

It was not a forgetfulness. I had just replaced the quotation with the equivalent paragraph of the lede of the updated source, my intention was to respect the format. However, I agree with replacing the quotation with a paragraph, it is more accurate because we can be more precise. I also think it is better this way. Best regards. --BallenaBlanca (talk) 15:47, 15 August 2016 (UTC)

Cool :-) Alexbrn (talk) 15:51, 15 August 2016 (UTC)

Since we have had long disputes with well-meaning users who confuse intestinal permeability (which is real) with leaky gut syndrome (which is hypothetical), I think it is important to make that distinction in the lede. I know that it is made early in the main text, but many readers never get past the lede, so if no one objects, I'm going to restore that brief disclaimer. DoctorJoeE ^{review transgressions}/_{talk to me!} 16:03, 15 August 2016 (UTC)

It makes sense what you say, but I do not know the disputes to which you refer. What do you propose? --BallenaBlanca (talk) 16:09, 15 August 2016 (UTC)

I think it is fine to boldly make that change to the lead DoctorJoeE. Bellena if you look at the history there have been many edits to this article to make leaky gut more than it is that experienced editors have reverted...Jytdog (talk) 19:15, 15 August 2016 (UTC)

Thank you very much, Jytdog, I understand. Best regards. --BallenaBlanca (talk) 22:01, 15 August 2016 (UTC)

A typical example of such a dispute is contained in the section immediately preceding this one, above. DoctorJoeE ^{review transgressions}/_{talk to me!} 00:40, 16 August 2016 (UTC)

A Misleading Dichotomy

User:Rslateriii the content you added today was mostly not about the topic of this article. Some was about gut flora and some was about intestinal permeability. Jytdog (talk) 19:21, 31 August 2016 (UTC)

User:Jytdog the content [9] discussing gut flora and intestinal permeability is highly relevant to leaky gut syndrome, and the references I added describe this physiologic principle in much greater detail. The notion that leaky gut syndrome is an entirely unrelated entity is outdated, and painting "leaky gut syndrome" in broad strokes as pseudoscience is increasingly inconsistent with available scientific literature. The statement that "there is currently little objective evidence to support the hypothesis that such increased permeability is the direct cause of any chronic diseases" is an over-generalization, and a quick perusal of PubMed will reveal a myriad of associations between abnormal intestinal permeability and chronic diseases.

Additionally, the above statement from DoctorJoeE that "The two articles were separated... to avoid confusing intestinal permeability (which is real) with leaky gut syndrome (which is hypothetical)" does not adequately take into account that leaky gut syndrome is a poorly-defined entity at this time. I see no reason to perpetuate a false dichotomy between abnormal intestinal permeability and leaky gut syndrome as two fully distinct entities. This seems to be an over-simplification and ignores substantial overlap between two increasingly related topics. Further, the content on the Intestinal Permeability page does not directly mention the human microbiota or the principle of dysbiosis, and this page seemed a more appropriate avenue for connecting those topics.

As it currently stands, this page leaves no room for leaky gut syndrome as a valid scientific hypothesis, and makes no mention that this is an active area of medical research. I was careful to maintain the original statements that leaky gut syndrome is not currently recognized as a distinct medical diagnosis, and that there are no current medically validated tests or treatments for it. That said, researchers believe that further elucidation of leaky gut holds both diagnostic and therapeutic potential -- rather than simply dismissing leaky gut syndrome as quackery, there should at the very least be a mention that research is ongoing. Rslateriii (talk) 22:34, 31 August 2016 (UTC)

Thanks for replying! The problem is that none of the sources you bring actually say that. The sources in the article (which are very high quality per WP:MEDRS) do say that "leaky gut syndrome" is bogus. What you have done is what we call WP:SYN - please read that. Thanks.Jytdog (talk) 23:05, 31 August 2016 (UTC)

Thank you very much for your effort, Rslateriii! You have part of reason and you have used good references, but I think we should clarify concepts.

The best way to understand the need to separate the two concepts ("leaky gut syndrome" and increased intestinal permeability) is reading this summary of an inverview with Alessio Fasano [10], pioneer in the investigation of intestinal permeability and its health implications, and discoverer of zonulin: the term “leaky gut” has been used and abused, mainly by the alternative and complementary medicine network that had, in a visionary fashion, identified leaky gut as a possible mechanism leading to many problems, but most of these statements were not based on factual evidence, to the point in which we went to the extreme to develop an entire field called "leaky gut syndrome" that had very few facts and a lot of fantasies. This is the reason why the traditional medicine establishment has been so skeptical for many years. "Leaky gut syndrome" was into the pipeline of alternative medicine even before the discovery of these doors. But there is no black and white, there are grays, and we have these two camps that saw this topic as either black, it does not exist, it’s bogus, or white and it would explain all the problems of humankind.

Anyway, I think the article is still confusing and should be improved, to make clear what is scientifically proven and I have intention to work on it.

I take this opportunity to ask you, Jytdog, what do you think about using that source on Conceptual basis and background section.

Best regards. --BallenaBlanca (talk) 00:15, 1 September 2016 (UTC)

I am horrified by the ad that popped up when I went to the site. But no, we don't use talks like that; they are not scientific publications. Someone could use it in an article about Fasano to describe his views, but no one can use it to support content about science or medicine. The MEDRS sources say that as of today "leaky gut syndrome" is nonscientific garbage. No responsible scientist should be feeding the hysteria. Jytdog (talk) 00:40, 1 September 2016 (UTC)

Thanks, Jytdog. Yes, it's what I imagined. :D It is only that I like his words "leaky gut syndrome" had very few facts and a lot of fantasies... it would explain all the problems of humankind.. Best regards. --BallenaBlanca (talk) 00:47, 1 September 2016 (UTC)

Thanks; very helpful information! My apologies for the over-reliance on primary sources. Some of the PubMed references I included are review articles, though, which should qualify as secondary sources. I should also point out that the views expressed by the currently used MEDRS sources (specifically Quackwatch and NHS Choices) are a bit overstated on this page. For example, Dr. Barrett makes a specific cautionary note that "Some medical scientists use the term 'leaky gut' for problems associated with abnormal intestinal permeability, but 'leaky gut syndrome' is not one of them." Also, those two sources haven't been updated since 2015, so that information should be amended.

The point I'm trying to make is that drawing a firm line between leaky gut (increased intestinal permeability) and leaky gut syndrome is probably a confusing distinction for the lay public, and this page, in its current state, could be improved to better reflect that leaky gut (abnormal intestinal permeability) is not "nonscientific garbage" - instead, this page could more accurately describe where the established studies for leaky gut stop and the hypothetical theories about leaky gut syndrome start. I would venture to say that members of the lay public are generally unfamiliar with the concept of intestinal permeability, but are more likely to have heard of leaky gut syndrome. If they encounter this article without reading the article about intestinal permeability, a reasonable conclusion to make is that both leaky gut and leaky gut syndrome are pseudoscience. As the old saying goes, this page (in its current state) is throwing the baby out with the bathwater. Rslateriii (talk) 18:15, 1 September 2016 (UTC)

I respectfully disagree. Since the difference between the two is spelled out quite explicitly in the lede, and again in the main content, I don't think such a conclusion would be at all reasonable.

