It is well documented that any dysfunction in the gut can lead to a host of symptoms, including those outside the digestive tract. Gut disturbances can cause fatigue, joint pain, headaches, muscle pain, allergies, autism, ADHD, depression, anxiety, asthma, chronic skin conditions, digestive disorders, and autoimmune diseases. Functional medicine recognizes the interconnectedness of body systems, so when someone comes to us with these symptoms, we often look to the gut first!
The 5R Protocol
There is a functional medicine protocol for gut repair called the “5R’s.” This protocol takes people through the five stages of restoring the balance of the gastrointestinal system, whose function can be compromised through various insults over time. The 5R protocol is used for those with digestive disorders, such as IBS or SIBO. However, the protocol is also used when lab testing reveals dysfunction in the GI tract, even if a person does not have gastrointestinal symptoms. The 5R program stands at the intersection of chronic health issues and poor GI function.
The 5R protocol has a number of goals:
- Address dietary and lifestyle issues and to make healthy changes
- Normalize digestion and absorption
- Achieve a healthy balance of gut bacteria
- Encourage a robust detoxification system
- Promote healing of the gastrointestinal tract
Lastly, the 5R program is not only applicable to those with poor diets. We often find that slim people, athletes, vegetarians, and anyone who is otherwise “healthy,” are just as likely to be good candidates for the program as a person with a poor diet. This is because our gut health is not only determined by our diet, but also by a myriad of other factors, including our physical environment, our early years growing up, our toxin exposures over time, and more.
Stages of the 5R Protocol
The 5R protocol is so called because it contains five stages of healing that all begin with the letter, “R.”
1) Remove any element that negatively affects the GI tract. These can be food sensitivities, pathogens, parasites, yeast or bacteria overgrowth. This stage also encompasses decreasing exposure to environmental toxins, food additives, processed foods, etc. The Remove stage involves following some type of Elimination diet where common food allergens are avoided for short-term, while focusing on eating whole-foods. It also involves taking particular supplements and herbs that eradicate overgrowths, parasites, molds, or toxins, where appropriate.
2) Replace the elements that are needed for proper digestion. This includes things like digestive enzymes, hydrochloric acid (stomach acid), bile acid, and proper motility. These are commonly compromised through a variety of factors, such as medications, stress, diseases, aging, and dietary habits. The goal is to replace only what a person needs. This stage is accomplished through taking supplements and practicing meal spacing.
3) Reinoculate the gut with beneficial bacteria. Taking probiotics (as food and as supplements), as well as eating prebiotic foods (which feed healthy gut bacteria), work together to reestablish balanced gut flora, increasing their growth and numbers. This stage involves eating specific foods such as prebiotic foods (artichokes, garlic, onion, leeks, etc), fermented/probiotic foods (tempeh, sauerkraut, miso, cultured yogurt, kefir), and soluble fiber. Probiotic and prebiotic supplements and fiber powder are also available. Be aware that those with SIBO may have exacerbated symptoms when eating these foods (which are largely high FODMAP). They would need to modify this stage or spend longer in the Remove stage.
4) Repair the gut lining now that our immune system no longer has pathogens, toxins, or overgrowths to react to. By now, not only are we free of these harmful agents, but our digestive process if functioning properly and supports a healthy gut flora. Repairing the gut lining involves strengthening the intestinal cells that line our gut. A healthy gut lining allows nutrients to be released into our bloodstream while preventing harmful compounds from doing so. Instead, these compounds must remain in the gut so that they can be eliminated from the body. The Repair stage involves ingesting specific vitamins, minerals, fibers, amino acids, and antioxidants. These all play a role in keeping our gut lining healthy and are often depleted in those who need a 5R program.
5) Rebalance your lifestyle going forward. A healthy gut not only requires healthy food, but also a healthy lifestyle. Proper exercise is critical, not just for our cardiovascular system and emotional wellbeing, but also for our intestinal function. Stress management is another essential aspect relating to gut health. Any stress response (whether psychological or physical) triggers reactionary steps throughout our body, including the slowing of digestive function. Sleep hygiene is our last element of rebalancing. Healthy sleep helps to calm an overactive stress response by regulating cortisol, a stress hormone.
The 5R Protocol in Practice
Walking through the 5R program takes between three to six months to complete and involves daily commitment to dietary changes; changes which can be fairly demanding and may cause temporary symptoms as your body removes harmful elements. However, not everyone who benefits from the 5R program requires completion of all the stages. Some stages may be bypassed completely or otherwise altered or shortened depending on what specific areas need improvement. For example, a person may already be avoiding harmful elements, such as high-sugar foods or environmental toxins, but they may need a boost in their digestion, like pancreatic enzymes or bile acid. In this case, he would not need to do the first stage, Remove, and can instead begin at the second stage, Replace.
If you struggle with chronic symptoms or disease, it would be worth investigating the underlying cause(s). Do not ignore your gut health or assume that your chronic health issues are unrelated to your gut! It is often said that all diseases begin in the gut. Indeed, the health of our gut affects (and is affected by) most other body systems, from our nervous system (brain) to our immune system. The 5R program is the most comprehensive way to heal the gut, normalize function, and, by extension, improve or reverse upstream chronic disease. Call our team at Healthy Connections to see whether the 5R protocol could help you! Schedule a free discovery call here