What is GAPS?

Gut ad Psychology Syndrome and Gut and Physiology Syndrome

The term GAPS, abbreviated from Gut and Psychology Syndrome was created by Dr Natasha Campbell-McBride MD, MMedSci (neurology), MMedSci(human nutrition) in 2004 after working with hundreds of children and adults with neurological  and psychiatric conditions, such as autism spectrum disorders, ADD/ ADHD, schizophrenia, dyslexia, depression, obsessive-compulsive  disorder and other neurological and psychiatric problems.

Since then the term GAPS has been extended to incorporate Gut and Physiology Syndrome because all autoimmunity begins in the gut.  These conditions include but are not limited to the following: multiple sclerosis, rheumatoid arthritis, diabetes type one, celiac disease, osteoarthritis, lupus and any other autoimmune conditions. There are many autoimmune disorders but these are the most common.

GAPS is explained as a condition, which establishes a connection between the functions of the digestive system, the brain and the immune system.

To learn about Gut and Psychology Syndrome, how it developes and how to treat it effectively with a sound nutritional protocol please read Dr Campbell-McBrides  book ‘ Gut and Psychology Syndrome, Natural treatments for autism, ADD/ ADHD, dyslexia, dyspraxia, depression and schizophrenia”.

The following article by Dr Natasha Campbell-McBride provides an initial understanding of GAPS:  Please read the GAPS book for a more comprehensive understanding. See book here

Understanding GAPS

By Dr. N. Campbell-McBride

We live in the world of unfolding epidemics. Autistic Spectrum Disorders, Attention Deficit Hyperactivity Disorder (ADHD/ADD), schizophrenia, dyslexia, dyspraxia, depression, obsessive –compulsive disorder, bi-polar disorder and other neuro-psychological and psychiatric problems in children and young adults are becoming more and more common.

In clinical practice these conditions more often than not overlap with each other. A child with autism often is hyperactive and dyspraxic. There is about 50% overlap between dyslexia and dyspraxia and 25-50% overlap between hyperactivity and dyslexia and dyspraxia. Children with these conditions are often diagnosed as being depressed and as they grow up they are more prone to substance abuse or alcoholism than their typically developing peers. A young adult diagnosed with schizophrenia would often suffer from dyslexia, dyspraxia or/and ADHD/ADD in childhood. Schizophrenia and bi-polar disorder are often described as two sides of one coin. We have created different diagnostic boxes to fit our patients in. But a modern patient does not fit into any one of them neatly. The modern patient in most cases fits into a rather lumpy picture of overlapping neurological and psychiatric conditions.

When we examine these patients in a clinical setting, we find that apart from so-called mental problems, they are also physically very ill. Digestive disorders, malnourishment, allergies, asthma, eczema, chronic cystitis, thrush and fussy eating habits are a consistent part of the picture.

What is a typical scenario we see in clinical practice?

Before examining the patient it is very important to look at the health history of the parents. Whenever the parents are mentioned people immediately think about genetics. However, apart of genetics there is something very important the parents, mother in particular, pass to their child: their unique gut micro-flora. Not many people know that an adult on average carries 2 kg of bacteria in the gut. There are more cells in that microbial mass than there are cells in an entire human body. It is a highly organised micro-world, where certain species of bacteria have to predominate to keep us healthy physically and mentally. Their role in our health is so monumental, that we simply cannot afford to ignore them. We will talk in detail about the child’s gut flora later. Now let us come back to the source of the child’s gut flora – the parents.

After studying hundreds of cases or neurological and psychiatric conditions in children, a typical health picture of these children’s mums has emerged.
A typical modern mother was probably not breast fed when she was a baby, because she was born in 60s or 70s when breast-feeding went out of fashion. Why is it important? Because it is well known that bottle fed babies develop completely different gut flora to the breast fed babies. This compromised gut flora in a bottle fed baby later on predisposes her to many health problems. Having acquired compromised gut flora from the start, a typical modern mum had quite a few courses of antibiotics in her childhood and youth for various infections. It is a well known fact that antibiotics have a serious damaging effect on the gut flora, because they wipe out the beneficial strains of bacteria in the gut. At the age of 16 and sometimes even earlier the modern mum was put on a contraceptive pill, which she took for quite a few years before starting a family. Contraceptive pills have a devastating effect on the beneficial(good) bacteria in the gut. One of the major functions of the good bacteria in the gut flora is controlling about 500 different known to science species of pathogenic (bad) and opportunistic microbes. When the beneficial bacteria get destroyed the opportunists get a special opportunity to grow into large colonies and occupy large areas of the digestive tract. A modern diet of processed and fast foods provides perfect nourishment for these pathogens and that is a typical diet a modern mum had as a child and a young adult. As a result of all these factors a modern mum has seriously compromised gut flora by the time she is ready to have children. And indeed clinical signs of gut dysbiosis (abnormal gut flora) are present in almost 100% of mothers of children with neurological and psychiatric conditions. The most common health problems in mothers are digestive abnormalities, allergies, auto-immunity, PMS, chronic fatigue, headaches and skin problems.

A baby is born with a sterile gut. In the first 20 or so days of life the baby’s virgin gut surface gets populated by a mixture of microbes. This is the child’s gut flora, which will have a tremendous effect on this child’s health for the rest of his/her life. Where does this gut flora come from? Mainly from the mother.
So, whatever microbial flora the mother has she would pass to her new-born child.

Gut flora is something we do not think much about. And yet the number of functions the gut flora fulfils is so vital for us that if some day our digestive tract got sterilised we probably would not survive.

The first and very important function is appropriate digestion and absorption of food. If a child does not acquire normal balanced gut flora, then the child will not digest and absorb foods properly, developing multiple nutritional deficiencies. And that is what we commonly see in children and adults with learning disabilities, psychiatric problems and allergies. Many of these patients are malnourished. Even in the cases where the child may grow well, testing reveals some typical nutritional deficiencies in many important minerals, vitamins, essential fats, many amino-acids and other nutrients. The most common deficiencies, recorded in these patients, are in magnesium, zinc, selenium, copper, calcium, manganese, sulphur, phosphorus, iron, potassium, vanadium, boron, vitamins B1, B2, B3, B6, B12, C, A, D, folic acid, pantothenic acid, omega-3, 6, 9 fatty acids, taurine, alpha-ketoglutaric acid, glutathione and many other amino-acids. This usual list of nutritional deficiencies includes some most important nutrients for normal development and function of the child’s brain, immune system and the rest of the body.

Apart of normal digestion and absorption of food healthy gut flora actively synthesises various nutrients: vitamin K, pantothenic acid, folic acid, thiamine (vitamin B1), riboflavin (vitamin B2), niacin (vitamin B3), pyridoxine (vitamin B6), ciancobalamine (vitamin B12), various amino-acids and proteins. Indeed, when tested people with gut dysbiosis always present with deficiencies of these nutrients. Clinical experience shows that restoring the beneficial bacteria in their gut is the best way to deal with these deficiencies.

