Leaky gut gets blamed for everything from everyday stomach issues to pain to anxiety, yet it is one of the most mysterious ailments to diagnosis and treat.

Part of the reason for this medical mystery is because the gut is such a vast and complex system. “Science continues to find new ways that the gut can influence everything from heart health to keeping our brains young,” says Dr. Alessio Fasano, director of the Center for Celiac Research and Treatment with Harvard-affiliated Massachusetts General Hospital. “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.”

What is leaky gut?

You have to begin at the cellular level. The lining of your intestine is made of millions and millions of cells. These cells join together to create a tight barrier that acts like a security system and decides what gets absorbed into the bloodstream and what stays out.

However, in an unhealthy gut, the lining can weaken, so “holes” develop in the barrier. The result is that toxins and bacteria can leak into the body. This can trigger inflammation in the gut and throughout the body and cause a chain reaction of problems, such as bloating, gas, cramps, food sensitivities, fatigue, headaches, and joint pain, to name a few.

How do these “holes” form? The biggest culprits are genes and diet, according to Dr. Fasano. “Some people may have a weaker barrier because they were born with it, or they follow an unbalanced diet low in fiber and high in sugar and saturated fats, which may be the trigger that weakens the gut lining.” Age also plays a role because as you age, cells get damaged more easily and heal slowly, if at all, so the gut becomes more vulnerable.

The role of leaky gut in overall health remains unclear

“Leaky gut could be the cause of some health problems, or a sign of something larger,” says Dr. Fasano. “The science is still up in the air.” For example, digestive conditions like inflammatory bowel disease, celiac disease, and Crohn’s disease share many of the same symptoms as leaky gut, and all are linked with chronic inflammation, but it’s not known how, or if, they are connected.

“The challenge is that it’s difficult to measure the strength of a person’s gut barrier, so you can’t know for certain when leaky gut is really present, or what influence it may have elsewhere in the body,” says Dr. Fasano.

Can you treat leaky gut?

You can, but the approach is similar to diagnosing a broken car, says Dr. Fasano. “You don’t know the exact problem until the mechanic lifts the hood, looks around, and tries different things — there is not a simple, direct approach to fixing the problem,” he says. “It’s the same with leaky gut. We have to try different strategies to see what helps.”

Your first step is to share your symptoms with your doctor. If leaky gut is a possibility, he or she can try several strategies to help relieve symptoms and reduce inflammation. The most common is to review your diet and eliminate known dietary causes of inflammation, such as excessive consumption of alcohol and processed foods, and to explore whether you have any food sensitivities — for instance, to gluten or dairy. “In theory, reducing inflammation from your diet like this also may rebuild the gut lining and stop further leakage,” says Dr. Fasano.

The best way to protect yourself from leaky gut is to invest more in your overall digestive health, he adds. This means being more attentive about following a gut-healthy diet that limits processed foods and high-fat and high-sugar foods, and includes enough fiber. Sticking to a regular exercise program also can strengthen your digestive system. For example, studies have suggested that taking a 15-to 20-minute walk after a meal can aid in digestion. “Your gastrointestinal system is complex, but caring for it doesn’t have to be,” says Dr. Fasano.

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