The 4r approach to digestive healing

As the name suggests the 4R approach to digestive healing includes 4 steps, which are:

  • Remove possible pathogens and food allergens
  • Replace stomach acid, pancreatic enzymes and gallbladder secretions
  • Re-inoculate the gut with friendly bacteria and provide the nutrients they require
  • Repair the intestinal tract by providing the nutrients necessary for the repair process


It's part of a healthy balance to have some yeast and bacteria (both good and bad) in the gut. Some only become a problem when the balance is lost and they begin to overpopulate others, such as parasites which should not be in the gut at all.

The three main approaches to removing and improving bacterial balance are:

  • Starve them out - 'bad’ bacteria and yeasts crave sugar and yeast, so avoid these
  • Crowd them out - add in lots of ‘good’ bacteria (see re-inoculate)
  • Kill them - using medication (i.e. antibiotics against helicobacter pylori which is behind many cases of ulcers), food oils (such as cinnamon, garlic, grapefruit seed), herbals (such as goldenseal and pau d’arco), caprylic acid (from coconuts).

The most common food allergens are wheat, dairy, eggs and citrus. Either the suspected foods may be avoided for a month and then re-introduced in a controlled manner, watching for side effects or a test such as the York Test IgG can be done on a blood sample to give an indication on which foods to avoid.


Stomach acid is primarily needed to start the breakdown of proteins and to disinfect the food entering the body. The production of stomach acid tends to reduce with age, some people naturally produce less, and as the production of the acid requires vitamin B12 and zinc, not having enough could be due to a lack of nutrients. Indigestion can be a sign that you either have too much stomach acid or too little.

Once past the stomach it is the pancreatic enzymes secreted into the intestine that continue to break down carbohydrates, fats and proteins. if the enzymes produced are insufficient then it becomes very difficult for the body to fully digest the food and release all the nutrients. Among other reasons this could be due to stress, nutritional deficiencies or a hereditary weakness.

The gall bladder stores and excretes bile, which the liver has produced, this is used to remove hormones, broken up worn out red blood cells and other products to be eliminated, and to emulsify fats. Lecithin is an important component of bile. The emulsification of fats allows them to be efficiently worked on by lipases (enzymes that break down fats). If the liver is struggling it often shows as a poor ability to breakdown fats.

To help normalise digestive secretions:

  • Think about food! Anticipating food starts the body preparing for digestion producing saliva and enzymes.
  • Take time to relax and chew your food well. Digestion starts in the mouth, and stress switches off all digestive secretions. Learning to relax and minimise stress is vital.
  • Dilute a teaspoon of vinegar or lemon juice in a small glass of water to drink with a meal. This will help increase the acid in the stomach. Or have a salad, dressed using vinegar or lemon juice, to start your meal.
  • Eggs are a good source of lecithin. Anything that helps the liver helps the gall bladder secretions.
  • If you find meat ‘heavy’ and difficult to digest try to eat only small portions and increase your intake of easier to stomach fish, or vegetable proteins such as beans and pulses.

To calm an irritated digestive tract:

  • Cabbage juice, or more palatably, eating cabbage (green, white, red, savoy).
  • Ginger, fennel or peppermint tea, added to food or as capsules, helps to quell nausea and is anti spasmodic.
  • Omega 3 and 6 oils from seeds and fish oil are very anti-inflammatory. Soaking a tablespoon of linseeds overnight in a glass of water is soothing.

NOTE: Alcohol, coffee, high fat food, spicy food, onions and chocolate can all trigger heartburn in some people.


We are born with sterile stomachs and immediately begin to pick up bacteria from our environment. Breast milk is a great source of friendly bacteria. Antibiotics can quickly destroy not only the bad but the good bacteria as well. They have so many wonderful functions that we should be seeking out ways to get them into our guts and ensuring they are well fed once there.

Friendly bacteria is important for the following reasons.

  • Manufacture B vitamins, vitamin A and K
  • Help regulate peristalsis (movement of food through the gut) and bowel movements
  • Produce antibiotics and antifungals to act against harmful bacteria and fungi
  • Increase the number of immune cells in the gut
  • Protect against mercury, pesticides and pollutants
  • Play a role in regulating serum cholesterol and triglycerides (fats)
  • Break down worn-out and rebuild hormones

Ways to welcome friendly bacteria:

  • Fruit and vegetables provide fibre that feeds the good bacteria. FOS (fructooligosachharides) and inulin are ‘Prebiotics’ – notably good for feeding friendly bacteria. These are found in bananas, artichokes, onions, chicory, garlic, leeks, asparagus and whole rye.
  • Eat bio yoghurt containing lactobacillus acidophilus and bifidobacterium (the naturally resident bacteria in our guts) such as Yeo Valley natural yoghurt.
  • Eat fermented foods such as naturally brewed soya sauce, pickles, miso, tempeh sauerkraut
  • Drink green tea


Even with any all the bad bacteria removed, allergens avoided, secretions normalised and good bacteria replaced your intestine will still be fragile, it needs time to recuperate. Keep eating the important nutrients, lots of fruit and vegetables, oily fish, whole-grains and water while avoiding sugar, alcohol, and caffeine. For some it maybe necessary to take specific supplements especially designed for healing the gut such as Glutamine, which is the main fuel of the intestinal walls.  When the gut is robust and allergens have been avoided long enough you may find yourself able once again to eat things that used to make you feel ill.

This article has
been written by
Terry Fairclough