The majority of children and adults with neurological and psychiatric conditions look pale and pasty. When tested they show various stages of anaemia, which is not surprising. To have a healthy blood we require many different nutrients: vitamins (B1, B2, B3, B6, B12, K, A, D, etc), minerals (Fe, Ca, Mg, Zn, Co, Se, boron, etc.), essential amino-acids and fats. These patients not only cannot absorb these nutrients from food, but their own production of many of them in the body is damaged. On top of that people with damaged gut flora often have particular groups of pathogenic bacteria growing in their gut, which are iron-loving bacteria (Actinomyces spp., Mycobacterium spp., pathogenic strains of E.Coli, Coryne bacterium spp. and many others). They consume whatever iron the person gets from the diet, leaving that person deficient in iron. Unfortunately, supplementing iron only makes these bacteria grow stronger and does not remedy anaemia. To treat anaemia the person requires all the nutrients we have mentioned, many of which healthy gut flora supplies.

Apart from taking a direct part in nourishing the body, beneficial bacteria in the gut act as the housekeepers for the digestive tract. They coat the entire surface of the gut protecting it from invaders and toxins by providing a natural barrier and producing a lot of anti-bacterial, anti-viraland anti-fungal substances. At the same time they provide the gut lining with nourishment. It is estimated that 60 – 70% of energy, the gut lining derives, is from the activity of bacteria, which live on it. So, it is no surprise that when the gut flora is abnormal the digestive tract itself cannot be healthy. Indeed most children and adults with learning disabilities, psychiatric disorders and allergies present with digestive problems. In many cases these problems are so severe, that the patients (or their parents) talk about them first. In some cases they may not be very severe, but when asked direct questions the parents describe that their child never had normal stool, that their child suffered from colic as a baby and that tummy pains, bloating and flatulence are a common part of the picture. Adult sufferers describe the same kind of symptoms. In those cases where these children and adults have been examined by gastro-enterologists inflammatory process in the gut was found along with faecal compaction and an over-spill syndrome. Dr. Andrew Wakefield and his team at the RoyalFree Hospital in London in the late 90s found an inflammatory condition in the bowel of autistic children, which they have named Autistic Enterocolitis. Schizophrenic patients were always known to have serious digestive problems. Dr. Curtis Dohan, MD has devoted many years to researching digestive abnormalities in schizophrenia. He found a lot of similarities between coeliac disease and the state of the digestive tract in schizophrenics. Indeed, in my clinical practice long before these patients develop psychotic symptoms they suffer from digestive problems and all other typical symptoms of gut dysbiosis pretty much from the start of their lives. Children and young adults with ADHD/ADD, OCD, depression and other neuro-psychological problems are very often reported to suffer from digestive abnormalities.

What other symptoms of gut dysbiosis do we know?

Well-functioning gut flora is the right hand of our immune system. The beneficial bacteria in the gut ensure appropriate production of different immune cells, immunoglobulins and other parts of the immunity. But most importantly they keep the immune system in the right balance. What typically happens in a person with gut dysbiosis is that two major arms of their immune system Th1 and Th2 get out of balance with underactiveTh1 and overactive Th2. As a result the immune system starts reacting to most environmental stimuli in an allergic or atopic kind of way.
A baby is born with an immature immune system. Establishment of healthy balanced gut flora in the first few days of life plays a crucialrole in appropriate maturation of the immune system. If the baby does not acquire appropriate gut flora then the baby is left immune compromised. The result is lots of infections followed by lots of courses of antibiotics, which damage the child’s gut flora and immune system even further. The most common infections in the first two years of life in the children with neurological, psychological and atopic disorders are ear infections, chest infections, sore throats and impetigo. At the same time in the first two years of life the child receives a lot of vaccinations. A child with compromised immune system does not react to vaccinations in a predicted way. In most cases vaccines deepen the damage to the immune system and provide a source of chronic persistent viral infections and autoimmune problems in these children. There has been a considerable amount of research published into the state of the immune system in children and adults with learning disabilities and psychiatric problems. The research shows deep abnormalities in all major cell groups and immunoglobulins in these patients. The most common autoantibodies found are to myelin basic protein (MBP) and neuron-axon filament protein (NSFP). These antibodies attack the person’s brain and the rest of the nervous system.

So, the modern patient (child or adult), who we are talking about, did not get normal gut flora from the start and then got it damaged even further by repeated courses of antibiotics and vaccinations. As a result these children and adults commonly suffer from digestive problems, allergies, asthma and eczema. But apart from that in people who then go on to develop neurological and psychiatric problems something even more terrible happens. Without control of the beneficial bacteria different opportunistic and pathogenic bacteria, viruses and fungi have a good chance to occupy large territories in the digestive tract of the patient and grow large colonies. Two particular groups which are most commonly found on testing are yeasts (including Candida species) and Clostridia family. These pathogenic microbes start digesting food in their own way producing large amounts of various toxic substances, which get absorbed into the blood stream, carried to the brain and cross the blood – brain barrier. The number and mixture of toxins can be very individual, causing different neurological and psychiatric symptoms. Due to the absence or greatly reduced numbers of beneficial bacteria in the gut flora, the person’s digestive system instead of being a source of nourishment becomes a major source of toxicity in the body.

So, what kind of toxins are we talking about?

There are many toxins, which we have not studied very well yet. But some toxins have received a considerable amount of research. Let us have a look at them.

Acetaldehyde & Alcohol

The most common pathogenic microbes shown to overgrow in the digestive systems of children and adults with neuro-psychiatric conditions are yeasts, particularly Candida species. Yeasts ferment dietary carbohydrates with production of alcohol and its by-product acetaldehyde. Let us see what does a constant exposure to alcohol and acetaldehyde do to the body.

Liver damage with reduced ability to detoxify drugs, pollutants and other toxins.

Pancreas degeneration with reduced ability to produce pancreatic enzymes, which would impair digestion.

Reduced ability of the stomach wall to produce stomach acid.

Damage to immune system.

Brain damage with lack of self-control, impaired co-ordination, impaired speech development, aggression, mental retardation, loss of memory and stupor.

Peripheral nerve damage with altered senses and muscle weakness.

Direct muscle tissue damage with altered ability to contract and relax and muscle weakness.

Nutritional deficiencies from damaging effect on digestion and absorption of most vitamins, minerals and amino acids. Deficiencies in B and A vitamins are particularly common.

Alcohol has an ability to enhance toxicity of most common drugs, pollutants and other toxins.

Alteration of metabolism of proteins, carbohydrates and lipids in the body.

Inability of the liver to dispose of old neurotransmitters, hormones and other by-products of normal metabolism. As a result these substances accumulate in the body, causing behavioural abnormalities and many other problems.

Acetaldehyde is considered to be the most toxic of alcohol by-products. It is the chemical, which gives us the feeling of hangover. Anybody who experienced a hangover would tell you how dreadful he or she felt. Children, who acquire abnormal gut flora with a lot of yeast from the start, may never know any other feeling. Acetaldehyde has a large variety of toxic influences on the body. One of the most devastating influences of this chemical is its ability to alter the structure of proteins. Acetaldehyde – altered proteins are thought to be responsible for many autoimmune reactions. Children and adults with neuro-psychiatric problems are commonly found to have antibodies against their own tissues.

