20Nov

The Steps to Digestion: A Quick Guide

Do you often experience abdominal pain, bloating, or acid reflux after eating? Do you reach for symptom soothers like Tums or Pepto bismol more often than you’d like to admit? Maybe you pop probiotics because you’ve heard from a friend that they help with bloating, but that isn’t working? Digestive symptoms typically signal that something has gone wrong during one of the steps to digestion.

Digestion is a very complicated process that most people don’t fully understand. There is much more going on than just food going through your mouth, reaching your stomach, and eventually coming out the other end. Each meal travels 26 feet before it ends up in the toilet! That’s 26 feet where potential problems could arise.

digestive system with neon pink blue green and turquoise

The digestive organs usually work in perfect coordination like a well-oiled machine. But like any machine, sometimes things can go wrong. Reaching for over-the-counter (OTC) symptom soothers is not always the best choice to address your digestive issues, especially if you are experiencing these symptoms regularly.

This blog is a quick guide to digestion and a basic explanation of all the steps to digestion. Reading this blog should help you realize that digestive issues are not usually an easy fix!

Digestion Starts in the Mouth

woman smiling and eating a yellow popsicle on white background

Digestion begins when you take a bite of your food and start to chew. The salivary glands in your mouth kick into action, infusing each bite with saliva that is filled with enzymes that kickstart the process of breaking down starches and fat. This fat digesting enzyme is only available in trace amounts for adults. In babies, it’s present in much larger amounts and helps the infant digest the fats in milk.

Chewing is imperative for multiple reasons. The first is because it breaks down your food into smooth bits that can be swallowed without choking. Chewing also helps you burst open foods like seeds that cannot be digested without being physically broken open. Many people eat way too quickly, so be mindful when you eat, and chew your food thoroughly before swallowing!

peristalsis graphic showing how it moves

Once you swallow your food, it travels down your esophagus where wave-like movements direct it towards your stomach. These waves are referred to as peristalsis.  A sphincter muscle allows entry to the stomach, and helps to prevent food from coming back up in the wrong direction. The next steps to digestion are outlined below.

The Stomach breaks down and liquefies your food

black and white xray image of torso organs with red highlight of stomach and esophagus

Once food exits the esophagus, it enters the stomach where it is added to stomach acid, enzymes, and fluids. Your stomach has 3 layers of thick muscles that tighten and relax, churning this mixture thoroughly until your food turns into a liquid called chyme.

There are actually a couple compartments within the stomach. When food enters the stomach, it gets stored in the top compartment shortly and then moves into the lower compartment where the churning begins.

Eventually after a lot of churning, the food becomes chyme: an acidic, mushy food paste that consists of partially digested food and gastric juices. The gastric juices contain concentrated hydrochloric acid, (HCl) water, and enzymes. Stomach acid is extremely acidic (~1.5 pH), but doesn’t damage your stomach due to the mucus produced by the walls of the stomach that protect the digestive lining. This acid will kill most bacteria that sneak their way into the stomach with your food.

At this point in digestion, the starches are partially split and proteins are uncoiled. Fats separate from the rest of the mixture and float on top of the watery, protein and carb-rich chyme. As the chyme leaves the stomach, the fat layer is the last to exit. The more fat in a meal, the slower digestion proceeds, which explains why you feel fuller longer after a fatty meal.

Food exits the stomach a little bit at a time through a valve at the bottom of the stomach called the pyloric valve. Your stomach spits out chyme into the small intestine for a few hours after your meal until it is empty.

The small intestine is responsible for nutrient absorption

The small intestine is an incredibly long and winding organ where the majority of nutrient absorption occurs. There is so much surface area on the walls of the small intestine that if it were laid out flat, it would cover 1/3 of a football field!

This hugely important organ receives and secretes enzymes in response to food to help break down carbohydrates, proteins, and fats in preparation for absorption. You may be able to guess that the role the small intestine plays is actually one of the most important steps to digestion, and you would be correct. Each step is extremely important, but nutrient absorption is essential to life.

