5R Framework for Gut Healing

There are many options and opportunities for healing the gut. One of the most common methods is the use of the 4 or 5 R's. In the case of the 5R method, we use a 5 step program to help reduce GI disfunction and reestablish a healthy gut system. The 5 R's are: remove, replace, re-inoculate, repair, and rebalance. Below is a quick guide to how this method works.

Remove

In this phase, we remove anything from the diet that may be contributing to inflammation, causing allergic reactions, or sensitivities. Often this involves some trial and error as not all sensitivities are obvious. Some commonly removed foods may include cane sugar, processed goods, dairy, wheat, corn, soy, eggs, citrus, etc.

Replace

This phase involves replacing elements that are necessary for proper digestion. Typically this includes supplements to boost hydrochloric acid, bile or enzymes.

Re-inoculate

To re-inoculate the gut, means to introduce healthy microbes to the environment. This means things like prebiotics, probiotics, and postbiotics. Fermented foods and supplements are very helpful in this phase. Eating a diet rich in prebiotic fiber is also important.

Repair

Repairing the gut lining is a key goal of this framework. By healing issues such as leaky gut, the gut is better able to digest and assimilate nutrients that we consume. In the case of food sensitivities and leaky gut, it is often possible to reincorporate such foods into the diet once the gut is sufficiently healed. In this phase, we often add in foods and supplements that help to tighten junctions in the epithelium and are soothing to the tissue lining of the gut. See my post on gut supplements for more.

Rebalance

The end goal of this program is to leave people with the power to choose foods that support their health and wellbeing. Rebalancing is the act of finding an equilibrium that best supports the individual person by helping to establish a more balanced life when it comes to work, life, love, and of course food. This may involve learning more about the foods that love your body, experimenting with breathing or meditation, or developing a gratitude practice.

1. Lukaczer D. The “4R” program. Jones D, Quinn S, Textbook of Functional Medicine. Federal Way, WA: The Institute for Functional Medicine; 2010:462-468.