Leaky Gut — Chronic vs Temporary
3 pairs added 2026-07-06. Skipped a generic "what is leaky gut" pair (already exists: qa-probiotics-gut-health-3). Added the valuable NEW angles: the diagnostic distinction + Hershey ruling + enzyme clarification.
The honest evidence framing
- Increased intestinal permeability is REAL and MEASURABLE (loosened tight junctions; lactulose-mannitol test; tightly linked to IBD/chronic enteropathy) — 🟡. PMC6467570.
- "Leaky gut SYNDROME" as a standalone diagnosis is used loosely (holistic/functional framing) — ⚪. So we anchor on the PATTERN, not a single symptom.
The distinction that matters (the whole point)
- True leaky gut = a CHRONIC, recurring pattern over months–years: non-resolving loose stool, persistent gas/bloat, recurring skin flares (gut-skin axis), REPEATED yeast/bacterial overgrowth, multiplying food sensitivities, poor coat + weight loss despite eating well, lethargy. Drivers are long-term (chronic NSAID/steroid, IBD, ongoing sensitivities, poor diet, chronic stress, repeated/prolonged antibiotics).
- NOT leaky gut = a single episode with a clear one-time trigger that resolves.
Hershey ruling (tier 3)
- One antibiotic course + a 2–3 week probiotic gap → yeast flare = temporary microbial disruption, reversible (flora depleted → antibiotics wiped flora → yeast opportunistically overgrew). Mechanistically ≠ structural gut-lining damage. Healthy history + single trigger + no chronic pattern = not leaky gut, even if surface symptoms overlap.
- Enzymes for a cooked diet ≠ absorption problem: cooking destroys natural food enzymes, so supplementing is a DIET-FORMAT requirement, not malabsorption. Decision rule: enzymes because of food prep = normal; enzymes because of weight loss / greasy stool / failure to thrive = real problem → vet workup.
Fact-check flag
Flagged in FACTCHECK_QUEUE: the ⚪ "leaky gut syndrome" terminology (permeability real & measurable; "syndrome" is looser/holistic) — confirm framing.
Related: [[GI Motility Recovery and Colon Support]], [[Hershey Case - Post-Antibiotic Yeast Overgrowth]], [[Condition Packs - GI and Yeast (evidence-graded)]].