The cells along the walls lining the small intestine have finger-like projections called villi that pick up vitamins, minerals, and broken down nutrients once they’re small enough to absorb. Each villus then directs these nutrients into your bloodstream or into your lymph.

villi of the small intestine

The liver and gallbladder are in charge of bile production and storage

Your liver has many functions, but did you know it plays a role in digestion? The liver produces bile, which helps digest fats. The liver sends bile over to the gallbladder for storage, where it remains until needed in the small intestine. Once the small intestine is in need of bile, hormone messengers signal the gallbladder to contract and squirt bile through the bile duct into the small intestine.

Bile is an emulsifier. What this means is that it causes the separated fat layer to become suspended within the watery chyme.  This leads to more fat being exposed to fat-digesting enzymes for optimal absorption. Most bile gets reabsorbed and reused, but some may exit the body with the feces at the end of all the steps to digestion.

diagram of the liver and gallbladder and their parts

It is indeed possible to live without a gallbladder, because the liver will continue to produce bile. But instead of the bile getting stored somewhere, it is delivered directly into the small intestine through a different duct. If you have had gallbladder removal surgery (and even if you haven’t), you may need some supplemental bile and enzyme support.

Your pancreas secretes digestive enzymes

black and white xray image of torso organs with pancreas highlighted in red

Your pancreas is in charge of making digestive enzymes that help break down macronutrients (carbohydrates, proteins, and fats) into smaller and smaller pieces until the nutrients are small enough to be absorbed.

The job of the pancreas is to release pancreatic juices containing these digestive enzymes into the small intestine. Pancreatic juices also include alkaline bicarbonate, which neutralizes the stomach acid that enters the small intestine with chyme. The pancreas plays an essential role in digestion because the small intestine cannot play its role in nutrient absorption without these digestive enzymes.

One type of nutrient that doesn’t get absorbed in the small intestine is fiber. So, fiber will move along into the large intestine for the next steps to digestion. 

Stool is formed in the large intestine

diagram of the intestines and all of its regions

Once the remnants of your food enter the large intestine (colon), digestion and absorption are mostly complete. Essentially all of the carbs, fat, and protein have been digested and absorbed at this point.

The colon absorbs any leftover minerals and reabsorbs water that was donated by other digestive organs earlier in the digestive process. What is left behind is a paste containing water, indigestible fiber, dead bacteria, and any other undigested materials: this is what makes up your feces. The longer stool sits in the colon, the more water is extracted and the harder your feces become, leading to constipation.

A lesser-known organ: the gut microbiota

Our colon contains about 100 trillion beneficial microbes. They outnumber human cells by about 10 times! In a way, the gut microbiota can be considered its own organ. For example, humans don’t create enzymes that allow us to digest fibers, so this is where the gut bacteria come in handy.

Gut bacteria are able to ferment and break down fibers for us. They salvage nutrients for us that we wouldn’t necessarily have access to otherwise. They turn fibers into short chain fatty acids (SCFAs) such as butyrate, propionate, and acetate that benefit us in many ways. For example, SCFAs can give energy to colon cells, can protect against inflammation, and can even promote brain health. 

Our gut microbiota also break down and help recycle the components of bile. They can even produce some vitamins for us, but not in amounts large enough to meet our body’s needs. So it is still very important to make sure you have a balanced diet based on a variety of foods to ensure you are consuming enough micronutrients.

gastrointestinal bacteria friendly vs unfriendly

Our gut microbiota can also be thrown out of balance, in a state called dysbiosis. Dysbiosis occurs when you have a higher proportion of unfriendly bacteria compared to friendly bacteria. This can lead to many other health complications. A comprehensive stool test can be used to determine whether or not you are experiencing dysbiosis or have a balanced microbiome.

Research about the gut microbiota is booming. There is still so much that we don’t understand, but we are just now realizing the impact these bacteria have on our lives.

Potential root causes of digestive dysfunction

hand holding marker and words that say root cause on black background

So now you should understand a little bit about the complex interrelation between the digestive organs. There are many points along the way where problems could arise.

