Is it time to finally hunker down and get your gut sorted out?
All that burping, bloating, gas, urgency, pain, heartburn, discomfort, and tossing and turning at night generally doesn’t self-resolve.
You are likely experiencing these symptoms because of something you are doing or not doing regularly. It will take a little investigative work to figure out which variables both support and negatively impact your gut.
This article is for you if you are finally ready to put a committed effort into improving your gut’s functionality.
If you are experiencing severe gastric symptoms, this blog post is NOT for you. Symptoms such as blood in stools, extreme pain, vomiting, chronic diarrhea/constipation, falling unconscious after meals, and the like will require a visit to your general practitioner. If you or any other person has a medical concern, you should consult with your health care provider or seek other professional medical treatment. Never disregard professional medical advice or delay in seeking it because you may have read on this blog or in any linked materials. If you think you may have a medical emergency, call your doctor or emergency services immediately.
Now let’s get back to the program
The most critical aspect of dealing with a reactive or symptomatic gut is time. In a not so distant past, I took a gut health course where I learned it takes approximately two years to make significant GI wellness improvements. Considering it takes seven years to replace all the cells in the body, two years seems like a fair estimate of the time to address gut health.
When a diagnosis is not present, the total time to improve the gut is relative to the degree it is compromised. In the presence of a diseased state such as Chron’s and ulcerative colitis, one can only seek to extend the time between flare-ups.
In the grand scheme of things, time is one of the most relevant and often overlooked components. Working on your gut health for a mere three months before returning to sabotaging habits is like pouring tar on a work of art.
The second most important rule is consistency. Whatever measures you decide to execute to improve your gut health, require execution for the long term.
Improving the gut’s function only to later trash it with hard alcohol, processed foods, low water intake, and gut irritants is again contradicting all the work you’ve done. Be warned!
#1 Rule + #2 Rule =
When you combine a dedicated length of time with consistent effort, you get results.
If you are finally serious about getting your gut in good working order, I suggest setting aside a period where you will not have little to no interruptions for at least 4-6 weeks at a time.
The time, money, and mental commitment to this process will pay you back for the rest of your life.
The amount of time spent in your gut health protocol, while using gut-specific supplements, is for you to decide. I believe as long as you continue to improve, keep the engagement going.
I will preface everything by saying these are the protocols where I have seen the fastest outcomes. In the same breath, there are probably other strategies to address gut health, which I encourage you to explore if they speak to you.
The upside of fast results tends towards heightened compliance. When significant shifts occur in the first four weeks, the likeliness of someone continuing (up to two years) is that much greater.
Assessing Your Gut Health
To know where you are going, you need to know where you are starting.
First begin with an overall look at your health:
- Do you have diagnosed health conditions?
- Do these conditions share relationships with gut health? (hint: most do)
What other symptoms do you display?Examples of symptoms commonly associated with poor gut health:
Gut Specific (bloating, pain, gas, heartburn, urgency, etc.)
+ many more
Your answers to the questions mentioned above dictate where to look for feedback with your progress. While working on your gut health is unlikely to resolve diagnosed chronic conditions, you should see improvements in symptom expression.
Secondly, you need to know which portion of your gut is compromised.
Humans are one tube from mouth to anus. When gut health concerns are prominent, it is not uncommon to see symptoms in the full length of the digestive tract. In females with poor gut health, UTI’s are common as bacteria that populate the gut also inoculates the vagina.
Those with milder symptoms will often experience concerns in localized areas of the digestive tract. The larger the area that is compromised, the longer it will take to reinforce.
The best way to determine which component of the gut is affected is to time out symptoms relative to food intake. However, there are exceptions to this rule.
As a general rule of thumb:
- If symptoms such as indigestion, heartburn, or fullness arise within 1.5 hrs after eating, then the gastric function is likely compromised.
- If symptoms such as pain, burning, aching, or nausea occur within 1-4 hours of eating, look to address inflammation.
- If you experience symptoms 2-4 hours after eating, look to small intestinal
- If symptoms such as constipation/diarrhea/distension don’t begin until 8 hrs till the next day, look to colon function.
Those with food allergies/intolerances/sensitivities may experience symptoms immediately after eating due to immune activation.
Laying Out the Plan
At this point, you should have a rough idea of which symptoms you want to reexamine over time and which portion of your gut is affected.
The 5R Plan for Gut Health
This system is one of the gold standards in the world of functional and holistic health and for a good reason. It works.
The 5R system is a multi-faceted approach to encourage the transition to a healthier digestive tract.
