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Repair – The Functional Medicine Approach to a Healthy Gut

By April 11, 2016Blog

The Functional Medicine Approach to a Healthy Gut

The 5 “R” Approach

  1. Remove
  2. Replace
  3. Re-inoculate
  4. Repair
  5. Rebalance


The Lining of our gut is only one cell thick:

The epithelial cells that line our gut are one cell layer thick.  In the small intestine these epithelial cells have villi.   The villi are small, finger-like projections that protrude from the epithelial lining of the small intestine’s walls.  These villi increase the surface area of the small intestine to increase our ability to absorb nutrients and each villi also has microvilli, which are even smaller hair-like projections that also increase the surface for absorbing nutrients and help move fluid through the tube of the intestines.  The connections or junctions between the cells lining our intestines are supposed to be very tight so that this lining acts as a barrier.  Only small nutrient molecules of protein, fat, carbohydrate, vitamins and minerals are supposed to be absorbed.  If these tight junctions loosen and gaps are formed, this can cause significant problems because it allows larger particles to be absorbed and this is called increased intestinal permeability or “leaky gut”.

Leaky gut can cause many health problems because the immune system of the gastrointestinal tract sits right behind the epithelial cells and is often referred to as the gut-associated lymphoid tissue (or GALT) and works to protect the body from invasion.  The digestive tract is an important component of the body’s immune system.  In fact, the intestine possesses the largest mass of lymphoid tissue in the human body.  Therefore, if foreign molecules or substances are passing through a leaky gut, then the immune system is going to be constantly irritated leading to inflammation and autoimmunity.

There is also a mucus layer in the intestines and colon that protects the epithelial cells from certain bacteria and help to keep the cells hydrated and the contents of the intestine moving through us so we can absorb the nutrients we need but keep the waste moving and expel it with our bowel movements.

Repairing the gut lining:

So, the fourth “R” in the Functional Medicine approach to optimal gut health is to Repair the gut lining and mucus layer.  Both must be kept optimally healthy to avoid developing or heal leaky gut.  Some of the most common supplements and foods used to repair the gut lining are:

L-glutamine: L-glutamine is an amino acid that is a building block of protein.  It is actually the most abundant amino acid in the bloodstream.  It is known for helping heal ulcers and leaky gut by acting as a protection from further damage and it Improves IBS and diarrhea by balancing mucus production, which results in healthy bowel movements

Bone Broth:  ingesting one cup daily of a broth made with chicken or beef bones will be filled with healing amino acids such as glutamine and glucosamine as well as MSM which are all going to help heal and rebuild a strong gut lining as well as help with your own joint problems.

Prebiotic Foods:   Prebiotics are typically water soluble fiber that is not digestible by the host (human) enzymes and therefore get fermented and digested by anaerobic bacteria in the colon.  The product of this fermenting by the bacteria in your gut are short chain fatty acids that are used as fuel by the enterocytes (cells lining the gut).  I had listed a number of commercial supplements and foods last week that are excellent prebiotics, but okra radishes and cabbage can also be excellent prebiotics.

Slippery Elm:  This comes from the inner bark of a specific species of elm tree and helps repair the mucus layer that is meant to protect your gut lining.  It can be purchased in a pill form or as a powder that can be added to a hot cereal or a smoothie.

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