Here are some examples of potential root causes that can lead to various digestive and absorption issues:

  • Not fully chewing your food
  • Sphincter muscle dysfunction between stomach and esophagus
  • Small intestine bacterial overgrowth (SIBO) due to bacteria leaking from the mouth or relocating from the large intestine
  • Low stomach acid production
  • Insufficient bile flow
  • Low production of pancreatic enzymes
  • Motility dysfunction of the small or large intestine
  • Dysbiosis of gut microbiota
  • Chronic stress
diagram showing stress causing brain gut dysregulation and altered motility of intestine

OTC medications simply mask your symptoms but they don’t address the root cause. This is like putting a band-aid on your symptoms, only providing temporary relief. Diving deep into the steps to digestion to really understand your digestive function, and finding the issue your symptoms stem from is often the only way to get rid of uncomfortable symptoms for good! 

Do you need some help figuring out the root cause that your digestive issues are stemming from?

Schedule your appointment today to get your digestive system back in check!

Interested in learning more about digestive health? Read our other blog, “Heal Your Gut with 5 Simple Lifestyle Changes” to learn more about what you can get started on doing today!

19Nov

Heal Your Gut with 5 Simple Lifestyle Changes

There is so much information on the Internet about how to improve gut health and relieve uncomfortable symptoms. It can be confusing to know where to begin if you’re doing the research on your own. Do I need to take any supplements? How about probiotics? Should I avoid certain foods? Should I get tested for – insert any of the multitude of gut conditions here? How do you really find out what is best for you to heal your gut?

Unfortunately, there is not a “one size fits all” answer when it comes to gut health. The types of things listed above should always be done in coordination with a dietitian, who has the knowledge to guide you in the right direction according to your personal needs.

The good news is that there are some easy gut health lifestyle changes that you can start doing today that can help lay the foundation for a healthy gut! 

Here are 5 simple lifestyle changes you can make that will help you to heal your gut!

1. Slow down while eating

Are you the type of person who rushes through their lunch break? Or maybe you’re finished with your meals within a mere 10 minutes. Please stop eating food too quickly! It is important to chew your food sufficiently in order to heal your gut.

Chewing is an essential part of digestion. Chemicals in our saliva, such as digestive enzymes, help us break down certain nutrients. The antimicrobial properties of our saliva also help to kill some potentially pathogenic bacteria that may be present in the things we consume.

Chewing until food is soft and smooth makes digestion easier further down the digestive tract. Not chewing food enough may lead to digestive problems, malnutrition, and dehydration. Bloating, diarrhea, acid reflux, maldigestion, gas, and abdominal cramping can all result from not chewing your food enough.

Mindfulness and eating go hand in hand because it promotes the parasympathetic, rest and digest state. This is the state you need to be in for the digestive processes to kick in and do their job. Avoid stress during meal times, and try to eat slowly to really enjoy your food. This should lead to better digestion and nutrient absorption.

How to slow down while eating:

  • Chew your food about 30 times before swallowing.
  • Aim to swallow only a couple of times per minute.
  • Make mealtimes relaxing and practice mindfulness

2. Quit snacking

Spacing out meals is really critical for gut health. We need to have periods of time without food in our system in order for the migrating motor complex (MMC) to fulfill its housekeeping duties.

The MMC is responsible for flushing out undigested materials and bacteria through our digestive tract to eventually be flushed down the toilet.  If the MMC cannot do its job, bacteria in the gut now have a chance to overgrow by thriving off of the undigested materials that continue to hang out in the gut. Repeatedly stalling the MMC can lead to conditions like SIBO (small intestine bacterial overgrowth), which can lead to many other digestive and systemic issues.

A general rule is to wait about 3 to 4 hours after a meal before eating again. This should ensure that your MMC can serve its purpose, leaving a clean slate for your next meal. Getting your MMC functioning optimally is essential to heal your gut.

Another perfect time for the MMC to perform its housekeeping duties is while you’re asleep! Sometimes that midnight snack sounds really appealing, but our digestive functions work best if given a 12-hour overnight break. So be sure to make your meals count: they should be nutritious, balanced, and keep you full until your next meal.

