The
gastrointestinal system (or the gut) is the core system to initiate either
healing or disease in a multi-systems approach to human health.

If you
eat a typical Standard American Diet (SAD) comprised of mostly white and brown
colorless and processed foods and you have been suffering from fatigue, joint
pain, anxiety, depression, irritable bowel syndrome, heartburn, weight gain,
bloating, gas, chronic pancreatitis, ulcerative colitis, or Crohn’s disease, you’ll
want to implement aspects of the Five ‘R’ Approach to gut health.

These
five actions are Remove, Replace, Re-inoculate, Repair, and Rebalance.

Remove

First and
foremost, we must remove the processed, packaged, irradiated, and sugar-laden
foods from our everyday intake.  Next,
remove foods that cause irritation and inflammation to our immune system.  Foods that trigger an immune response may
differ from person to person but completing a Comprehensive
Elimination Diet can determine what foods are wreaking
havoc in your immune system.  The
categories that are typically linked with an immune response include: gluten,
dairy, eggs, soy, alcohol, processed foods, sugar, caffeine, peanuts, and
shellfish.

We live
in a symbiotic relationship with bacteria and would die without bacteria in our
colon. But, as much as we want the good bacteria to reside in our gut, we want
to remove bad bacteria. There are many forms of bacteria and yeast, like
candida, that can cause dysbiosis or dis-ease in our gut environment. A
comprehensive stool analysis can report which bacteria are present in your
stool and to what quantity or degree. If needed, different treatments such as antibiotics,
antimicrobials, herbs, supplements, and dietary changes can be taken to remove
the bad bacteria and promote the good bacteria.

Finally,
remove all medications* that may be promoting an unhealthy environment in your
gut. Anti-inflammatory medications like ibuprofen or other NSAID’s can promote
intestinal permeability, or leaky gut, and should be removed or limited as much
as possible. Antacids are not meant to be taken for long periods of time as the
stomach is supposed to be an acidic environment with a pH around 2. Altering
the pH of the stomach prevents contents of the digestive tract to regurgitate
back up the esophagus and cause heartburn or gastroesophageal reflux disease
(GERD).

Replace

If our
digestive tract and the organs that support it are not functioning optimally,
then there are supplements and foods that you can take to replace the different
enzymes and other chemicals necessary.

Digestion
is the process of breaking a bite of food down into the nutrients we absorb
(protein, carbohydrate, and fat molecules). The process of digestion begins in
the mouth with chewing and an enzyme in our saliva called amylase. This enzyme
starts the process of breaking down carbohydrates. Swallowing then sends the
food down the esophagus to the stomach.

The
stomach is an acidic environment (pH of 1.5 – 3.0) filled with hydrochloric
acid (HCl), which kills bacteria in our food, and pepsin, which breaks down
proteins into individual amino acids. These amino acids need to be broken apart
in the stomach and upper intestine in preparation for absorption in the lower
intestine.

Ensure
that you are chewing food thoroughly before swallowing and optimizing your
stomach acid. Things that can be taken to optimize stomach acid are apple cider
vinegar and/or lemon juice diluted in a small glass of water and consumed prior
to meals.

Supplements
of betaine HCl and pepsin enzyme can be taken with meals to help increase
stomach acid and improve stomach digestive function in those without ulcers or
severe heartburn. Those with ulcers or severe heartburn should work with a
functional medicine practitioner to improve the situation with food and diet
and other measures prior to adding HCl supplements.

The
pancreas produces a collection of pancreatic enzymes that can break down fats,
carbohydrates, and proteins and secretes these enzymes into the upper small
intestine. Many people with gut problems and dysbiosis are not breaking down
the foods they eat effectively and need to replace or supplement pancreatic
enzymes with meals.

The
gallbladder produces and secretes bile salts into the intestine to help
breakdown fats and remove cholesterol and toxins. These bile salts also help
with the motility or movement of digested substances through the digestive
tract. Bile salts can be taken as a supplement such as ox bile, but eating
certain foods like dandelion greens, chicory, artichokes, and daikon radishes
can increase the production of bile salts as well.

Re-inoculate

The human
colon is populated with as much as two pounds of bacteria and outnumber human
cells by a ratio of 10:1. We must promote diversity and stability of the
beneficial gut bacteria with probiotics and prebiotics. The beneficial bacteria
in the colon have numerous functions that include helping with fermentation and
digestion, providing protection against pathogens, synthesizing vitamins, and
producing short chain fatty acids.