To the other point: Fasano is a reputable guy -- and apparently, he is one of a small minority of legitimate researchers who does believe that “leaky gut syndrome” could be real, and may play a role in food allergies, type-1 diabetes, celiac disease, Crohn’s disease, irritable bowel syndrome, and perhaps other digestion-related maladies. But neither he nor anyone else has proved it. Or to put it another way, beliefs are neat, but they should never be confused with scientifically demonstrated facts. If and when Fasano (or somebody else) convincingly demonstrates any of the above, with real data, we will certainly reflect that information in the article. As of now, that has not happened; and unfortunately, as Fasano himself points out, the term “leaky gut” has been used and abused for decades by alternative medicine practitioners who -- based on zero credible evidence -- cite it as the cause of everything from autism to cancer. So public speculation by legitimate scientists like Fasano that "leaky gut syndrome" might be a real phenomenon -- likewise based on no evidence -- serves only to muddy the waters even further. IMHO he should keep his mouth shut until he has some data. DoctorJoeE ^{review transgressions}/_{talk to me!} 19:05, 1 September 2016 (UTC)

Rslateriii is right, the page is confusing, especially for the lay public. It is necessary to clarify the concepts.

DoctorJoeE, I have the impression that you have not understood: Alessio Fasano (who is a pediatrician and researcher, and one of the world's leading authorities in gluten related disorders and autoimmunity) do not defends "leaky gut syndrome" as doctors of alternative medicine pose, he speaks about increased intestinal permeability, which is a real entity. And yes: it has been proven that increased permeability allows passage of macromolecules, favoring the appearance of some systemic disorders. A clear model is celiac disease. Another example: sepsis due to intestinal bacterial translocation. And gradually more evidence are accumulated. As NHS states, currently (on 2015..) there is little evidence, because some cases are proven. The difference is trying to explain all health problems by a leaky gut, which it is unreal and full of fantasies. Best regards. --BallenaBlanca (talk) 19:29, 1 September 2016 (UTC)

Perhaps you should read my post again. I did not say, nor did I mean to imply, that Fasano has defended the "leaky gut syndrome" charlatans. And yes, of course, he is aware -- as am I, along with everybody else interested in intestinal diseases -- that increased intestinal permeability is real, and that it is demonstrable in the presence of some diseases, such as the ones I mentioned. What has not been demonstrated is a cause/effect relationship. That is, the fact that increased intestinal permeability and, say, celiac disease coexist does not prove that one causes the other. (It's easy to draw bad conclusions from good data -- for example, if your headache goes away after you take an aspirin, you would be wrong to conclude that headaches are an aspirin-deficiency disease.) If and when someone does establish cause & effect, then "leaky gut syndrome" will, in a sense, prove to be a real phenomenon -- but not at all in the same way that the charlatans claim -- nor, I'm pretty sure, will it ever turn out to be a magical answer for every idiopathic disease, as the charlatans claim. DoctorJoeE ^{review transgressions}/_{talk to me!} 20:28, 1 September 2016 (UTC)

Yes and in light of the charlatancy (word?) of people trying to make money off of other people who are legitimately suffering, and because of the advocacy of those who are really suffering and believe they have "leaky gut syndrome", this article needs to maintain an extremely bright between 1) "leaky gut sydrome" which is based on an unproven assumption and all the claims within it are pseudoscience; and 2) the interesting and difficult science between done around the relationships among genes, potential toxins, intestinal permeability, and various diseases/conditions, etc. The charlatans and advocates persist in their exploitation/deluston by fuzzifying that line. Jytdog (talk) 20:51, 1 September 2016 (UTC)

Yes, the distinction needs to be clear. Mixing "legitimate" stuff in here won't do that. Alexbrn (talk) 08:53, 2 September 2016 (UTC)

• Bellena you have three of us here saying please don't do what you just did..... Jytdog (talk) 09:14, 2 September 2016 (UTC)

Jytdog, Three people can be wrong...

DoctorJoeE, celiac disease is a weel studied model, in which increased intestinal permeability appears secondary to the abnormal immune reaction induced by gluten (not just coexist) and allows fragments of gliadin protein to get past the intestinal epithelium, triggering an immune response at the intestinal submucosa level that leads to diverse gastrointestinal or extra-gastrointestinal symptoms. Eliminating gluten from the diet leads to normalization of intestinal permeability and the autoimmune process shuts off.

With all due respect, I think Alexbrn also needs to clarify concepts and should be more cautious before editing about these issues. Because of him, basic concept mistakes has been kept on several pages for more than two years, which nobody else noticed, for example:

• His text on Leaky gut, 20 January 2014: [11]
• My correction, 16 August 2016: [12]
• His text on Leaky gut syndrome, 11 September 2014: [13]
• My correction, 17 August 2016: [14]

And now, he reverts my last edit saying (Reverted to revision 737099542 by Jytdog (talk): This blurs the distinction between this fake condition, and legitimate stuff. I think by eliminating this information, he gets exactly the opposite and keeps mixing concepts, or at least not distinguish between what is scientifically proven and what not.

Let's see what Doc James thinks.

Best regards. --BallenaBlanca (talk) 09:40, 2 September 2016 (UTC)

Yes and so can one, and it is more likely.  :( Jytdog (talk) 10:03, 2 September 2016 (UTC)

With respect to "Increased intestinal permeability is a factor in several diseases" the refs are more tentative than that. This paper says "emerging link between obesity and increased intestinal permeability"[15] and this one "Possible links between intestinal permeability and food processing"[16] This is more tentative hypothesis than conceptual basis or background. Doc James (talk · contribs · email) 12:08, 2 September 2016 (UTC)

Precisely what I have been trying to get across, thanks. And BallenaBlanca, I have no idea what a "weel studied model" is, but gluten sensitivity is an entirely different kettle of fish. Don't get me started on the gluten mishugas; 99.9% of people on "gluten-free diets" are not gluten sensitive in the first place. DoctorJoeE ^{review transgressions}/_{talk to me!} 12:51, 2 September 2016 (UTC)

she meant "well"... and she did. But I agree that this content was not what this article needs... Jytdog (talk) 12:58, 2 September 2016 (UTC)

Oops! "Well" :) But not "she", I am a man... :D

Let's see what you think so. I'll make some corrections, adjusting to the source already presente of NHS Choices.

If we say "These supporters say that undigested food particles can pass through the "leaky" bowel wall and into the bloodstream" it seems we are saying that the passage of molecules through the intestinal mucosa is part of the unfounded theory, when it is not. Germs and large molecules can pass through an incompetent intestinal barrier (This barrier is effective at absorbing nutrients, but prevents most large molecules and germs passing from inside the bowel into the bloodstream and potentially causing widespread symptoms.). Is true that the immune system can react to germs, toxins or other substances that have been absorbed into the bloodstream via a porous bowel, but not that this fact cause all the health problems they say ("leaky gut syndrome"). (In some circumstances, this barrier can become less effective and "leaky", although this in itself is not generally thought to be sufficient to cause serious problems. ... This, they say, is linked to a much wider range of health problems, including:...

Also, per WP:SEAOFBLUE we should make a bit clarification about increased intestinal permeability.

I do not know if I expressed myself well, sorry if is not.

Best regards. --BallenaBlanca (talk) 14:42, 2 September 2016 (UTC)

Bellena "leaky gut syndrome" = the entirety of the following: "the bowel wall becomes leaky, stuff gets through, the body raises a systemic inflammatory response, and this causes a whole host of diseases, which can be treated by closing the leaky gut". If you look at different parts of that, yes there is science behind some of the parts. But the whole thing, with its claim of causation and the treatment that flows from the cause, and claiming this with certainty, is bullshit. Actually diagnosing and treating people based on this is not medicine and not science. The people who sell this idea and the diagnoses and the treatments (and the people who sadly suffer and have come to believe and buy) take the parts that are supported with science and claim that they prove that the whole thing is true. This is not OK, and this article is not going to play that game. This may be an entirely different story next year or in five years. But that is the deal now.

