• Danielle Cheplowitz, CRNP

Step 1: Remove. Why fixing your gut first will cure almost all of your other ailments.

Updated: Dec 10, 2019

Gastrointestinal health is the key to unlocking the doors of chronic disease. It is one of the main components in functional medicine, and always where I start with my clients. This concept is gaining more traction, as evidenced by all of the supplements and probiotics emerging onto the market in multiplying numbers. While supplements definitely have their place— *spoiler alert*— they are not always needed to have great results. Over these next five blog posts, I will share with you how you can improve your gut with food and by tweaking the lifestyle choices you make every single day.

When looking to improve gastrointestinal health, we must first stop the influx of negative influences. This is the most fundamental step because we can make a huge impact on our gut health just by removing triggers. There are four areas that should be considered when we think about removing triggers; food, pathogens, environmental toxicants, and stress. I will go into each section in more detail below.


This one is really specific to each individual. In my personal opinion, there is no one diet that can be applied to everyone. What works for me might not work for you. Each person is at a different time in their lives, going through different circumstances, has different genetics, lives in different conditions, and responds to emotional stimuli differently. We all do not look the same or act the same, so why should we eat exactly the same? Some individuals may also require a few different styles of diet/eating throughout their lives as their environment & epigenetic inputs change.

That being said, I believe that there is a simple, raw template in which everyone should follow: eating whole & unadulterated foods. This means eating food that is not processed, and does not have any additives, preservatives or chemicals. Eating as close to nature is the best policy here. There are some food additives that are likely wreaking havoc on our gastrointestinal systems. One study found that sodium benzoate, sodium nitrite, and potassium sorbate can act as antimicrobial properties (aka antibiotics), and are reducing the amount of healthy bacteria that line our intestines. The reduction of healthy bacteria can cause an imbalance, leading to compromised immunity and increased inflammation (PMID: 30656592).

Some folks may have certain food allergies, intolerances, or sensitivities in which they may need to avoid. This could be temporary or life-long. Food sensitivities typically arise when there has already been damage to the gastrointestinal lining. Once the gastrointestinal tract lining is compromised, certain food particles can pass through into the blood stream causing the immune system to respond inappropriately, targeting the food particles and creating immunoglobulins (antibodies) to them. This is also known as “leaky gut”. Removing certain trigger foods temporarily and then reintroducing them back into the diet once the gut lining has healed is the first step to reversing leaky gut.


I have already said that we have bacteria living in our gastrointestinal tract, and that they are essential for life. However, not all bacteria are created equal. When we have good bacteria, we also have “bad bacteria” or pathogenic bacteria. When there is an imbalance in the microbiome and the pathogenic bacteria supersedes the beneficial bacteria, symptoms and illness can arise. Other pathogens aside from bacteria include fungi and parasites. Fungi is also another NORMAL inhabitant in our gastrointestinal tract, however, when the beneficial bacteria counts reduce, the fungi can become overpopulated. Some of you may also know this term as “candida”.

In order to know what pathogens to remove, it is most helpful to test. Conventional stool tests are available to identify the common and the most debilitating parasites and bacteria. Other specialized stool testing can be utilized to identify the bacteria, parasites, and fungi that may not cause exaggerated symptoms initially, but can become cumulatively problematic over long periods of time. Treatment for these pathogens may include herbal or botanical preparations, or in some instances, pharmaceutical formulations.

Environmental Toxicants

While we cannot ever be “toxin free” , we can most definitely reduce our toxic burden. Our livers are designed to detox us every second of every day…that’s its job. Over time, however, our liver can become overly taxed and may not function optimally. This can further contribute to hormone disruption, autoimmune conditions, and other chronic diseases. In addition to stressing the liver, environmental toxicants can also contribute to leaky gut syndrome by disrupting our beneficial bacterial/healthy microbiome. One of the biggest culprits is BPA (Bisphenol A). In an animal study, BPA was shown to lower the amount of short chain fatty acids (SCFA) in the gastrointestinal system. This lead to intestinal permeability (leaky gut), and increased inflammation (PMID: 29034330). SCFAs are needed to feed the healthy bacteria. We get SCFA from fiber, specifically soluble fiber found in plant foods. When the levels of SCFA are low, the beneficial bacteria needed to protect and maintain the gastrointestinal integrity will also decrease.

While we cannot live in the bubble and avoid all toxicants, we can significantly reduce our exposures. The most common toxicants that have been shown to disrupt the body’s natural processes include Bisphenol A, Phthalates, PCBs, Perfluorinated Chemicals (PFOA/PFOS), Organophosphates, and Dioxins. Some of the easiest and most effective ways to reduce your exposure to is avoid the use of plastic with any food or beverage, take off your shoes when entering your home, dust and vacuum often, avoid canned foods and beverages, and choosing wild caught seafood, organic produce, & pasture-raised/grass fed animal products (PMID: 18075622).


This is a biggie, and often the most difficult one to put into application. You can remove everything that I listed above, eat the most amazing diet and live in the greenest, cleanest environment, but if you cannot remove some stress from your life, your gut will not be able to fully heal. When mental, emotional, or physical stress is perceived, the body will release the hormone cortisol. The body uses cortisol to keep itself alive— it is the flight or fight response. This is perfectly normal and sometimes needed when it is elevated temporarily/briefly. Chronically elevated cortisol levels will lead to immune suppression and/or increased risk for infection, dysfunction and disease. When speaking specifically to the gut, elevated cortisol has been shown to impair digestion. When digestion is impaired, food may not only be poorly dissembled and absorbed, but the lining of gut can actually start to break down, resulting in intestinal permeability (PMID: 29276734).

One of the best ways to reduce stress is to change how one perceives stress. This is called neuroplasticity, and we can actually change the hard-wiring of our brains to think differently. It takes continued and consistent practice in order to make this change. Some great ways to reduce stress include meditation, walking, yoga, singing, acupuncture, resting/sleep, journaling, gratitude practice, and partaking in other activities that you enjoy.

So there you have it---four different areas to assess when considering the removal of triggers to improve gastrointestinal health. Next time I will talk about step number 2: Replace. See you next week!

**This post is for educational purposes only and is not intended to act as or replace medical advice. Always seek medical advice from your own practitioner. **


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mSystems. 2017 Oct 10;2(5). pii: e00093-17. doi: 10.1128/mSystems.00093-17. eCollection 2017 Sep-Oct. (PMID: 29034330).

Neurobiol Stress. 2017 Dec; 7: 124–136. (PMID: 229276734).


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