Clostridia Neurotoxins

There are about 100 different Clostridia species known so far. They are present in the stools of people with autism, schizophrenia, psychosis, severe depression, muscle paralysis and muscle tonus abnormalities and some other neurological and psychiatric conditions. Many Clostridia species are normal inhabitants of a human gut. For example Clostridium tetani is routinely found in the gut of healthy humans and animals. Everybody knows that tetanus is a deadly disease, due to an extremely powerful neurotoxin Clostridium tetani produces. Clostridium tetani, which lives in the gut, is normally controlled by the beneficial bacteria and does us no harm, because its toxin cannot get through the healthy gut wall. Unfortunately, patients, which we are talking about, do not have a healthy gut wall. In gut dysbiosis this powerful neurotoxin can get through the damaged gut lining and then cross the blood-brain barrier affecting the person’s mental development. Many other species of Clostridia (perfringens, novyi, septicum, histolyticum, sordelli, aerofoetidum, tertium, sporogenes, etc) produce toxins similar to tetanus toxin as well as many other toxins. Dr. William Shaw at Great Plains Laboratories describes in detail number of autistic children, who showed serious improvements in their development and biochemical tests while on anti-Clostridia medication. Unfortunately, as soon as the medication was stopped the children slipped back into autism, because these children do not have healthy gut flora to control Clostridia and not to allow their toxins through the gut lining into the bloodstream. In many cases Clostridia were not identified in the stools of these children, because Clostridia are strict anaerobes and are very difficult to study. We need to come up with some better ways of testing for these potent pathogens.

Yeasts and Clostridia have been given a special opportunity by the era of antibiotics. Broad-spectrum antibiotics do not touch them while killing the beneficial bacteria in the gut, which are supposed to control the yeasts and Clostridia. So, after every course of antibiotics these two pathogenic groups get out of control and overgrow. The patients that we are talking about usually are exposed to numerous courses of antibiotics pretty much from the beginning of their lives.

Gluteomorphins & Casomorphins or opiates from gluten and casein.

Gluten is a protein present in grains, mainly wheat, rye, oats, barley. Casein is a milk protein, present in cow, goat, sheep, human and all other milk and milk products. In the bodies of children and adults with autism and schizophrenia these proteins do not get digested properly due to the fact that their digestive systems are full of abnormal microbial flora and hence unhealthy. As a result of misdigestion gluten and casein turn into substances with similar chemical structure of opiates, like morphine and heroin. There has been quite a substantial amount of research done in this area by Dohan, Reichelt, Shattock, Cade and others, where gluten and casein peptides, called gluteomorphins and casomorphins, were detected in the urine of schizophrenic patients and autistic children. Incidentally, these substances were also found in patients with depression and rheumatoid arthritis. These opiates from wheat and milk get through the blood-brain barrier and block certain areas of the brain, just like morphine or heroin would do, causing various neurological and psychiatric symptoms. Based on this research the gluten and casein free diet(GFCF diet) has been developed.

Dermorphin & Deltorphin

These are two frightening toxic substances with opiate structure, which have been found in autistic children by a biochemist Alan Friedman, PhD. Dermorphin and deltorphin were first identified on the skin of a poison dart frog in South America. Native people used to dip their darts into the mucous on these frogs in order to paralyse their enemy, because deltorphin and dermorphin are extremely potent neurotoxins. Dr Friedman believes that it is not the frog that produces these neurotoxins, but a fungus, which grows on the skin of this frog. It is possible that this fungus grows in the gut of autistic children, supplying their bodies with dermorphin and deltorphin.

Organic Acid Testing available now in many laboratories around the world identify various metabolites of microbial activity in the gut, which get absorbed and finish up in the patient’s urine. Many of these metabolites are highly poisonous substances.

Low Serum Sulphate is a common picture in these patients, which is an indirect indication of toxicity in the body, because sulphates are essential for many detoxification processes and normalmetabolism of brain neurotransmitters. In many cases the person may be getting plenty of sulphates through the diet, but they all get consumed by the detox pathways struggling with the river of toxicity, which is constantly coming from the person’s gut. At the same time another large group of bacteria, which commonly overgrow in the gut dysbiosis situation are sulphate-reducing bacteria, which make sulphur unavailable for the body to use. These bacteria metabolise sulphate coming from food into sulphites, many of which are toxic like hydrogen sulphide for example, which is the gas with rotten egg smell. Some parents of autistic, hyperactive and other children tell me that their child’s stool has this characteristic smell.

The mixture of toxicity in each child or adult can be quite individual and different. But what they all have in common is gut dysbiosis. The toxicity, which is produced by the abnormal microbial mass in these people, establishes a link between the gut and the brain. That is why I have grouped these disorders together and gave them a name: the Gut and Psychology Syndrome (GAP Syndrome). The GAPS children and adults can present with symptoms of autism, ADHD, ADD, OCD, dyslexia, dyspraxia, schizophrenia, depression, sleep disorders, allergies, asthma and eczema in any possible combination. These are the patients who fall in the gap in our medical knowledge. Any child or adult with a learning disability, neurological or psychiatric problems should be thoroughly examined for gut dysbiosis. Re-establishing normal gut flora and treating the digestive system of the patient has to be the number one treatment for these disorders, before considering any other treatments with drugs or otherwise.

Gut And Psychology Syndrome (GAP Syndrome or GAPS) establishes the connection between the state of the patient’s gut and the functioning of the brain. This connection has been known by medics for a very long time. The father of modern psychiatry French psychiatrist Phillipe Pinel (1745–1828), after working with mental patients for many years, concluded in 1807: “The primary seat of insanity generally is in the region of the stomach and intestines.” Long before him Hippocrates (460-370 BC), the father of modern medicine has said: “All diseases begin in the gut!” The more we learn with our modern scientific tools, the more we realise just how right they were!


Absolon CM at al. Psychological disturbance in atopic eczema: the extent of the problem in school-aged children. Br J Dematol, Vol 137(2), 1997, pp.24105.

Ashkenazi et al. Immunologic reaction in psychotic patients to fractions of gluten. Am J Psychiatry 1979; 136:1306-1309.

Baruk H. 1978. Psychoses of digestive origins. In: Hemmings and Hemmings (eds), Biological Basis of Schizophrenia. Lancaster MTP Press.

Bolte ER, (1998). Autism and Clostridium tetani. Medical Hypothesis 51(2): 133-144.

Cade R et al. Autism and schizophrenia: intestinal disorders. Nutritional Neuroscience. March 2000.

Dohan CF. Cereals and schizophrenia: data and hypothesis. Acta Psychiat Scand 1966; 42: 125-152.

Dohan CF et al. Relapsed schizophrenics: more rapid improvement on a milk and cereal free diet. Brit J Psychiat 1969; 115: 595-596.

Dohan et al. Is schizophrenia rare if grain is rare? Biology and Psychiatry. 1984: 19(3): 385-399.

Dohan FC. Is celiac disease a clue to pathogenesis of schizophrenia? Mental Hygiene. 1969; 53: 525-529.

Ferrari P et al. Immune status in infantile autism: Correlation between the immune status, autistic symptoms and levels of serotonin. Encephale 14:339-344, 1988.

Finegold SM. Therapy and epidemiology of autism–clostridial spores as key elements. Med Hypotheses. 2008;70(3):508-11.

