The 4 "R" Protocol for suspected dysbiosis

One of the Q & As in Part 2 of our interview with Cass Nelson-Dooley of Metametrix deals with the condition known as dysbiosis. Cass places a great deal of emphasis on the importance of the treatment provided by a physician for dysbiosis to be tailored to the patient's particular condition. Testing for this condition should be the first step before beginning any type of protocol to ensure that the proper treatment is being applied as opposed to further aggravating the condition.

I think the “4R Protocol” is the most general treatment advice and it’s comprehensive, but every doctor has a different approach and dysbiosis treatment should be tailored to the patient.

Question:
Is there general treatment advice for 'suspected' dysbiosis or does it vary too much ? For instance, take nystatin and metronidazole in a 'scorched earth' policy ?


Answer:

I think the “4R Protocol” is the most general treatment advice and it’s comprehensive, but every doctor has a different approach and dysbiosis treatment should be tailored to the patient.

Treatment using 4 “R” Protocol for Intestinal Health from the GI Effects Interpretive Guide

Remove offending foods, medications, gluten (if sensitive) and reduce poor quality fats, refined carbohydrates, sugars, and fermented foods (if yeast is present). Consider antimicrobial, antifungal, and/or antiparasitic therapies in the case of opportunistic/pathogenic bacterial, yeast, and/or parasite overgrowth (see below for specific recommendations).

Replace what is needed for normal digestion and absorption such as betaine HCl, pancreatic enzymes, herbs that aid in digestion such as deglycyrrhizinated licorice and marshmallow root, dietary fiber, and water.

Reinoculate with favorable microbes (probiotics such as Lactobacillus sp., Bifidobacter sp., and Saccharomyces boulardii). To enhance the growth of the favorable bacteria, supplement with prebiotics such as inulin, xylooligosaccharides, larch arabinogalactans, beta glucan, and fiber.

Repair mucosal lining by giving support to healthy intestinal mucosal cells, goblet cells, and to the immune system. Consider L-glutamine, essential fatty acids, zinc, pantothenic acid and vitamin C.

---

Additional Reading:

Gastrointestinal Dysregulation: Connections to Chronic Disease, a monograph, 2008, available from the Institute for Functional Medicine, www.functionalmedicine.org
authors: Leo Galland, M.D. with Helen Lafferty

Adapted from Lukaczer D. The “4R Program” in Jones DS, ed. Textbook of Functional Medicine, Gig Harbor, WA: The Institute for Functional Medicine

http://www.healthy.net/scr/Article.asp?Id=425&xcntr=1