How to stop mindless snacking:

  • Eat balanced meals containing protein, healthy fats, and complex, fiber-rich carbs with sufficient calories that will keep you fuller for longer
  • Meals should be spaced out about 3 to 4 hours
  • Don’t eat between dinner and breakfast for a 12-hour overnight fast

3. Remove stressors from your daily life

Stress negatively impacts many aspects of our overall gut health. Most people are familiar with experiencing digestive issues when going through stressful situations such as job interviews, a big exam, or a presentation at work.

Spending more time doing the things you love, and less time doing things that stress you out is an easy way to elevate your overall health. Not only will you feel happier… you will also become healthier and each of these leads to an overall increased sense of wellbeing. Healing your lifestyle can directly lead to you being able to heal your gut.

Keep track of the moments when you feel stressed and find the patterns. There may be some things you’re able to remove completely.

  • Maybe your home environment is cluttered and messy?
  • What if you have a toxic relationship with social media?
  • Maybe your email inbox is at 13,000 unread emails?
  • Perhaps you’re always running late?
  • Maybe you tend to procrastinate?

These are all situations that can be avoided and removed.

  • Clean your house to help declutter your mind.
  • Take a weekly social media hiatus and spend the time you gain back on a hobby.
  • Break up the big task of going through 13,000 emails into smaller increments, scattered throughout the week.
  • Leave earlier for work, appointments, and plans with friends.
  • Use time-blocking to organize your time better, leaving no room for procrastination.

Doing the work to remove the stressors that are under your control can put you on the path to better overall health.

Sometimes the things that stress us out are out of our control. If it isn’t possible to completely remove certain stressors, the next best thing would be to improve your response to stress.

4. Practice mindfulness and relaxation techniques

Relaxation techniques that are successful in improving gut health outcomes include things like: deep breathing exercises, mindfulness, meditation, and yoga.

Square breathing (AKA 4×4 breathing, block breathing) during a stressful event is an effective way to help pull your focus off of the negative feelings and elicit a state of calm within the body. To do this, inhale for 4 seconds, and then hold for 4 seconds. Next, you exhale for 4 seconds, and then hold for 4 seconds. Repeat this cycle until you feel more zen and less stressed. It is important to note that when you inhale, your belly should expand rather than your chest.

Mind-body practices like mindfulness, meditation, and yoga have been shown to reduce perceived stress and help regulate stress response systems. Mindfulness involves being more aware and conscious in the present moment.

This can be done by tuning into bodily sensations, paying detailed attention to your surroundings, and allowing thoughts to come and go without judgment. Mindfulness is a form of meditation that can easily be performed any time or place. Yoga, mindfulness, and meditation (in the classic, more formal sense) can all improve your reactions to stressors over time.

Using whichever relaxation technique that best works for you can help heal your gut and improve your overall well being. Being able to respond more calmly to stressful situations comes with practice, and this ability is directly related to the function of a very special nerve in your body: the vagus nerve.

5. Improve your vagal tone

The vagus nerve is often under-appreciated. It relays signals between the brain and almost every organ in your torso, however it works best when we are in an unstressed state. This is the reason why digestion doesn’t work properly when you’re stressed out! The vagus nerve creates what we call the gut-brain connection.

Many people live with chronic stress which directly impacts gut function. This chronic stress can lead to poor vagus nerve function, but there are measures we can take to stimulate the vagus nerve and have an increased vagal tone. Increased vagal tone indicates that you can relax quickly after you experience stress.

Stimulating the vagus nerve can be done in several different ways, and can lead to the dampening of the stress response, putting you in a state of relaxation.  A couple of the easiest ways to stimulate the vagus nerve are possible due to the fact that the nerve runs through the muscles in the back of the throat.

One of these simple exercises includes humming or singing at the top of your lungs while showering or driving to work. Gargling warm salt water for 30 seconds (until your eyes begin to water) will also activate the vagus nerve.