Finegold SM, Molitoris D, Song Y, Liu C, Vaisanen ML, Bolte E, McTeague M, Sandler R, Wexler H, Marlowe EM, Collins MD, Lawson PA, Summanen P, Baysallar M, Tomzynski TJ, Read E, Johnson E, Rolfe R, Nasir P, Shah H, Haake DA, Manning P, Kaul A. Gastrointestinal microflora studies in late-onset autism. Clin Infect Dis. 2002 Sep 1;35(Suppl 1):S6-S16.

Furlano RI, Anthony A, Day R et al. Colonic CD8 and gamma delta T-cell infiltration with epithelial damage in children with autism. J Pediatr 2001;138: 366-72.

Horrobin DF, Glen AM, Vaddadi K. 1994. The membrane hypothesis of schizophrenia. Schiz Res 18, 195-207.

Horvath K, Papadimitriou JC, Rabsztyn A et al. Gastrointestinal abnormalities in children with autism. Journal of Pediatrics 1999; 135: 559-563.

Kawashima H, Takayuki M, Kashiwagi Y et al. Detection and sequencing of measles virus from peripheral blood mononuclear cells from patients with inflammatory bowel disease and autism. Digestive Diseases and Sciences. 2000;45:723-729.

Kirjavainen PV, Apostolov E, Salminen SS, Isolauri E 1999.New aspects of probiotics – a novel approach in the management of food allergy. (Review)(59refs).Allergy. 54(9):909-15, 1999 Sep.

Kontstanareas M and Homatidis S, (1987). Ear infections in autistic and normal children. Journal of Autism and Developmental Disorders, 17: 585.

Krasnogolovez VN. Colonic disbacteriosis – M.: Medicina, 1989 (Russian).

Lewis SJ, Freedman AR (1998). Review article: the use of biotherapeutic agents in the prevention and treatment of gastrointestinal disease. (Review)(144 refs). Alimentary Pharmacology and Therapeutics. 12(9):807-22, 1998 Sep.

Lykova EA, Bondarenko VM, Sidorenko SV, Grishina ME, Murashova AD, Minaev VI, Rytikov FM, Korsunski AA (1999). Combined antibacterial and probiotic therapy of Helicobacter – associated disease in children (Russian).Zhurnal Microbiologii, Epidemiologii I Immunobiologii. 1999 Mar-Apr;(2):76-81.

Macfarlane GT, Cummings JH (1999). Probiotics and prebiotics: can regulating the activities of intestinal bacteria benefit health? (Review) (48 refs).BMJ. 1999 April;318:999-1003.

McCandless J. Children with starving brains. 2003. ISBN 1-883647-10-X.

Mycroft et al. JIF-like sequences in milk and wheat proteins. NEJM 1982; 307: 895.

Papalos D, Papalos J. The bipolar child. Broadway Books, 2000.

Parracho HM, Bingham MO, Gibson GR, McCartney AL. Differences between the gut microflora of children with autistic spectrum disorders and that of healthy children. J Med Microbiol. 2005 Oct;54(Pt 10):987-91.

Plioplys AV at al. Lymphocyte function in autism and Rett syndrome. Neuropsychobiology 7:12-16, 1994.

Reichelt K et al. Gluten, milk proteins and autism: dietary intervention effects on behaviour and peptide secretions. Journal of Applied Nutrition. 42:1-11, 1990.

Reichelt K et al. Biologically active peptide-containing fractions in schizophrenia and childhood autism. Adv Biochem Psychopharmacol 28:627-47, 1981.

Rimland B. New hope for safe and effective treatments for autism. Autism Research Review International 8:3, 1994.

Samonis G et al. (1994). Prospective evaluation of the impact of broad-spectrum antibiotics on the yeast flora of the human gut. European Journal of Clinical Microbiology and Infections Diseases 13: 665-7.

Schoenthaler SJ et al. The effect of randomised vitamin-mineral supplementation on violent and non-violent antisocial behaviour among incarcerated juveniles. J Nut Env Med, Vol 7, 1997, pp.343-352.

Singh V. Neuro-immunopathogenesis in autism. 2001. New Foundations of Biology. Berczi I & Gorczynski RM (eds) Elsevier Science B.V. pp 447-458.

Singh V at al. Changes in soluble interleukin-2, interleukin-2 rector, T8 antigen, and interleukin-I in the serum of autistic children. Clin. Immunol. Immunopath. 61:448-455, 1991.

Singh V et al. Immunodiagnosis and immunotherapy in autistic children. Ann NY Acad Sci 540:602-604, 1988.

Singh V et al. Serological association of measles virus and human herpesvirus-6 with brain autoantibodies in autism. Clinical Immunology and Immunopathology. 1998:89; 105-108.

Singh & Kay. Wheat gluten as a pathogenic factor in schizophrenia. Science 1975: 191: 401-402.

Sioudrou et al. Opioid peptides derived from food proteins. The exorphins. J Biol Chem. 1979; 254:2446-2449.

Shaw W. Biological Treatments for Autism and PDD. 2002. ISBN 0-9661238-0-6

Tabolin VA, Belmer SV, Gasilina TV, Muhina UG, Korneva TI. Rational therapy of intestinal disbacteriosis in children. – M.:Medicina, 1998, 22p (Russian).

Vorobiev AA, Pak SG et al. (1998). Disbacteriosis in children. A textbook for doctors and medical students.(Russian). M.: “KMK Lt.”, 1998. 64p. ISBN 5-87317-049-5.

Waizman A et al. Abnormal immune response to brain tissue antigen in the syndrome of autism. Am J Psychiatry 139:1462-1465, 1982.

Wakefield AJ, Anthony A et al. Enterocolitis in children with developmental disorders. AIA Journal, Autumn 2001.

Wakefield AJ, Murch SH, Anthony A, et al. Ileal-lymphoid-nodular hyperplasia, non-specific colitis and pervasive developmental disorder in children. Lancet 1998; 351:637-41.

Wakefield AJ and Montgomery SM. Autism, viral infection and measles, mumps, rubella vaccination. Israeli Medical Association Journal 1999;1:183-187.

Walker-Smith JA. Autism, inflammatory bowel disease and MMR vaccine. Lancet 1998; 351: 1356-57.

Ward NI. Assessment of clinical factors in relation to child hyperactivity. J Nutr Environ Med, Vol 7, 1997, p.333-342.

Ward NI. Hyperactivity and a previous history of antibiotic usage. Nutrition Practitioner, Vol 3(3), 2001, p.12.

Waring (2001). Sulphate, sulphation and gut permeability: are cytokines involved? In: The Biology of Autism – Unravelled. Conference proceedings 11th May 2001, Institute of Electrical Engineers, London.

Warren R et al. Immune abnormalities in patients with autism. J. Autism Develop Dis. 16, 189-197, 1986.

Warren PP at al. Reduced natural killer cell activity in autism. J Am Acad Child Phychol 26: 333-335, 1987.

Wilson K, Moore L, Patel M, Permoad P. Suppression of potential pathogens by a defined colonic microflora. Microbial Ecology in Health and Disease. 1988; 1:237-43.

Yonk LJ et al. D4+ per T cell depression in autism. Immunol Lett 35: 341-346, 1990.

GAPS Protocol

The GAPS Protocol is a three part program designed to heal the gut lining, restore the gut with beneficial flora and relieve the body of an excess toxic load.  The program incorporates a nutritional program supported by specific supplements with an emphasis on detoxification and reduction of exposure to environmental toxins.  The program requires persistence, perseverance and 100% commitment!

