The 4 R's of Digestive Healing

Naturopathic doctors believe that optimal digestive health is an important foundation for good overall health.

The 4 R’s for Digestive Healing is a comprehensive and tailored approach to addressing health concerns when gut health is at the root or along the way.

  • Remove – Remove the irritators – e.g. blood test for food sensitivities (up to 220 different foods), and stool test for dysbiotic microbes (can test for over 1400 different bacteria, parasites, candida/yeast, SIBO, and other bad “bugs” in the digestive tract).
  • Replace & Restore function – Improving digestive enzymes for optimal nutrient absorption/digestion and establishing healthy bowel movement patterns.  
  • Reinoculate – With probiotics and prebiotics (stool testing can help individualize which probiotics you are deficient in and which you are sufficient in to create microbiome balance).
  • Repair & Replenish – the “leaky gut” with specific nutrients, fibres, and plant-based herbs. Also, replenish any nutrient deficiencies caused by improper digestion or absorption of foods.

When healing the digestive tract, each of these R’s are addressed individually, and I find the best results are seen when they are dealt with in this order. It is less effective to repair the digestive tract if you are still eating foods that you are sensitive to on a daily basis or if your gut contains microbes that are continually irritating the lining of your digestive tract.

We also like to explain this as: imagine a sink that is overflowing with water all over the floor and you were the only one around to clean it up. What would you do? You could mop up the extra water all day long (i.e. repairing the gut), or you could address the cause of the spill and turn off the tap (i.e. removing food sensitivities), and then mop up the remaining mess (i.e. repairing the gut). It's also a good idea to look at the reasons why it was so easy to overflow so you can unclog any blockages in the drain (i.e. restoring proper digestive function and reinoculating with healthy probiotics). So that's how all of those fit together, and why the order is so important! 

I try to get my patients to look beyond the miracle cures and miraculous therapies and, instead, use a systematic approach to address their unique imbalances.

Why Testing?

I see a lot of patients who have tried probiotics or other digestive supplements but without much benefit. However, when testing, I often find an unaddressed irritator (e.g. food sensitivities, microbe imbalance).  And only after removing the irritator, then do the other digestive supports work more effectively. 

After testing, I often find that the person was taking the wrong probiotic for their microbiome balance. Or I find that an irritating microbe (bacteria, yeast/candida, parasite) is blocking the regrowth of their good probiotic bacteria. I view these irritating microbes like weeds on a lawn, and consider probiotics like grass seeds. If their lawn has been overgrown with weeds (i.e. irritating microbes), then even if you throw grass seeds (i.e. probiotics) all day long at the weed field, it will be hard for the grass seeds to kick out the weeds and grow a healthy lawn. Luckily, stool testing does sensitivity testing on any irritating microbes detected and shows us exactly which natural products would be best to pull out your specific weed. I find this individualized approach produces the best patient outcomes.    

As you can tell, I love testing. I find that testing helps streamline the plan specific to the patient. It helps rule in and helps rule out the underlying causes. Similar to stool testing, I find blood testing for food sensitivities can be invaluable in helping determine the hidden food irritators. I don’t believe in telling someone to go gluten-free or dairy-free without testing. These foods can be a healthy part of a person’s diet. However, if found to be a hidden irritator through testing, I usually recommend cutting out that specific food for 1-3 months. Also, I don’t believe that food sensitivity reactions should automatically mean that the person must avoid that food for life. At the end of the three months, I usually recommend a reintroduction/challenge of that food back into their diet (reintroduced in a specific way). I find that if you address the other 4Rs at the same time as removing the irritator, there is a greater chance of being able to add that food back into the person’s diet without any further irritation.  However, for patients that have done all the 4Rs, but react whenever they try adding those harmless foods back into their diet, I sometimes suggest a 5th R of digestive healing (Reset). I received training in Low Dose Allergen (LDA) therapy, which is micro-injections every 7-8 weeks, to help retrain the immune system to not react to harmless foods. But this is a conversation for another day!

These “4 Rs for digestive healing” can be used for more than just digestive complaints! For example, when naturopathic doctors see a patient coming in with skin complaints, they think of healing the patient from the inside out and usually start optimizing gut health. In fact, naturopathic doctors typically find gut health plays a role in the underlying cause of many conditions including hypothyroidism, asthma, migraines, skin conditions, joint pain, or any other condition related to inflammation or immune reactivity. Naturopathic doctors conduct a comprehensive initial visit to determine all contributing factors affecting your health and all obstacles preventing you from healing.


If you found this helpful, you can book with Dr. Nicholas Anhorn, ND in our Moncton clinic by clicking here!


In health, 



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