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" One frigid day last winter, I made my way to the northern New Jersey practice of Inna Topiler, a nutritionist who bills herself as a medical detective and whose complexion suggests that she glows from within. I&amp;#039;d waited two months for an opening, and now here I was, sipping mint tea, \u2028staring at her wall of supplements. After she ushered me into her office, I described the ever-shifting constellation of health problems that had bedeviled me for the past decade. Recently the most pronounced had been stomach pain and its attendant complications, which had inspired a lot of Internet-driven dietary fiddling. I gave up coffee, started (then stopped) a hard-to-follow diet that limits foods easily fermented by gut bacteria (including seemingly innocuous items like avocados and onions), and tried, intermittently, to avoid gluten, but to no avail.  Related:  The Bad Seed: The Health Risks of Genetically Modified Corn Topiler was just the latest stop on what had thus far been a largely fruitless search through the maze of our medical system and the often wacky alternative circus that exists alongside it. I&amp;#039;d gotten lots of diagnoses\u2014temporomandibular joint disorder (a jaw problem), irritable bowel syndrome, thoracic outlet syndrome, low-grade lupus (mentioned casually, as if this would not elicit a degree of concern on my part)\u2014but generally they functioned more as descriptions of symptoms than they did answers. As I&amp;#039;d soon learn, many others were in this same illness purgatory. We supported vast economies built around B12 shots, herbal tinctures, energy healers, and detox podcasts. We kept entire quadrants of the Web permanently occupied as we stared into the glow of our computers at 3 a.m., never finding what might be wrong, never able to stop looking. Related: The Workouts and Diets Everyone Wants to Know About The mainstream medical establishment has names for us\u2014frequent fliers, heartsink patients, crocks\u2014all of which carry an edge of derision that takes on a darker hue when you learn that a large majority of those with what are known as &amp;quot;medically unexplained physical symptoms&amp;quot; are female. Fibromyalgia, a diagnosis underneath this umbrella, is nine times more common among women than men. For multiple chemical sensitivity, the ratio is four to one; irritable bowel syndrome is two to one. In fact, sex is such a stark predictor of these mysterious ailments that some have wondered if perhaps they&amp;#039;re simply a modern-day version of what would have been labeled hysteria in the nineteenth century. Topiler&amp;#039;s office was bathed in diffuse sunlight filtered through filmy white window shades, and that, combined with the flowering orchid and her attentive listening, made me feel as if I were already floating in a curative cloud (in Hoboken). She suggested some blood work, another check for heavy metals (I&amp;#039;d done one years earlier, to no great effect), and a stool test. She also offered a few ideas of what might be going on, including one I&amp;#039;d already been wondering about: leaky gut syndrome. I&amp;#039;d come across the term on one of my midnight Internet walkabouts, and it had stuck with me, not just for its supremely unfortunate name, but because the array of troubles it purportedly can cause\u2014food sensitivities, joint pain, bloating\u2014matched many of my own. The concept originated in the alternative medicine world, but new research suggested a leaky gut might play an important role in the development of numerous autoimmune diseases, and some gastroenterologists had begun to begrudgingly reconsider its legitimacy. Could this be my needle in the haystack? I told Topiler I&amp;#039;d do all the tests\u2014even the heavy metals one, which required that her office assistant cut off enough tendrils of hair to give a fine-haired person such as myself a mini panic attack\u2014 bought some probiotics, and stepped out into the Jersey sun. For something that went on to become so amorphous, my cascade of physical maladies had an oddly precise beginning. When I was 24, I got a root canal that resulted in a raging infection the surgeon failed to diagnose for six months, a second root canal on the same tooth, and a long course of antibiotics. Soon after that I got the flu, which turned into bronchitis, which became a string of urinary tract infections, tension headaches, hand tremors, and pain that shot insistently down my neck to my arms and made it hard to drive a car, much less use a computer. The first doctor I visited jumped onto the exam table behind me and started massaging my shoulders. &amp;quot;You don&amp;#039;t want bronchitis? Move out of the city,&amp;quot; he said. &amp;quot;You don&amp;#039;t want a UTI? Stop fucking.&amp;quot; Then he threw down a handful of muscle relaxants and pain relievers. &amp;quot;Take these,&amp;quot; he said, and popped two into his mouth. For real. Up until then, the bulk of my medical experience had been with my childhood physician, a benevolent man I rarely saw because I was almost never sick. I have since been to many doctors and know this particular one was an extreme example of the unpleasant weirdos sometimes listed among the more levelheaded primary care physicians covered by any given health plan, but when I remember that scene now, here is what I think: Welcome to modern medicine. I hoped I&amp;#039;d get better on my own, but instead I developed more symptoms: something called myofascial pain, which felt like worms were crawling through the bones in my cheeks; tingling in my extremities; muscles that were sore without cause. Then came the anxiety, which started to strike for no apparent reason\u2014at baby showers and motels, as I drove along the highway at night with nowhere to be and nothing to do. I&amp;#039;d imagine the valves in my heart pumping furiously, my body rattling like a car that was about to break down. But try telling any of this to doctors. Their eyes glaze over. Then they send you to a shrink. Particularly, again, if you&amp;#039;re a woman. One oft-cited study found that not only are women who complain of pain treated less aggressively than men, they&amp;#039;re also more likely to have their pain discounted as emotional\u2014i.e., &amp;quot;not real.