Your desire to bring nuance is great; please do that on the articles that deal with science (and please be conservative, not cutting edge; Wikipedia is not cutting edge). This article needs to address the pseudoscience, and do that clearly. Jytdog (talk) 16:01, 2 September 2016 (UTC)

• This article had become a fractured mess, trying to fit it into the standard MEDMOS structure. There was stuff in the lead that was not in the body. I just collapsed it into a brief article, and weeded out the duplications. I think it is much more clear now. Jytdog (talk) 15:56, 2 September 2016 (UTC)

I agree; I think the article is more clear now. I added a bit to the first sentence, which is denoted in bold type: " While increased intestinal permeability is a phenomenon recognized by mainstream science and medicine, claims for the existence of "leaky gut syndrome" as a distinct medical condition are made by practitioners of alternative medicine. " Thoughts? Rslateriii (talk) 17:43, 2 September 2016 (UTC)

Contents not adjusted to or not present on the sources

Jytdog, I agree to collapse the article, now really looks better.

I do not agree with your reasoning ( "leaky gut syndrome" = the entirety of the following: ...) As I said, we must distinguish the proven part (the loss of the protective barrier of the intestine by increased permeability may cause the passage of macromolecules, germs, toxins, antigens... and this can cause immune reactions and health problems) from the not proven theory ("leaky gut syndrome" theory explains a extraordinarily wide range of disorders as a direct cause of an increased intestinal permeability, and therefore may cure them by correcting the intestinal barrier).

We should not build a Wikipedia article based on one or two sources (WP:NPOV), which is what happens now with the article (two sources which match WP:MEDRS and two opinions of renowned persons).

Anyway, even accepting to use only a couple of sources, we can not make "free interpretation" of them, nor distort their content, nor add content referenced with a source in which does not appear any similar text, in order to reflect "what the editor wants" and not what the sources say. And that is what you have done.

I want to make clear that you and I think alike about quacks and pseudoscience. But I can not agree with your approach "This article needs to address the pseudoscience, and do that cleary" Your goal is to make clear that all this is a pseudoscience, but my goal is to be neutral, as required by Wikipedia policies. And in fact, NHS Choices states that there is "little evidence".

I will make some edits, with the exclusive aim of adapting the text to the real content of the sources. I will explain at summary edits.

I still think the article needs a brief explanation about what is increased intestinal permeability (as it has been done at the NHS Choices source), but I will respect the decision to let interested people navigate to wikilinks. Thus, or we explain everything or nothing is explained, because of information out of context what gets is confuse the reader.

Best regards. --BallenaBlanca (talk) 23:39, 3 September 2016 (UTC)

quacks use the "proven part" to justify the whole load of shit they peddle - the theory and all "cures". There is no way we are going to feed quackery here.

the detailed science goes in intestinal permeability; there is no reason to duplicate that here.

No one agrees to add this, Bellena. Let it go. Jytdog (talk) 00:30, 4 September 2016 (UTC)

Yes, this article is about the quackery. The non-quackery stuff goes in the other article. This is distinction we make (as stated in the header) to manage our topic space. Alexbrn (talk) 06:25, 4 September 2016 (UTC)

Alexbrn, you can not simply revert all edits at once. Please, do not treat this matter so lightly. You have to argue.

I will number the edits I'm going to do (again) for adjust the text to the real content of the sources (are nine ten in total). Propose any changes you want, you have to argue it here and provide solid arguments, explaining point by point, step by step. Look closely, please, because there are serious problems, such as texts that are not in the sources and distorted conclusions.

You should not miss neutrality and make "cherry picking", choosing only the parts of the sources that interest you to assert your own position.

1. [17] Removed this content not supported by the source: "gastrointestinal disorders are more common in people with autism, and the correlation is often mistaken for causation." Please, copy here where the ref says that.
2. [18] This sentence: “and none have been shown to be safe and effective in clinical trials;” as is included, refers to all listed above, but It does not fit the reference content. The source says: “Thus, the leaky gut cures being sold at a variety of internet sites and alternative medicine stores should be considered with caution. None have been tested in randomized clinical trials”
3. [19] Removed duplicated (already mentioned at the top of the page).
4. [20] Removed text not supported by the current version of the NHS Choices: "the claimed symptoms are generic and there is no medically validated test". Yes, it is true and it is logical and agree. Not a valid diagnosis, no tests. But the fact is that the source does not mention anything about tests.
5. [21] No need to "hide" that "leaky gut" refers to increased intestinal permeability, which may be caused by various conditions and medications. It is necessary for understand the context. So I adjusted to the source, which says "While it's true that some conditions and medications can cause a "leaky" gut (what scientists call increased intestinal permeability)."
6. [22] NHS Choices source says "Leaky gut syndrome" is a proposed condition some health practitioners claim is the cause of a wide range of long-term conditions” “Exponents of "leaky gut syndrome" – largely nutritionists and practitioners of complementary and alternative medicine” The other source by Odenwald et al. says: “The topic is further confused by use of the term “leaky gut syndrome” within the lay and alternative medicine communities, and even by some physicians, and claims that this is responsible for a dizzying array of disorders” So I adjusted to the source: “are mostly made by nutritionists and practitioners of alternative medicine , and also by some physicians.”
7. [23] And now the most problematic issues (7., 8. and 9.). This text: “permitting toxins, microbes, undigested food, or other substances to "leak" into the bloodstream, triggering the immune system” belongs to the description of intestinal permeability and as you proposed, the non-quackery stuff goes in the other article and is enough to keep the wikilink There is a wikilink to intestinal permeability - people can read all about it there. (NOTE: content removed for error on this edit, added back on a further edit
8. [24] This text is not adjusted to the source: “These supporters say that overgrowth of yeast or bacteria in the bowel, a poor diet, and/or the overuse of antibiotics... NHS Choices provides a previous explanation about "leaky gut" and what causes it, and a list of known causes (alcohol, medications, diseases...). The exponents of the theory of "leaky gut syndrome" add more factors. NHS Choices says: “Exponents of "leaky gut syndrome” believe the bowel lining can become irritated and "leaky" as the result of a much wider range of factors, including an overgrowth of yeast or bacteria in the bowel, a poor diet and the overuse of antibiotics.”
9. [25] And NHS Choice says, after listing diseases that are found to cause increased intestinal permeability: This, they say, is linked to a much wider range of health problems, including:...
10. [26] I edited to add edit Nº10: NHS Choices says: "you should be wary of treatments offered by people who claim to be able to "cure" "leaky gut syndrome" as there is little scientific evidence to suggest they are beneficial for many of the conditions they are claimed to help"

Best regards. --BallenaBlanca (talk) 11:00, 4 September 2016 (UTC)

Added back content removed by an error and added several reviews of 2016. Best regards. --BallenaBlanca (talk) 12:13, 4 September 2016 (UTC)

References

BallenaBlanca, I think these are worthwhile revisions. -- Rslateriii (talk) 15:41, 4 September 2016 (UTC)

recent edits turned this back into a confused mess. I fixed it Jytdog (talk) 20:48, 4 September 2016 (UTC)

Restored BallenaBlanca's hard work seeing that Rslateriii and myself agree with the improvements Ballen has made. Best Regards,

Barbara (WVS) (talk) 21:18, 4 September 2016 (UTC)

Barbara you are new to this discussion and if you review the talk page above you will see that there is no consensus for these changes. Please note that misrepresenting the discussion is disruptive and please note that this article is under CAM discretionary sanctions. Jytdog (talk) 21:36, 4 September 2016 (UTC)

Jytdog, I agree with your latest revisions. Some of the prior sentences seemed a bit clunky; I think your edits streamlined them and improved clarity.