The 5R’s are: Remove, Replace, Reinoculate, Regenerate, and Retain.
The first measure to calm down a hyper-reactive or symptomatic GI tract is by removing or foods, liquids, and lifestyle practices, which lead to poor gut health.
It is almost impossible to resolve gut health issues in the presence of gut health irritants, so those need to go.
Foods: You may already be keenly aware of what you need to remove. Do you find yourself symptomatic after specific meals? Or are you completely disconnected from your food-symptom relationship?
If you don’t know what to remove, always start with the eight most common allergens.
- Tree nuts (such as almonds, cashews, walnuts)
- Fish (such as bass, cod, flounder)
- Shellfish (such as crab, lobster, shrimp)
Reintroducing the foods one at a time after a 4-6 week break will determine the impact they have on your gut health. It is up to you to decide whether abstaining from certain foods holds value for your health for the long term.
In some circumstances, removing these foods do not lead to satisfactory symptom relief.
Those who are highly symptomatic will need to remove more food groups. It is best to consult with a health care practitioner if transitioning to a highly restrictive diet.
Other variables that need consideration are alcohol consumption, NSAID use, overconsumption of synthetic sweeteners (this extends to your training supplements).
It is best to be in the absence of all gut irritants for the full duration of time you are looking to address gut health.
Clients with a long history of heavy antibiotic usage or poor lifelong dietary habits often need anti-microbial supplements at the onset of their gut health program. The use of naturally derived anti-microbial agents is best under professional guidance.
Now is the time to plan a dietary approach to reinforce your gut and overall health. The healthier the body, the faster you will see positive health changes over time. If building a sturdy nutritional foundation is an elusive concept, check out PART II from my article, ‘Considerations for Sustainable Weight Loss.’ In this article, I discuss the basic premise of a healthy diet.
Fiber is vital in a gut health program as it provides food specific to beneficial microbes.
‘Replace’ in the context of the 5R plan also involves the addition of enzymes for digestive support. The rationale here is enzyme function is low due to low nutritional status. If you have heartburn, use betaine HCL + a broad-spectrum digestive enzyme blend. If you do not have heartburn or indigestion following meals, simply add a digestive enzyme blend.
As digestive enzymes will downregulate endogenous enzyme production over time, I do not recommend use over four weeks at a time.
In this step, we add healthy bacteria to strengthen the digestive tract’s integrity and working function.
Probiotics are KEY. While fermented vegetables are beneficial, they often don’t hold a candle to scientifically validated strains in efficacious dosages.
When selecting a probiotic, quality and dosage matter a lot.
Probiotics are also transient. Which means they don’t become a part of our permanent colonizers.
Fun Fact: Your microbiome diversity is decided between birth to six months of age.
Find a quality brand that uses scientifically validated strains. If you have specific concerns, look for strains that carry research trials for the symptoms you are looking to address. As a general rule of thumb, the lower you go in your digestive tract, the higher the dosage you need to compete with the density of bacteria in that region. For more severe GI health symptoms, you require as much as 500 billion-1000 billion per day. Those who have mild concerns can often get away with 50 billion per day. Maintenance doses are anywhere between 15-50 billion per day.
Avoid probiotic use if you have a compromised immune system.
Regenerate means something different for every practitioner. While the application of the first 3R’s are pretty consistent across the board, the 4th R is more variable.
In my understanding, ‘regenerate’ is an opportunity to emphasize absolutely anything that can intensify your program’s effects.
What you add in this step will vary depending on initial symptoms and which region you are looking to address.
Added measures might include prebiotic supplements, support nutrients (colostrum, glutamine, fiber supplements, deglycyrrhizinated licorice, slippery elm, vitamins, and minerals, liposomal glutathione, etc.), meditation, sauna, etc.
Again, the nutrient density and carbohydrate/fiber diversity of the diet is a critical factor for positive long-term outcomes.
Think of this as your long-term maintenance protocol. The gut is considered the second brain of the body. All of our daily actions and thoughts link into the physiological function of our gut. The more stressed out we are, the more porous, leaky, and troubled the GI tract becomes.
Therefore, not only should you emphasize a gut supportive nutritional program for the long term, but lifestyle and stress management also play critical roles in sustaining positive outcomes.
Activities such as meditation, yoga, deep breathing, baths, massages, acupuncture, relaxing walks, and healthy relationships contribute to a healthy digestive tract.
The steps mentioned above can be worked through in a step-wise manner or compounded for an expedited approach. Ultimately, what one executes sustainably and consistently will lead the way to the most profound changes.