General Conditions Reference
Gut Dysfunction and Chronic Disease: The Benefits of Applying the 4R GI Restoration Program
Gut Dysfunction and Chronic Disease: The
Benefits of Applying the 4R GI Restoration Program
By DeAnn J. Liska, PhD and Dan Lukaczer, ND
The ability of the body to maintain healthy
gastrointestinal (GI) function, and to heal the GI
barrier when its integrity is compromised, is necessary
for healthy aging and protection from many diseases and
disorders. Research has shown an association between
impaired GI function and various conditions, such as
gastritis, peptic ulcers, colon cancer, inflammatory
bowel disease, irritable bowel syndrome, rheumatoid
arthritis, asthma, eczema, metabolic bone disease,
allergies, nutrient malabsorption, and esophageal
reflux.1-8 There are many factors associated
with impaired GI function including food allergies,
excessive stress, and the use of non-steroidal
anti-inflammatory drugs and corticosteroids.9
GI complaints are presently the most common reason for
hospitalization, with over 70 million Americans
suffering from some form of serious GI disorder.
Fortunately, recent work has been carried out to define a
systematic approach to support optimal GI function.
Based on the concepts of Remove, Replace,
Reinoculate, and Regenerate, the 4R GI
Restoration Program promotes overall GI health by
removing unhealthy bacteria from the intestinal tract
and allergenic foods from the diet, replacing supportive
stomach acids and digestive enzymes, reinoculating the
intestine with healthy bacteria (probiotics), and
regenerating the intestinal lining with targeted
GI Restoration and the 4R Program
focuses on eliminating harmful bacteria, viruses,
fungi, parasites, and other environmentally derived
toxic substances from the GI tract. An oligoantigenic
or ?elimination? diet is important to this step of the
4R GI Restoration Program, since foods to which a
patient is intolerant or allergic can worsen GI
dysfunction and stimulate negative immune and
It is important to keep in mind that even a healthy GI
tract may permit food proteins, gut bacterial breakdown
products, and environmental toxins, such as pollutants
and pesticides, to reach the circulation system.
Therefore, removal of offending substances and
microorganisms is a critical component in GI
refers to the replacement of enzymes and other
digestive factors lacking or in limited supply in an
individual?s GI environment. These include crucial
digestive enzymes, such as pepsin, proteases, lipases,
and saccharidases, as well as hydrochloric acid (HCl)
and intrinsic factor.
HCl is particularly important to consider, especially in
individuals older than 60, since inadequate levels
(hypochlorhydria) are often associated with GI
dysfunction. HCl is necessary for proper digestion,
nutrient absorption, and the breakdown of protein for
further digestion in the small intestine. Furthermore,
HCl has been shown to effectively kill harmful
organisms in the GI tract?which results in the decreased
likelihood and severity of certain bacterial and
parasitic intestinal infections.
Nutritional deficiencies can also impact GI function,
protection, and health. Extensive evidence suggests a
strong association between Helicobactor pylori
infection and vitamin C deficiency.13,14
H. pylori is a bacteria that can cause peptic
ulcers and stomach inflammation (chronic gastritis).
Since vitamin C may help eradicate H. pylori,
this deficiency, when coupled with poor intake of
vitamin C, may increase both the colonization of H.
pylori and the threat to the GI tract. In addition,
zinc deficiency is known to worsen inflammatory bowel
disease, delay GI restoration, and cause a variety of
functional problems, including interruption of protein
synthesis and reduced cell-mediated immunity.15,16
refers to the process of reintroducing and
supporting a healthier balance of desirable microflora
in the GI tract with probiotics, such as
Lactobacillus acidophilus and
Bifidobacterium lactis. Probiotics are
"friendly" bacteria that serve a variety of
functions in the GI tract: they synthesize various
vitamins, assist with intestinal cell growth and
function, prevent colonization of harmful bacteria, and
help break down toxins.
