The 4Rs Protocol to Heal Your Gut Naturally

Your gut hosts trillions of bacteria, fungi, viruses, and other microbes, collectively known as the gut microbiome. Dysbiosis refers to an imbalance of good and bad microbes in the gut, which leads to poor gut health. This may lead to symptoms of gastrointestinal discomfort and a wide range of diseases, including autism, inflammatory bowel disease (IBD), diabetes, obesity, allergic disorders, and colorectal cancer.

Your gut lining has many layers of defense. It establishes a semi-permeable membrane that allows nutrients and other substances to pass through it and prevents toxins and pathogens from entering your system. Dysbiosis is one of the leading causes of leaky gut syndrome — a condition in which the intestinal barrier becomes more permeable than usual and lets pathogens like toxins, viruses, fungi, and parasites enter your bloodstream. Here are the Top Symptoms of Leaky Gut, which you can look out for.

Dysbiosis can occur due to many reasons, such as a poor diet, exercise (or lack thereof), high-stress levels, sleep patterns, medications, and invasion by pathogens, which leads to bacterial and yeast overgrowth.

People often consider a colon cleanse to improve their gut health as it is known to have many health benefits. It involves flushing out your large intestine with fluids to remove waste and other toxins. While it may be beneficial short term in some cases, it comes with its risks. It flushes out the beneficial bacteria along with the bad ones and also depletes electrolytes from your body. Moreover, the idea of irrigating your colon doesn’t sound very pleasant. So, what can one do?

The 4R method is a safe and effective method that encourages you to use your diet to heal your gut. It is a widely accepted protocol in functional medicine, which is an alternate form of medicine that aims to find the root cause of chronic diseases.

What are the 4Rs?

Alleviating the symptoms of a poor gut isn’t easy as many factors contribute to a gut imbalance. The 4Rs refer to a four-step protocol to repair your gut and improve your digestive tract and health, which involves the four stages:

1. Remover,
2. Replace,
3. Re-inoculate, and
4. Repair.

It can take up to 12 months to fully repair your gut, depending on the severity. It is advisable to work with a healthcare practitioner to guide you through the process and tailor the plan according to your specific needs.

#1. Remove (3-12 weeks)

The first step of this program involves removing pathogens and inflammation triggers from the body. These include:

Stress

The brain has a direct effect on your digestive system and vice versa. Stress is a normal part of life, but chronic stress can impair digestion and proper nutrient absorption as it can alter your gut microbiome by altering the healthy microflora balance. Moreover, when a person is in fight-or-flight mode, the digestion slows down to divert all the energy to fight the perceived threat.

Some people are better at coping with stress than others despite their bodies being stressed out, meaning that you may not realize your body is under stress. This is why it is important to pay close attention to your body’s cues. Some of the most prominent signs of stress include poor sleep, acne, weight gain, high blood sugar levels, and salt cravings. In case of less severe stress, digestion may get temporarily suspended, resulting in abdominal pain and other digestive problems.

Drinking lemon balm tea is known to induce tranquillity and effectively reduce stress levels. Additionally, activities like walking, breathing exercises, journaling, yoga, and spending time with your loved ones can help you reduce your stress levels.

Food sensitivities

People who have food sensitivity or intolerance have trouble breaking down certain foods. The undigested food is recognized as a foreign substance by your immune system and is attacked by a large number of antibodies against it, causing food allergies. People may have food allergies without knowing about them.

Testing for food sensitivities can help you identify which foods trigger your symptoms and which don’t. An elimination diet may be helpful in the case of food allergies. However, the symptoms of food intolerances may take up to 72 hours to show up, in which case testing for food sensitivities is a more feasible option. The symptoms of food intolerance may show up as headaches, joint pains, eczema, fatigue, or depression.

If you avoid the foods, you’re sensitive to, it could take about 2-4 weeks for the antibodies to reduce and for you to notice a significant improvement. IgG is a common blood test for food sensitivities that measures the antibodies in response to a certain food.

