This page serves as a resource to review helpful tools for healing your gut. Modifying your diet to center around fresh vegetables, fruit, protein, whole grains, nuts, seeds and fermented foods while eliminating processed foods, packaged ‘diet foods,’ sugar and allergenic foods will be the most important change you can make. Just remember that one person’s health food (for instance, wheat bran or greek yogurt) can be another person’s inflammatory food.
Below is a brief review of dietary and supplemental suggestions for specific digestive issues. Following the 4 R Protocol, described below, is a safe and effective way to soothe an upset digestive tract for any type of digestive issue, so I’ve listed it above specific digestive issues. The 4 R Protocol is also extremely useful in repairing damage done by food allergies, sensitivities and intolerances. Remember, migraines, skin problems and many other non-gastrointestinal symptoms may just be your physical symptoms of a compromised gut. When in doubt, heal your digestive tract first.
Taking supplements at random, without the advice of a professional, will not assist in your healing process, and may actually hinder it. Work with someone who can help guide you, educate you on therapeutic levels of nutrients and supplements, and create a personalized diet catered to your symptoms and digestive issues.
4 R Protocol
Removing what’s causing inflammation in your gut is an absolute must. If you find out that gluten or coffee or whatever is causing problems, then you need to face the music and get it out of your life. I have learned the hard way that you simply cannot heal until you eliminate whatever it may be that’s destroying your gut. For many people that’s food, for others it’s antibiotics, birth control, stress, alcohol, environmental toxins or a combination of all of the above. At first it may seem overwhelming to uncover these sensitivities and allergies, but you can, and you’ll be feel so much better once you make the commitment to remove it (or them) from your life. It’s may not be easy, but it will become second nature to live with these changes, and working with a nutritionist or health professional can substantially help.
Think of removing the offending items from you life as a detox. Below are a list of herbs known for their detoxification properties, making your dietary changes all the more powerful.. Taking random amounts of these can actually hinder your situation, so be smart and work with a professional for recommendations.
- Licorice, ginseng, goldenseal, pau d’arco, seaweed, garlic, herbs
- Dandelion root, milk thistle and artichoke help cleanse the liver
- Grapefruit seed and garlic are strong anti-microbials
- Goldenseal and oil of oregano can lower yeast count
You must replace what is needed for normal digestion and absorption which may include one or all of the following, depending on your specific condition:
- Dietary fiber
- Betaine hydrochloric acid
- Digestive enzymes
- Serotonin precursor 5-HTP
- Herbs that aid in digestion, such as fennel seed, ginger and papaya extract
Reinoculating your gut with healthy bacteria is crucial for proper gastrointestinal function. Store bought probiotics are fine, but not all brands are equal. Check on the back of the bottle to make sure they include favorable microbes Lactobacillus sp and Bifidobacteria sp. In your initial healing stage, an ideal product will contain at least 10 billion organisms. Saccharomyces boulardii (yeast on yeast) may also be helpful, especially for people with IBD. Natural food sources in the form of fermented foods should be included in everyone’s diet: sauerkraut, kombucha, kefir, unsweetened yogurt, miso and kimchi are all great sources.
Remember that probiotics (living bacteria) also need food, so feed the ones inside you with prebiotics, which are found in:
- Oligofructose – also known as FOS: garlic, rye, blueberries, bananas, chicory
- Inulin: artichoke and chicory
- Xylooligosaccharides and fiber: bran and psyillium husk
Help the healing process by supporting the mucosal lining’s intestinal mucosal cells, goblet cells, and immune system: L-glutamine, N-Acetyl Glucosamine, gamma-oryzanol, essential fatty acids, zinc, pantothenic acid (vitamin B5), vitamin C, zinc, peppermint oil, aloe vera, marhsmallow root, deglycyrrhizinated licorice, marshmallow root, slippery elm bark, cumin, chamomille, and purified water are all very healing.
* There are many different options for utilizing these herbs and supplemental therapies. Some brands offer many herbs in one supplement, and all brands are not equal. This is yet another reason to use your health practitioner as a guide for the multitude of products on the market. Don’t waste your money on ineffetive supplements!
