Last week we reviewed how the gut and the skin are connected to each other as well as other body systems.

When there is inflammation in the gut, there is likely inflammation elsewhere in the body and vice versa, when there is inflammation in the body there is likely inflammation in the gut because the systems are all connected.

So where do we begin to start reducing inflammation and start healing?

In functional medicine, we use the concept of the “5 R Approach” as one of the key ways to address inflammation and promote gut healing.

I’m excited to share this approach with you as I’ve have had so many success stories of patients healing their acne, psoriasis, eczema, rosacea etc.


What is the 5 R Approach?

The 5 R Approach is a strategy to improve digestive health, decrease inflammation and promote healing.

The 5R’s are: Remove, Replace, Reinoculate, Repair and Rebalance.

This approach to gut inflammation can help improve the symptoms of inflammation as well as potentially eliminate the underlying root cause of your inflammation.


The 5R’s:

1. Remove

This step focuses on getting rid of things that are in excess or creating inflammation.

For the gut, this can be foods that your body reacts to such as dairy, gluten, fried foods, processed foods, soy, eggs, corn, high histamine foods, FODMAPS etc.

You can have testing to determine which foods your body is reacting to, or you can do a temporary elimination of foods you suspect as triggers.

Ideally, you eliminate the foods for at least 3 weeks and possibly as long as 6 weeks.

Reintroducing foods is a very important step in this process.

You will want to keep track of your symptoms carefully as you reintroduce ONE food at a time.

I advise taking a few days and trial one food reintroduction at at time and not introducing another new food until you are clear that each food you introduce is not triggering your symptoms again.

Work with your practitioner to determine which elimination food plan is right for you and the details of how and when to reintroduce foods. Be sure you are still getting your essential minerals, vitamins and micronutrients while you are implementing an elimination food plan.

In the removal process of the 5R Approach, there also may be a problematic microbe triggering inflammation.

Exploring problematic microbes is a new and developing area of medicine and can be rather complex.

You may want to explore advanced testing options with a functional medicine physician that specializes in this area to determine if this is part of your triggers.

Treating problematic microbes may involve both prescription and herbal treatment options in addition to your nutrition plan.


2. Replace

Optimize your digestion by adding essential micronutrients, vitamins, and minerals that may be missing due to prior nutritional issues.

If you removed dairy (milk, cheese, yogurt, ice cream, cottage cheese, cream cheese, sour cream, whipped cream etc ) from your nutrition temporarily, you will be replacing it with non-dairy options such as items made from almond milk, coconut milk, hemp milk, etc.

FYI: There is a high reaction to goat milk products in people that have a sensitivity to cow milk products so I typically advise not using goat milk products as a replacement.

If you removed gluten from your nutrition, you can also replace those items with gluten-free items, however a few pitfalls that could happen here.

One pitfall is that you eat gluten-free, but you still are eating a high amount of processed foods that can still trigger inflammation. For example, you may be gluten-free, but are you still having pancakes, bagels, muffins etc for breakfast that are gluten-free instead of whole food nutrition for breakfast?

Gluten-free doesn’t always mean processed food free. So be mindful that you are shifting into a more whole food nutrition program where you are eating most of your foods from nature (veggies, fruits, grass fed meats, poultry, etc) and less items that you open in a package that were made in a factory.

The second pitfall is that you may be sensitive to corn and many gluten-free items may contain corn. For example, tortilla chips are considered gluten-free because they are made of corn, however if you also have a sensitivity to corn, you may need gluten free and corn free tortilla chips. Also, chips are an example of a processed food so you may want to transition them out of your nutrition for that reason as well.

You may be eating the essential nutrients you need but your digestive system is not breaking it down in ways that that gut can process and utilize the nutrients.

In these cases, your digestion can be enhanced by the addition of supplements that assist in breaking down foods such as digestive enzymes, betaine, etc.

Adding fiber to your nutrition plan will also help how long it takes food to travel through the gut and assist with eliminating toxins.


3. Reinoculate

The health of the microbiome of the gut is another key component in your healing.

Repopulating the microbiome of your gut with a healthy microbial balance can be addressed by adding prebiotic and probiotic foods as well as probiotic and synbiotic (synbiotics have both prebiotics & probiotics) supplements.

We are learning so much about which microbes are associated with inflammation and which ones assist the body with its anti-inflammatory processes.

We are also finding out that the microbiome is rather individualized and unique to each person, much like our fingerprints.

You may want to start with a combination probiotic supplement that contains species of Lactobacillus, Bifidobacterium, and Saccharomyces boulardii along with eating a nutrition plan that is rich in probiotic and prebiotic foods.


4. Repair

Repairing the gut lining is key to absorbing nutrients and decreasing inflammation.

This takes time and works in tandem with ensuring you aren’t re-triggering leaky gut with inflammatory foods sneaking into your nutrition plan.

Adding key nutrients such as zinc, vitamin d, omega 3’s, magnesium, amino acids such as L-glutamine, aloe vera and other supplements can assist in repairing the gut lining.


5. Rebalance

Finding balance and time for relaxation and serenity will assist in calming the gut and lessen the impact of hormonal imbalances that occur with stress.

How to Deal with Stress

Taking time to add deep breathing, yoga, meditation, nature walks, and rest to your day can be more meaningful that you think.


How long will it take before I see a change?

Implementing the “5 R approach” will take some time.

The first step is identifying your personalized needs at each step.

Next is diligent adherence to the plan and understanding that each tiny step you take will accumulate over time.

Be patient with yourself and understand that each body is different and has a different journey. The health issues we have didn’t happen overnight and likely took years to unfold and accept that it may take many, many months to years to reverse and unravel.

They say it’s all about the journey anyways, right?