What are CAM discretionary sanctions? -- Rslateriii (talk) 23:04, 4 September 2016 (UTC)

Good question. CAM = Complementary and Alternative Medicine (this article is in that category). Basically, since this is one of the areas of WP that editors tend to... disagree more heatedly... in, we are expected to follow WP:s rules of behaviour, dispute resolution etc more rigidly. If we don´t, admins are empowered to deal with disruption quicker and more harshly than otherwise. Something like that. More at WP:AC/DS. Gråbergs Gråa Sång (talk) 06:32, 5 September 2016 (UTC)

Makes sense; thanks! --Rslateriii (talk) 17:09, 5 September 2016 (UTC)

I added a bit to the last sentence of the first paragraph to clarify that the evidence is lacking that directly relates leaky gut syndrome to the many chronic diseases that have been claimed. The prior version could have been interpreted as saying that there is little evidence that "a wide range of factors (such as overgrowth of yeast or bacteria in the bowel, a poor diet, and/or the overuse of antibiotics) cause the intestines to be "leaky", allowing proteins, toxins, bacteria and other matter from inside the intestines to enter the circulation, causing chronic inflammation" - this first half of the hypothesis is generally consistent with the underlying idea of abnormal intestinal permeability. The claims that leaky gut syndrome causes a wide array of chronic diseases (the second half of the hypothesis) is where the hypothesis branches and becomes less substantiated. --Rslateriii (talk) 17:09, 5 September 2016 (UTC)

Thanks, Rslateriii, you have improved it. However, I remain unconvinced. We have to review calmly.

Well, Jytdog, slowly we move forward. But we still need to clarify the points 2. 5. 6. 7. 8. 9.

Let's take a look now at point 6 and your recent edits: (again, remove false distinction about physicians. LGS is not medicine, it is alt med. period) (“"and nutritionists" is not a meaningful distinction; anyone who advocates LGS is alt-med; we don't need to break down the kinds of alt-med practioners”) It is not a "false distinction". The used refs clearly say that it is a theory proposed by health practitioners, especially of alternative medicine, but also physicians. You can not alter the content of the references for the personal goals you want to achieve on this page ” “quacks use the "proven part" to justify the whole load of shit they peddle - the theory and all "cures". There is no way we are going to feed quackery here. the detailed science goes in intestinal permeability; there is no reason to duplicate that here.” The reality is that there is no clear line separating science of unproven facts, and is increasingly more blurred; we must be neutral and accept it, and especially not alter the content of the references. Rememeber, please: Wikipedia:Neutral point of view All encyclopedic content on Wikipedia must be written from a neutral point of view (NPOV), which means representing fairly, proportionately, and, as far as possible, without editorial bias, all of the significant views that have been published by reliable sources on a topic.

This is not a matter of opinion or to discuss, is simply reflecting the content of the sources, with neutrality, without biasing. So I will restore it.

And if there is any doubt, in addition to the references cited in the text, these are some examples of the use of the term "leaky gut syndrome" by different scientists:

PMID 15154150
Leaky gut syndrome is a phenomenon of increased intestinal permeability which is thought to be related to and perhaps and etiological factor in a variety of disorders including Crohn’s disease, celiac sprue, chronic fatigue syndrome, and fibromyalgia.

PMID 25810794 [27]

Compromised intestinal mucosal integrity and breakdown of gastrointestinal mucosal barrier function, a condition generically referred to as “Leaky Gut Syndrome”, are associated with starvation, injury, infection, immunosuppression, chemotherapy, and lack of enteral feedings, radiation and other types of stress. Disruption of gut mucosal integrity and barrier dysfunction results in increased permeability to allergens, toxins and pathogens, leading to immunological stress response and inflammation (28, 34). Severe trauma and burn increases intestinal permeability to bacteria and endotoxins leading to sepsis and multiple organ failure (51). A rapid resealing of gut epithelial barrier function following injury under physiological conditions is essential as infection is a major cause of morbidity.

PMID 27114435 [28]

The leaky gut syndrome has received increasing attention in the recent past. The leaky syndrome is simply a phenomenon of passage of lipopolysaccharide or toxins of gram-negative bacteria into the blood stream due to disintegration of intestinal mucosa, which causes bacteremia, endotoxemia, and systemic inflammation. Increased intestinal permeability is known to be associated with several circumstances; the leaky gut syndrome is associated with the long-term use of nonsteroidal anti-inflammatory drug (NSAID), which is an essential pathogenesis of inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS).1–4 It also contributes to the expression and progression of the alcoholic liver disease and chronic liver disease as well as congestive heart failure.5,6 Moreover, the leaky gut syndrome has been viewed as an important pathogenesis of diabetic mellitus and obesity in relation to insulin resistance

PMID 26604935 [29]

An altered composition of the flora allows the growth of bacterial, viral or fungal pathogen populations and activates a local inflammatory response with alteration of intestinal permeability that will cause the LEAKY GUT SYNDROME. The passage into the circulation of molecules not properly filtered by the bowel causes a systemic inflammatory reaction that can be expressed in various target tissues including the osteo-articular apparatus. This syndrome participates heavily the etiology of osteoporosis also for the mechanism of malabsorption of nutrients

PMID 20664075 [30]
In some circumstances, outside stresses on the host (such as injury, infection, or unhealthy diet) can promote a dysregulation of intestinal mucosal homeostasis, resulting in a “leaky gut” syndrome and translocation of gut bacteria or bacterial products to systemic sites, which further aggravate the host’s health.

PMID 24991549 [31]

Susceptibility to IBD has been associated with the so-called leaky gut syndrome (LGS), in which a decrease in the gut epithelial barrier led to an increase of antigens from food and bacteria from the gut lumen leaking into the body [24]. Also, it is known that excessive bacterial translocation in CD is a key factor in the development of the disease, in which certain genetic mutations affect the autophagy pathway [25]. In fact it has been proposed that antigens belonging to commensal microbiota could interact with the immune system evoking antibody-driven inflammatory responses [26].

PMID 27340433 [32]
Intestinal barrier dysfunction or disruption, known as “leaky gut” syndrome, is characterized by the translocation of macromolecules, bacteria or their toxins to the lamina propria, which is implicated in the pathogenesis of numerous diseases [4]

PMID 23482055 [33]
Chronically increased intestinal permeability (or leaky gut syndrome) allows for the increased translocation of both microbial and dietary antigens to the periphery which can then interact with cells of the immune system.

PMID 26973613 [34]
During infancy and early childhood, these restrictions could contribute to the development of an abnormal microbial population and weaken the first line of the gut barrier (Vaziri et al., 2013). This eventually leads to a “leaky gut syndrome.”

PMID 26462264 [35]
Together, our data further affirm the importance of a balanced gut microflora biodiversity in host immune homeostasis and suggest that prescribing oral antibiotics to patients, especially those with a leaky gut syndrome, have to be carefully weighed if outcomes from postoperative systemic inflammation leading to sepsis are to be improved

PMID 25184418
Taken together, we report the novel finding of a “leaky gut” syndrome including zonulin upregulation in the EAE animal model for human MS. Recent reports showing that IBD patients are at higher risk for MS, while the course of the IBD disease is not influenced by the MS [8], [9], is further supporting a key role of the gut in the modulation of CNS autoimmunity.[36]

PMID 25276205[37]
Liquorice can be used to treat ileitis, leaky gut syndrome, irritable bowel syndrome and Crohn›s disease as it is antispasmodic in the bowels

PMID 17123981 [38]
These mechanisms, including intestinal bacterial overgrowth, are increased permeability of mucosal barrier (leaky gut syndrome) and deficiencies in host immune response.32

PMID 24605015 [39]
Moreover, increased gut permeability in alcoholic liver disease may be aggravated by increased expression of inducible nitric oxide synthase (iNOS) and NF-κB, which, in turn, enhance the translocation of LPS between tight junctions of adjacent enterocytes[58,59]. This increased gut permeability is also called leaky gut syndrome (LGS).