Practicing vagus nerve stimulation can serve to modulate your body’s automatic stress responses, and over time you may actually find yourself more capable of remaining calm and stress-free. Tuning in to your body and being mindful of how you respond to stress — and noting how often you feel stress — is the first step in improving how your body reacts.

 

Now you have a few more tools in your toolkit that will help you to heal your gut!

Always pay attention to your body and trust your gut! Never be afraid to ask for help. 

For personalized guidance for how to achieve a healthy gut, schedule your appointment today!

11Nov

Stress and the Digestive System

Stress is something that, unfortunately, we are all very familiar with. The gut problems that result from stress are also no stranger to most of us.

This blog will explain some of the physiological changes that happen in the body when we’re stressed out that lead to the discomfort you may be feeling.

Can stress cause gastrointestinal problems?

Think of any gut issue, and it’s extremely likely that it is somehow connected to stress. Many of us have experienced an upset stomach from stress at some point in our lives. There are many gastrointestinal (GI) symptoms that illustrate the connection between stress and the digestive system.

Here are some examples of GI symptoms that are related to stress:

  • Abdominal pain
  • Indigestion
  • Heartburn and acid reflux
  • Diarrhea
  • Constipation
  • Nausea and vomiting
woman holding stomach in pain

To some extent, all of us are familiar with most, if not all, of these uncomfortable symptoms.  Here, we will explain why these symptoms occur to explain the connection between stress and the digestive system.

Low Stomach Acid

Contrary to popular belief, the stomach actually produces less stomach acid (concentrated hydrochloric acid – HCl) when we’re under stress. So how does less acid lead to acid reflux and heartburn?

This happens because the sphincter muscle connection between the esophagus and the stomach relies on sufficient stomach acid production to determine when it should be closed. This means, when stomach acid levels are low, the opening stays open and what little acid there is in the stomach can now enter the esophagus and cause heartburn.

woman in black and white with cartoon stomach on fire

Low levels of stomach acid also cause issues with digestion. Certain nutrients may not be as easily absorbed because they won’t get properly broken down without enough stomach acid.

Also, any bacteria we consume with our food (or even bacteria that naturally live in the mouth) may not be killed, which could lead to food poisoning. This can also lead to other dysbiosis (microbial imbalance) issues in the gut, such as SIBO (small intestinal bacterial overgrowth).

Interrupted Bile Flow

Another symptom that is common with stress and the digestive system is interrupted bile flow. Bile is produced by the liver and stored in the gallbladder. When we’re stressed, bile flow is interrupted and grinds to a halt.

Why does this happen? First of all, the stress response suppresses bile release from the liver into the gallbladder because energy is being diverted away from digestive processes and towards your muscles. Also – since digestion stops when you’re stressed, the stomach doesn’t release any food into the small intestine, which is the signal for the gallbladder to pump bile to aid in digestion.

So why is this a problem? The gallbladder is the storage organ for bile, which assists with fat digestion. When the gallbladder is repeatedly inhibited from releasing its bile stores, the entire biliary system gets disrupted. 

Some issues that can arise include fat malabsorption, fat-soluble vitamin malabsorption, diarrhea, abdominal pain after eating fatty foods, nausea, and feeling heavy after eating. Interrupted bile flow can also cause bile to become over-concentrated with cholesterol and potentially lead to painful gallstones.

gallstones inside gallbladder

Changes to Gut Motility

Gut motility alteration also signals to the connection between stress and the digestive system.

The hormones that are released while you’re stressed out are shown to impact gut motility. This causes the upper gut (your stomach and small intestine) to slow down its digestion process and also decreases the absorption of nutrients. Food stays stagnant in the stomach and small intestine. Stagnant food causes issues such as malnutrition, abdominal distention, bloating, nausea, and vomiting. This is why you can sometimes feel nauseated or even vomit when you’re extremely nervous.

woman holding up cardboard image of intestines

The opposite situation usually happens in the large intestine. During stress, the large intestine speeds up, disregarding its duties of packing our excrement into shape and reabsorbing water. This reduced gut transit time explains why we might experience diarrhea when we’re stressed out.

