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The Five “Rs” of Gut Health Remove, Replace, Reinoculate, Repair and Rebalance Framework

By Dr. Amy Davis, MD

Optimal function of the digestive system is critical to health. Problems within the gut can cause more than just stomachaches, gas, bloating or diarrhea. GI issues may be the root of chronic health problems including autoimmune diseases, skin problems, fatigue, headaches and heart disease. How can we correct what’s gone wrong in the gut?
In Functional Medicine a program called the “5Rs” – Remove, Replace, Reinoculate, Repair, and Rebalance – can be applied to various chronic health issues, and often it leads to dramatic improvement or complete resolution of symptoms.

Here’s how it works:

  1. Remove Stressors – Remove GI tract irritants like food allergens (gluten, casein, sugar) and undesirable bacteria, yeast and parasites. Identifying the specific issues involved might require an elimination diet, food antibody testing, or stool microbiology to aid diagnosis and guide treatment.
  2. Replace – Digestive Secretions including digestive enzymes, bile acids, bitter greens, fiber, and hydrochloric acid can all be helpful to improve GI functioning which may be compromised by diet, medications, diseases, pathogens (viruses, bacteria, yeast), aging, or other factors.
  3. Reinoculate – Beneficial bacteria or Probiotics are “friendly” bacteria (flora) such as bifidobacterium and lactobacillus species. Soluble fiber (prebiotics) help support the healthy flora by providing a food supply for them and can be found in foods such as artichokes, garlic, leeks, onion, chicory, tofu, and other soy products. Grains such as barley, flax, oats, and wheat are also good sources of prebiotics. Fermented foods such as yogurt and kefir naturally support the flora. It is important to consider your gut health when taking antibiotics, since these will attack both the bad AND good bacteria found in your gut. Supplementing with probiotics during an antibiotic treatment can help you avoid residual issues.
  4. Repair – Help the lining of the GI tract repair itself by supplying key nutrients such as zinc, antioxidants, omega 3 fatty acids, and glutamine.
  5. Rebalance – It is important to pay attention to lifestyle choices. Sleep, exercise, and stress can all affect the GI tract. Balancing those activities is important for an optimal digestive tract.

Restoring gut health is challenging but well worth the effort. I look forward to helping you improve your gut and overall health.

Wishing You the Best of Health!
Dr. Amy Davis M.D.
Dr. Tracie Fleshman D.C.
Stacy Gellman – Health Coach
and Craniosacral
Nita Achelpohl –
Certified Hynpotherapist
Crossing Back to Health
11477 Olde Cabin Rd. Suite 100
Creve Coeur, MO 63141

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