THE 5-R PROGRAM
A properly functioning digestive system is critical to good health. In functional medicine we use a program that goes by the simple acronym of the ‘5Rs’: remove, replace, reinoculate, repair and rebalance. When applied to various chronic problems, the 5R program can cause dramatic improvement in symptoms, and sometimes even complete resolution of the problem.
This cuts to the core of the functions of the gastrointestinal tract. It is becoming increasingly recognized that disturbances in the function of the GI tract can result in a number of symptoms and conditions. These range from symptoms such as fatigue, joint pain, muscle pain, and headaches, to medical conditions such as inflammatory bowel disease, allergies, asthma, autism, ADHD, and chronic skin conditions. It is this association between GI function and ill health that the 5-R Program is intended to address.
5-R Program Goal
- To address dietary and lifestyle issues, and to begin the process of dietary education and change.
- To normalize digestion and absorption.
- To normalize the balance of gastrointestinal bacteria.
- To promote a balanced system of detoxification.
- To promote gastrointestinal healing.
5-R Program Elements
- Remove: Remove stressors: get rid of things that negatively affect the environment of the GI tract including allergic foods, parasites or other bad bugs such as bacteria or yeast. This might involve using an allergy “elimination diet” to find out what foods are causing GI symptoms or it may involve taking drugs or herbs to eradicate a particular bug.
- Replace: Replace digestive secretions: add back things like digestive enzymes, hydrochloric acid and bile acids that are required for proper digestion and that may be compromised by diet, drugs, diseases, aging, or other factors.
- Reinoculate: Help beneficial bacteria flourish by taking in probiotic foods or supplements that contain the so-called “good” bacteria such as bifidobacteria and lactobacillus species, and by consuming the high soluble fiber foods that good bugs like to eat, called “prebiotics.”
- Repair: Help the lining of the GI tract repair itself by supplying key nutrients that can often be in short supply in a disease state, such as zinc, antioxidants (e.g. vitamins A, C, and E), fish oil, and the amino acid glutamine.
- Rebalance: Pay attention to lifestyle choices – sleep, exercise and stress can all affect the GI tract.
THE FUNCTIONS OF THE GASTROINTESTINAL TRACT
- DIGESTION- This is the process whereby our food is broken down into smaller portions that are more easily absorbed by the intestines.
- ABSORPTION- This is the process whereby the digested food is taken up by the intestine and delivered to the body for utilization as energy, nutrition, and other cellular functions.
- EXCLUSION- This refers to the barrier function performed by the GI tract as it appropriately excludes substances from entering the body.
- DETOXIFICATION- This is the complex process involving the liver and GI tract whereby toxins are metabolized for elimination from the body. Toxins include such things as medication we take that must be metabolized, to pesticides, preservatives, dyes, and flavor-enhancers we ingest knowingly in our food, as well as the over 4 million chemicals present in our environment not intended for use in our bodies.
- ELIMINATION- After digestion has occurred, and the metabolic phase of detoxification is complete, the GI tract must then eliminate the digestive and metabolic wastes of these processes. Some refer to this as excretion.
Use the 5-R Program and the information given to restore your digestive health.
15 Comments
Nice! Thanks for sharing this 5 R’s for our digestive system’s health. Me and my alternative treatments to cancer center appreciates your tips so much! Thanks.
Is there a prepackage supplement or program that one can take for a week or month or whatever the time might be to restore these without having to go out and find all these individual Simplements mentioned above? In other words a prepackaged pill or powder that contains the right amount of items to restore gut health?
Short answer, no. But my favorite gut restore shake is Xymogen Opticleanse GHI which is a good place to start. You can order direct from Xymogen with code: DrJill and last name Carnahan
RE: Xymogen Opticleanse GHI
Just looked at the ingredients; aren’t the dried cane syrup and various gums ingredients to be avoided?
Hi Lois, I like this formula and organic and syrup is preferred over artificial sweeteners or fructose. I also do not like xylitol as it exacerbates patients with fungal dysbiosis and SIBO. Stevia is preferred. For my more sensitive patients, I recommend Xymogen VegaPro which has no added sweeteners. Code to order – DrJill
Hi Dr. Jill, would this be something I could start prior to my first appointment with you in October? My gut is such a mess :(. I looked for it online, but apparently I need a code to order it. Is there any way to purchase it online? Or, could I come to your office and buy it?
Thanks, Nancy
Hi Nancy – you can order products from Xymogen by setting up patient account. Use code# DrJill when asked for code and last name: Carnahan
Warmly
Dr Jill
Hello,
This might be a silly question so I apologize but I always thought that simply addressing what is causing the gut to be leaky like gut infections, and then the gut heals itself automatically. So I guess I’m confused as to why the 5R approach is needed. For example, if someone has a parasite and they treat that, then the gut should heal itself right? So why are probiotics, digestive enzymes, l’glutamine and all these other things needed? I’m confused. Isn’t it as simple as treating the gut infection like yeast, parasites, or bacteria like you mentioned in the remove stage and then once that is treated, the gut should heal itself?
Getting rid of the infection is the first step but it is important use the other methods to heal the enterocytes and any damage to the tight junctions.
Dr. Jill,
I noticed in many Leaky-gut cookbooks that many of the recipes call for beef and pork. However, I stopped eating both, years ago when I was first diagnosed with an autoimmune disorder. I saw a TED talk once that was lecturing on how our DNA and mammal DNA is too close and if it passes through the single cell wall our bodies can get confused, which is why I stopped eating it. If many auto-immune disorders are caused by a leaky gut, shouldn’t the cookbooks be discouraging eating those foods? I know that beef can inflame Gout and other disorders, so just how safe is it to eat those foods?
Best,
Hillary
It depends… Many patients with digestive disorders have a harder time digesting red meat, myself included
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