Gut Health – The 5 R Framework

gut health

Gut Health – The 5 R Framework

HOW DO I IMPROVE MY GUT HEALTH?

 

Gut Health – The 5 R Functional Medicine Framework 

 

  • Remove
  • Replace
  • Reinoculate
  • Repair
  • Rebalance

 

The Institute for Functional Medicine has long been talking about gut health and healing and came up with the 5R Framework for healing the gut as a way to help support and heal the digestive tract. This is the approach that I follow with patients to improve health and optimize wellness. The steps are individualized to each person but there are common themes that anyone can benefit from. They are not done in a stepwise fashion but a person will be working through many of the “R’s” at any given time and some may be ongoing. A comprehensive stool test may be helpful in guiding treatment decisions but it is not totally necessary to take basic steps for better gut and overall health. This approach is also not just for those who have gut related symptoms, anyone with chronic disease or who is not feeling optimal could likely benefit from a gut restoration program. Let’s dive in!

Remove: This refers to the removal of any foods that may be causing sensitivities or intolerances leading to inflammation of the gut and beyond. This can also refer to the removal of pathogenic bacteria that may be found on a comprehensive stool test by using traditional antibiotic therapy for more severe bacteria or antimicrobial herbs for less worrisome strains. 

Replace: For those who have trouble digesting foods such as protein, this step is to replace factors involved in digestion such as digestive enzymes, hydrochloric acid, or digestive bitters.

Reinoculate: Probiotics have become a household name and most people have probably taken them at one time or another. Probiotics are meant to be temporary placeholder in the gut while you focus on improving the diet to include more natural probiotic and prebiotic foods that will ultimately help the gut to heal and restore balance. Probiotics can help to crowd out pathogenic bacteria while allow the good, commensal bacteria to thrive. 

Repair: In order for the gut to function optimally and to decrease overall inflammation, we must repair the gut lining. When we are exposed to foods we are sensitive too, toxins, stress, medications and much more (see the blog post on increased intestinal permeability HERE), our gut lining can become more permeable, letting things into our body to cause downstream inflammation and disease. Things that can help to heal the gut lining include collagen peptides, bone broth, serum derived bovine immunoglobulins, phytonutrients, and l-glutamine. There are also herbal supplements like slippery elm, marshmallow root, aloe, licorice root and curcumin. 

Rebalance: We cannot heal when we are in a sympathetic nervous dominating state (aka fight-or-flight), so the final step that is critical to overall healing is rebalancing your life and decreasing stress. Focusing on sleep, rest, mindfulness, and other parasympathetic driven activities that help to calm the nervous system and reduce stress are a big key to healing, not just the gut but ourselves. In our fast paced, go-go-go world this is often the missing piece and you can take all the supplements in the world but if you are not focusing on reducing stress or balancing your life, the body will not be able to fully heal. 

If you are looking to work with a practitioner on restoring gut and optimal health, book a free introductory call with me today!

For more on gut health, the microbiome and dysbiosis, check out our previous blogs: The Gut Microbiome and Leaky Gut!