You don’t just have to put up with digestive discomfort, acid reflux or GERD, bloating, diarrhea, constipation, or food sensitivities. Using a Functional Medicine approach, which looks at the root causes of any health issue, it is possible to find the root causes of a gut complaint. Once you know the root causes driver your condition, you can follow a step by step approach to heal your gut. In this article, I’ll explore what that process might look like.
Basically, there are four logical steps to regaining gut health: Remove, Repair, Reseed, and Rebalance. It is possible to do this on your own, and Dr. Ruscio offers a good protocol in his book. However, I would suggest working with a Functional Medicine practitioner such as myself, to provide personalised guidance and support which can be invaluable during this process.
In the Remove phase, we identify and then remove triggers of intestinal inflammation and digestive discomfort.
Candida, a bacterial or protozoa overgrowth, SIBO, Helicopter Pylori, and viruses can all drive gut conditions. These are often associated with an overly reactive intestinal immune system which can, in turn, drive inflammation throughout the body through a permeable intestinal barrier (leaky gut).
A stool test that can be done from the comfort of your home can test for these pathogens. I recommend the GI Map test or the GI 360 test in Australia. These tests analyse the DNA of the microbes in your stool and are therefore very precise. They also include markers for leaky gut, digestive enzymes, secretory IGA, gut inflammation, and short-chain fatty acids, making them very complete tests. Small intestinal bacterial overgrowth (SIBO) testing may also be appropriate depending on your symptoms (bloating with 90 mins of eating is a tale-tale sign).
When working with a practitioner, lab testing isn’t always necessary or within budget. In which case, the approach is based can be based on clinical symptoms, history, and treatment response.
If parasites are found or are likely, then there are a number of options including herbal anti-microbials, specific probiotics, and antibiotics. I work with the first two options but you always have the option of talking to your GP about the antibiotic option.
Particular foods can also be a stressor for some people. This can include trigger foods such as gluten, dairy, added sugar, oxalates, or histamine containing foods. When I work with someone, I always start by looking at their diet, identifying potential trigger foods and looking at the impact of high FODMAP foods. Ensuring enough digestive enzymes and stomach acid production is also vital to digesting our food properly. Food sensitivity testing is an option.
I find the Low FODMAP diet helps many people with IBS. The first phase of the diet removes all high FODMAP foods which may be causing your gut symptoms. After three to six weeks, we systematically re-introduce these foods. This allows us to identify your personal trigger foods that can then be avoided whilst maintain as diverse a diet as possible.
When there’s inflammation in the gut, you can also expect there to be increased intestinal permeability, commonly known as Leaky Gut. A leaky gut allows toxins, larger food molecules, unwanted bacteria, and viruses to enter the bloodstream. Lining the gut, we have the mucosal system which protects us from these threats.
When foreign substances pass through the gut barrier, the immune system launches an inflammatory response to defend us from these invaders. The associated intestinal inflammation has been linked to a diverse range of symptoms such as food sensitivities, fatigue, brain fog, nutrient malabsorption, and has been linked to diseases in remote organs in the body e.g. kidney, lungs, liver.
Calming the intestinal immune system, and repair the gut lining is therefore an essential step in regaining gut health.
To heal a leaky gut, you also need to consider your lifestyle such as stress levels, making time for yourself, and getting enough sleep. Getting the nutrients you need to support the immune system lining our gut, as well as repairing the gut wall are important. Foods, which contain these nutrients include bone broth, stewed apples, as well as polyphenol-rich foods such as blueberries, blackberries, purple sweet potatoes, purple carrots. The choice of supplements varies from person to person but could include such as Colostrum, L_Glutamine, and Zinc, probiotics such as Sacchromyces Boulardi or Lactobacillus GG.
This phase is all about encouraging a diverse range of ‘good’ gut bacteria. This is vital as, without it, your gut issues are likely to return. Time needs to be spent fixing your gut microbiome. It’s a necessity for ongoing gut health!
We can reseed our guts through probiotics, fermented foods, and also soluble fibres known as prebiotics. Our gut bugs love fiber-rich veggies and whole grains such as flaxseed, chia seed, buckwheat, and other non-gluten containing grains.
By this stage, you should be able to handle more prebiotics than you could in stage 1. Healthy high FODMAP foods and resistant starches can be introduced to feed your ‘good’ gut bacteria. Remember high FODMAP foods are often healthy foods and we are working towards being able to tolerate them.
For probiotics, there a number of options including a Lactobacillus / Bifidobacterium blend, Saccharomyces Boulardii, and soil-based probiotics. Different people can find different types of probiotics effective, and I urge you to experiment with a different type if you are not responding to a particular one. For instance, if you are not responding to a Lactobacillus / Bifidobacterium blend after a 4-6 week trial, then try a soil-based probiotic. When trialing a probiotic like this, you are looking for a reduction in your personal symptoms and noticing how it makes you feel. People often find a combination of these probiotic types can be effective.
Saccharomyces Boulardii and Lactobacillus GG have also been found to combat Candida, Blastocystis Hominis and pathogenic bacterial overgrowth.
This final stage is focussed on preserving the gains from the previous stages into the future so that your gut stays resilient and tolerates a wide range of foods. Here, we pay particular attention to lifestyle choices such as sleep, exercise, and stress.
Of particular interest is that when we eat, as well as what we eat. Nowadays, we tend to eat all day (16 hours) and fast for just 8 hours overnight. It’s during this fasting period that the gut lining repairs itself and the body clears out unprocessed foods and bacteria from the small intestine. This helps prevent small bacteria overgrowth or SIBO through a process known as the ‘migrating motor complex’.
Spending longer periods without food, say 12 or even 16 hours overnight, and reducing snacking, may help your gut health, improve your overall health and prevent chronic diseases.
Everyone is different
These four steps provide a framework for regaining gut health. But that doesn’t mean that the steps look exactly the same for everyone. A practitioner can help you identify the root causes of your health issues, identify appropriate lab testing, diet, and supplements, and provides the expertise to filter the scientific research to help you improve your gut health.
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Stephen Ward (MSc) is trained in assessing the root cause of chronic health issues through Functional Medicine.
He uses nutrition, lifestyle changes, and nutraceuticals (targeted supplements) to help you achieve your goals and improve your health.