_{A gut repair blend of herbs to use with this gut repair programme.} 

_{Ingredients: marshmallow root*, calendula*, licorice root*, chamomile* & ginger* *Organic 50g}

The 4R Program for Gut Healing

To simplify the process of healing the gut, I teach my clients the 4R program. It takes about 4-12 weeks and it looks like this:

Remove: In this you’re removing food triggers and microbiota that have become overgrown This is done with an “Elimination Diet,” (I prefer a Basic Healing Diet now rather than Elimination which sounds like you’re losing something, rather than exploring how food affects you) and consists of 4 to 6 weeks of eating a simple diet from which you have removed the most common food triggers including gluten, sugar, dairy, eggs, soy, coffee, soda, and artificial ingredients - as well as anything you typically crave (i.e., sugar, carbs, salty snacks). In Ayurveda and Traditional Chinese Medicine they typically eat warm easy to digest foods at this stage.

Ideally, also many medications would be stopped, especially reflux medications, NSAIDS (ibuprofen, etc.), and antibiotics - but make sure this is medically cleared with your primary care provider! For reflux, DGL licorice is a great alternative to PPIs and H2 blockers. It safely heals the stomach without the potentially serious adverse effects of the above medications. However, this should be done with appropriate medical    guidance/supervision, and not if the medications are truly necessary. The blend Avipattikara can be taken as capsules with meals and also works well for reflux https://www.totallynaturalskincare.co.uk/collections/ayurveda/products/avipattikara

The elimination diet takes little bit of planning and coordination but it is simple and makes a huge difference. Carefully done, this can also be safe for pregnant and breastfeeding women. When a client/patient has or is struggling with an eating disorder, disordered eating (orthorexia) or body dysmorphia, the elimination diet should also be done with great care.

Constipation is cleared up in this phase for further gut healing to be effective. Plenty of fibre from fresh vegetables and ample water are important. Supplements such as flax seed, psyllium, triphala (1/2 tsp. or 2 capsules at bedtime) https://totally-natural-skincare.myshopify.com/products/triphala?_pos=1&_sid=dd67bb85a&_ss=r and magnesium citrate are safe for most people to take daily. The goal is one healthy BM every day. See the Bristol Poop Index online.

Additionally, you are removing/reducing overgrowth of organisms in the microbiome that have become problematic or pathogenic. This is done with a combination of herbs, taken for 2 to 12 weeks, that include one of the berberine containing herbs, a blend such as https://totally-natural-skincare.myshopify.com/collections/herbs-of-grace-formula/products/fung-cand-formula?variant=4002089861143 or our paracleanse tincture https://www.totallynaturalskincare.co.uk/collections/blended-herbal-tinctures-syrups/products/paracleanse-tincture, they are contraindicated in pregnancy. I use proprietary products in my practice which can be found in my online formulary. These herbs are contraindicated in pregnancy.

Replace: After 1-2 weeks on the Elimination Diet, you begin to replace the nutrients and factors the gut needs to support a healthy microbiome, which includes high quality fats, and making sure to continue to emphasize fibre. Olive oil, ghee which is rich in n-butyrate, and avocados are excellent choices, and ensure up to 8 servings of fruits and veggies daily. If there is evidence of low digestive enzyme function, consider adding in a digestive enzyme product, although there is scant evidence for these for most people for routine use. This is safe for pregnant and breastfeeding women.

Reinoculate: After another week, add in a daily ‘dose’ of lacto-fermented foods (yogurt, sauerkraut, kimchi, lactofermented veggies, miso, etc.) if needed, a good quality probiotic. This is safe for pregnant and breastfeeding women.

Repair: The following supplements can now be taken for about a month (up to 6 months in more extensive cases) to help to heal the intestinal lining:

• Turmeric, marshmallow root, slippery elm and licorice are some of the most effective herbs for healing the gut lining. Licorice is not for use in pregnancy; turmeric only as a regular seasoning spice, not in medicinal doses https://www.totallynaturalskincare.co.uk/collections/herbal-capsules/products/turmeric-ginger-capsules
• Gut Restore Tea: Prepare and drink 1 cup of the tea 3 times per day.
• Zinc carnosine: 75 mg/day
• A multivitamin containing vitamins A and beta-carotenes, C, E, and selenium. Pregnant women should get these from their prenatal vitamin only, and should not supplement these additionally.
• Fish oil / Flax Oil: Anti-inflammatory, provides healthy fats for the gut
• L-Glutamine Powder: 5-10 g of powder twice daily for one month. (Not for use in pregnancy).
• PLUS! Rebalance: Pay attention to lifestyle choices – sleep, exercise and stress can all affect the GI tract. Reduce stress, Practice sleep hygiene, Exercise more, Do yoga, Meditate, and Spend time in nature.

A useful article about the elimination diet https://avivaromm.com/elimination-diet/

Do not take in pregnancy, if taking medication seek professional advice.