PART II
The DIGIN Model and the 5 Rs

In conventional medicine, a clinician makes a diagnosis and there are standard therapies for each diagnosis. In functional medicine, there is no cookie-cutter approach. Finding the underlying mechanisms of disease rather than focusing on symptom relief is the goal. Two people with the same diagnosis may need completely different therapies. At the same time, two people with completely dissimilar diagnoses may benefit from the same therapy. For example, irritable bowel syndrome, migraine headaches, attention deficit disorder, and fibromyalgia may seem like different diagnoses, but they may all have the underlying cause of leaky gut syndrome or food intolerances. On the other hand, three people with irritable bowel syndrome could have completely different underlying causes, including small intestinal bacterial infection, a deficiency of protective bacteria, too little fiber, food sensitivities, lactose intolerance, celiac disease, imbalances in neurotransmitters, or stress-induced IBS, to name a few.

So how do we begin looking for underlying mechanisms? I call it the DIGIN approach. In the following chapters we’ll explore each aspect of this model (see Figure II.1). I consider this section to be the heart of the book. No matter what the diagnosis, there is probably some aspect of this model that will help bring you back into better balance.

THE DIGIN MODEL FOR ASSESSMENT OF DIGESTIVE ISSUES

DIGIN is an acronym for the five primary categories of digestive imbalances:

Digestion/absorption

Intestinal permeability

Gastrointestinal microbiota

Figure II.1 The DIGIN model.

Immune function and inflammation

Enteric nervous system

By assessing each of these areas, you can discover how to best get your body back into balance.

THE 5 RS

The principles of repair in functional medicine are fairly simple. As one of the pioneers in the field, Sidney Baker, M.D., said: Get rid of what you don’t need, and get what you do need. The 4 Rs were originally put together by Jeffrey Bland, Ph.D., and Metagenics. Recently at the Institute for Functional Medicine, we’ve updated this to the 5 R Program, which includes:

Remove: Nutrient-depleted food, processed foods, poor-quality fats and oils, parasites, metals, infections, foods that don’t agree with us. This is the critical first step.

Replace: Processed foods with whole foods, nutrients, digestive enzymes, hydrochloric acid, bile salts.

Reinoculate (Repopulate): Beneficial probiotics and prebiotics from food and supplements.

Repair: Using foods and supplements such as glutamine, gamma-oryzanol, duodenum glandular, N-acetyl glucosamine, fiber, boswellia, geranium, licorice, quercetin, goldenseal, wormwood, aloe, celandine, cranesbill, marshmallow root, rice protein powders, essential fatty acids, okra, cabbage, fasting.

Rebalance: Stress management, improved sleep habits, exercise and movement, changes of attitude and belief systems. Come to a new sense of who you are. Accept that and regroup your lifestyle to promote a healthier way of living and being.

The 5 Rs are sprinkled throughout this section of the book and continue in Part III, “Coming Back into Balance.”