&amp;quot; After 11 physicians and $3,000 worth of tests, I stuck my records in the back of my filing cabinet and started simply trying to address the symptoms. I went to a physical therapist, got acupuncture, juiced, drank fish oil, meditated, and exercised. I went on Celexa, because I knew I had a tendency toward depression (not to mention the recent bouts of anxiety), and I was aware it often causes physical symptoms. (Half the time, according to one study.) The medication helped briefly, though it dulled my emotions to the point that when my grandmother died, I felt nothing. I quit cold turkey the day of her funeral. Ill advisedly, I also went to not one but two healers who claimed to be able to detect allergies by holding tinctures over my stomach and pushing on my arm. But at least I didn&amp;#039;t pay $1,000 for the detox regimen one of them tried to sell me. My condition seemed to improve, and for a while I thought maybe it had all just been a somatization disorder, the physical expression of psychological distress. But gradually, even as the anxiety dissipated, I discovered that the other symptoms would still come and go. My hips would hurt, making walking uncomfortable. My stomach began aching, so much so at times that I&amp;#039;d double over, unable to speak, though it would quickly pass. None of this was debilitating, but it was unpleasant and, most of all, scary. So as unlikely as this sounds, by the time I made it to Topiler&amp;#039;s office I found myself excited to think I might have a leaky gut\u2014though I also knew enough to be skeptical. At the forefront of the leaky-gut world is one man: Alessio Fasano, MD, a gastroenterologist who runs the Center for Celiac Research &amp;amp;amp; Treatment at Massachusetts General Hospital, teaches at Harvard Medical School, and is, presumably, the only person ever described as &amp;quot;an absolute rock star in the world of gluten intolerance, intestinal permeability, and autoimmune disease.&amp;quot; One could even make the argument that he prompted the gluten-free craze colonizing ever more grocery store shelves and best-seller lists: He graduated from the University of Naples in 1981 having been taught that one in 10,000 people suffered from celiac disease, a statistic that remained medical dogma until he published a landmark study in 2003 showing that in America, at least, it was actually one in 133. (In between, he moved from Italy to Maryland, thinking this would allow him to focus on diseases other than celiac. But life had other plans.) A few weeks after my appointment with Topiler, I drove up to western Massachusetts to hear Fasano, the author of Gluten Freedom, give a talk at a local hospital. It appeared it would be one of the most popular lectures they&amp;#039;d ever organized, the hospital&amp;#039;s PR rep told me as we waited for Fasano by the entrance. (It ended up beating out everything but the talk on Lyme disease, about which people in the area were in full pandemic mode.) Finally he rushed enthusiastically into the lobby wearing slim slacks, his wavy salt-and-pepper hair bunched up around his shoulders. He had a charming way of speaking English (&amp;quot;Why this gluten make so much of a trouble?&amp;quot; he asked during the talk, explaining that in fact no one can fully break gluten into easily digestible pieces), and a penchant for dad-joke metaphors: &amp;quot;The gut is not like Las Vegas! What happens in the gut does not stay in the gut!&amp;quot; But more than anything, he came off as a man juggling so many responsibilities about which he is passionate that he could not talk to one person without putting 10 others off; indeed, during a short phone conversation we had a few days later, his inbox pinged more than a dozen times. &amp;quot;Leaky gut,&amp;quot; he said to the crowd as we noshed on quinoa salad (gluten-free, naturally). &amp;quot;I don&amp;#039;t like the term! It&amp;#039;s been vilified. But now there is science behind the fact that there can be a breach of the barrier, and not just with celiac disease.&amp;quot; For decades, he explained, researchers assumed that the cells lining the gut were cemented together. But in the late 1980s, a Japanese team discovered that these junctions were actually gates, and if they were gates, the reasoning went, they must be able to open. Eventually, via a circuitous path that involved a failed cholera vaccine and the intestines of &amp;quot;a poor gentleman&amp;quot; who had crashed his motorcycle, Fasano&amp;#039;s team stumbled upon a protein responsible for regulating the functioning of the gates. In other words: the key. &amp;quot;After many years looking for a ghost, we found it,&amp;quot; he said. &amp;quot;We named it zonulin.&amp;quot; It also turned out that if a person produced too much zonulin, the gates could get stuck open, allowing undigested food particles, viruses, and chemicals to pass into the bloodstream, where they don&amp;#039;t belong. Alternative practitioners had long hypothesized that such a mechanism might contribute to a wide variety of ailments. Conventional medicine&amp;#039;s verdict? Bogus. &amp;quot;When we discovered zonulin, those in traditional medicine said, &amp;#039;You fuel this insanity!