How to heal your gut in 5 steps

Learn 5 stages of gut healing.

One of the most common questions I am asked is how to improve digestive function and heal the gut. Recently, the awareness of the importance of gut health has grown tremendously. In fact, problems with the gastrointestinal (GI) tract can cause more than just stomach aches or diarrhea. GI issues may underlie several other chronic health problems that seem unrelated to digestive health, including autoimmune diseases such as rheumatoid arthritis and Type 1 diabetes, skin problems such as eczema and acne, heart disease, interstitial cystitis (just to name a few).

So, in the bigger picture, how can we deal with all that can go wrong with the gut? In functional medicine, we use a program that goes by the simple acronym of the '5R': Remove, Replace, Reinoculate, Repair, Rebalance.

When applied to various chronic conditions, the 5 R program can lead to dramatic improvements in symptoms, and sometimes can lead to a resolution of the problem. Let's take a closer look.

1. Remove

Remove stressors: get rid of things that negatively affect the environment of the GI tract. These include allergenic foods and parasites or other bad bugs such as bacteria or yeast. At this stage, it might be necessary to implement an elimination diet to find out what foods are causing GI symptoms. Reduce or eliminate foods high in added sugar, artificial sweeteners, and additives. Functional stool tests can be very helpful at identifying various pathologies and harmful microorganisms, as well as evidence of bacterial or fungal overgrowth. If a pathogenic load is high, herbal antimicrobial therapy may be very effective during this stage.

2. Replace

Replace digestive secretions. Prolonged drug use (acid blockers) , bad diet, and aging can reduce vital digestive secretions like hydrochloric acid, digestive enzymes, and bile acids. Adding these elements may greatly improve the digestive function and assimilation of foods. Poor digestion and assimilation of nutrients are what drive nutrient deficiencies and malnutrition. Because, in essence, we are not what we eat but what we absorb!

Bitter herbs like dandelion root, gentian, ginger, turmeric, and bitter fennel taken before meals are helpful in stimulating your own digestive enzymes, bile, and gastric acid. They may also soothe gas and bloating, ease constipation, and regulate bowel movements.

3. Reinoculate

Antibiotics disrupt a delicate microbial balance in the gut. Antibiotic use, especially among IC patients, is quite high and frequent since IC is commonly misdiagnosed as a UTI. Probiotics in the form of supplements or foods are needed to reinoculate the gut. You can help beneficial bacteria flourish by eating fermented foods or by taking a high-quality probiotic containing species such as bifidobacteria and lactobacillus*.

Consume a diet high in soluble fiber that beneficial bacteria like to eat, called prebiotics. Prebiotics are non-digestible food components that selectively stimulate the growth of beneficial microorganisms already in the colon. In other words, prebiotics feed probiotics. Foods like artichokes, garlic, leeks, onion, chicory, flax, oats, and inulin fiber are good sources of prebiotics. Another good probiotic source is a supplement called fructo-oligosaccharides or FOS.

Postbiotics. The use of postbiotics in modulating the microbiome has gained recent interest in functional clinical practice. Postbiotics are metabolic by-products of bacterial activity. These metabolites have been found to modulate the immune response, reduce inflammation, promote antioxidant production, improve blood lipid, and destroy cancer cells.

Butyrate is especially beneficial for the gut as it is the main energy source for the enterocytes, the cells that line the gut epithelium. It helps to renew and repair this layer and improve the tight junctions between the cells, "sealing the gut". It can also improve food tolerance by modulating gut immunity. [2]

*A note for individuals with Interstitial Cystitis:

You may need to stay away from fermented foods for a while since these foods are higher in histamine and may cause a flare. Choose a probiotic with strains that do not stimulate excess histamine in the gut. Those typically include Bifidobacteria spp.

4. Repair

This step is important to help the gut epithelium lining heal. The integrity of this layer is critically important. When the gut lining is damaged, it allows for the undigested particle and other substances to slip into the circulation and cause an immune reaction. Help the gut lining of the GI tract repair itself by supplying key nutrients that can be in short supply such as zinc, antioxidants (vitamins AC, and E), omega-3, and the amino acid L-glutamine. Consuming foods rich in collagen will help restore the mucosal layer. Some of the most beneficial foods for restoring the gut lining is bone broth (meat broth if you suffer from IC, histamine intolerance, oxalate issues, or MCAS), wild-caught salmon, broccoli sprouts, coconuts and coconut oil, garlic and onions, ginger, home-made yogurt.

5. Rebalance

Pay special attention to lifestyle choices-sleep, exercise, and stress levels as all these can affect the GI tract. Maintain a whole, nutrient-rich diet.

References:

1. Camilleri, M., & Vella, A. (2022). What to do about the leaky gut. Gut, 71(2), 424–435. https://doi.org/10.1136/gutjnl-2021-325428

2. Żółkiewicz, J., Marzec, A., Ruszczyński, M., & Feleszko, W. (2020). Postbiotics-A Step Beyond Pre- and Probiotics. Nutrients, 12(8), 2189. https://doi.org/10.3390/nu12082189