In addition to probiotics, prebiotics may also be useful
in supporting a healthy bacterial balance. Prebiotics
are non-digestible food ingredients that selectively
stimulate the growth of friendly bacteria. Extensively
studied prebiotics include fructooligosaccharides, rice
fiber, some soy fibers, and arabinogalactans.17-20
refers to providing support for the healing and
growth of the GI mucosa. Part of the support for healing
comes from promoting healthy microflora and removing
impediments that continually re-injure or irritate the
mucosa. In addition, appropriate nutritional support is
crucial to overall health and responsible for reversing
GI dysfunction and eliminating the chronic diseases
associated with it. Important nutrients for support of
GI regeneration include vitamins C and E and the
carotenoids, for their antioxidant effects, and zinc
and vitamin B5 (pantothenic acid), due to
their roles in supporting the healing
mechanisms.21,22 In addition, the following
dietary factors are particularly helpful for the
healing and regeneration of the GI tract.
Plantain Extract?Plantain extract is composed of
protective lectins and flavonoids, which protect the
gastric layer from damage by exogenous
agents.23,24 Plantain extract assists the
mucus coating in protecting against infestation by
microbes such as H. pylori and has been used
therapeutically as an anti-ulcer agent.
Phosphatidylcholine?Recent studies show that
consumption of phosphatidylcholine (lecithin) with
potential ulcer-causing substances like aspirin or bile
salts protects the gastric layer from damage and
L-Glutamine?The amino acid glutamine is
considered a preferred fuel for the rapidly replicating
cells of the GI mucosa.28-30 Glutamine may
promote production of glutathione (an important
antioxidant) in the GI cells, which supports healing
and provides additional protection from free radical
damage during inflammation.31 Dietary
glutamine is important for maintenance of GI mucosa
during stress, injury, inflammation, and sepsis?a
serious, severe illness caused by infection of the
bloodstream.32 Furthermore, glutamine
deficiencies are often associated with degenerative
changes in the small intestine following intestinal
injury, infection, surgery, or radiation.33
Lactoferrin and Lactoperoxidase?These proteins
are found in milk and other secretions and play
important roles in the intestinal immune system. They
both have antimicrobial and antiviral properties,
stimulate the immune system, and promote healing of the
Arabinogalactans?Arabinogalactans are non-starch
polysaccharides found in many vegetables and grains.
Considered a fiber, arabinogalactans have prebiotic
functions that may stimulate immune activity in humans,
promote healthy intestinal bacteria, and prevent the
spread of cancer tumor cells in animals.37-40
GI function is a primary factor in overall health and can
influence many conditions. Fortunately, the constant
renewal of intestinal cells provides an opportunity for
healing, but requires appropriate nutritional and
probiotic support for assured GI integrity and function.
While the overall concept of the 4R GI Restoration
Program defines a basic approach, its use should be
individualized to the needs of each person based on his
or her own unique combination of GI factors.
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Advanced Nutrition Publications ©2002
Gut Dysfunction and Chronic Disease: The Benefits of Applying the 4R GI Restoration Program
Herbal Antimicrobials for Intestinal Infections: A Summary
Proven Therapeutic Benefits of High Quality Probiotics: A Summary
Harmful bacteria growth reduced by certain strains of Lactobacillus acidophilus
Probiotics support a healthy and balanced gut flora
Probiotics provide protection against various gastrointestinal diseases
Bifidobacterium promotes immune function in the elderly
Lactoferrin possesses antiviral activity
Lactoperoxidase kills Helicobacter pylori
Antibiotics increase functional abdominal symptoms
Lactobacillus acidophilus NCFM® shows strong adherence to the intestinal wall
The Problem of Antibiotic Resistance
The Effects of Antibiotics on Intestinal Microflora
The Effects of Probiotics on Antibiotic-Associated Diarrhea
The Importance of Probiotic Selection
Additional Substances that Support the Intestinal Microflora
Lactoferrin inhibits a wide variety of harmful microorganisms
The beneficial health effects of oligosaccharides
The anti-inflammatory actions of curcumin and boswellia
Probiotics shown to support gastrointestinal health
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