Adapted from Lukaczer D. The “4R Program” in Jones DS, ed. Textbook of Functional Medicine, Gig Harbor, WA: The Institute for Functional Medicine
Specific Digestive Health Issues
Once you determine what’s contributing to your intestinal permeability, you need to remove that from your life. Whether it be a particular food, non-steroidal anti-inflammatory drugs (aspirin, ibuprofin, naproxin, etc.), medications, alcohol or a combination of these and other causes, you must completely eliminate them. Does this mean you’ll never be able to eat that food again? Not necessariliy. Can you never take Advil again? Probably not the case. What it does mean is that you cannot heal unless you remove them at least for a period of time – potentially a few months to a few years. Some substances – particularly legitimate food allergies, may mean saying goodbye forever. No matter how ‘healthy’ you are or how many supplements you take, your efforts will be fruitless without complete removal of inflammatory substances, as you will have chronic low levels of inflammation and permeability.
Following the 4 R Protocol will be crucial in the healing process of the digestive tract. Be dedicated to taking probiotics and digestive enzymes. Probiotics are absolutely crucial in the reinoculation of your gut to maintain proper gut flora. These are the good guys that help keep your digestive system properly functioning. Saccharomyces boulardii is a non-pathogenic yeast that has been clinically proven help raise your Secretory IgA levels.
Some supplemental therapies will contribute tremendously in the healing and repair of your gut. Glutamine, also referred to as L-Glutamine, is an amino acid that is hugely effective in helping your intestinal lining repair itself, as it’s a big game player in intestinal function, metabolism and structure. Healing happens much quicker with glutamine. Glutathione, N-Acetyl cysteine and quercetin are all important components in the defense again free-radical induced tissue damage and can assist in inhibiting histamines.
Some herbs , such as milk thistle & dandelion root, are important for detoxifying the liver, which is imperative as it is most likely overloaded with all the toxins it’s been filtering from your blood. Other helpful herbs include slippery elm, licorice root and echinacea. You have to revive your liver along with healing the digestive tract. Essential fatty acids are anti-inflammatory in function and help sooth mucosal deterioration. They help form healthy cell membranes and are imperative for proper development and functioning of nervous system. Zinc, vitamin B5 (pantothenic acid) support healing mechanisms of the gut while vitamin C and vitamin E provide antioxidant support. A high quality, food based multi-vitamin should be included in your daily regimen as well.
Good nutrition, healing supplements, time, and ultimately, persistance, will heal leaky gut.
Dysbiosis & Candida
The first thing you can do is overhaul your diet. The initial few weeks will be the most challenging, so working with a nutritionist will help. Serious withdrawls may occur, and to ensure you are being careful with your health, work with a professional.
your new diet will be to initially eliminate all sugar and starchy foods. For a period of time (determine with your health professional) eliminate completely: sugar, yeast (including beer!), starchy vegetables, fruit and fruit juice, processed foods and meats, all mushrooms, vinegar, aged cheese, alcohol and dried fruits. Make sure to eat plenty of good quality protein and fiber rich vegetables. You may want to avoid raw vegetables until digestion has improved. Start incorporating fermented foods into your diet, as they will naturally reinoculate your digestive tract with healthy bacteria. Sauerkraut, kefir & yogurt (plain, full-fat and unsweetened – if you can handle dairy), kimchi, miso, tempeh and pickled vegetables are good sources. Use spices and garlic liberally in your food, preferably uncooked. Good sources of fats are of particular importance, try including cold water fish, avocados, nuts, seeds, virgin coconut oil, organic butter and extra virgin olive oil. Foods known to particularly inhibit yeast growth are dark leafy greens, broccoli, cauliflower, brussel sprouts, radishes, turnips, shallots and hot peppers.