PMID 26488575 [40]
These findings demonstrate indirectly that matriptase plays a pivotal role in the development of barrier integrity; thus matriptase dysfunction can facilitate the occurence of leaky gut syndrome observed in intestinal inflammatory diseases.

PMID 25409020 [41]
Prolonged and intensive exercise is associated with hyperthermia, splanchnic hypoperfusion, loss of intestinal barrier integrity, and increased intestinal permeability or the so-called ‘leaky gut’ syndrome [22]–[24]

PMID 24678255 [42]
Pathogens, through their activation of a potent signaling molecule called zonulin, induce a breakdown of the tight junctions in cells lining the gut, leading to “leaky gut” syndrome

Best regards. --BallenaBlanca (talk) 19:43, 5 September 2016 (UTC)

Here we are with the WP:WALL. OK, "nutritionists" can stay per the NHS source. The "and physicians" is a bad reading of the source which says "The topic is further confused by use of the term “leaky gut syndrome” within the lay and alternative medicine communities, and even by some physicians, and claims that this is responsible for a dizzying array of disorders, including chronic fatigue syndrome, fibromyalgia, allergies, depression, and skin disorders ". All that says about physicians is that "some physicians" sometimes use the term. The stuff after "including" does not necessarily include "physicians". Removing that. Jytdog (talk) 20:36, 5 September 2016 (UTC)

I agree, this concern (point 6: "also by some physicians") is much more difficult to delineate. Most of the linked articles are written in regards to specific diseases or groups of diseases, but I'm not aware of a consensus in the literature regarding precisely which conditions are potentially associated to abnormal intestinal permeability. Therefore, I agree with Jytdog that we should avoid making a blanket statement that some of the physicians believe all of the conditions are related to leaky gut.

The difficulty is that some physicians believe that some of the following conditions may be related to leaky gut:

3. Neuropsychiatric diseases

5. Immune-Inflammatory and Neuroimmune disease

6. Alcoholic liver disease

7. Critical illness / sepsis

20. perhaps an etiological factor in a variety of disorders including Crohn’s disease, celiac sprue, chronic fatigue syndrome, and fibromyalgia

21. sepsis

22. IBD and IBS; liver disease; insulin resistance and diabetes

23. Osteoarthritis

25. IBD

26. “various diseases” (non-specific)

29. Post-operative sepsis

30. Multiple sclerosis

33. Alcoholic liver disease

34. IBD

(These conditions were numbered in regards to their reference number).

So, perhaps a sentence like: "some physicians believe that some of these diseases may be related to abnormal intestinal permeability, but as of 2016, there is little evidence to support the hypothesis that leaky gut syndrome directly causes the entire array of diseases that have been claimed.” --Rslateriii (talk) 00:21, 6 September 2016 (UTC)

Rslateriii, I like what you propose, but also agree to leave it like is now. It seems enough adding "mostly".

Let's take a look at point 2.

I removed this, to discuss: "None have been adequately tested to determine if they are safe and effective for this purpose, and they may do more harm than good."

In the context, this sentence refers to the sentence above (dietary supplements, probiotics, herbal remedies, gluten-free, low FODMAP, low sugar, or antifungal diets). But the source says: “Thus, the leaky gut cures being sold at a variety of internet sites and alternative medicine stores should be considered with caution. None have been tested in randomized clinical trials” Correct me if I misinterpret. I understand that it refers to "material things" that are being sold (supplements, probiotics, herbal remedies...). A diet is not sold, it is not a thing. And being sold in internet sites and alternative medicine stores, this does not include pharmacies, we can not include (all) probiotics nor (all) suplements in this asseveration. It seems that refers to uncontrolled products.

In addition, the sentences is incorrect and / or outdated, since various types of diets, supplements, probiotics have in fact been tested in randomized trials in various diseases, in order to assess the impact on intestinal permeability and associated symptoms, with diverse results, including some with improvement of symptoms. For this reason, the updated version of NHS Choices has replaced the previous text "There is ... no evidence that so-called "treatments" for "leaky gut syndrome"..." with "There is also little evidence that the "treatments...""

I propose to remove this text and find another better reference; or at least, if we use this same ref, word it adjusted to the content of the source, as for example: None of the products being sold to cure the "leaky gut syndrome" at alternative medicine stores and internet sites have been adequately tested, and they may do more harm than good.

Best regards. --BallenaBlanca (talk) 00:17, 7 September 2016 (UTC)

References

• ""None have been adequately tested to determine if they are safe and effective for this purpose, and they may do more harm than good."[1]" is true and supported by the source. Alt med pushers love to pump up the scant evidence that something ~might~ work. What is important is whether something has been adequately tested to see if it is safe and effective to treat X. No "treatment" for LGS has been shown to be safe and effective. When one is (as described in a MEDRS source) we can of course add that. Until then we are not hyping potentialities. Of course if anybody is aware of a treatment for LGS that has been shown to be safe and effective in adequately powered clinical trials I am all ears. Jytdog (talk) 01:38, 7 September 2016 (UTC)

I have been amazed by your words, Jytdog. I had not included links because I believed that is well known that many studies have been performed. Gluten-free diet and probiotics are the areas with more research, including favorable results and safety. We have, for example, the 2008 Cochrane systematic review, where they have even found favorable effects in three symptoms of autism (overall autistic traits, social isolation,and overall ability to communicate and interact; no outcomes were reported for disbenefits including harms.).

But we are not debating whether or not there are positive results on symptoms and / or intestinal permeability, we are considering whether or not we can say. "None have been adequately tested to determine if they are safe and effective for this purpose, and they may do more harm than good.” refered to special diets, probiotics, and supplements.

Clearly, we can not say this because there are dozens of randomized trials. A small example of a quick search on PubMed: PMID 25004237, PMID 27286693, PMID 25304296, PMID 26853855, PMID 25520366, PMID 27080737, PMID 27367724, PMID 25601299, PMID 25469528, PMID 25244414, PMID 24501384, PMID 24381638, PMID 24150782, PMID 23820246, PMID 23657308, PMID 23357715, PMID 23235200, PMID 23101545, PMID 22992437, PMID 22955359, PMID 22955358, PMID 22872030, PMID 22038507, PMID 23314670,......

So, again, I will remove the sentence.

Best regards. --BallenaBlanca (talk) 07:41, 7 September 2016 (UTC)

Bellena the 2008 cochrane review supports exactly what I wrote: Here is the conclusion: "Research has shown of high rates of use of complementary and alternative therapies (CAM) for children with autism including gluten and/or casein exclusion diets. Current evidence for efficacy of these diets is poor. Large scale, good quality randomised controlled trials are needed." are needed. Meaning "not adequate". Why in the world are you throwing a bunch of primary sources into this discussion? Jytdog (talk) 07:51, 7 September 2016 (UTC)

Bellena I do not understand why you are digging on this quackery. We need to seek some kind of dispute resolution. What do you suggest. Jytdog (talk) 07:59, 7 September 2016 (UTC)

I have been explaining my reasons here. I am sure that we can reach an agreement. I can not support the charlatans and pseudoscience, but I want to let the concepts clear and be neutral, leaving aside my beliefs.

We can ask for more opinions on WikiProject Medicine. Do you agree?

Best regards. --BallenaBlanca (talk) 08:16, 7 September 2016 (UTC)

At the very least, the sentence "None have been adequately tested to determine if they are safe and effective for this purpose, and they may do more harm than good," is a tad redundant. I propose that we either drop "safe" or "they may do more harm than good" - these two statements appear interchangeable to me. I would personally favor dropping the last bit ("more harm than good") for the sake of concision.

