By Dr. Lina Sakr

Medical conversations about gut health often revolve around diet and food intake – a natural starting point when it comes to a complex digestive system that requires coordination among the esophagus, stomach, liver, gallbladder, pancreas and small and large intestines.

More broadly, gut health plays a prominent role in one’s overall health and wellness, with gut bacteria and other microbiomes impacting cardiovascular health, obesity levels, diabetes, cancer and other chronic conditions.

Worse, a leaky gut (increased intestinal permeability) can lead to more serious disorders like chronic fatigue, brain fog, arthritis, and allergies.

And a growing body of research into the “gut-brain axis” shows that digestive issues have been linked to mental health disorders such as anxiety and depression.

A 360-degree approach

The symptoms of digestive illness often present as abdominal pain, acid reflux, cramps, bloating, nausea and more.

In functional medicine, we take a more holistic approach by considering the patient’s overall health, lifestyle and diet when developing a treatment plan, including a series of lab tests that help provide a 360-degree view of the symptoms on display.

We will enlist a comprehensive stool analysis to assess gastrointestinal health, including a test for the presence of intestinal permeability, or “leaky gut,” which can sometimes be identified by elevated levels of the protein Zonulin in blood or stool tests.

Gut-healthy diets

Dessert Jars with RaspberriesWhile diet is just one piece of the healthy gut puzzle, it’s an essential one. Here are a few gut health, dietary best practices:

  • eat whole foods high in fiber, such as fruits, vegetables, nuts, seeds and legumes
  • eat foods high in probiotics: yogurt, vinegar, sauerkraut, kimchi and other fermented foods
  • limit sugar intake
  • follow a variation of the Mediterranean diet, which is rich in antioxidants, anti-inflammatories and high in fiber. Staples of this diet include olives and olive oil, whole grains, little to no red meat.
  • reduce or eliminate processed food, which is high in sugar, unhealthy fats and artificial ingredients, including soda and other sugary drinks.

Food allergies or other insensitivities can also adversely impact gut health. Conversely, talk to your medical professional about the potential need for dietary supplements, such as those that boost fiber, or magnesium, which has also been shown to benefit gut health.

The 5R Framework

When it comes to digestive health, functional medicine specialists rely on what is known as the 5R Framework: Remove, Replace, Re-inoculate, Repair and Rebalance.


Identify and remove any food or substance that might be causing inflammation or dysbiosis (a microbial gut imbalance), through either a food elimination plan and/or a comprehensive food sensitivity test.


This step involves replacing missing nutrients or digestive enzymes through the use of supplements such as digestive enzymes, bile salts or stomach acid, based on an individual patient’s test results.


Repopulate the gut with beneficial bacteria, by using proper probiotics and fermented food.

This will restore the balance of the gut microbes and improve digestion, immunity and overall health.


Repair any damage to the gut lining, such as through the use of L-glutamine, zinc and other supplements that help repair and maintain the gut lining. We also recommend a proprietary supplement from the Naples Center for Functional Medicine that includes glutamine, an amino acid that is the predominant fuel and nitrogen source for the gastrointestinal tract’s mucosal lining.


This involves lifestyle choices, such as increased sleep and exercise and more effective stress management, all of which can affect the gut health.

Healthy gut, healthy life

People Walking on the Street while Holding Tumblers Remember, gut health isn’t just about your diet but in fact is often a marker for one’s overall health. And as we get older, it’s even more vital to actively embrace a healthy gut – and take the necessary steps to maintain that health, beyond just popping a pill.

About the author:

Dr. Lina Sakr is a board-certified internal medicine physician at Naples Center for Functional Medicine with nearly 40 years of experience. She specializes in metabolic and nutritional medicine, anti-aging medicine and women’s health.

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