Current treatment strategies
Growing evidences show a clear association of gut leakage with several diseases at extra-intestinal distinct organs including liver, lung, brain and metabolic diseases like obesity, etc. Leaky gut syndrome is a theory that intestinal permeability is not only a symptom of gastrointestinal disease but an underlying cause that develops independently. Currently, the suggested treatment options are probiotics to restore gut barrier function. This treatment may help maintain the health of gut lining by preventing overgrowth of pathogenic bacteria in the gut. However, the ability of probiotics to recover intestinal barrier function needs further investigation. The other treatment option is prebiotics, usually plant fibers that might feed beneficial gut bacteria. In contrast, avoiding dietary fats and sugars, which diminish pathobionts, could support the growth of beneficial gut bacteria. Moreover, a diet format, Low FODMAP Diet (stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, which are short-chain carbohydrates (sugars) that the small intestine absorbs poorly) has been suggested for the treatment of irritable bowel syndrome (IBS) and/or small intestinal bacterial overgrowth (SIBO). FODMAP foods are assumed to aggravate the gut leakage, however, there are no scientific evidences available. In addition, bacteria such as aerotolerant lactobacilli or wound-associated Akkermansia muciniphila might be critical for wound and anastomotic healing in the gut [82]. Moreover, kinase inhibiting drugs like ruxolitinib were found to alleviate inflammation, apoptosis, and intestinal barrier leakage in UC via STAT3 [83]. Vitamin D and the amino acid L-glutamine may specifically help repair gut lining [84, 85] however, more evidence is required to conclude these experimental findings. Nevertheless, there are certain limitations in treatment with probiotics and dietary habits. For example, designed dietary habits are considered difficult to follow with a modern lifestyle and the probiotics might induce unfavorable gut dysbiosis and further exaggerate the conditions. Fecal microbiota Transfer (FMT) has shown promising effects in experimental studies [86], while a single clinical study using total gastrointestinal flora transplantation showed a success rate of 89.3% in attenuating leaky gut syndrome [87]. Therefore, there is an urgent need to search for new therapeutic options to treat gut leakage that stands as an underlying condition for several other diseases.