Some of the common allergenic foods to avoid include dairy, soy, gluten, nuts, artificial sweeteners, processed foods, refined sugar, saturated fats, shellfish, eggs, pork, and prolonged use of laxatives. It is also important to avoid caffeine, alcohol, and smoking in this protocol as they are linked to the overgrowth of bad bacteria in the gut.

Make sure to include the following in this phase:

• Green tea: It suppresses allergic immune responses and increases the number of good gut bacteria.
  
  
• Turmeric: It contains the compound curcumin, which is a powerful anti-allergic agent.
  
  
• Vitamin D: It helps to reduce immune reactions without reducing the efficiency of the immune system.

When you have a leaky gut, there aren’t enough good bacteria to digest the large amounts of fiber present in raw vegetables, this may lead to uncomfortable symptoms. Going on a carnivore diet is highly beneficial when you have a leaky gut as it provides several nutrients without adding too much fiber to your diet. Avoid commercial meats as they contain antibiotics, which are sold as growth factors for farm animals. Organic meats are much healthier as they’re free from pesticides, are not genetically modified, and don’t contain antibiotics.

If that’s not feasible for you, consuming cooked or fermented vegetables can help break down the fiber in vegetables significantly.

Pathogens

Fungi, viruses, and bacterial or yeast overgrowth contribute to gut-related problems. Many tests are available to identify and eliminate pathogens. A stool test can determine the health of your gut microbiome as it checks for an abnormal amount of microbes in your gut. Infections can be cured either through pharmaceutical medications or antimicrobial herbs.

Here are some natural ways to fight infections naturally.

• Drinking apple cider vinegar helps to acidify your stomach and increase phagocytosis, a process by which white blood cells destroy pathogens.
  
  
• Sulforaphane is an important phytonutrient that helps kill pathogens. It is found in foods such as broccoli, kale, and Brussels sprouts. 
  
  
• Foods like ginger, garlic, turmeric, oregano, and cinnamon act as natural biofilm disruptors, which are produced by opportunistic bacteria to protect themselves from the action of antibiotics.
  
  
• Berberine, garlic oil, onions, oregano oil, Artemisia, and caprylic acid have antimicrobial and antiparasitic properties.
  
  
• Licorice, mastic gum, black walnut, and zinc carnosine have antifungal and antibacterial properties.
  
  
• Cat’s claw, reishi mushrooms, echinacea, vitamin C, vitamin D3, and zinc have antiviral properties.

#2. Replace (6-8 weeks)

The next step is to replace inflammatory foods with nutritious, gut-healing foods to improve your GI health. This includes bringing back all those factors that were previously missing from your diet, such as digestive enzymes, insufficient stomach acid, and overcoming nutrient deficiencies, which is an inevitable side effect of a leaky gut.

Digestive Enzymes: They help you break down food for effective nutrient absorption and help in building tissues. When you don’t have enough digestive enzymes or stomach acids, the food ferments in the gut, resulting in bloating and abdominal pain.

Digestive enzymes are produced by the salivary glands, liver, pancreas, stomach, and small intestine, where most of the digestion occurs. The three most important digestive enzymes are protease, lipase, and amylase. The easiest way to include more enzymes in your diet is to chew your food thoroughly and to eat more raw fruits and vegetables. Natural sources of enzymes include bananas, avocados, kefir, pineapples, papayas, ginger, honey, kiwi, mangoes, and sauerkraut.

Stomach Acid: It is not only important for digestion but is also required for protein building, and it works as a defense mechanism against pathogens. Indigestion is the most common sign of low stomach acid. A person suffering from indigestion may experience acid reflux, gas, fullness, and nausea.

It is believed that constipation is only caused due to lack of enough fiber in the diet. However, the lack of enough enzymes and stomach acid in the body may also lead to constipation.

Some of the major factors that lower your stomach acid levels include aging, prolonged antacid use, and consumption of medications containing proton pump inhibitors and H2 blockers. The normal pH of stomach acid is between 1 to 3, which is highly acidic. When there isn’t enough acid in the stomach, or it isn’t acidic enough, it fails to trigger the liver to produce bile juices from the gall bladder, which helps to break down fats.

