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.
  • Lauren Pallija

    Hey Dr. Lipman, I just bought olive leaf extract so that I can get rid of the bad bacteria in my gut. I wanted to ask you how long I need to do this before introducing probiotics. Thanks!

  • Svetlana

    Hi there, where I can buy this 4 R program?