Regarding whether these products have been proven effective, I agree with Jytdog - the studies aren't strong enough yet. I found this to be a useful review: Intestinal permeability – a new target for disease prevention and therapy. Here's an excerpt: "Among the diets, some sound promising such as dietary restriction of fat and sugars, or possibly also of poorly absorbed short-chain carbohydrates (FODMAPs). Clearly, more intervention trials are urgently needed now to assess the effects of such substances as preventive or therapeutic agents in different populations and diseases, respectively. For these trials, not only known substances, but also new dietetic components and probiotic agents selected according to their beneficial effects on the gut barrier have to be identified and tested."

This article, along with the many other studies that have been mentioned in this talk (above), all indicate that research is active and ongoing. This was one of my initial contentions with this article - it makes no mention that leaky gut is being studied rather intensively. I don't think this concern has been properly addressed: is there any reason that a sentence or phrase such as "research is ongoing" can't be added to the article? --Rslateriii (talk) 14:47, 7 September 2016 (UTC)

I am fine dropping the "may do more harm than good" and adding PMID 25407511 as a ref. Leaky gut is being studied but the claim Leaky gut actually causes X Y Z, and the offering of treatments based on that claim, are bullshit. Much bullshit is generated by claims of certainty where none exists, and that is exactly what LGS is based on. The ongoing research into the relationships among intestinal epithelium, the intestinal mucosal barrier, gut flora, environmental factors, genes (human and otherwise), and various diseases and conditions is indeed very rich and interesting, but has no place in this article on Leaky Gut Syndrome. Jytdog (talk) 17:30, 7 September 2016 (UTC)

Defining the dispute

I think the dispute we are having centers on the scope of this article.

In my view it should define the pseudoscience idea, say that it is pseudoscience, and that's it. It should have WLs to the articles where actual science and medicine are taking place and those articles should discuss it in as much detail as is appropriate in an encyclopedia. In my view, the article should look pretty much like this.

I think in Bellena's view, the scope should include pretty detailed discussion of the science, especially where it supports the LGS hypothesis; in the article history, this version is an example of maximal expansion so far (not sure if there is more that Bellena wanted to add).

Is that accurate? If so, that is the question we can bring to others for input... Jytdog (talk) 17:38, 7 September 2016 (UTC)

I think I favor the current shorter version, but would be curious to see what others think.

In regards to the prior discussion, I'm not advocating for detailed discussion of the science on this page - but I do think it is worth mentioning that research is being done. I added four words to the end of the first paragraph as an example. I don't think this implies any sort of certainty about the findings of the research; merely that research is ongoing. --Rslateriii (talk) 18:20, 7 September 2016 (UTC)

am trying in this section to identify the core dispute, not so much resolve it at this time... do you agree that this is the core of the matter? If not, how would you define it? Jytdog (talk) 19:31, 7 September 2016 (UTC)

Actually, I think we've made solid progress, and don't have any major objections to the article in its current state. But let's see what BallenaBlanca thinks. --Rslateriii (talk) 20:05, 7 September 2016 (UTC)

Thanks to you both, we really have made solid progress.

My scope is to choose between one of these two options: a) explaining concepts to give the whole picture (as NHS Choices), because the information gives weapons to distinguish charlatans, but currently there is a huge mess of concepts and misinterpretations, or b) keep only the pseudoscience in this article. I agree rule out the option a) and keep wikilinks. What not to do is to mix both, not transmit the idea that the concept of the passage of substances from inside the intestines to the circulation, nor the possible causes of increased permeability, are pseudoscience. As we can read for example at the proposed source, this is not a pseudocience.

Intestinal permeability – a new target for disease prevention and therapy

The barrier assessments are further hindered by the natural variability of this functional entity depending on species and genes as well as on diet and other environmental factors. In the final part, we discuss selected diseases associated with increased intestinal permeability such as critically illness, inflammatory bowel diseases, celiac disease, food allergy, irritable bowel syndrome, and – more recently recognized – obesity and metabolic diseases. All these diseases are characterized by inflammation that might be triggered by the translocation of luminal components into the host. In summary, intestinal permeability, which is a feature of intestinal barrier function, is increasingly recognized as being of relevance for health and disease, and therefore, this topic warrants more attention. A number of different diseases comprising intestinal and extraintestinal diseases have been found to be associated with alterations in the intestinal barrier and increased permeability, respectively (Table ​(Table6).6). Table 6 Diseases related to intestinal permeability Among these, IBD and IBS, critical illness, and – more recently – obesity and metabolic diseases have experienced increasing attention and therefore they will be discuss in this chapter in more detail. Other diseases such as celiac disease need to be mentioned as an example of a disease related to intestinal permeability [175],[176]. The realization that the barrier is so important, raises the question of what can disrupt the barrier. Even though no final conclusions can be drawn, it became more and more evident that besides nutrients acting as down-regulators of tight junctions or as histone deacetylase (HDAC) inhibitors, also viral infections, toxins, hypoperfusion of the gut play a role (Table ​(Table7).7). Lifestyle factors such as living place (farming/country site or urban environment), exercise and drug usage seem to play an important role as well, and they offer new approaches for improving gut barrier function [4],[6]............. Pathogens, as well as usage of antibiotics, might disturb the intestinal mucus layer, either by enhancing mucus degradation, or by inhibiting the normal commensal triggers for mucus production [86]........ Most importantly, malnutrition is associated with increased intestinal permeability, as shown in liver cirrhosis patients, suggesting that nutrients are needed to maintain normal barrier function in the intestine [133]........... Dietetic factors that promote increased intestinal permeability and subsequent translocation of bacteria resulting in inflammatory reactions in the liver, the white adipose tissue, the brain, and other organs trigger metabolic diseases such as insulin resistance. This pathophysiological cascade is now accepted to be of major relevance for the development of metabolic diseases including type II diabetes, cardiovascular diseases and non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH) [88]-[93]. Several diseases have been linked to changes in the microbiota populations, or to reduction of the microbiota's diversity, including, atopic diseases, inflammatory bowel disease (IBD), diabetes, obesity, cancer and very recently, even neuropathologies. Some of these pathologies are associated with altered barrier function and increased permeability of the epithelium [6],[7]........... The altered intestinal barrier and the subsequent translocation of small amounts of bacteria or bacterial products is now regarded as one important mechanism causing the low-grade inflammation characteristic for metabolic diseases possibly linked to the subsequent infiltration of organs such as liver, muscle and heart muscle with fat [223]-[226]. Western style diet rich in fat and sugars alters the intestinal barrier in a way resulting in enhanced permeability and elevated endotoxin levels in the portal vein [104],[150],[227]. The result of such alterations is enhanced infiltration of tissues with bacteria and bacterial products and subsequent tissue inflammation and fat accumulation, which can be observed first in the liver and later on in other tissues such as muscle or heart muscle [150],[219],[228]. Also in peripheral blood and in adipose tissue bacteria or bacterial products can be observed following feeding with energy-rich Western style diet, an observation that might enable to define new bacterial biomarkers of intestinal barrier dysfunction in metabolic diseases [89],[214]. However, the two alterations, barrier dysfunction and microbiota alteration, are not necessarily linked, but can occur independently [229]. These findings provide a new concept on the pathophysiology of obesity and metabolic diseases that might offer new therapeutic strategies both at the level of diets and of drugs (Figure ​(Figure77)

So, I propose to remove the content that belows to increased intestinal permeability, and let this...:

Proponents claim that a wide range of factors (such as overgrowth of yeast or bacteria in the bowel, a poor diet, and/or the overuse of antibiotics) cause the intestines to be "leaky", allowing proteins, toxins, bacteria and other matter from inside the intestines to enter the circulation, causing chronic inflammation throughout the body, that results in a wide range of conditions, including chronic fatigue syndrome, rheumatoid arthritis, lupus, migraines, multiple sclerosis, and autism.