The following foods can help restore these factors:

• High-fiber foods such as fruits, vegetables, and whole grains.
• Anti-inflammatory herbs such as turmeric, garlic, and rosemary.
• Bitter foods like bitter gourd, arugula, kale, and saffron also stimulate digestive enzymes and stomach acid.
• Eating foods such as beet tops, ginger, milk thistle, and lemons help the liver in the production of bile salts.

Certain dietary supplements may also assist in proper digestion and nutrient absorption:

• Digestive enzymes such as lipase, amylase, protease, and pepsin.
  
  
• Brush Border Enzymes are particularly beneficial in a low FODMAP diet as they’re designed to break down carbohydrates and other sugars.
  
  
• Betaine HCL is a weaker acid that builds up the hydrochloric acid in your stomach.
  
  
• Nutritional supplements help address the nutritional deficiencies that are necessary for digestive functions. They include vitamin B12, potassium, magnesium, iron, and zinc.
  
  
• Vitamin C contributes to collagen production in the body, which provides strength and structure to the connective tissues in your gut.
  
  A deficiency of vitamin C contributes to a leaky gut. The best way to consume vitamin C is from fruits and vegetables. Citrus fruits, parsley, green tea, cruciferous vegetables, and sprouted buckwheat are all great sources of vitamin C.
  
  
• Vitamin B1 (thiamine) is a key nutrient that helps support the vagus nerve, which plays a key role in digestion. Nutritional yeast and sunflower seeds are some of the best sources of vitamin B1.

#3. Reinoculate (6-12 weeks)

Reinoculation refers to re-introducing the good bacteria (probiotics) in the gut to achieve a healthy gut microbiome. The more diverse your microbiome is, the healthier it is. Good bacteria play a major role in the maintenance of the integrity of your intestinal barrier.

Your gut is lined with a mucus monolayer that protects the epithelium from pathogens. Good bacteria help in mucus production and help in protecting the esophagus and gut from burning due to the harsh stomach acid.

They also produce short-chain fatty acids, such as butyrate, propionate, and acetate, which increase mucus production, protect against inflammation and reduce the risk of colorectal cancer.

Additionally, they produce lactic acid, which prevents the growth of pathogens in the body and plays a role in nutrient absorption and maintaining the pH balance of the stomach.

Moreover, probiotics act as antioxidants that neutralize harmful free radicals and produce amino acids that are the building blocks for neurotransmitters that are vital for all bodily functions.

Prebiotics and probiotics can be added to your diet through foods and/or supplements. Probiotics and prebiotics are two different types or types of nutrients, learn more.

• Fermented foods: These include whole milk kefir, yogurt, sauerkraut, tempeh, pickles, natto, buttermilk, kombucha tea, and certain types of cheeses.  Explore the complete list of Probiotic Foods from here!
  
  
• Probiotic supplements: Choose probiotics with multiple bacterial strains. The most common species of probiotics found in supplements are Lactobacillus and Bifidobacteria.
  
  However, if you’re sensitive to them, Saccharomyces boulardii is a great option as well, explore the Top 10 Best Probiotics Supplements for Leaky Gut with a blend of Prebiotics. If you are taking antibiotics, make sure to take probiotics, ideally within two days, to compensate for the loss of good gut bacteria and its consequences. The recommended dose of probiotics for children is 5 to 10 billion colony-forming units (CFUs) per day, while that for adults is 10 to 20 billion CFUs per day.
  
  Probiotic bacteria feed on a special type of dietary fiber, known as prebiotic fibers. These fibers can’t be digested by humans and are broken down by gut microbes.  
  
  
• Prebiotic foods: They are naturally found in many foods such as asparagus, chicory root, leeks, bananas, garlic, onions, dandelion greens, and Jerusalem artichokes. You can also discover the entire list of Prebiotic Foods.
  
  
• Prebiotic supplements: Fructooligosaccharides (FOS), xylooligosaccharides (XOS), galactooligosaccharides (GOS), and inulin are the most common types of prebiotic fibers.
  