This information is not designed to replace the Gut and Psychology Syndrome book, but provide a simplified version of the GAPS protocol at a glance.  Please read the GAPS book to fully understand how and why this particular intervention works, why other diets are inappropriate for GAPS patients and how to implement the protocol correctly.

GAPS Protocol is a three part program

1. Diet

2. Supplementation

3. Detoxification and life-style changes


The GAPS diet provides the most comprehensive approach in effectively cleaning up the digestive system.  It is built upon the Specific Carbohydrate Diet (SCD) developed by Dr Sydney Valentine Hass in the first half of the 2oth century, and then followed by Elain Gotchall with Breaking the Vicious Cycle.  The main difference identified between the SCD diet and GAPS diet is the use of dairy products.  The SCD diet allows lactose-free dairy products from the beginning which is present in SCD yoghurts, sour cream and cheese.

The lactose in these products are consumed by bacteria during the fermentation process making it easier to digest.  Dr N. Campbell McBride advises that whilst the lactose is consumed during fermentaiton, it is the milk protein casein that causes the problem.  Casamorphins from miss-digestion of milk protein casein get absorbed through the gut wall into the blood stream and across the blood brain barrier which affect the functions of the brain.  Dairy is also a concern with its ability to create allergies and food intolerance.

When dairy is completely removed from the diet of a child with autism or an adult with schizophrenia, the changes can be quite astonishing.  Many report improved communication, eye contact, correction of eczema and asthma and improvements in social well-being.  Dr N. Campbell-McBride’s book and the introduction diet goes on to discuss the correct measures to take when introducing fermented dairy and milk fats.

The GAPS protocol therefore, provides an effective approach for allergies, sensitivities, digestive disfunction and many other physiological and psychological conditions.

The GAPS diet is best implemented following the below steps:

 1. Pre-diet

Become familiar with the GAPS foods and explore with cooking.

Become familiar with your local health food suppliers, stores and markets.

Gradually wean off the GAPS unfriendly foods Switch to the ‘Foods to Avoid’ toggle to learn about what foods to eat after GAPS

Introduce more GAPS friendly foods TIP: You can get a free copy of the GAPS Shopping list from our Free Ebook – Simply join our free subscription to download

 2. The Introduction / detox diet

The introduction diet consists mostly of homemade rich bone broths and vegetable soups, boiled meats and stews with high fat content.  This gives the digestive system the best chance to kick start the healing process.  The 6 introductions stages should not be rushed and requires strict adherence and patients.

Join our free email subscription to receive our free ebook with the 6 stages to the GAPS Introduction diet

The free GAPS Getting Started Orientation E Book contains a descriptive step by step process for the 6 steps in the introduction diet.  Subscribe to our newsletter to access this fir free.

3. The main diet – Full GAPS

Dr N. Campbell-McBride advises people with severe digestive disorders to remain on the GAPS diet for a minimum of two years before moving onto the next stage where new foods from Wise Traditions are explored.  The full GAPS diet is found in the book.

 4. After GAPS

Switch to the ‘After GAPS’ toggle to learn about what foods to eat after GAPS


Please read the GAPS Supplementation Criteria to in the GAPS book to ensure that you select good quality and therapeutic strength supplements that are suitable for GAPS.  We have compiled a Supplementation Guide EBook to help you learn how to select supplements that meet the GAPS Supplement Criteria.

You may access the GAPS Supplementation ebook under our resources page

The GAPS Supplementation Protocol Criteria

The essential supplementation Protocol for GAPS advised by Dr Natasha Campbell-McBride follows:

1. An effective therapeutic strength Probiotic

2. Essential fatty acids

►  A good seed or nut oil blend in the ratio of 2:1 omega 3 to omega 6 fatty acids

►  A good Cod Liver Oil

►  Fish Oil with a higher ratio of EPA to DHA

3. Vitamin A & D in the form of Cod Liver Oil

4. Digestive Enzymes only for some

5. Vitamin, Mineral and Amino Acid Supplements

Dr. Campbell-McBride does not recommend any vitamin or mineral supplementation at the beginning of the program until the digestive system shows signs of improvement. Some patients may require targeted supplementation but this is a matter for a qualified practitioner to decide and should be avoided where possible so that it does not interfere with the healing process.

If you are going to use supplements:
► Choose supplements without any ingredients which may aggravate the gut condition.
► Choose supplements with added fulvic acid ensuring a high absorption rate.
► Keep supplements to an absolute minimum.

Detoxification and life-style changes

We live in a toxic world

Modern foods are processed and bombarded with pesticides, herbicides, and fungicides most of which stay on or in the food right through to the point that you eat it. Animal products are treated with hormones, antibiotics, and synthetic stimulants.    Food in the supermarket is treated with preservatives to create longevity. To enhance their flavour and colour they are pumped full of other chemicals which have no place in nutrition. Your body needs a regular supply of essential nutrients which are missing in these modern foods. It needs a large and well balanced variety of minerals, vitamins, and other nutrients to combat these unwanted ingredients, and to strengthen the body against failure to function normally.

Unaware, we continue top up our toxic load with chemical contained personal care products, house cleaners and expose ourselves to traffic exhaust fumes.  Paint, building materials, carpet and new furniture all leach toxic chemical gasses into the air that we breathe day in and day out.

Healthy people can manage to detoxify these toxins however a GAPS patient’s detoxification system is overloaded and overworked because they are deficient in the appropriate supply of important nutrients, minerals, trace elements, enzymes, amino acids and essential fats.  In order for a GAPS patient’s detoxification system to function properly, there are several steps required to detoxify the system and reduce the toxic load.

Tags:restore the gut

The GAPS Diet

By Dr Natasha Campbell-McBride

Implementing the GAPS Diet: How to start

Most people will start the diet with the Introduction Diet followed by the Full GAPS Diet, however some people need to start with the Full GAPS Diet and it depends on their condition as to whether they attempt the introduction stages later.  A Certified GAPS Practitioner can assist you in determining which one to start with first.

1.  Introduction Diet
2.  The Full GAPS Diet with the typical menu

What is the GAPS Diet

Your patient needs to carry on completely avoiding starches and sugar for two years at least. It means avoiding all grains, sugar, potatoes, parsnips, yams, sweet potato and anything made out of them. The flour in your cooking and baking can be replaced with ground almonds (or any other nuts or sunflower or pumpkin seeds ground into flour). In about 1 – 1.5 years you may be able to introduce new potatoes, fermented buckwheat, millet and quinoa, starting from very small amounts and observing any reaction. Wheat, sugar, processed foods and all additives will have to be out of the diet for much longer.

Slowly increase the amounts of fermented foods. You can ferment vegetables, fruit, milk and fish (please look in the recipe section). I would also recommend reading a wonderful book by Sally Fallon “Nourishing Traditions”, it will provide you with a lot of good recipes. Eating fermented foods with every meal will help your patient to digest the meal without using supplements or digestive enzymes. Make sure to introduce all new fermented foods into the diet very gradually starting from 1-2 teaspoons a day.

