The digestive system is also responsible for defending the body against foreign invaders, destroying old intestinal cells and creating new ones, fostering the growth of beneficial bacteria, making certain vitamins like K and B12, and releasing hormones that communicate with the brain and heart. But this intricate system is easily derailed by our modern lives. Stress, chemicals and pesticides, a lack of fiber, and the use of medications can all alter the functioning of the gastrointestinal system and the beneficial bacteria that reside there—and once the gut becomes compromised, the whole body suffers.  

Symptoms that indicate a need for gut healing are numerous but may include gas, bloating, cramping, irregular bowel movements, food allergies and sensitivities, indigestion, fatigue, brain fog, irritability, skin conditions like acne and eczema, brittle nails, and poor hair health.

Healing the gut properly requires a comprehensive approach that involves five critical components: remove, replace, restore, reinforce, and rebalance (or the “5R Program”). Taken together, this program emphasizes removing aggravating substances, eating the right foods, as well as supporting the system with the right nutrients.

One: Remove

Remove stressors that negatively affect the GI tract environment, including processed foods; allergenic foods; food sensitivities; environmental toxins; and problematic bugs, such as parasites and overgrowth of bacteria and yeast (Candida), which could be causing infections.

People often want to skip this step, instead looking for the magic combination of pills that will “just fix it,” but this step is critical. If you are continually exposed to gut stressors, all the gut-healing nutrients in the world will only take you so far because the damage will continue to occur. The first things to eliminate are processed foods containing artificial chemicals and ingredients. Choose organic food to avoid pesticides, switch to filtered water, and eliminate added sugars. Next eliminate the foods that you are personally sensitive to. For most people with gut problems, adopting a gluten-free diet is a good place to start, since three out of 10 Americans are sensitive to gluten. After gluten, dairy and grains (including corn) are probably the next biggest culprits; sensitivities to soy are also common.

An elimination diet can help you identify which foods may be triggering symptoms for you. If symptoms continue to persist following an initial elimination diet, you might consider exploring and eliminating more specific food sensitivities, including high-histamine foods, FODMAPs (fermentable oligo-, di-, mono-saccharides and polyols; these are short-chain carbohydrates that cause some people to have digestive distress after eating them), and nightshades. It might also be pertinent to work with a qualified gastroenterologist or naturopathic doctor who can help identify the presence of parasites, bacterial overgrowth (SIBO), or Candida, which may also contribute to gut symptoms.

Not So Great Grains

There is research that suggests that all grains, even whole grains, may not be as healthful as we’ve been led to believe. Grains contain anti-nutrients, such as phytates and lectins. Phytates bind to minerals in the digestive tract, rendering them unavailable for absorption, and a high intake of grains has been associated with zinc, iron, and calcium deficiencies. Lectins compromise the structural integrity of the intestinal lining, increasing gut permeability and encouraging the spread of bad bacteria. Both of these processes ultimately compromise the immune system and are associated with the occurrence of nearly every autoimmune disease. Finally, while often being touted as nutritious, all grains are mostly starch and, calorie for calorie, supply far fewer vitamins, minerals, and other phytonutrients than vegetables and even meat.

Two: Replace

Replace digestive secretions that support proper digestion. This includes digestive enzymes, hydrochloric acid, and bile acids, which may be compromised by diet, medications, aging, or other factors.

Digestive enzymes aid in the chemical part of digestion and those with compromised digestion are often lacking in their own production of these enzymes. Supplement with a broad-spectrum enzyme and remember to take it with meals, since it works by coming in contact with foods. You many also choose to take an enzyme supplement containing bile, which supports digestion and absorption of fats and fat-soluble vitamins in the small intestine.

Hydrochloric acid (HCl) is the main component of stomach acid. In addition to helping digest food (specifically protein), HCl is also important for simulating digestion in the lower GI tract. It does so by signaling the pancreas to release digestive enzymes into the small intestine. It also neutralizes and kills pathogens that enter the body with food, which is important for maintaining bacterial balance within the gut. Aging, chronic use of acid-suppressing medications like proton-pump inhibitors, and severe H. pylori infections are all factors that contribute to low HCl levels and benefit from HCl supplementation.

Three: Restore

Restore the microbiome and help these bugs flourish by consuming probiotic-rich foods and supplements that contain “good” bacteria and prebiotics that good bugs like to eat.

