Gut Repair-4™ Program (IBS-D)
A doctor-formulated, 28-day clinical protocol for diarrhoea-predominant IBS. Targets the Proteobacteria overgrowth driving endotoxin release, repairs the leaky gut barrier, and rebuilds the protective species that calm urgency and restore stool consistency. Drawn from 30 years of clinical practice and the latest microbiome research.
IBS-D is a gut barrier problem before it's a motility problem.
Urgency. Frequency. Loose stools. Cramping. The hallmark symptoms of IBS-D aren't a motility disorder in isolation — they're the downstream consequence of a distinctive microbial imbalance and a compromised gut barrier.
Proteobacteria overgrowth — gram-negative, endotoxin-producing bacteria including E. coli and Veillonella — is the most consistent finding across IBS-D studies. These organisms release LPS endotoxins that drive systemic inflammation. Combined with a serotonin transporter (SERT) that's significantly downregulated, serotonin lingers in the gut wall and drives excessive peristalsis, increased secretion, and amplified pain.
Add the 57% biofilm prevalence, the 80% rate of widened tight junction gaps, and the 25-33% of patients with bile acid malabsorption — IBS-D is fundamentally a microbiome and barrier problem. And the microbiome is where it must be solved.
Two phases. Twenty-eight days. Four mechanisms.
Pathogen + Biofilm Eradication
NAC biofilm disruptor + dual herbal antimicrobials
57% of IBS patients harbour mucosal biofilms — bacteria inside these structures are 10–1,000× more resistant to antimicrobials. NAC strips the biofilm's protective matrix. A berberine-based herbal blend plus an enteric-coated essential oil capsule then deliver broad-spectrum antimicrobial coverage via two complementary delivery systems — targeting the Proteobacteria, E. coli, and Veillonella overgrowth characteristic of IBS-D.
Phase 1 — strip biofilms and suppress endotoxin-producing pathogens.
Endotoxin Neutralisation
Serum-derived bovine immunoglobulin (>50% IgG + IgA, IgM)
Gram-negative bacteria release LPS endotoxins that drive the leaky gut barrier and systemic inflammation underlying IBS-D. These immunoglobulins bind LPS directly inside the gut lumen — neutralising them before they translocate across the compromised barrier. In a randomised, double-blind trial, IBS-D patients on daily SBI experienced significant reductions in days with loose stools, abdominal pain, and urgency.
Phase 1 — neutralise the toxins driving urgency and diarrhoea.
Multi-Strain + Therapeutic Yeast
25B CFU 3-strain probiotic + S. boulardii (500mg)
L. acidophilus NCFM induces μ-opioid and CB2 receptors in intestinal epithelium for natural analgesic effect. L. rhamnosus GG normalises ZO-1 and occludin tight junction proteins. Saccharomyces boulardii — a therapeutic yeast unaffected by antibacterials — was significantly efficacious in 84% of treatment arms across 27 RCTs (5,029 patients), halving diarrhoea prevalence in IBS-D specifically.
Phase 2 — restore barrier integrity and halve diarrhoea prevalence.
Butyrate-Producer Restoration
Livaux kiwifruit + Pomella pomegranate + digestive enzymes
F. prausnitzii — the gut's primary butyrate producer — cannot be supplemented; it must be fed. Livaux gold kiwifruit doubles F. prausnitzii abundance (3.4% to 7.0%, p=0.024). Pomella pomegranate provides ellagitannins that gut bacteria convert into urolithin A — a postbiotic that strengthens tight junctions. Digestive enzymes address the bile acid malabsorption present in 25-33% of IBS-D patients.
Phase 2 — feed the butyrate producers your gut is missing.
Backed by the gut-brain axis.
From urgency to stool consistency restored.
Diagnostic test + Microbiome Doctor consult.
Complete your gut microbiome test. A Microbiome Doctor reviews your results, identifies whether bile acid malabsorption or specific pathogen overgrowths are present, personalises the protocol, and — where indicated — prescribes targeted antibiotics to complement the herbal antimicrobials.
Phase 1 — Eradication.
Biofilm disruptor (NAC) strips protective layers from pathogenic bacteria. Two complementary herbal antimicrobials kill exposed Proteobacteria, E. coli, and biofilm-forming organisms. Immunoglobulin powder binds and neutralises the LPS endotoxins released during die-off — the primary driver of leaky gut in IBS-D. Strict Low FODMAP diet keeps the inflamed gut quiet.
Phase 2 — Rebuild.
Multi-strain probiotic (25B CFU) restores tight junction integrity and produces natural analgesic effects via opioid receptor signalling. Therapeutic yeast (S. boulardii) cleaves bacterial toxins, halves diarrhoea prevalence, and remarkably increases F. prausnitzii abundance. Kiwifruit + pomegranate prebiotic blend feeds the butyrate producers. Digestive enzymes address bile acid malabsorption.
Maintain.