The best foods for the GAPS person are eggs, meats and fish (bought fresh or frozen, not smoked or canned, and cooked at home), shellfish, fresh vegetables and fruit, nuts and seeds, garlic and olive oil. As well as eating the vegetables cooked it is important to have them raw in the form of salads and sticks. In this form they will provide your patient with valuable enzymes and detoxifying substances, which will help in digesting meats. Raw fruit should be eaten on their own, not with meals, as they have a very different digestion pattern and can make the work harder for the stomach. At that stage let your patient to have fruit as a snack between meals. Remember, that about 85% of everything your patient eats on a daily basis should be savoury – made out of meats, fish, eggs, vegetables and natural fats. Sweet baking and fruit should be snacks between meals in limited amounts.

It is very important for a GAPS person to have plenty of natural fats in every meal from meats, butter, ghee, coconut and cold pressed olive oil. The fat content of the meal will regulate the blood sugar level and control cravings for carbohydrates.

If your patient gets a tummy bug or any other form of diarrhoea go back to the low fibre diet for a few days: remove all nuts, raw vegetables and raw fruit out of the diet; go back to meats cooked in water and meat stock, fish, eggs, fermented dairy and cooked vegetables (skinned, de-seeded and well cooked with meats as soups and stews) until diarrhoea completely clears. After the stools stay normal for a week introduce raw vegetables slowly, one at a time and starting from small amounts. When vegetables are introduced, try to introduce nuts, seeds and fruit gradually.

It is important for your GAPS patient to balance the meals so that his or her body pH stays normal. All protein foods, such as meats, fish, eggs and cheese leave an acid ash in the body, which may aggravate his or her condition. Vegetables are alkalising, so you need to combine meats, fish and eggs with good amount of vegetables cooked and/or raw. Raw fruit, vegetables and greens have particularly strong alkalising ability. Apple cider vinegar is very alkalising, it is good to have it every day: just add one teaspoon of cider vinegar into every glass of water your patient drinks. Hot water with cider vinegar will makes an excellent warming and alkalising drink. Fermented foods are also alkalising.

It is very important to avoid processed foods (any packet or tinned foods). They are stripped from most nutrients that were present in the fresh ingredients used for making these foods. They are a hard work for the digestive system and they damage the healthy gut flora balance. On top of that they usually contain a lot of artificial chemicals, detrimental to health, like preservatives, colorants, E-numbers, etc. Try to buy foods in the form that nature made them, as fresh as possible.

Do not use a microwave oven, as it destroys food. Cook and warm up food using conventional oven and stove.

The 6 introduction stages to the GAPS Nutrition Protocol provide individuals with a kick start to healing.

The GAPS Introduction Diet

 The Introduction Diet has been designed for people with serious digestive problems, persistent diarrhoea, food allergies and intolerances.  These individuals should follow the Introduction Diet before progressing into the full GAPS diet.  People who experience constipation during the introduction stages should strongly consider implementing an enema as described in the GAPS book.  An individuals body can become very toxic if constipation is left too long and bowls do not move for more than 36 hours.  Please refer to page 225 in the GAPS book for more information before you commence with the introduction stages because the detox is a low fibre diet.

*Note:  Those who start with the Introduction Diet will introduce dairy earlier than those who go right into the full GAPS diet.  Always do a sensitivity test prior to introducing dairy.

Starting the Itroductions Stages

We recommend that most GAPS patients follow the Introduction Diet before going into the Full GAPS diet.  Depending on the severity of your patient’s condition he or she can move through this program as fast or as slow as his/her condition will permit: for example you may move through the First Stage in one or two days and then spend longer on the Second Stage.  Following the Introduction Diet fully is essential for people with diarrhea or severe constipation: it reduces symptoms quickly and speeds up the healing process in the digestive system.  Even for healthy people, if you or your child gets a ‘tummy bug’ or any other profuse diarrhea, following the Introduction Diet for a few days will clear the symptoms quickly and permanently without needing any medication.

Those without severe digestive problems can move through the Introduction Diet quite quickly.  However, please do not be tempted to skip the Introduction Diet and go straight into the Full GAPS Diet, because the Introduction Diet will give your patient the best chance to optimize the healing process in the gut and the rest of the body.  I see many cases where skipping the Introduction Diet leads to long-term lingering problems, difficult to deal with.


Start the day with a cup of still mineral or filtered water.  Give your patient the probiotic.  Make sure that the water is warm or room temperature, not cold, as cold will aggravate his or her condition.

Only foods listed are allowed: your patient must not have anything else.  On the First Stage the most drastic symptoms of abdominal pain, diarrhea and constipation will quickly subside.  If, when you introduce a new food, your patient gets back diarrhea, pain or any other digestive symptoms then he/she is not ready for that food to be introduced.  Wait for a week and try again.

If you suspect an allergy to any particular food, before introducing it do the Sensitivity Test.


Take a drop of the food in question (if the food is solid, mash and mix with a bit of water) and place it on the inside of the wrist of the patient.  Do it at bedtime.  Let the drop dry on the skin, then let your patient go to sleep.  In the morning check the spot: if there is an angry red reaction, then avoid that food for a few weeks, and then try again.  If there is no reaction, then go ahead and introduce it gradually starting from a small amount.

6 Introduction Stages


Homemade meat or fish stock.
Meat and fish stocks provide building blocks for the rapidly growing cells of the gut lining and they have a soothing effect on any areas of inflammation in the gut.  That is why they aid digestion and have been known for centuries as healing folk remedies for the digestive tract.  Do not use commercially available soup stock granules or bullion cubes, they are highly processed and are full of detrimental ingredients.  Chicken stock is particularly gentle on the stomach and is very good to start from.  To make good meat stock you need joints, bones, a piece of meat on the bone, a whole chicken, giblets from chicken, goose or duck, whole pigeons, pheasants or other inexpensive meats.  It is essential to use bones and joints, as they provide the healing substances, not so much the muscle meats.  Ask the butcher to cut in half the large tubular bones, so you can get the bone marrow out of them after cooking.  Put the bones, joints and meats into a large pan and fill it with water, add natural unprocessed salt to your taste at the beginning of cooking and about a teaspoon of black peppercorns, roughly crushed.  Bring to boil, cover and simmer on a low heat for 2.5-3 hours.  You can make fish stock the same way using a whole fish or fish fins, bones and heads.  After cooking take the bones and meats out and sieve the stock to remove small bones and peppercorns.  Strip off all the soft tissues from the bones as best as you can to later add to soups or encourage your patient to eat all the soft tissues on the bones.  Extract the bone marrow out of large tubular bones while they are still warm: to do that bang the bone on a thick wooden chopping board.  The gelatinous soft tissues around the bones and the bone marrow provide some of the best healing remedies for the gut lining and the immune system; your patient needs to consume them with every meal.  Take off all the soft tissues from fish bones and heads and reserve for adding to soups later.  The meat or fish stock will keep well in the fridge for at least 7 days or it can be frozen.  Keep giving your patient warm meat stock as a drink all day with his meals and between meals.  Do not use microwaves for warming up the stock, use conventional stove (microwaves destroy food).  It is very important for your patient to consume all the fat in the stock and off the bones as these fats are essential for the healing process.  Add some probiotic food into every cup of stock (the details about introducing probiotic food follow).