Heightened Gut Hypersensitivity

Studies also show that sensitivity within the gut increases when we’re under stress. Heartburn and other gastrointestinal (GI) symptoms can actually feel worse when we’re under stress than the same symptoms feel when we’re relaxed.

This relates to irritable bowel syndrome (IBS) – where you experience hypersensitivity in addition to changes in motor function of the gut. Unfortunately, patients with IBS and other GI issues are subject to a vicious cycle where stress contributes to the severity of their symptoms, which then causes even more stress…

Weakened Immune System

Chronic stress can weaken the immune system, making it more likely that we will get sick. When we’re stressed out long-term, the continuous surges of cortisol and other hormones cause widespread inflammation and slow immune cell production, both of which can increase the risk of infection and tissue damage.

sick woman in blanket blowing nose looking at thermometer

Did you know that 60 to 70% of your immune system is in your gut? This makes sense when you really think about it. Our digestive systems are connected to the outside world – humans are essentially just tubes with a lot of complicated accessories.

People consume dangerous pathogens through food and drink every day. Our immune system needs to be especially active in our gut to help protect us from things like food poisoning and small intestine bacterial overgrowth (SIBO).

Hidden Inflammation

Inflammation is valuable in small doses. The inflammatory response is the part of the immune response that promotes tissue healing. Inflammation is supposed to stop once healing is complete, however, this doesn’t always happen. Chronic stress can lead to chronic inflammation, which can then contribute to much larger problems.

woman holding stomach with xray intestines

Inflammatory bowel diseases (IBD), including Crohn’s disease and ulcerative colitis, are exactly what they sound like – diseases caused by excessive inflammation and irritation in the intestines. These are autoimmune conditions, where your immune system thinks your own cells are foreign enemies. Studies suggest that these diseases are ultimately triggered by disruptions in the immune function within the gut, imbalances in gut microbiota, and leaky gut – all of which can be the result of chronic stress.

A Quick Note About the Gut Microbiome

The bacteria that live in our digestive systems (mostly within the large intestine) are usually beneficial for us. They can produce various products such as essential vitamins and short chain fatty acids that our bodies need. 

Each person’s microbiome is as unique as his or her fingerprint. We obtain these bacteria throughout our lives, starting with our journey through the birth canal and continuing with exposure to the environments and foods we are raised with. These bacteria are there to work with the immune system to strengthen the gut lining, prevent inflammation, and protect against any intruding bacteria from colonizing where they don’t belong.

intestines with blue bacteria

Bacterial Imbalance of the Gut Microbiome

When we experience stress, the gut microbiome is altered. One way this can happen is because when digestion shuts down, any food in the small intestine just hangs out there. This means that our housekeeping system, the migrating motor complex, cannot sweep the small intestine clean of invading bacteria.

Without this housekeeper, any pathogenic or unwanted bacteria that has found its way into our intestines, through our food or from our mouths, is now likely to take refuge there. This can lead to an imbalanced microbiome, uncomfortable GI symptoms, increased colon inflammation, autoimmune diseases like Crohn’s disease, and conditions like SIBO.

microscopic bacteria in intestines

Something that you may find really interesting is that your personal microbiome also affects how you respond to stress. Research indicates that people who are able to stay calm during stressful situations have similar microbiomes, which are very different when compared to those who react the most strongly under stress.

The gut-brain connection is bidirectional, but the signals from the gut to the brain are much stronger than the other direction. We know that chronic stress can change both the proportions and the diversity of these bacteria in your gut. So when stress causes an imbalance in your gut bacteria, the newly reigning gut bacteria may actually diminish your resilience to stress.

It all boils down to the gut-brain connection!

When we’re stressed, the nerve that controls digestive functions doesn’t work properly. This contributes to the issues we spoke about above, like low stomach acid, low bile flow, issues with gut motility, inflammation, and more.

This extremely important nerve is called the vagus nerve, and it has become the subject of a lot of research in more recent years. It also has a vast impact on our mental health! The proper function of gut-brain connection via the vagus nerve is essential to maintaining our health and overall wellbeing.

brain neurons and nerves

You can get started on some relaxation techniques today in order to improve your vagus nerve function and reduce stress, so that you can achieve optimum gut health and function!