  
• Symbiotic foods are foods that contain both prebiotics and probiotics, such as sauerkraut, miso, fermented vegetables, and kimchi. They have a synergistic effect, and the presence of prebiotics can increase the survival rate of probiotics in the stomach.

• Soluble fibers: They are another class of dietary fiber that are critical for healthy digestion. They absorb the water from the intestines to form a gel-like substance. They improve the passage of food through your digestive system, increase feelings of satiety, and add bulk to your stool.
  
  Foods such as nuts, cucumbers, avocados, flax seeds, celery, oats, carrots, peas, strawberries, pears, and apples are high in soluble fibers. Arabinogalactans are starch-like chemicals and a type of soluble fiber found in corn, wheat, tomatoes, and radishes.
  
  Both soluble and insoluble kinds of dietary fibers mostly pass through your system without being digested. They both are naturally present in most foods but in different amounts. Processed or refined foods contain fewer dietary fibers than whole foods.
  
  As you re-populate your gut with probiotics in this phase, it will be a lot easier for you to digest raw fruits and vegetables.
  
  Experts recommend taking 25-30 grams of fiber per day. It is recommended to start with small amounts of prebiotics and probiotics in your diet and build up gradually.
  
  
• Polyphenols: They are plant-based antioxidant compounds that are beneficial for gut health as they help improve bacterial diversity in the gut. They give fruits and vegetables their colors and are also found in other foods, including tea, coffee, and dark chocolate. Eating fruits and vegetables along with their peels increases your intake of both dietary fibers as well as polyphenols.

#4. Repair (up to 12 months)

The last and most critical step focuses on repairing the intestinal barrier through the right nutrition. Apart from eating a healthy diet and avoiding problematic foods, certain supplements may help to further reduce inflammation and decrease the permeability of your gut. These include:

• Glutamine: It is considered a vital nutrient for healing a leaky gut since it works as a fuel for intestinal cells. A low level of glutamine has been linked to chronic inflammation, intestinal barrier disruption, and digestive disorders. Glutamine is naturally abundant in bone broth.
  
  
• Deglycyrrhized licorice (DGL): It increases mucus production and protects the gut from acid. It also helps in restoring the gut lining through the synthesis of protein required for cell production.
  
  
• Zinc carnosine: It improves the integrity of the stomach lining and stabilizes bowel integrity.
  
  
• Quercetin: It modulates your gut microbiome and regulates the expression of tight junction proteins in the gut, which reduces gut permeability.
  
  
• Marshmallow root: The mucilage of marshmallow root coats the inner lining of the gut to protect against burning sensations.
  
  
• Slippery elm: It stimulates the nerve endings of your gastrointestinal (GI) tract, which leads to increased mucus production. It also protects against excess acidity and peptic ulcers.
  
  
• Aloe vera: It protects and soothes the gut and helps to restore the lost mucus. Additionally, it preserves the water balance of your intestines and controls candida overgrowth.
  
  
• Wheatgrass powder: It contains chlorophyll, which is an important phytonutrient. Wheatgrass powder is gluten-free and doesn’t overwhelm your gut as it doesn’t contain too much fiber, which may be difficult to digest if you have a leaky gut.
  
  
• Omega-3 fats: They stimulate the growth of Bifidobacteria in the gut that help decrease gut permeability. It is also naturally present in fatty fish, nuts, seeds, and olive oil.
  
  
• Purified bile salts: The gut microbes produce secondary bile salts, and an altered gut microbiome could indicate that you’re deficient. Bile salts are important to keep the junctions of your colon tight and decrease its permeability.

Additional Support Considerations

Sleep

When you don’t get enough sleep, your body produces high levels of cortisol, known as the ‘’stress hormone’’. In small amounts, cortisol is required by the body as it helps to curb harmful or non-essential functions in a flight-or-flight situation. However, too much cortisol suppresses the digestive system and alters your immune system responses.

1. It also stimulates histamine production, which triggers inflammatory responses and worsens existing digestive conditions.
2. Moreover, it triggers the production of zonulin, a protein that contributes to a leaky gut.

Getting 8 hours of sleep is only a general guideline, and you may need more or less sleep depending on your personal requirements.