Homemade soup with your homemade meat or fish stock.
Please look for some recipe ideas in the recipe section of the book.  Here we will go through some details, specific for the Introduction Diet.  Bring some of the meat stock to boil, add chopped or sliced vegetables: onions, carrots, broccoli, leeks, cauliflower, courgettes, marrow, squash, pumpkin, etc. and simmer for 25-35 minutes.  You can choose any combination of available vegetables avoiding very fibrous ones, such as all varieties of cabbage and celery.  All particularly fibrous parts of vegetables need to be removed, such as skin and seeds on pumpkins, marrows and squashes, stalk of broccoli and cauliflower and any other parts that look too fibrous.  Cook the vegetables well, so they are really soft.  When vegetables are well cooked, add 1-2 tablespoons of chopped garlic, bring to boil and turn the heat off.  Give your patient this soup with the bone marrow and meats and other soft tissues, which you cut off the bones.  You can blend the soup using a soup blender or serve it as it is.  Add some probiotic food into every bowl of soup (the details about introducing probiotic foods follow).  Your patient should eat these soups with boiled meat and other soft tissues off the bones as often as he/she wants to all day.

Probiotic foods are essential to introduce right from the beginning.
These can be dairy based or vegetable based.  To avoid any reactions introduce probiotic foods gradually, starting from 1-2 teaspoons a day for 2-5 days, then 3-4 teaspoons a day for 2-5 days and so on until you can add a few teaspoons of the probiotic food into every cup of meat stock and every bowl of soup.  If your patient is ready to introduce dairy, then use your homemade yogurt or kefir.  If dairy is still out [by results of sensitivity test or negative reaction when introducing it], then into every cup of meat stock or soup add juice from your homemade sauerkraut, fermented vegetables or vegetable medley (please look in the recipe section of the book).  Make sure that the food is not too hot when adding the probiotic foods, as the heat would destroy the beneficial probiotic bacteria.

Ginger tea with a little honey between meals.
To make ginger tea, grate some fresh ginger root (about a teaspoonful) into your teapot and pour some boiling water over it, cover and leave for 3-5 minutes.  Pour through a small sieve and add honey to taste (optional).


Continue with Stage 1.
Keep giving your patient the soups with bone marrow, boiled meats or fish and other soft tissues off the bones.  He or she should keep drinking the meat stock and ginger tea.  Keep adding some probiotic food into every cup of meat stock and every bowl of soup: juices from sauerkraut, fermented vegetables or vegetable medley, or homemade kefir/yogurt.

Add raw organic egg yolks.
It is best to have egg yolks raw added to every bowl of soup and every cup of meat stock.  Start from 1 egg yolk a day and gradually increase until your patient has an egg yolk with every bowl of soup.  When egg yolks are well tolerated add soft-boiled eggs to the soups (the whites cooked and the yolks still runny).  If you have any concerns about egg allergy, do the sensitivity test first.  There is no need to limit number of egg yolks per day, as they absorb quickly almost without needing any digestion and will provide your patient with wonderful and most needed nutrition.  Get your eggs from a source you trust: fresh, free range and organic.

Add stews and casseroles made with meats and vegetables.
Avoid spices at this stage; just make the stew with salt and fresh herbs (look for a recipe of Italian Casserole in the recipe section of the book).  The fat content of these meals must be quite high: the more fresh animal fats your patient consumes, the quicker he or she will recover.  Add some probiotic food into every serving.

Increase daily amount of homemade yogurt and kefir, if introduced.  Increase the amount of juice from sauerkraut, fermented vegetables or vegetable medley.

Introduce fermented fish, starting from one piece a day and gradually increasing.  Look for recipes in recipe section.

Introduce homemade ghee, starting from 1 teaspoon a day and gradually increasing.  Look for recipe in recipe section.


Carry on with all the previous foods.

Add ripe avocado mashed into soups, starting from 1-3 teaspoons and gradually increasing the amount.

Add pancakes, starting from one pancake a day and gradually increasing the amount.
Make these pancakes with three ingredients: 1) organic nut butter (almond, walnut, peanut, etc); 2) eggs; 3) a piece of fresh winter squash, marrow or courgette (peeled, de-seeded and well blended in a food processor).  Fry small thin pancakes using ghee, goose fat or duck fat.  Make sure not to burn them.

Egg scrambled with plenty of ghee, goose fat or duck fat.
Serve it with avocado (if well tolerated) and cooked vegetables.  Cooked onion is particularly good for the digestive system and the immune system: melt 3 tablespoons of duck fat or ghee in the pan, add sliced large white onion, cover and cook for 20-30 minutes on low heat.

Introduce the sauerkraut and your fermented vegetables (your patient has been drinking the juices from them for a while now).
Start from a small amount, gradually increasing to 1-2 tablespoons of sauerkraut or fermented vegetables per every meal.


Carry on with all previous foods.

Gradually add meats cooked by roasting and grilling (but not barbecued or fried yet).
Avoid bits, which are burned or too brown.  Let your patient eat the meat with cooked vegetables and sauerkraut (or other fermented vegetables).

Start adding cold pressed olive oil to the meals, starting from a few drops per meal and gradually increasing the amount to 1-2 tablespoons per meal.

Introduce freshly pressed juices, starting from a few spoonfuls of carrot juice.
Make sure that the juice is clear, filter it well.  Let your patient drink it slowly or diluted with warm water or mixed with some homemade yogurt.  If well tolerated gradually increase to a full cua a day.  When a full cup of carrot juice is well tolerated try to add to it juice from celery, lettuce and fresh mint leaves.  Your patient should drink the juice on an empty stomach, so first thing in the morning and middle of afternoon are good times.

Try to bake bread with ground almonds or any other nut and seeds ground into flour.
The recipe (please look in recipe section of the book) requires only four ingredients: 1) nut flour; 2) eggs; 3) piece of fresh winter squash, marrow or courgette (peeled, de-seeded and finely sliced); 4) some natural fat (ghee, butter, goose or duck fat) and some salt to taste.  Your patient should start from a small piece of bread per day and gradually increase the amount.


If all the previous foods are well tolerated try to add cooked apple as an apple pure.
Peel and core ripe cooking apples and stew them with a bit of water until soft.  When cooked add some shee to it and mash with a potato masher.  If ghee has not bee introduced yet add duck or goose fat.  Start from a few spoonfuls a day.  Watch for any reaction.  If there is none gradually increase the amount.

Add raw vegetables starting from softer parts of lettuce and peeled cucumber.
Watch your patient’s stool.  Again start from a small amount and gradually increase if well tolerated.  After those two vegetables are well tolerated gradually add other raw vegetables: carrot, tomato, onion, cabbage, etc.

If the juice made from carrot, celery, lettuce and mint is well tolerated, start adding fruit to it: apple, pineapple and mango.  Avoid citrus fruit at this stage.


If all the introduced foods are well tolerated try some peeled raw apple.  Gradually introduce raw fruit and more honey.

Gradually introduce baking cakes and other sweet things allowed on the diet.  Use dried fruit as a sweetener in the baking.

As I mentioned before, your patient may be able to move through the Introduction Diet faster or slower depending on the stool changes: let the diarrhea start clearing before moving to the next stage.  You may have to introduce some foods later than in the program depending on his/her sensitivities.  Make sure that you carry on with the soups and meat stock after your patient has completed the Introduction Diet at least once a day.