Probiotics are the friendly bacteria, like bifidobacteria and lactobacillus species, that occupy the intestinal tract. These bacteria help to keep the intestines free of undesirable bacteria, make food for the intestinal cells, and even help to make some vitamins. Saccharomyces boulardii is a beneficial yeast that has honorary status as a probiotic. S. boulardii has similar benefits to bacteria-based probiotics but also supports the work of other probiotics by creating an environment that beneficial bacteria can thrive in. It helps to preserve the integrity of the intestinal lining and supports healing of intestinal cells as well. There are many different strains of probiotics, which can make it seem daunting to choose a probiotic supplement. Just remember that probiotics from reputable companies are designed to help restore populations of friendly bacteria in your gut. A good way to start is to choose a basic multi-strain, high-potency product in addition to an S. boulardii supplement. Alongside supplementation, incorporate probiotic-rich foods like plain, full-fat yogurt and kefir (if dairy is tolerated); unpasteurized fermented veggies like sauerkraut and kimchi; miso; and kombucha.

Prebiotics nourish the growth of beneficial microbes already in the gut; in other words, prebiotics are food for our beneficial “bugs.” Fructooligosaccharides (FOS) and inulin tend to get a lot of attention as prebiotics, but certain herbs can be prebiotic powerhouses that may have an even greater effect on microbial communities than isolated prebiotics. The herb turmeric and the plant compound berberine (found in Oregon grape, goldenseal, and barberry) both appear to be highly impactful prebiotics, promoting populations of beneficial bacteria and the many downstream effects that come with them. Another underappreciated prebiotic source is chia seeds, which not only contain lots of fiber to feed beneficial microbes, but are also especially high in soluble fiber and mucilage, which help protect the gut lining while also keeping things moving.

Four: Reinforce

Reinforce gut barrier integrity with a nutritious diet and supplements. Help repair the gut lining by supplying key nutrients that can be in short supply in a compromised gut, such as zinc, antioxidants (e.g. vitamins A, C, and E), vitamin D, fish oil, and the amino acid glutamine.

Multivitamin. If your gut has been damaged for any length of time, your ability to absorb nutrients has also been impaired and you may be deficient in one or more essential nutrients. A high-quality multivitamin serves as a starting point to provide important nutrients like zinc, essential in promoting healthy cells in the GI tract; vitamin A, needed to support mucosal membrane health in the GI tract; vitamin C, to support intestinal cell regeneration; and vitamin E, which protects intestinal barrier function due to its antioxidant activity.

L-glutamine is an amino acid that supplies fuel for the intestinal cells, allowing for healthier cells with better absorptive abilities.

Zinc is necessary for the healing of the stomach lining as well as the intestinal lining. Zinc carnosine in particular supports the mucosal cells of the stomach, helping to protect the stomach lining. A number of human clinical studies have found it to be useful for the prevention and treatment of gastritis and gastric ulcers. Zinc carnosine also appears to help prevent irritation caused by the use of NSAIDs and modulates inflammation throughout the digestive tract.

EPA/DHA & Vitamin D. Adequate amounts of EPA and DHA (omega-3 fats found in fish oil) and vitamin D are especially important for digestive health. They work by modulating gut inflammation, promoting gut barrier integrity, and supporting and maintaining a healthy gut immune system and microbial balance.

Other Gut Supportive Supplements

DGL (Deglycyrrihizinated licorice) promotes mucus secretion in the stomach lining, protecting the stomach and allowing mucosal cells to heal. The effects of DGL are felt quickly and are a favorite of people suffering from heartburn and indigestion.

N-acetylglucosamine (NAG) is a derivative of the monosaccharide glucose that helps repair the mucosal lining in both the stomach and the intestines by aiding in the synthesis of the viscous top layer of the gut mucosa.

Aloe vera is healing and soothing to an inflamed digestive tract. Choose a juice that is pressed from the inner filet to avoid the bowel stimulant properties the whole leaf can have.

Herbs such as fennel and chamomile can inhibit muscle spasms and help to dispel gas and bloating. Peppermint and ginger are traditional digestive tonics, while slippery elm or marshmallow have demulcent properties that soothe and nourish the mucus membranes of the digestive tract.

Five: Rebalance

Rebalancing involves paying attention to lifestyle choices that support optimal digestive health. Stress management practices like yoga, meditation, and deep breathing, alongside adequate sleep, healthy amounts of exercise, and quality relationships, can help take us from a chronic fight or flight state to a state of rest and digest. This has the sought-after effect of supporting overall digestive health, and thus the health of your entire body.

Gut cells are very willing to heal when given the proper conditions. Following a gut-healing routine for three to six months should be sufficient for most people, but be flexible and don’t be afraid to follow that gut feeling!

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