Heal Your Gut with the 4R Program (2024)

Contrary to popular belief, symptoms are not always related to the location that they are associated with. For example, if you have asthma, acne, or headaches, the root causes may not be located in your lungs, skin, or head. Many symptoms stem from a systemic imbalance—often originating in your gut (gastrointestinal tract). This can be true even if you don’t have any obvious digestive issues.

Maintaining gut health and alleviating related symptoms is not easy, as there are many factors that can cause a gut imbalance. The 4R program offers four steps—remove, replace, reinoculate, and repair—that can address the underlying causes and restore balance, helping to alleviate symptoms. Depending on the severity of your condition, it can take up to six months to fully repair your gut. Work with your physician first to determine the best approach—particularly if you are considering new supplements. If you need additional support, many functional medicine physicians are familiar with this program.

1. Remove

First, identify and remove the factors that may be contributing to your symptoms, including:

• Stress: Stress can impair your digestion and absorption—particularly if you eat too quickly, too much, or at varying times of day.
• Allergenic foods: Develop an elimination diet plan with your physician to help determine if you have food allergies. The diet involves removing potentially allergenic foods for a length of time (the length of the elimination phase will vary based on your individual needs and protocol), then reintroducing the foods, one at a time, every two days, while monitoring for symptoms. Potentially allergenic foods include processed foods, oranges, dairy, eggs, corn, grains with gluten, pork, shellfish, beef, veal, soy, peanuts, alcohol, coffee, soda, refined sugar, chocolate, ketchup, and most other condiments.
• Pathogens: Bacterial and yeast overgrowth, viruses, fungi, parasites, and other toxic substances are common contributors to gut-related symptoms. A variety of tests, medications, and dietary and home remedies are available through your physician or a functional medicine physician to identify and remove pathogens.

2. Replace

Second, replace stomach acid and digestive enzymes, which may be lacking in your gut. Lab tests, such as fat absorption tests and gastric analysis, can help determine what factors need to be replaced. Work with your physician to determine supplements that could support your healing, such as:

• Digestive enzymes, including protease, lipase, amylase, and pepsin
• Hydrochloric acid

3. Reinoculate

Third, for six to twelve weeks, reinoculate your gut with good bacteria to help regain a healthy microflora balance. Intestinal microflora are microorganisms that live in our gut and are helpful in aiding digestion and nutrient absorption. This can be accomplished with a variety of foods and supplements:

• Fermented foods: These foods include tea, pickles, sauerkraut, kimchi, miso, yogurt, kefir, and kombucha. You can also make your own fermented foods.
• Prebiotics: These are non-digestible plant components that nourish the body’s microflora. They include:
  • Oligosaccharides and Fructo-oligosaccharides (FOS): Types of carbohydrate found in some fruits and vegetables, including leeks, onions, asparagus, jicama, bananas, garlic, and Jerusalem artichokes; also available in supplement form
  • Arabinogalactans: Arabinogalactans are a type of soluble fiber; small amounts can be found in carrots, radishes, pears, corn, wheat, and tomatoes, although if you’re looking for a meaningful amount, they are available in supplement form
  • Soluble fiber: Fiber that easily dissolves in water; found in sources such as oatmeal, beans, apples, pears, strawberries, nuts, flaxseeds, psyllium, cucumbers, and celery
• Probiotics: Probiotics are live bacteria that aid the digestive process and keep our gut health and intestinal function strong. Probiotics are available as supplements; purchase a refrigerated brand with live, mixed flora such as lactobacillus and acidophilus.

4. Repair

Fourth, repair the lining of your gut through good nutrition—this can take up to six months. In addition to an allergen-free, healthy diet, a variety of foods and supplements may help to reduce inflammation and support cell growth in your digestive tract, such as:

• Omega-3 fatty acids
• Glutamine
• Kiwi
• Zinc
• Vitamin B5
• Vitamin D

The information in this article is intended for your educational use only; does not necessarily reflect the opinions of the Chopra Center's Mind-Body Medical Group; and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition and before undertaking any diet, supplement, fitness, or other health program.

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