Anyone experiencing digestive problems, especially those accompanied by pain, fatigue or low energy, is a good candidate for the Four R Programme.
A cornerstone of nutritional therapy, the programme was designed by Jeffrey Bland, PhD, to provide everything you need to optimise health by restoring the correct function of the digestive system. It asks:
1. What needs to be REMOVED?
2. What needs to be REPLACED?
3. Do we need to RE-INOCULATE with probiotics?
4. Does the intestinal lining need to be REPAIRED?
STEP 1: REMOVE Chronic digestive complaints can be a result of a number of factors, including bacteria, yeasts, parasites and certain foods, environmental toxins and stress.
The wrong types of bacteria can provoke immune responses and create inflammation,. Parasites and yeast overgrowths have also been linked with digestive complaints and other conditions.
Particles from allergenic foods may also create inflammatory symptoms.
Diet: Remove commonly problematic foods such as gluten-containing grains, dairy, sugar, mould and yeasts (in cheeses, alcohol and dried fruit), alcohol, eggs and peanuts. Base your diet on gluten-free grains such as rice and quinoa, legumes, fruits, vegetables, fish and poultry.
Supplements: Helpful antimicrobials include caprylic acid, high strength garlic and grapefruit seed extract.
STEP 2: REPLACE
The replacement of enzymes and other digestive factors can help to restore digestive function, especially for those experiencing bloating, gas formation or reflux.
Enzymes are needed for digestion and absorption, as well as protection from harmful bacteria. Our enzyme levels decrease with age, and the processing of foods also decreases natural levels in the food.
Diet: Try eating fermented foods such as miso, soy sauce and sauerkraut to encourage production of digestive enzymes. Include foods with a high enzyme content such as sprouted seeds, pineapples, bananas and papayas.
Supplements: Digestive enzyme supplements are also useful in this respect. Holford's Digest Pro and Biocare's Spectrumzyme are both good quality options offering broad spectrum support.
STEP 3: REINOCULATE
Healthy levels of 'good' bacteria in the gut are essential for proper digestion. They also protect the gut and support a healthy immune response.
Poor diet, stress and infection are just some of the factors that can damage levels of good bacteria in the gut, and this can result in problems with bowel transit, diarrhoea, bloating and other IBS symptoms. Restoring the gut's ecosystem is therefore a critical step in restoring digestive health.
Healthy bacteria can be supplemented directly, and their growth can also be encouraged through dietary choices such as boosting prebiotic foods and soluble fibre.
Diet: Increase prebiotic foods such as leeks, soybeans, asparagus, Jerusalem artichoke and bananas. Boost soluble fibre with milled flaxseed, oats, fruit and vegetables.
Supplements: Prebiotics and probiotics can also be supplemented. Products I have used in practice are Lepicol, Lamberts FOS or Optibac's For Every Day Extra Strength probiotic.
STEP 4: REPAIR
Causes of damage to your gut wall include food allergens, long-term nutritional deficiencies, drugs and alcohol, imbalance of bacteria in the gut, infection and chronic inflammation.
A 'leaky' gut wall has been linked with all manner of conditions, from eczema and psoriasis to rheumatoid arthritis.
Removing the causes of any damage is clearly a priority when repairing the gut wall. Then nutritional measures can taken to help repair the gut wall by promoting cell growth, improving cell function and repairing damaged cells.
Quick tips: Diet: Try fermented cabbage juice for its tremendous gut-healing properties, as this supplies a little-known healing vitamin called Vitamin U, alongside billions of beneficial bacteria. 'Demulcent' foods which protect the intestinal lining can also be helpful. These include slippery elm tea, oatmeal and flaxseeds.
Supplements: Nutrients involved in the repair of the gut wall include glutamine, DHA and EPA (from fish oil), pantothenic acid (Vitamin B5) and zinc. Supplements to consider include Eskimo-3 liquid, Lamberts L-Glutamine and Biocare's Slippery Elm Plus.
And finally ...
It can be helpful to try this type of approach under the guidance of a nutritional therapist, who can also offer tests to measure markers of digestive health such as levels of bacteria, inflammatory markers and digestive enzymes.
When used in the right way, the Four R Programme is an incredibly useful tool to restore digestive health, especially in those with ongoing digestive complaints that have been unresponsive to other measures.