You will need to follow the 4 R protocol, while strictly adhering to your new diet plan, in order to eliminate yeast overgrowth. Taking digestive enzymes at each meal will be very beneficial in improving digestive function. If you have low stomach acid, hydrochloric acid (HCl) will help you break down crucial vitamins and minerals. You must work with a health professional to help you obtain the right levels of minerals, vitamins and other supplements, otherwise you run the risk of causing more harm than good. Vitamin C, vitamin E, selenium, zinc, B-complex, essential fatty acids, magnesium, calcium, lactobacillus acidophilus & bifidobacterium infantis, caprylic acid, L-glutamine and butyric acid have all been known to play a part in dealing with dysbiois.
Dealing with IBS will involve a protocol very similar to Leaky Gut, as they are so closely intertwined. IBS is hugely dependent on diet and stress levels. Managing physical and emotional stressors in your life – work, relationships, food allergies, etc., will play a pivotol role in dealing with your symptoms. It may be wise to remove the most usual provocative suspects: glutinous grains, dairy, sugar (including high sugar fruits) and gas inducing vegetables – such as broccoli, cauliflower, brussel sprouts and cabbage. Coffee acts as a stimulant and can acutely affect people with IBS, the same goes for alcohol. Including raw garlic, a variety of vegetables, good sources of protein and dietary fiber will support your efforts. Working with your nutritionist, figure out a specific diet plan that caters to you and your lifestyle; some people have success on the Specific Carbohydrate Diet.
Strictly following the 4 R Protocol is imperative to eliminate IBS symptoms and help rebuild a healthy digestive tract, particularly if you have Leaky Gut symptoms. At least for a period of time, include therapeutic supplements that can help you get back on track. This is important – healing is impossible without removing the provocateurs, but removing them alone may not necessarily give your body what it needs to rebuild the digestive tract. The herbs referenced above for Leaky Gut smptoms will prove therapeutic for IBS as well. Adding additional magnesium to the diet is important with IBS (very effective for IBS with constipation, use caution in IBS with diarrhea). Eating magnesium in dark leafy greens will be a great source, but additional supplementation may be needed, particularly with constipation. Since IBS is so closely linked to the brain, you may want to replentish serotinin levels with 5-HTP, a precursor to serotonin.
Slippery elm, marshmallow root and DGL will all all be helpful demulcents. Aloe leaf juice or gel can be very therapuetic for those with IBS-C (constipation predominant). Peppermint oil (enteric coated so it doesn’t digest in the stomach and reaches the intestines) is very soothing for spasms and pain. Other important additions should include probiotics, digestive enzymes, essential fatty acids, and a high quality, food based multi-vitamin.
IBD: Crohn’s Disease & Ulcerative Colitis
There is no known cure for IBD. You may experience periods of improvement followed by flare-ups. There are certain medications, such as Accutane, that have been linked to digestive disorders including Crohn’s and Ulcerative Colitis, so evaluate your past and current medical history.
Nutrition choices are extremely important in IBD. Choosing to eat smaller meals throughout the day has been shown to help people with digestion. Because IBD is an autoimmune disorder, you may want to remove gluten from the diet, as it has been highly associated with autoimmune conditions. The body can have a very difficult time with the protein found in glutinous grains, however not everyone with autoimmune disorders is affected by gluten. When you eliminate gluten you must do it 100% or you will have chronic low levels of inflammation. This can initially be a daunting task for people. Check out my gluten page on how to do so and hidden gluten sources, such as soy sauce.
Patients are often told to avoid fiber rich foods, but there is some debate about that, or at least, the source of the fiber. It has also been recommended to eliminate dairy products. Many people have shown major improvements on a Specific Carbohydrate Diet, which is gluten, casein, dairy and refined sugar free, based on the book Breaking the Vicious Cycle. It’s similar to the “Paleo Diet,” in that it recommends consuming only meats, fish, nuts and low-sugar fruits and vegetables that were eaten prior to the introduction of grains in the human diet. One study found that people with Crohn’s are most likely to react to cereals, dairy and yeast. Clearly, it’s a complicated challenge to find out what’s triggering your IBD symptoms. For some people it’s dairy, for another it’s yeast. I would suggest anyone with Crohn’s to work with with their doctor and a nutritionist, do an elimination diet and closely track what is triggering symptoms.
