The 4R Program To Promote Gastrointestinal Health

The 4R Program to promote gastrointestinal health, developed by Jeffrey Bland, Ph.D., and his associates at the Functional Medicine Institute, is an extremely effective way to address and treat gastrointestinal dysfunctions and promote gastrointestinal health. It is a simple four-step program, and it is what I use with my patients:

The program simplifies the complex interactions in gastrointestinal health by asking four questions:

  1. What needs to be REMOVED?
  2. What needs to be REPLACED?
  3. Does one need to RE-INOCULATE with probiotics?
  4. Does the intestinal lining need to be REPAIRED?

Step 1: Remove

  • Toxins in food
  • Gastric irritants (e.g., caffeine, alcohol, and non-steroidal anti-inflammatory drugs)
  • Food allergies, sensitivities, or reactions
  • Chronic low-grade infections in the gut (e.g., yeast and parasites)

Step 2: Replace

  • Stomach acid (or stimulate stomach acid with bitters)
  • Digestive enzymes

Step 3: Reinoculate

  • Restore beneficial bacteria to reestablish a healthy balance of microflora in the gut.

Step 4: Repair

  • Provide nutrients to heal the gut wall or lining.
  • Support the immune functioning of the gut.
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