...as follows:

Proponents claim that a "leaky gut" causes chronic inflammation throughout the body, that results in a wide range of conditions, including chronic fatigue syndrome, rheumatoid arthritis, lupus, migraines, multiple sclerosis, and autism.

Or, perhaps better, something like this:

Proponents claim that proteins, toxins, bacteria and other matters, which can pass through a "leaky gut" and enter the circulation, cause chronic inflammation throughout the body, that results in a wide range of conditions, including chronic fatigue syndrome, rheumatoid arthritis, lupus, migraines, multiple sclerosis, and autism.

We must let clear that "leaky gut syndrome" is a proposed medical condition sustained mainly by nutritionists and practitioners of alternative medicine that is taking the scientific research and extrapolating it beyond what it should be, ensuring that increased intestinal permeability ("leaky gut") is the direct cause of an incredible amount of health disorders (many more than so far seem to have relationship, the little evidence that NHS Choices mentions) and that they can be cured if the intestinal permeability normalizes (on which there is not evidence for the vast majority of alleged related diseases).

Best regards. --BallenaBlanca (talk) 22:28, 7 September 2016 (UTC)

OK so we it seems that we agree on the more narrow scope? I agree with any of your proposed revisions above. Jytdog (talk) 22:36, 7 September 2016 (UTC)

Yes. I'm glad to reach an agreement. :) Let's see what Rslateriii thinks. Best regards. --BallenaBlanca (talk) 22:48, 7 September 2016 (UTC)

I have chosen the shorter wording. Ok? Best regards. --BallenaBlanca (talk) 23:21, 7 September 2016 (UTC)

All good. hooray! Jytdog (talk) 23:22, 7 September 2016 (UTC)

--BallenaBlanca (talk) 23:27, 7 September 2016 (UTC)

I too prefer the shorter wording; I think separating the pathophysiology of abnormal intestinal permeability from this page decreases potential confusion regarding the overlap between the two.

Also, I'd like to extend my gratitude for the help in orienting me to WP. Although I've been reading articles here since the early 2000s, this is my first time to register and edit anything substantive. The process of revising this page has further increased my respect and appreciation for what I consider to be the most informative website on the planet. Isn't dialectical discourse wonderful? --Rslateriii (talk) 00:17, 9 September 2016 (UTC)

) This was a bit more intense than most and different than most. Mainstream medicine has a much better literature; things get ugliest in WP where the literature is weakest  :) Sorry this was kind of a baptism by fire. Jytdog (talk) 04:41, 9 September 2016 (UTC)

Question

Has anyone looked at this reference? https://www.researchgate.net/publication/304535544_The_Role_of_the_Microbial_Metabolites_Including_Tryptophan_Catabolites_and_Short_Chain_Fatty_Acids_in_the_Pathophysiology_of_Immune-Inflammatory_and_Neuroimmune_Disease It appears to be used to suggest that there isn't evidence that intestinal permeability causes various diseases. However, the cited article suggests that intestinal permeability is connected to several diseases. Seems like this citation should be removed, reworked to show some support for the hypothesis or the relevant section quoted from the article as I can't see how this supports the point made here. 2605:A000:1317:2026:9D27:352E:4D4C:106 (talk) 18:57, 14 February 2017 (UTC)

as this article describes well, "leaky gut syndrome" is not the same as intestinal permeability. Jytdog (talk) 22:22, 14 February 2017 (UTC)

Self-Contradiction

The article says leaky gut syndrome is unrecognized by modern medicine, then follows up immediately by saying leaky gut is a medically recognized condition. Not cool. Octaazacubane (talk) 23:20, 10 March 2017 (UTC)

Read it again, more carefully. You (like others before you) are conflating "leaky gut" with "leaky gut syndrome". The distinction is clearly made in the article. DoctorJoeE ^{review transgressions}/_{talk to me!} 00:06, 11 March 2017 (UTC)

Leaky Gut Syndrome Legitimised

Is the role of the digestive epithelium in immune response still in question?

One indication of why your edit is bad is the fact that you removed links and citations to it being a pseudoscience, despite it still being on those lists. You removed links to the NHS, and added links to two papers by one man as citation that it's a "growing body of evidence." The one link to an independent, legitimate source - Time Magazine - is an interview of, drumroll... Fasano. This is like sourcing vaccines-causing-autism to Andrew Wakefield, without critique. So I won't even answer your question, because the premise in which it's presented - your edit - is invalid. It doesn't matter if I think it's in question - it's that you have failed to show any reason why we should care. --Golbez (talk) 22:07, 30 November 2017 (UTC)

There is a growing body of evidence. And Fasano is a the forefront of the research. You could actually contribute to the page and the edit by doing some research of your own and collecting more citations, adding to it rather than dismissing it. But that would actually take time and effort. Will you review the following articles and contribute to the edit in a meaningful way?

1. https://www.nature.com/articles/ajg199930
2. https://link.springer.com/article/10.1007%2Fs11894-999-0023-5?LI=true
3. http://www.sciencedirect.com/science/article/pii/S0165032712001371
4. http://europepmc.org/abstract/med/18063928
5. http://onlinelibrary.wiley.com/doi/10.1111/j.1467-789X.2010.00845.x/full
6. https://www.karger.com/Article/Abstract/333083
7. https://www.hindawi.com/journals/mi/2015/628157/abs/

On Wikipedia, we generally need reliable third party sourcing - see WP:RS. You telling us these links are useful doesn't matter; we need to be able to point to a news source, or otherwise independent source saying they are. So these papers existing means nothing, on their own. Again, you're trying to litigate the subject itself, rather than provide adequate sourcing for your statements, as well as adequate reasoning as to why you removed sources that disagree with you, which were, I will point out, well-sourced. As for "could actually contribute to the page," and "that would actually take time and effort," I won't dignify that with a response. If you want to convince others to see things your way, your first step shouldn't be to insult them. --Golbez (talk) 23:06, 30 November 2017 (UTC) (note - added numbers to refs above Jytdog (talk) 23:47, 30 November 2017 (UTC))

There is good content about this on intestinal permeability which is a physiological phenomenon. The topic of this article, "leaky gut syndrome", is not medical. Jytdog (talk) 23:45, 30 November 2017 (UTC)

1. PMID 9934756 is a primary source from 1999. Fails WP:MEDRS
2. PMID 10980980 is a review from 1999. Fails WP:MEDRS
3. PMID 22410503 is a primary source from 2012. Fails WP:MEDRS
4. PMID 18063928 is a case report from 2007. Fails WP:MEDRS
5. PMID 21382153 is a review from 2011. Almost WP:MEDRS; it lays out what we understand about intestinal permeability and about diabetes and they ~might~ relate to one another. This is a far cry from the alt med notion described in this WP article.
6. PMID 22179430 is a primary source from 2012. Fails WP:MEDRS
7. PMID 26582965 is a review from 2015 in a very low quality journal (see Hindawi Publishing Corporation). Not what we want to be using. Jytdog (talk) 23:57, 30 November 2017 (UTC)

Leaky gut syndrome

I was disturbed by the flippant disregard to alternative medicine in this article. As someone who suffers from ongoing, un-diagnosed abdominal pain, I was hoping to find information here that would lead my research in a productive direction. This article does not refer to any of the professionals that support this diagnosis, or who have spent time and energy studying it.

