Many many years ago I was taught the four R’s of digestion.
It went something like
Remove (bad bugs)
Replace (digestive acid/enzymes)
Re-inoculate (good bacteria)
Repair (the gut lining)
And it is still used by me and many other practitioners to some extent, though our understanding out of the gut microbiome from when I started 2001 is completely different.
But in 2007 I was sat in the offices of Metametrix labs (subsequently sadly bought by Genova) with a man called Tony Hoffman (who went on to set up Diagnostic solutions, who sell the GI-MAP stool test).
We were discussing whether or not Rick Carr-Hyde and I would take on the UK distributorship.
He had recently developed the first commercially available DNA (PCR) based stool test.
He explained that 95% of the gut microbiome is anaerobic, so trying to culture the bacteria once they’d left gut is impossible.
They simply die when exposed to oxygen.
This was all something of a revelation to me.
Turns out lactobacillus and bifidobacteria, whilst important may not be the centre of the gut universe.
He then dropped in casual comments that stayed with me forever, it went something like this:
“You can do a stool test and measure the lactobacillus as low, then prescribed probiotics and retest seeing raised levels. This shows you have re-inoculated the bowel”
Sweet I thought, yes I know this, back onto safe ground.
Then he went and rained on my parade.
“but if you waited one month after you stop the probiotic and retested them, they will all have gone”.
Me: “ahhh, OK, really?, yes of course, obviously…..hmmmm“
My body language is saying WTF Tony, but I have managed to tilt my head in feigned interest/gentle surprise, yet trying to look accepting and knowledgable at the same time.
Internally, of course, it’s actually: F**k off Tony, you’re sh**ing on my parade here pal.
He was saying the idea of “re-inoculation” subconsciously suggests the bacteria within the probiotic take up residence in the bowel.
Then start having babies live happily ever after. Forever keeping your immune robust but not too frisky.
This it turns out, is utter bollocks.
If you buy a good probiotic that actually makes it to the colon, they will dead and gone within 2 to 3 weeks.
They can still do awesome things while they are there, but they are gone in weeks.
Bear in mind also that we have 100 trillion bacteria in our gut (ish and depending on who you read).
Lactobacillus make up 1% of your total gut microbiota if you’re healthy.
1% – think about that.
What about the other 99 trillion?
This doesn’t mean they don’t have a role to play therapeutically, because they certainly have significant clinical effect if the correct strain is used for the correct condition.
But it does mean if we want a healthy 100 trillion we need to feed our own gut bacteria.
These frisky little beasts will replicate en masse without having sex (boooo)
But they need feeding prebiotics.
They need as diverse a range of plants and colours as you can manage, as we say “eat the rainbow”.
The colours are polyphenols which we can’t breakdown but they can.
The fibre we can’t break down, they can and they love it.
Remember the resistant starch from a few weeks ago?
White rice/potato boiled and cooled, the starch is resistant to our digestive juice, so it arrives in the colon and your bacteria love it.
This is where a good vegan gets its right, they eat tons of plants.
Note to vegans, eating processed junk food with no meat or dairy in it, is still a processed junk food diet with massive health risks, it’s just free from meat & dairy – deal with it.
With ingredients like this, why would you want to eat dairy free “cheese”.
Point being, diverse foods of more than 30 different plants a week, means diverse food and thus diverse bacteria population.
If you want to try some supplemental prebiotics try partially hydrolysed guar gum, it’s generally very well tolerated.
You have to be cautious with supplemental prebiotics, once bacteria starting feeding and multiplying they make gas – hydrogen and methane.
Think bloating and extreme flatulence.
So always start those low and slow.
Action to take today:
If you want high quality and clinically researched probiotic for general gut health/IBS type stuff (I hate the term IBS but I guess its a convenient frame of reference) try the Lab4 strains by Proven Probiotic, also available in some Biocare products.
You can get those via
For prebiotics try GI restore by BioMedica, you can get it via
As always, don’t waste those valuable adjustments.
PS: This was taken from the microbiome section of the Core Concepts in Chiropractic Nutrition, it’s still work in progress, but I am soooo excited to be getting this stuff out to more people via all you lovely Chiropractors in the new year.