Probiotics
are dosed in billions of CFU’s. This stands for “colony forming unit” and is a
measurement of the good bacteria and yeasts capable of living and reproducing
to form a group of the same bacteria or yeasts.

When
first initiating re-inoculation to optimize gut health, a higher dose of
probiotics (100 billion CFUs) are taken daily. Later, a more maintenance dose
of 10 to 20 billion CFUs daily can be used. More and more studies are showing
that diversity is the most important aspect of a healthy gut microbiome, so
eating probiotic foods daily is extremely important.  Probiotic foods include yogurt, miso,
sauerkraut, kefir, kombucha, pickles, tempeh, and kimchi.

Prebiotics
are typically water-soluble fiber that is not digestible by the host (human)
enzymes and therefore get fermented and digested by anaerobic bacteria in the
colon. The product of this fermenting by the bacteria in your gut are short
chain fatty acids that are used as fuel by the enterocytes (cells lining the
gut). If you want a healthy gut lining, then you need to be ingesting good
prebiotics every day. Supplemental prebiotics include inulin,
fructooligosaccharides, and arabinogalactans, while food source prebiotics
include onion, garlic, Jerusalem artichokes, leeks, chicory, chia seeds, flax
seeds, asparagus, bananas, root vegetables, and apples.

Repair

The
epithelial cells that line our gut are only one cell layer thick.  The
connections or junctions between these cells are supposed to be very tight so
that this lining acts as a barrier.  Only small nutrient molecules of
protein, fat, carbohydrate, vitamins, and minerals are to be absorbed.  If
these tight junctions loosen and gaps are formed, this can cause significant
problems because it allows larger particles to be absorbed through increased
intestinal permeability or “leaky gut.”

There is
also a mucus layer in the intestines and colon that protects the epithelial
cells, keeps the cells hydrated, and helps the contents of the intestine move
through the digestive tract so that nutrients are absorbed but waste is
expelled.

To
optimize gut health, you’ll have to repair the gut lining and mucus
layer.  Some of the most common supplements and foods used to repair the
gut lining and mucus layer include:

  • L-glutamine – an amino acid, a building block of protein
  • Bone broth – broth made from chicken or beef bones
  • Prebiotic foods – water-soluble fiber that becomes fermented and digested
    by anaerobic bacteria in the colon
  • Slippery elm – supplement derived from the inner bark of a species of elm
    tree

Rebalance

The
gastrointestinal or enteric nervous system is embedded in the lining of the
gastrointestinal system, beginning in the esophagus and extending down to the
anus.

The
enteric nervous system has been described as a “second brain” and can operate
autonomously or separately from the rest of the body’s nervous system. 

The
nerves of the gastrointestinal nervous system control peristalsis, the contractions
of the intestinal muscles that churn and move digested food through our
gastrointestinal tract.  The enteric nervous system is also responsible
for the secretion of several different enzymes, proteins involved in digestion
and other chemical reactions.  

The
enteric nervous system also makes use of more than 30 neurotransmitters, most
of which are identical to the ones found in the brain, such as acetylcholine,
dopamine, and serotonin. These neurotransmitters can be very involved in mood
stability, anxiety, and depression so maintaining neurological and
psychological balance is extremely important when it comes to your gut health.

The
chronic stress that modern life imposes on us can take an enormous toll on our
health and well-being if we do not rebalance our nervous system.

One of
the best ways to balance your cortisol or stress hormone levels is to get at
least 8 hours of sleep per night.  Trouble falling asleep or waking in the
middle of the night and have trouble getting back to sleep are both signs of
cortisol imbalances. Taking a low dose of melatonin (3 mg) prior to
bedtime can be very helpful not only for sleep but also for quieting the
enteric nervous system in people with multiple gut problems such as heartburn
and irritable bowel syndrome.

Another
way to rebalance your nervous system is to have a daily stress reduction
practice.  Breathing exercises, for example, can be done in many different
mindful ways to quiet the mind, reduce stress, and improve oxygenation.
Meditating can involve emptying the mind of all thought or giving the mind
something to focus on mindfully, such as repeating a mantra or prayer.  Activities
like yoga, walking in nature, or dancing can all be forms of moving meditation.  Practicing any or all these stress-reducing
activities daily will help to rebalance your nervous system.

For more support and guidance about implementing the Five ‘R’ Approach,
please schedule your free phone consultation to speak with a staff member from
Discover Health Functional Medicine Center.

* Please note that the functional medicine approach to healing the gut
does not happen overnight and it is never recommended that a person should
remove any medication right away.