Potassium works as a physiological tranquilizer and helps calm your nervous system. Including enough potassium in your diet, such as by eating bananas, can help you sleep better.

Exercise

It is scientifically proven that moderate exercise improves both the number and diversity of good bacteria in the gut, reduces inflammation, and decreases intestinal permeability. Experts recommend getting 150 minutes of moderate exercise per week, such as brisk walking, swimming, cycling, and yoga. Going for long walks during the day may also help you sleep better.

With that being said, people with leaky gut syndrome should avoid high-intensity workouts as they are known to worsen the condition.

Who should opt for the 4R Protocol?

Many people believe that digestive issues are the sole indicators of poor gut health. But as the gut influences various other health aspects, symptoms of gut problems may appear in ways, you didn’t expect. The 4R strategy is suitable for anyone who wants to improve their gut health as it isn’t restrictive in any way. However, it is an intense process and requires commitment.

Here’s how to tell if you need to follow the 4R protocol.

• Skin problems: Just like your gut walls, your skin is also semi-permeable. A leaky gut can disrupt the protective skin barrier and manifest symptoms of autoimmune responses, such as skin eruptions, acne, rashes, and more.
  
  
• Poor sleep quality: 90% of serotonin is produced in the gut, which plays an important role in regulating functions such as sleep. Thus, poor sleep quality may be a sign of poor gut health.
  
  
• Depression or irritability: Serotonin is also one of the main neurotransmitters that regulate your mood.
  
  
• Falling sick often: About 70% of immune cells are present in the gut. Moreover, bacteria such as Bacteroides fragilis are known to trigger many autoimmune conditions, wherein the body attacks itself.
  
  
• Chronic pain: An imbalance in the gut microbiome may lead to chronic inflammation and trigger headaches and joint pain.
  
  
• Brain fog: Inflammation due to a leaky gut disrupts the communication between the gut and brain, resulting in forgetfulness and brain fog.
  
  
• Unexplained weight gain: Good bacteria in the gut help in the proper digestion of food, and the lack of enough good bacteria may lead to weight gain.

You don’t need the 4R protocol, if:

• You won’t experience any uncomfortable symptoms after eating, such as gas, bloating, or heartburn.
• You have 2-3 healthy bowel movements every day.
• You tolerate most foods well.
• You have sustained energy levels and mental clarity.
• You have your stress levels in check.

Conclusion

Your digestive system is a connecting system, meaning if something affects your digestion, your other parts of the body are also affected. Various dietary and lifestyle aspects can affect your gut health, which in turn affect factors including immunity, sleep quality, energy levels, mood, stress levels, weight, and skin health. The 4R protocol has been used in functional medicine to restore gut microbiome homeostasis. Its goal is to regulate the factors that lead to inflammation and an increased intestinal permeability as well as to include factors that restore your gut health.

It involves eliminating your stressors, replacing the nutrients in your diet, re-populating the gut with probiotics, and repairing the intestinal barrier. Some people may have higher nutritional needs than others due to an underlying medical condition or a demanding lifestyle. Targeted supplementation can help you achieve your daily nutritional requirements to heal your gut.

Since gut health is related to many other health aspects, paying attention to symptoms such as skin eruptions, fatigue, unexplained weight gain, and low immunity can help you identify the symptoms of poor gut health.

The 4R protocol provides a long-term solution for treating gut problems such as leaky gut, irritable bowel syndrome (IBS), small intestinal bacterial overgrowth (SIBO), gut inflammation, and more.

The entire process can take up to 12 months and may be tricky to follow on your own. If you think you could benefit from it, it is recommended to follow this protocol with a healthcare practitioner to address your particular needs and guide you through the process. Most of the recommendations in the 4R protocol can be implied in your daily life. Eating a diverse diet and managing your stress levels as well as avoiding inflammatory and processed foods is beneficial for your digestive health and overall wellbeing. An ideal gut-friendly diet should include raw fruits, vegetables, proteins, healthy fats, complex carbohydrates, and probiotic foods. You can learn in details, some effective way to Improve Gut Health Naturally.