Following the 4 R Protocol will help the healing process of the digestive tract once you have determined what is causing flare-ups. Be dedicated to taking probiotics and digestive enzymes as well. Because patients with IBD are likely to have malabsorption, inadequate levels of many crucial nutrients are very common. It’s important to supplement with a high potency and high quality multi-vitamin and mineral support, with adequate amounts of folic acid and iron. Vitamin B12, zinc and folic acid are known to repair the intestinal damage done by IBD. Additional supplementation of Omega-3 fatty acids EPA and DHA (fish oil source), vitamin D (most people with IBD are deficient) are also recommended. Diarrhea casued by Crohn’s has partially responded to Saccharomyces boulardii supplementation. Herbs known to soothe the digestive tract have traditionally been used to treat discomfort: slippery elm, goldenseal, wild indigo, marshmallow root, chamomile, licorice and aloe.
Mark Hyman, MD, has done extensive research on autoimmune disorders and cooling the inflammation in our body. Check out this article and read his 9 steps to treating autoimmune disease, naturally.
Heartburn & Acid Reflux
In order to alleviate heartburn, you’ll need to change your diet and avoid certain foods – some for a long time and some you may be able to reintroduce. As mentioned on the Heartburn and Acid Reflux page, you need to determine if low or high stomach acid is the casue of your symptoms. Do so by working with a doctor or nutritionist who can help you determine this. Regardless of the outcome, there are a few foods and tactics that are extremely beneficial in managing your symptoms: Vegetables, particularly bitter greens and other alkaline foods, will help your stomach. Make your meals smaller and you may notice immediate improvement. Fatty proteins, such as commercial red meat and fried foods, will be very hard to digest. Alcohol and coffee severely exacerbate high or low stomach acid.
You can support and repair your digestive system with herbs, vitamins and minerals. Probiotics and digestive enzymes are recommended for everyone with burning symptoms. High stomach acid responds well to L-glutamine, deglycyrrhizinated licorice (DGL), aloe, slippery elm, soaked flax seeds, raw potato juice, Traditional Chinese Medicine, vitamin A and vitamin B5. Low stomach acid responds well to bitters, spicy food, slow eating, Traditional Chinese Medicine, Zinc and Magnesium. While you’re in the initial stages of dealing with low stomach acid you may want to ingest lemon juice or apple cider vinegar with each meal, or alternatively take supplemental Hydrochloric acid, which comes in capsules in the form of HCl betaine, but consult with a nutritionist or health specialist on the best way to do this and the most ideal supplements for your particular needs.
Celiac Disease & Gluten Sensitivity
The only treatment for celiac disease and gluten sensitivity is a gluten-free diet. This should be looked at as a two phase plan. The first phase is eliminating gluten from your diet, 100%. That does not mean indulging on weekends or eliminating everything “except beer and late night pizza,” which is something I often hear. What it means is eliminating gluten from your diet entirely, in all forms. Once you have done this, your symptoms should subside, and that will be that. The second phase, which you can begin the same day you eliminate gluten from your diet, will be to follow the 4 R Protocol, described in detail above.
Eliminating gluten from your life may be a difficult pill to swallow, particularly once you understand just how much gluten is a part of the standard American diet. It’s everywhere, or at least it sometimes feels that way. It can be difficult on a social level as well, as sometimes you may feel like the odd one out or isolated. Giving up gluten can also cause withdrawls for the first few weeks, as grains can induce opiate effects on the brain, which makes the initial elimination no easy feat. It’s important you educate yourself on hidden sources, all varieties of wheat, and how to read nutrition labels.
Meeting with a nutritionist can help you through the early transition period. Joining a celiac online or local support group may be very helpful for those who feel particularly addicted to gluten containing foods. The good news is that now is a great time for the gluten-free person, as new gluten-free products are literally coming out everyday. Check out my gluten & wheat page for specific details on how to go gluten-free, and my recipe substitions page to teach you how to bake and cook without it.