For guided assistance to get to the root cause of your gut problems, schedule your appointment today!

I can order your comprehensive stool analysis so we can look for any maldigestion markers, inflammation, dysbiosis, metabolic imbalance, or infection that could be occurring within your gut!

 

 

 

 

Sources: 

http://www.med.unc.edu/ibs/files/2017/10/Stress-and-the-Gut.pdf

https://gut.bmj.com/content/47/6/861

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5859128/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4858318/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1140465/

https://www.sciencedirect.com/science/article/pii/S2352289516300509

https://medicalxpress.com/news/2018-03-gut-bacteria-essential-healthy-immune.html#:~:text=The%20gut%20is%20able%20to,may%20impact%20how%20we%20behave.

12Oct

Restore Gut Health Using the 5 R Protocol

There are so many different problems we can face when it comes to gut health. Constipation, diarrhea, cramping, gas, acid reflux… These uncomfortable symptoms are annoying, but they are also usually signs of a much larger problem! So how do we restore gut health?

Many of us tend to reach for short-term solutions that alleviate symptoms but do nothing to restore gut health! Addressing the root cause is the only way to guarantee better health outcomes in the long-term, but this is something that often requires a bit of guidance.

Currently, one of the best approaches to restore gut health outcomes is to utilize the 5R Protocol guided by your functional medicine dietitian.

This involves correcting the problems in the order that they occur, beginning with the neuroendocrine system (stress), to the gastrointestinal system, and then finally repairing the liver detoxification system. 

Working on the 5R Protocol for a full year is the best practice in order to see ideal results.

This means utilizing adrenal testing for stress hormone levels, organic acid testing for intestinal health, neurotransmitter activity, and detoxification demands, and additional testing, such as micronutrients, SIBO, or food sensitivity testing as needed.

These types of tests help your dietitian obtain enough information to identify the root cause of your symptoms, making them able to restore gut health.

What is the 5R Protocol?

The Institute for Functional Medicine established The 5R Protocol as a comprehensive method to address a variety of gastrointestinal (GI) issues.

This approach is effective because it addresses all aspects of gut health, improving symptoms while also tackling the root causes of dysfunction! This protocol is also individualized. It directly targets your issue based on your symptoms and your distinct needs.

Digestive health is the key to your overall health! Digestion keeps our cells healthy and functional by absorbing nutrients. Your GI tract is also home to many immune cells, so it makes sense that any disorder in the digestive tract can lead to bigger problems if the root cause isn’t sorted out.

Treating symptoms is only the tip of the iceberg. Improving gut health requires a multilayered approach to ensure outcomes that actually last.

So, what are the 5 R’s and what does each step involve?

Step One to Restore Gut Health: Remove

The first step of the 5R protocol is to Remove. Remove any stressors, irritants, or excess bacteria that could be causing issues in the gut.

Gut irritation can be caused by:

  • Certain foods
  • Medications
  • Infections
  • Bacterial overgrowth (like SIBO)
  • Emotional stress

This step might involve eliminating triggering foods. This could include food sensitivity testing to determine what kind of foods are causing your issues, temporarily removing a couple foods (or food groups), or following  a therapeutic elemental diet protocol. You could also take a comprehensive stool test to determine whether your issues are the result of an infection or a microbiome imbalance.

Once you determine the irritants, you will eliminate those foods from your diet altogether. If there is an infection (bacterial, parasitic, or viral), a referral to your doctor may be necessary to receive the appropriate medication. You may also be asked to follow a supplement protocol.

Chronic stress is an overarching cause of many bodily ailments. Our bodies release stress hormones (like cortisol) to help combat threatening situations. In modern society, we tend to utilize our stress response far too often.

This results in digestive issues and inflammation, among other issues such as HPA axis dysfunction (adrenal dysfunction and adrenal fatigue). Consequently, reducing your daily stress and improving your ability to remain in a calm state are vital to restore gut health.

