The phrase: “Death begins in the colon”, coined by Nobel Prize winner professor Elie Metchnikoff, is a well known one; at least amongst my peers and I. I’m not sure who originally coined the 4 R’s approach to digestive disorders, but it is certainly a great way to help someone gain optimal digestive health. The 4 R’s are: 1) Remove. 2) Replace, 3) Re-inoculate, 4) Repair. I’ll discuss each individually.
1) Remove – This refers to removing food allergens, sugar (in most forms), alcohol, artificial sweeteners and colors, and perhaps even gluten from the diet. Additionally, “removal” of pathogens such as: (an overgrowth of) yeast, parasites, harmful bacteria, viruses, protozoa, etc. is part of the “remove” step. This can be accomplished through the making healthy food choices and taking specific nutritional and/or herbal formulas.
2) Replace – This refers to “replacing”, really adding the biochemicals (via dietary supplements) necessary to digest food. For example, one may need digestive enzymes (to break down fat, carbohydrates, and protein) and/or hydrochloric acid to help with digestion of protein in the stomach, among other important reasons.
3) Re-inoculate – This step involves adding beneficial flora (or gut bacteria) in the form of dietary supplements. This helps to ensure the “good” and “bad” bacteria in the digestive tract is balanced in a healthy way. Often, there will be an overgrowth of organisms (those mentioned in step 2), that necessitates “re-inoculation” of good bacteria into the intestines. There are purportedly about 500 different species of bacteria residing in the gut. The common ones you’ve probably heard of are acidophilus and bifidus. These bacteria perform so many important functions that the topic deserves an article of its own.
4) Repair – This refers to repairing the structural integrity of the stomach and digestive tract. The digestive lining is easily irritated, especially from food allergens and foreign (natural or artificial) chemicals. The small intestine lining specifically tends to lose its integrity easily and can result in a condition known as “leaky gut syndrome”. This is when the cells that create the barrier against food getting into the bloodstream become damaged, thus allowing large undigested food particles (and chemicals) to be released systemically. As a result, the body can mount an immune response in reaction to these “foreign” and undigested chemicals causing a whole host of symptoms, especially allergic reactions leading to systemic inflammation. There are a variety of remedies that address this situation.
In my experience each individual does not necessarily need to go through all of these steps in order to feel better. However, implementing at least one (usually 2-3) can be the difference between success and failure. Changing the diet alone is usually not sufficient enough to feel and function better, especially if the condition is chronic.
Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology
I have had chronic UTI’s this winter, ecoli being the culprit. I take care of myself hygenically. Can this be associated with leaky gut?
Hi Marcia,
It could be, but if I had to guess, I’d suspect an imbalance in the gut flora and the presence of (too many) pathogenic organisms. So leaky gut may result, but it wouldn’t necessarily be the cause, and only focusing on the gut lining may not be enough. The microbial situation needs to be figured out.
Hope this helps,
Dr. Rob D’Aquila
I am 50 years old, and recentley had a lower back fusion on my L1 S5. three month post.. I have always been somewhat healthy and not many health problems, I have always had stomach problems along with depression and now I am having metapause syptoms… Memory loss weight gain confusion hair loss.. (lots of hair loss) but not having hot flashes just occasional sweats.. the hair loss concerns me .. also the weight gain.. I quit smoking 2 weeks pre-op. the cravings are bad also the weight gain is worse.. 12 lbs in three months.. I am very very stressed over the weight gain..and hair-loss.. also there have been 3 deaths in my imidiate family .. one including my father.. in the past 8 months .. I am STRESSED….. I was diagnosed by my family pract. Dr with H-paroli.. and have recently undergone a series of antibiotics along with Pepto-Bismol and Prilosec to treat it…. I am still having stomach pain and burning ..also attacks of throwing up.. Is this stress related or homone related .. or What?
Hi Tammy,
It sounds like a combination of stress and hormonal imbalances. Also, you may want to have your thyroid checked, considering the weight gain and hair loss.
Best,
Dr. Rob D’Aquila
Can you do step 4 repair as in taking L glutamine while you doing the other three steps or is it best to wait? Thank you so much for your articles.
Hi Debbie,
I can’t give you specific advice regarding this as you’re not a patient of mine. However, for my patients, yes, I do prescribe the “repair” step along with the other three. I find it best to do all together as missing one piece of the puzzle can lead to poor progress.
You’re welcome for my articles – thanks for taking the time to read them and comment.
Take care,
Dr. Rob D’Aquila
Thanks for your great blog. Its very informative and direct 🙂