Transition to the Gut Maintain probiotic for a minimum of 6 months. Supplemented probiotic strains decline to baseline within 7-10 days of cessation — daily maintenance is the difference between a temporary improvement and lasting recovery. Continue the GutBiome Restore Diet principles with guided FODMAP reintroduction.
Re-test your microbiome.
Repeat your gut microbiome test to objectively validate diversity gains, confirm Proteobacteria reduction, and decide whether continued intervention is warranted. Bristol stool chart improvement from Type 6-7 (loose, watery) to Type 3-4 (smooth, soft) plus reduced urgency is the primary clinical marker.
Questions, answered.
Who is this protocol for?
Adults with diarrhoea-predominant IBS (IBS-D) — clinically diagnosed or self-identified based on Bristol stool chart Type 6-7 (loose, watery), 3+ bowel movements per day, urgency, post-prandial cramping, or post-infectious IBS following gastroenteritis. Also appropriate for patients with suspected bile acid malabsorption, food sensitivity flare patterns, or those who have not responded to standard low-FODMAP advice or loperamide.
Do I need a Microbiome Doctor consult before starting?
Strongly recommended. A consult provides three things: a personalised review of your gut microbiome test (identifying Proteobacteria dominance, bile acid malabsorption, or specific pathogen overgrowth), a protocol calibrated to your findings, and — where indicated — a prescription for targeted antibiotics to complement the herbal antimicrobials. The protocol is designed to be used alongside clinical oversight.
Will my diarrhoea get worse before it gets better?
Possibly — yes. A Jarisch-Herxheimer (die-off) reaction can occur in the first 3-7 days of Phase 1 as pathogens are killed and endotoxins released. Some patients see a temporary worsening of urgency, increased bloating, or fatigue. The immunoglobulin powder is specifically included to bind and neutralise these endotoxins. Contact the clinic if diarrhoea is significantly worse than baseline beyond 10 days, or if you experience any concerning reaction.
Can I take this with my IBS-D medications?
Generally yes. No dangerous interactions have been documented with common IBS-D medications — loperamide (Imodium), antispasmodics (Buscopan, Colofac), tricyclic antidepressants used for IBS, or PPIs. Berberine in the herbal antimicrobial blend may interact with the P450 enzyme system, so disclose all supplements to your prescribing doctor. Separate supplement intake from prescription medications by 1-2 hours.
Can I take this if I'm pregnant or breastfeeding?
Please consult your treating doctor before starting. Some components — including concentrated essential oils, berberine-containing herbs, and wormwood — carry pregnancy advisories and are not recommended during pregnancy or breastfeeding. The immunoglobulin powder, S. boulardii therapeutic yeast, and digestive enzymes are labelled pregnancy-safe but should still be cleared with your doctor.
Are there any allergens I should know about?
Tree nuts: The herbal antimicrobial blend contains Black Walnut hull — avoid if you have a tree nut allergy. Bovine: The immunoglobulin powder is derived from bovine sources — avoid if you have a dairy allergy (lactose intolerance is typically fine, this product is very low lactose). Sulphites: The enteric-coated essential oil blend contains sulphites and bovine gelatin. Review allergen labels before starting.
How long until my bowel movements normalise?
Most patients see early urgency reduction in Week 1, more substantial stool consistency improvement in Weeks 3-4 as Phase 2 probiotics and S. boulardii take effect. The goal is Bristol Type 3-4 (smooth, soft, sausage-shaped) — IBS-D patients typically present at Type 6-7 (loose, watery). Full microbiome rebalancing takes the complete 28-day program plus a minimum of 6 months on the maintenance protocol. Dr Froomes also recommends an extended 4-12 week synbiotic course for deeper sustained results.
Do I have to follow a Low FODMAP diet forever?
Emphatically no. Monash University's Low FODMAP protocol is a three-phase medical tool — strict elimination should last only 2-6 weeks. Long-term restriction reduces Bifidobacterium populations and harms microbial diversity (FODMAPs are themselves prebiotics). Phase 2 of the program runs structured FODMAP reintroduction so you discover your specific triggers, then expand to the broadest, most diverse diet your gut can comfortably handle.
Important — general advice only. Information presented on this page is general health information and is not personal medical advice. Always consult your treating practitioner before starting any new supplement, particularly if you are pregnant, breastfeeding, immunocompromised, or taking prescription medications.
Allergens: The herbal antimicrobial blend contains Black Walnut hull — avoid if you have a tree nut allergy. The immunoglobulin powder is derived from bovine sources — avoid if you have a dairy allergy. The enteric-coated essential oil blend contains sulphites and bovine gelatin. Some components carry pregnancy advisories and are not recommended during pregnancy or breastfeeding.
These products are listed complementary medicines and are not intended to diagnose, treat, cure, or prevent any disease. The Microbiome Clinic has no commercial affiliation with any specific supplement brand included in this protocol — supplements are selected on the basis of clinical evidence alone, in line with the Microbiome Clinic Independence Guarantee.