Can a leaky gut cause IC? Well, I have been seeing some great success in the reduction of pain symptoms when working with my interstitial cystitis (IC) clients to improve their overall health and quality of life.

One thing I found consistent across the board was the wide range of digestive issues that people with IC have.

I believe that IC is more than just an isolated bladder condition, rather a global dysfunction in the body often caused by so-called “leaky gut syndrome”.

Leaky gut has been associated with a variety of medical conditions such as:

• allergies,
• celiac disease,
• inflammatory bowel disease (IBD),
• eczema,
• rheumatoid arthritis,
• Hashimoto’s thyroiditis,
• type 1 diabetes,
• systemic lupus erythematosus
• and, I believe, a leaky gut could cause interstitial cystitis (IC), as well.  

The Leaky Gut Syndrome & General Health  

 The leaky gut syndrome is really a nickname for the formal term “intestinal permeability” which basically means that your small intestine’s lining is malfunctioning.

In case if you read more on this topic, just know that your gut lining is formally called the intestinal barrier or epithelial layer.

Intestinal Barrier: To Serve And Protect

The gut lining consists of various commensal microbiota that provides a protective function for the intestinal tissue.

Your gut lining wears two hats:

1. Nourishment: “…breakdown and absorption of nutrients, production of vitamins and hormones, and prevention of colonization by pathogenic bacteria” (Bischoff et al., 2014).
2. Protective barrier: “…it works to block the entry of diverse exterior antigens..” (Mu, Kirby, Reilly, & Luo, 2017).  This barrier works in 3 ways:

• it’s a physical barrier,
• a biochemical barrier,
• and an immunological barrier.

In this post, I mostly focus on the protective role of the gut lining, since many of the triggers of IC (such as the inflammation induced by the bacteria’s endotoxins) can be related to bacterial overgrowth and infections.  

When any part of protective barrier is malfunctioning, you can get a leaky gut that in turn predisposes you to a variety of health issues. As I mentioned above, I believe, IC is one of the problems that stemmed from the issues with gut lining. Let’s explore the mechanics of the disease.

Physical barrier malfunction

A healthy gut lining consists of commensal bacteria that act as a physical barrier and promote resistance to colonization by pathogenic bacteria. If the composition of commensal bacterial colony changes, they can no longer stay on the way of pathogenic bacteria. This could lead to a so-called bacterial translocation process. For example, E.coli bacteria (the most frequent cause of UTIs) can “leak” into other organs, and that includes your bladder.

I also find it interesting that many women with mycoplasma infections complain of having urethral pain. Recently, there have been some correlations with Lyme disease and IC as well. There are definitely some trends found in the gut (as well as systemic) infections that need to be explored deeper.

Biochemical barrier malfunction

Within the antimicrobial properties are the biochemical molecules that aid in reducing the load of colonizing bacteria.  When this functionality of the gut barrier is impacted, pathogenic bacteria could grow faster and form thriving communities.  The bacteria can create the inflammation and pain that is so often seen with IC. Also, bacteria can damage the gut and allow toxins and particles to get into the body that also can cause inflammation. This, in turn, could lead to a disruption of various important processes leading to chronic health problems.

Immunological barrier malfunction

And finally, the barrier consists of a variety of immune cells that regulate the immune response.  A major role of the immunological barrier is secretory IgA (SIgA), the most abundant immunoglobulin in the body that resides primarily on intestinal mucosal surfaces (Mu et al., 2017).  

Almost every lab I have viewed of clients with IC are low in SIgA, although a small percentage also demonstrate elevated levels.

High levels of SIgA may indicate a variety of clues such as:

• chronic stress,
• intestinal barrier dysfunction,
• acute GI dysfunction.  

Lowered SIgA levels, on the other hand, are associated with immune dysfunction and may indicate that the client has been under attack with infections for a very long time, and the body’s defenses have given up.

Altered levels of SIgA in the GI tract can contribute to many detrimental effects, such as:

• dysfunction in the immune recognition of intestinal bacteria ( which weakens your immune system’s ability to defend you)
• dysbiosis of the microflora (ratios of good and bad bacteria),
• increased food allergies and food sensitivity issues (think gluten intolerance)
• more bacterial infections (think chronic UTI’s)
• and chronic low-grade inflammation (think pain and inflammation associated with IC).

Who Can Get Leaky Gut?  

Leaky gut, as you understand now, results from a damaged intestinal barrier, which in return decreases your gut’s ability to function as a physical, biochemical, and an immunological barrier to protect you.  

There are many causes of why this happens, the most common are:

• chronic stress,
• dysbiosis (imbalanced bacteria),
• environmental toxins,
• GI diseases such as inflammatory bowel disease,
• immune dysregulation,
• poor food choices,
• pathogenic bacteria (for example, H. pylori) and especially gram-negative bacteria (E. coli) releasing endotoxins.  
• parasites and yeast,
• and prolonged use of non-steroidal anti-inflammatory drugs (NSAIDs).

Tests For Leaky Gut Syndrome

1. SIgA levels. Low SIgA is also associated with IC.  This is an indication of gut immunity, and if your gut immunity is weak, more pathogens can enter into your system.  On the flip side, if your SIgA levels are high, that could indicate your immune system is working hard defending you against pathogens.  In any case, the marker is an indication of gut function gone haywire.
2. Food sensitivity tests– Often times when a food sensitivity test comes back with a plethora of food intolerances, it can be assumed that this is due to leaky gut.  That is because food antigens are allowed to enter the system through a permeable gut lining, and can contribute it inflammation and immune dysfunction.  
3. Vitamin D– Low vitamin D levels are associated with the leaky gut syndrome.  Low levels are associated with elevated levels of bacteria in the gut as well as increased bacterial translocation. Vitamin D is able to protect the gut lining against bacterial-induced damage to the tight junctions, as it has the ability to induce the formation of antimicrobial peptides in the gut. Vitamin D deficiency is also associated with increased inflammation, which is often seen in IC.
4. Leaky Gut test-this test measures zonulin, an important marker of intestinal permeability.  Increased levels are associated with leaky gut, which can be demonstrated in diseases associated with increased intestinal inflammation.  This test also measures DAO, an enzyme that breaks down histamines, which is involved in many inflammatory conditions such as IC. In fact, many of the foods patients with IC react to are often high in histamine.  This test also measures histamine as well. An excess of histamine may be a result of ingested histamine (certain foods), released histamine from food or environmental triggers, or a DAO deficiency (needed for the breakdown of histamine).
5. Gut pathogen test– A gut pathogen test can determine what pathogens are plaguing your gut and making the lining permeable.  The test can also evaluate the ratios of good and bad bacteria and will let you know if you have dysbiosis ( imbalanced ratios). A gut test will help your clinician select appropriate antimicrobial agents specific for the bacteria to facilitate reducing the damage and inflammation caused by them.  Repeating the test is often recommended to gauge progress.

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