If the author of this article comes across my comments here, my message is this: Real People Suffer, really. And filling our public resources with opinionated, negative, half-information is not going to serve the reader of your article. I have no statistics to support it, but would bet one pain-free day on the idea that more people suffering from abdominal pain have read this article, than people who have a personal disdain for alternative medicine. My CT scans cost $1,400.00 out of pocket, but improving my diet and my lifestyle is free, and can not cause harm. Please be more contentious of what subject matter you choose to act as expert on. Possibly, focus on traditional medicine topics you support. Had you have not posted this article, someone with helpful information, data or statistics, or at minimum, and unbiased viewpoint could have initiated this article and actually helped the people who are suffering enough to spend time "Googling" this topic. {subst:unsigned|Vfbuckley|00:23, 2 December 2017‎ (UTC)}}

I am sorry you are suffering. There is no medical information about "leaky gut syndrome" and you are the exact kind of person that is victimized by people selling "cures" for it. Please see intestinal permeability for what we know about the science and medicine. (Which isn't much... it is all still early days for the science even... medicine is further away yet) Jytdog (talk) 00:31, 2 December 2017 (UTC)

The article has many authors, actually. I'm curious, what was it that spurred your visit to this talk page as your first ever edit to Wikipedia? --Golbez (talk) 05:17, 2 December 2017 (UTC)

Add Dr Alessio Fasano's Statement

I suggest adding a paragraph about the statement from Doctor Alessio Fasano, director of the Center for Celiac Research and Treatment with Harvard-affiliated. How about the draft paragraph below?

Doctor Alessio Fasano, director of the Center for Celiac Research and Treatment with Harvard-affiliated Massachusetts General Hospital, stated that "There is much we know about leaky gut in terms of how it affects people’s health, but there is still so much that is unknown."

Sources

Francewhoa (talk) 22:18, 21 October 2021 (UTC)

---

This page is out of date

The NHS have pulled down their page on leaky gut because it's no longer accurate and makes unsubstantiated claims. Any statements that cite that page should be removed. In addition, researchers at UCL implicated increased intestinal permeability (i.e. leaky gut) in the pathogensis of rheumatoid arthritis in mice, where the application of larazotide (which tightens the intestinal wall) ameliorates the symptoms of RA. https://www.cell.com/med/fulltext/S2666-6340(21)00162-8 91.110.110.60 (talk) 20:42, 3 November 2021 (UTC)

Leaky gut vs. Increased intestinal permeability

I am struggling with reconciling the "leaky gut" fad with the very real concept of "increased intestinal permeability". It seems that there is evidence that a "leaky gut" (which seems just a more layman way to describe increased intestinal permeability) can, in fact, contribute to a number of diseases and conditions, especially as it relates to autoimmunity and inflammation. That said, it is clear there are a lot of people peddling leaky gut misinformation and/or claims without evidence. I'll work to find the right balance of this, but I'd love any additional input. HumetheHistorian (talk) 03:06, 5 July 2022 (UTC)

The distinction between the quackery and non-quackery needs to be clear; that is why there are two articles with a hat note. The quackery goes in this one. Alexbrn (talk) 05:15, 5 July 2022 (UTC)

That is fair! I'll try to add a little language to make the distinction as clear as possible on both pages. I think I was struggling because quackery is hardest to define when it contains a substantial element of truth. Thanks for your input. HumetheHistorian (talk) 23:06, 12 July 2022 (UTC)

I think you achieved the opposite. The scams and health fraud go in this article, the actual science in the other one. Alexbrn (talk) 05:36, 13 July 2022 (UTC)

Phrasing the distinction this way doesn't seem to exist in the scientific community. Hundreds of NIH grants go to research with published papers using the phrase "Leaky Gut" that alias to intestinal barrier and permeability research. Tonytopper (talk) 23:25, 19 December 2022 (UTC)

The article is not about "leaky gut", but about the fake medical condition most usually called "leaky gut syndrome". Because the terminology is confusing Wikipedia needs to disambiguate the topic space. Bon courage (talk) 03:57, 20 December 2022 (UTC)

I agree with Tonytopper. The wikipedia article is mainly based on the first NHS source, which is outdated and actual false regarding todays scientific consensus and is not even available on their website anymore. Even though the concept of leaky gut is misused by the New Age community, it is an established concept in science now and we can even measure it (LPS and CD14 in blood). This article should be retired and there should be a new leaky gut one with the science of it and a paragraph at the bottom about esoteric misuse of the concept.LuxMaryn (talk) 05:22, 19 April 2023 (UTC)

Hypothetical?

"a hypothetical, medically unrecognized condition"?? Really?

How about Harvard's opinion?

https://www.health.harvard.edu/blog/leaky-gut-what-is-it-and-what-does-it-mean-for-you-2017092212451 82.77.245.176 (talk) 21:55, 16 March 2023 (UTC)

The blog post author Marcelo Campos is an "integrative medicine" promoter. It's not a reliable source. ScienceFlyer (talk) 22:03, 16 March 2023 (UTC)

That's not "Harvard's opinion," it's a single blog post from a single lecturer. --Golbez (talk) 13:57, 17 March 2023 (UTC)

How about Nature Reviews in Microbiology or frontiers in immunology ? Is that also not reliable? They are all using the term leaky gut, the frontiers in immunology one even uses leaky gut syndrome describing a scientific established condition LuxMaryn (talk) 05:27, 19 April 2023 (UTC)

References

The first article does not mention Leaky Gut Syndrome. Frontiers journals are generally dodgy. Bon courage (talk) 05:35, 19 April 2023 (UTC)

Yes it does so several times in the article. Quoting from the nature review in microbiology:

'For example, infection with SslE-producing bacteria increases IL-8 production, stimulating neutrophil recruitment, barrier destabilization and the potential onset of a leaky gut45.'

'Gut permeability (or ‘leaky gut’) is a common consequence of barrier disruption by enteric pathogens.'

'In turn, inflammation intended to combat the infection can contribute to leaky gut, systemic complications and improper repair' etc.

And Frontiers in Immunology is literally in the Top 8% of immunology journals. So it does not seem justified to call it dodgy.

Again, the term is used over and over in the research community and just by putting a syndrome behind it does not substantially distinguish from a factual condition. It would be fine to talk about misuse of the concept, but like what btw.? Autism? There is no clear evidence, true, but even that connection is seriously explored.

Currently the article makes it sound that leaky gut is esoteric BS, which is far from reality. LuxMaryn (talk) 07:29, 26 April 2023 (UTC)

Leaky gut is not leaky gut syndrome in the same way that grapes are not grape nuts. Leaky gut is covered at intestinal permeability. This article is about the health scam. Frontiers has a reputation for publishing junk. Bon courage (talk) 07:41, 26 April 2023 (UTC)

Is it really so hard to understand that "leaky gut" IS NOT the esoteric BS "leaky gut SYNDROME"?

Really? --Julius Senegal (talk) 17:56, 26 April 2023 (UTC)

If you look at the Intestinal permeability article it has already a section about leaky gut syndrome which is almost identical with this article. This article is obsolete and outdated. Look at the first reference of this article. It is not available anymore for a reason. Again, it is completely fair to call out esoteric BS, but this is already done in the other article. We don't need duplicate articles with outdated information. LuxMaryn (talk) 21:48, 29 April 2023 (UTC)

Yeah that's a summary section in WP:SYNC with this main article, in the normal way. No information is outdated; this stuff is quackery. If you want to propose this article for deletion (it won't succeed), WP:AFD is that way but mind WP:BEFORE. Bon courage (talk) 02:29, 30 April 2023 (UTC)

So, are you now suddenly complaining that under Intestinal permeability the abstract about the quackery "Leaky gut syndrome" is too long? Or are you just complaining that it is called quackery?

In any case this is not a WP:FORUM. If you don't bring new information acc. to reliable sources, stop it. --Julius Senegal (talk) 08:00, 30 April 2023 (UTC)