Gastrointestinal Disorders: The 5R Framework for Gut Restoration

A properly-functioning digestive system is a key part of good health. Any problems with the gastrointestinal (GI) tract can not only lead to stomachaches, gas and bloating, or diarrhea, but can also indicate chronic health problems that may seem unrelated, including autoimmune diseases such as rheumatoid arthritis and type 1 diabetes. Skin problems, such as eczema and rosacea, as well as heart disease, are also connected to the health of the GI tract.

To help ensure that everything is functioning properly with this integral body system, or to restore health, we use a program in Functional Medicine called the ‘5R’s: remove, replace, reinoculate, repair, and rebalance. This program can lead to dramatic improvements in symptoms, even sometimes clearing them up altogether.

The 5R Framework

• Remove
  The first step to a healthy GI is to remove stressors, things that negatively affect the environment of the GI tract, such as allergic foods, parasites, and potentially problematic bacteria or yeast. An allergy “elimination diet” may be useful to find out what foods are causing GI symptoms. Medications or herbs may also be taken to eradicate a particular bug.
• Replace
  After removing stressors, including foods that may be aggravating the digestive system, the next step is to replace digestive secretions by adding back things such as digestive enzymes, hydrochloric acid, and bile acids. These are all required for proper digestion and may be compromised by diet, medications, disease, aging, or other factors.
• Reinoculate
  While the use of antibiotics kills bad bacteria that may be harming you, it unfortunately also kills off good bacteria. Beneficial bacteria, or probiotics, are helped to return and flourish by ingesting supplements or by consuming foods that are good sources of probiotics, namely fermented foods like yogurt, miso, and tempeh. These “good” bacteria feed on prebiotics, which are in the colon. Prebiotics can be found in many foods that contain a fiber called inulin. Examples of these foods are artichokes, leeks, garlic, onion, chicory, tofu, and other soy products. Grains such as barley, flax, oats, and wheat are also good sources for prebiotics, as well as a supplement called fructo-oligosaccharide, or FOS.
• Repair
  The lining of the GI tract will have sustained some damage if it hasn’t been functioning properly. To help repair it, it is important to supply it with key nutrients such as zinc, antioxidants (e.g. vitamins A, C, and E), fish oil, and the amino acid glutamine. These nutrients may have gotten to be short in supply if the gut was not healthy.
• Rebalance
  Once the system has been restored, it’s important to properly maintain it. This requires balance, so it’s advisable to pay attention to lifestyle choices. Sleep, exercise, and stress all can have an effect on the GI tract. Keeping them in balance can help sustain an optimal digestive tract.