&amp;#039;\u2009&amp;quot; Fasano said. &amp;quot;We were object of, how to put this in a polite way, criticism. But then the human genome was completed. Genes that control gut permeability turn out to be associated with many autoimmune diseases, and even the nonbelievers start to believe.&amp;quot; Some of them, at least. When I started calling around to hospitals, I found that if I so much as mentioned &amp;quot;leaky gut,&amp;quot; I couldn&amp;#039;t even get by the PR department. But once I asked about &amp;quot;increased intestinal permeability,&amp;quot; we were back in business. The doctors I spoke with all knew that gastrointestinal autoimmune diseases like Crohn&amp;#039;s and celiac, in which the immune system attacks the intestines, are associated with increased gut permeability, but they weren&amp;#039;t convinced that if you closed the gates you&amp;#039;d resolve the conditions. I heard a more extreme version of the same story for non-GI autoimmune disorders. Sure, we know that leaky gut is more common among people with type 1 diabetes, multiple sclerosis, et cetera, but who knows whether it actually causes these illnesses? &amp;quot;Every article ends by saying that further research is needed,&amp;quot; said Lilli B. Link, MD, a New York integrative nutrition specialist. &amp;quot;But how much research do you need before you can say something is a problem?&amp;quot; Some proof of Fasano&amp;#039;s theory may be in the offing. As part of Phase II clinical trials conducted at multiple medical centers across the country, 85 people with celiac disease\u2014the only autoimmune disease for which the environmental trigger is known\u2014were given either a placebo or low doses of a drug called larazotide acetate that controls the intestinal gates, as well as daily capsules of gluten. Compared with the placebo, the drug cut fatigue and constipation in half and diarrhea by almost 75 percent. Its maker, Alba Therapeutics, followed this up with a larger study, the findings of which were also promising, according to the lead author, Joseph A. Murray, MD, of the Mayo Clinic (he couldn&amp;#039;t say more until the results were published). The drug is now moving on to the final phase of testing. &amp;quot;Here&amp;#039;s my prediction,&amp;quot; said integrative medicine physician David Brady, MD, the vice provost of health sciences at the University of Bridgeport. &amp;quot;When a zonulin drug is ready and approved, we&amp;#039;ll see commercials all over TV for leaky gut syndrome. Then it becomes real. Was it not real 20 years ago? Sure, but it had to go through the legitimizing process commercially. In 10 years, it will be well accepted and understood. It will seem obvious.&amp;quot; My tests with Topiler took a while to come back, so in the interim I went to a gastroenterologist at Manhattan&amp;#039;s Mount Sinai Hospital, Gina Sam, MD. She said I might have small-intestinal bacterial overgrowth, so I got tested for it: negative. That didn&amp;#039;t necessarily rule out leaky gut, but it was demoralizing to yet one more time have a cause advanced and rejected. It made me think of something a rheumatologist, Sinai&amp;#039;s Yousaf Ali, MD, told me when I asked how often his patients have symptoms he can&amp;#039;t diagnose (frequently). &amp;quot;Their expectation is that we have the answers, and when we don&amp;#039;t, they get upset,&amp;quot; he said. &amp;quot;That&amp;#039;s why we lose people to the homeopathic route.&amp;quot; But setting aside the fact that mainstream and alternative practitioners aren&amp;#039;t opposing teams battling for patients (though it sometimes seems that&amp;#039;s how both perceive it), the non-traditional route often doesn&amp;#039;t offer clear explanations either. In mid-March I returned to Hoboken. My test results were &amp;quot;interesting,&amp;quot; Topiler said, but it looked like perhaps my stomach unrest actually had to do with a lack of digestive enzymes. Also maybe my adrenals were fatigued (another diagnosis scoffed at by conventional medicine). Neither of those would explain my other physical symptoms. As for leaky gut, after all that, the test was negative. Maybe I had bacterial overgrowth in my small intestine? Yet Topiler didn&amp;#039;t tell me that what I was experiencing wasn&amp;#039;t real. What we&amp;#039;ll do, she said, is try a few approaches and go from there. (She suggested certain supplements and dietary changes\u2014no alcohol, for one\u2014that have helped with the gastrointestinal discomfort but, God help me, will hopefully not be necessary for the rest of my life.) &amp;quot;It&amp;#039;s not always as easy as black and white,&amp;quot; she e-mailed the next day. &amp;quot;But don&amp;#039;t worry, we will get to the bottom of things.&amp;quot; Maybe she&amp;#039;ll help me feel better, but I believe I can definitively say at this point that there will be no panacea. The search for one among people with undefined ailments almost reminds me of a religious pilgrimage at times, both in the healing we seek and the intensity with which we seek it. I&amp;#039;ve spent hours, for example, in the health section of Barnes &amp;amp;amp; Noble flipping through books filled with accounts of people who suffered years of medical misery until being finally, permanently cured. But the other day, I stopped in at a bookstore and found that those aisles no longer held my interest. My latest lap through the medical complex had made me realize that my fear of the symptoms\u2014of what was causing them, of what they might become\u2014often caused me more pain than the symptoms themselves. And recognizing this shrank the situation down to a more manageable size. At least momentarily. Hope for a single, simple answer\u2014no matter how deluded or unhelpful that hope might be\u2014is a hard habit to break. This article appeared in the June 2014 issue of ELLE magazine. 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