By Kim Martin, RD
Phrases like “gut dysfunction” and “bowel disease” conjure up ghastly images and generally are not popular topics of conversation. The irony is, however, that gastrointestinal dysfunction is incredibly common and we could probably all benefit from knowing the actual approach to healing our guts.
Gastrointestinal health and function is absolutely crucial to our overall health and wellbeing. When our GI (gastrointestinal) tract is working optimally our immune systems are stronger, our metabolism works well and even aging is slowed down. A number of studies have shown associations between compromised GI functioning and a whole host of conditions including; inflammatory bowel diseases, irritable bowel syndrome, gastritis, peptic ulcers, colon cancer, rheumatoid arthritis, asthma, eczema, metabolic bone disease, allergies, reflux and metabolic bone disease.
The Four R Approach
Dr Jeffery S Bland of the Institute for Functional Medicine in America and his team have coined the name for their solution to gastrointestinal dysfunction: “The Four R Approach”. Due to its original success, numerous health professionals around the globe have since adopted this dietary protocol for the management of GI disorders in their own practices. And it may just be the cure we have been searching for!
Here’s what the four Rs stand for:
Applying these four steps can bring the restoration that your GI tract so desperately needs.
This stage involves the removal of each and every potential allergen in the diet. The goal is to get rid of anything that will negatively affect the environment of your GI tract. These irritants and allergens include:
– Gastric irritants like alcohol, caffeine or drugs.
– Inflammatory foods such as gluten, dairy, corn, soy, sugar and (in some cases) eggs.
This leaves you with a low-allergy-potential diet focused on gluten-free products, legumes, fish, meat, poultry, and a lot of fruit and vegetables.
Step 1 was about removing all the bad, so now we need to replace with the good. The essential ingredients for optimal digestion and absorption may have been depleted over time as a result of poor diet, disease, aging or even medication (such as antacids). The following nutrients can be supplemented temporarily until your normal function kicks in. They include digestive enzymes, hydrochloric acid and bile acids.
When you hear the word ‘reinoculate’ it sounds like a vaccination, but it’s really just a fancy word for repopulate. In a healthy gut you have millions of tiny bacteria that are vitally important. These bacteria, called probiotics, may also get depleted over time through poor diet, disease, medication (antibiotics) and aging. We literally need to re-populate our gut with these good bacteria! Look for a probiotic supplement with lactobaccilus or bifidobacterium strains (these are the good ones), and aim for a CFU (colony forming units) content in the billions. Also take in a healthy amount of prebiotic foods such as your soluble fibres (in oats, legumes and vegetables), which feed the probiotics and promote a healthy population of them in your gut. Be sure to drink enough water if you are eating a fibre-rich diet (aim for 2-3 litres per day).
This phase of the program should be tapered up over a 2 week period as too much fibre and too many probiotics at once may cause GI discomfort.
After the two weeks of reinoculation, you are ready for the repair phase. Your diet should be rich in fruits and vegetables by now, but some extra immune system and repair-boosting nutrients will definitely help you on your road to recovery. For the best possible repair of your GI lining, consider a course of L-glutamine supplements. Others to consider include zinc, omega 3 fish oils, and vitamins A, B5, C and E. At the very least ensure adequate intake (through diet primarily) of these foods, but if you can supplement, at least temporarily, it will help greatly.
How To Use The Four R Approach
The proposed protocol is a 12-week commitment, and any person suffering from symptoms such as chronic fatigue, pain and low energy accompanied by digestive problems is a candidate. If the condition is more chronic (e.g. Crohn’s disease or Ulcerative Colitis), 12 weeks will be a good target for restoration of proper function, although a longer commitment to the protocol may be necessary to prevent re-occurrence of unwanted symptoms.
At the end of the program, find the system that works for YOU! If you find that gluten consumption brings back the symptoms – stick to gluten-free. Likewise when it comes to dairy or sugar. It all starts with poor diet, so keep your eating in check once you’ve healed your gut!