Adrenal stress hormone testing, stool analysis, and food sensitivity testing are all extremely helpful for Step 1. 

Step Two to Restore Gut Health: Replace

Eliminating certain foods and food groups from your diet can lead to other issues, so it is meant to be only temporary.

After removing the triggers to your digestive issues, the next step involves replacing anything you are personally missing in your gut that is critical for proper digestive function. 

Depending on your condition, you may need to add digestive enzymes, support stomach acid (important for protein digestion) and bile flow (important for fat digestion), or tackle any nutrient deficiencies. 

Stool testing and microbiome analysis are helpful in Step 2. 

Step Three to Restore Gut Health: Repopulate

The next step of the 5R protocol is to reinoculate your microbiome by reintroducing and supporting beneficial bacteria through consuming probiotics and prebiotics.

Probiotics are live, beneficial microbes that we ingest through certain drinks, foods, and supplements.

While taking a probiotic supplement is convenient, there are also benefits to consuming fermented, probiotic-rich foods and drinks. These include things like kombucha, pickles, yogurt, kefir, sauerkraut, kimchi, tempeh and miso.

Prebiotics are non-digestible fibers that feed your beneficial gut bacteria, helping them to repopulate your GI tract in healthy levels.

Some foods rich in prebiotics include garlic, asparagus, onions, leafy greens, whole grains (quinoa, oats), apples, flaxseed, lentils, jicama, and chicory root. Partially hydrolyzed guar gum (PHGG) is a great option for a supplemental prebiotic fiber.

Microbiome analysis is helpful in Step 3. 

Step Four to Restore Gut Health: Repair

Now, the intestinal wall needs to be restored so you can optimize digestive function.

Leaky gut is a condition where your intestinal wall is unstable, leaking toxins, bacteria, and other large particles into your bloodstream. This can cause systemic inflammation and lead to other chronic illnesses.

Repairing the gut lining reduces this permeability and prevents harmful substances from traveling outside the digestive system. This allows for their elimination when we use the bathroom!

Consuming essential key nutrients such as zinc, glutamine, and vitamins A/C/D/E can help restore the linings of the digestive tract and promote absorption. Many of these nutrients cannot be properly utilized when your gut is out of whack.

Micronutrient testing is helpful with Step 4.

Step Five to Restore Gut Health: Rebalance

Now that you’ve set the stage for proper digestive function by improving the environment of your microbiome, the final step of the 5R protocol is to adjust your overall lifestyle.

Rebalancing your lifestyle is crucial for continued maintenance of your restored, healthy gut. Things like sleep, exercise, diet, emotional states, and stress all impact digestive function

So what kind of things can be done to improve these segments of your lifestyle?

Focus on improving the quality of your sleep by reducing blue light exposure after the sun has set. Possibly attempt a new workout regimen to ensure you get your muscles moving regularly. Eat a nutritious diet that continues to support your healthy gut.

Tune into your emotional states and practice relaxation methods.

Maybe try to practice mindfulness, yoga, and add gratitude exercises to your list of daily tasks. Be sure to reduce stress where possible and nurture your stress response to improve your stress resilience. Practice vagus nerve activation to keep your body in a parasympathetic, tranquil state instead of falling into unhealthy stress response patterns.

Summary of the 5 R Protocol

First, we must determine and eliminate the root cause of your symptoms. Then, any missing components of digestion are supplied and then fortified. Next, nourishing your gut microbiome and your gut lining should set the stage for efficient digestive function. And finally, we fine-tune our lifestyles to maintain the improvements we accomplished in the previous steps.

By now, you should understand the importance of a full lifestyle overhaul to combat your gut issues and restore gut health.

Treating the symptoms alone is usually not enough to cut it, because symptoms are the result of a larger problem.

We use the 5R Protocol to assure that your individual problems are contended with. The 5R Protocol lays the foundation for maintaining gut health by supporting your overall wellbeing.

Why not get started today to restore gut health? Schedule your appointment now to get started on your own individualized 5R Protocol!