Leaky Gut & IBD: Which Comes First? @ByronHerbalist
Leaky Gut & IBD: Which Comes First?  @ByronHerbalist
Uploaded June 2025 | Updated September 2026, 1 week ago
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My name is Todd Mansfield and I’m a clinical herbalist dedicated to digestive health. Every week I treat Australian and New Zealand patients with IBS, IBD, SIBO, reflux, indigestion, bloating, loose bowel movements and constipation.

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In Crohn’s and ulcerative colitis, increased intestinal permeability is nearly always present—but whether it’s a driver of inflammation or simply a consequence remains a key question.

Evidence shows that leaky gut can exist before clinical IBD symptoms appear, especially in first-degree relatives of IBD patients. This suggests a possible role in disease onset, not just disease progression.

Tight junction dysfunction, microbial imbalance, and loss of oral tolerance all feed into this loop—damaged barrier, immune activation, inflammation, repeat. In practice, supporting the gut lining alongside immune modulation and microbiome work can be crucial for long-term stability.

Understanding this dynamic is critical when mapping out a truly root-cause approach to IBD.
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Leaky Gut & IBD: Which Comes First?

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