After the Introduction Diet is completed and when your patient has more or less normal stools move into the Full GAPS Diet.


A Typical Menu:

Start the day with a glass of still mineral water or filtered water with a slice of lemon.  It can be warm or cold to personal preference.

If you have a juicer your patient can start the day with a glass of freshly pressed fruit/vegetable juice diluted with water.
A good juice to start the day is 40% apple + 50% carrot + 10% beetroot (all raw of course).  You can make all sorts of juice mixes, but generally try to have 50% of therapeutic ingredients: carrot, small amount of beetroot (no more than 5-10% of juice mixture), celery, cabbage, lettuce, greens (spinach, parsley, dill, basil, fresh nettle leaves, beet tops, carrot tops), white and red cabbage, and 50% of some tasty ingredients to disguise the taste of therapeutic ingredients: pineapple, apple, orange, grapefruit, grapes, mango, etc.  Your patient can have these juices as they are, with some yogurt or diluted with water.

Every day our bodies go through a 24 hour cycle of activity and rest, feeding and cleaning up (detoxifying).  From about 4 am till about 10 am the body is in the cleaning up or detoxification mode.  Drinking water and freshly pressed juices will assist in this process.  Loading the body with food at that time interferes with the detoxification.  That is why many of us do not feel hungry first thing in the morning.  It is better to have breakfast around 10 am when your body has completed the detox stage and is ready for feeding.  At that stage we usually start feeling hungry.  Children may be ready for their breakfast earlier than adults.


A variation of English breakfast: eggs cooked to personal liking and served with sausages and vegetables, some cooked, some fresh as a salad (tomato, cucumber, onions, celery, and fresh salad greens, etc.) and/or avocado and/or meat.  The yolks are best uncooked that the whites cooked.  Use plenty of cold pressed olive oil as a dressing on the salad and eggs.  Mix a tablespoon of pre-soaked or sprouted sunflower and/or sesame and/or pumpkin seeds with the salad.  Sausages (full fat) should be made of pure minced meat with only salt and pepper added.  Make sure that there are no commercial seasonings or MSG (Monosodium Glutamate) in the sausages.  I recommend finding a local butcher, who would make pure meat sausages for you on order

Avocado with meat, fish or shellfish, vegetables raw and cooked, lemon and cold pressed olive oil.  Serve a cup of warm meat stock as a drink with food.

Pancakes made with ground nuts.  These pancakes are delicious with some butter with honey, or as a savory snack.  If you blend some fresh or defrosted berries with honey, it will make a delicious jam to have with pancakes.  Weak tea with lemon, ginger tea or mint tea.

Any of the home baked goods: muffins, fruit cake and bread.


Homemade vegetable soup or stew in a homemade meat stock.

Avocado with meat, fish, shellfish and raw and/or cooked vegetables.  Use olive oil with some lemon squeezed over it as a dressing.  Serve a cup of warm homemade meat stock as a drink.

Any meat/fish dish with vegetables.


One of the dishes from the lunch or breakfast choices.

There are many recipes found in the book.  You can also take old recipes and give them your own GAPS diet update.

GAPS List of Allowable and Non Allowable foods can be located in the GAPS book, along with the GAPS recipes.


Tags:, Dr Natasha Campbell-McBride, The Full GAPS Diet

Detoxification Steps

1st Step

The first step involves removing the main source of toxicity which means cleaning up and restoring digestive health through the GAPS diet intervention protocol.

Dr Campbell-McBride has a theory explaining how both salicylates and phenols have strong antioxidant and detoxifying abilities and therefore creating a detox reaction whilst flushing toxins from storage sites in body tissues and into the blood stream where it causes the detox reaction.  These toxins are then released though urine, sweat or bile.  Detoxifying is very important; therefore phenols and salicylates play an important part in the detoxification process and also benefit a host of very important vitamins.

2nd Step

The removal of toxins and heavy metals stored within the body.

  • Juicing
  • GAPS Introduction Diet

3rd Step

This step is an important part of the protocol because it aims to reduce the general toxic load.  This takes an enormous amount of pressure off the individuals detoxification system.  The major source of toxicity is in the gut and this is produced from anything we eat, breath, touch or allow to absorb through our skin from the environment around us.

The following list is compiled to assist you in reducing the toxic load.

Avoid chemicals:

  • Remove domestic cleaning chemicals
  • Personal care products and replace them with safer ones.
  • Avoid washing powders with chemicals contained in them and replace with a safer option. Eco Balls or Wash Nuts (especially for sensitive skin and eczema).

Alternative Options:

  • Sour cream made from yoghurt or Kefir or coconut oil/butter as a moisturiser.
  • Avocado mixed with some Bio-Kult is another great source for soothing eczema.
  • Clean your home with bi-carb soda, lemon, vinegar and T tree oil.  Bi-carb sprinkled in the oven with a spray of vinegar provides wonderful cleaning results.  Lemon juice has great cleaning properties and holds a lovely fresh smell.  T tree oil is also a great product for cleaning and provides for a fresh crisp smell in the toilet. Teatree oil is beneficial in the use of antiseptic for minor cuts, abrasions and insect bites.
  • I use Australia’s GRANTS extra fresh herbal toothpaste with organic tea tree oil, it has a fresh taste, that helps keep teeth and gums thoroughly clean and leaves the mouth feeling sparkling fresh. It contains no harmful aluminium, fluoride, sugar, or Sodium Lauryl Sulphate and NO PARABENS.  Dr Natasha recommends brushing your teeth with olive oil.
  • Avoid painting or renovating your home, especially whilst your GAPS patient is detoxing.  When you do need to select a paint, choose eco friendly paints with no or low VOC’s.
  • Avoid buying new furniture during the first year on GAPS and especially during detox.  New furniture, as well as paints and carpets all release toxic chemical gasses that are absorbed into our lungs, skin and mucous membranes.
  • Avoid swimming pools with chlorine as they are considered a chemical soup. The Enviro-Swim System is the only sanitiser on the market that meets stringent Queensland and New South Wales Department of Health guidelines and it can be installed for a little over $2,000 in new pools as well as retrofitted to existing swimming pools. It also saves you money because you no longer have to add chlorine.
  • Avoid sunscreen and monitor your time in the sun.  Products in everyday sunscreens are toxic and may be considered worse than the exposure to the sun itself yet every day well meaning schools are enforcing a no sunscreen no play policy with an intent to protect the children.  Whilst we may now maintain a concern for the chemicals in sunscreen, it is of greater concern that Australian products do not disclose a full list of its ingredients for the consumer to make an informed decision. Wear long sleeve shirts and a sensible hat.  It is also important to consider that GAPS patients are vitamin D deficient and that sensible sun bathing provides a wonderful source of vitamin D.  In situations where sunscreen is unavoidable you can seek guidance on the safest sunscreens at the Environmental Working Group online website.
  • Avoid taking children to chemical hair salons, there are several salons available which provide haircuts only.  “Just Cuts” is located within most Australian Westfield Shopping Centres Australian wide.  Regular use of hair dyes can place one at risk of cancer.  The list of chemicals found in hair salons are exhaustive.
  • Avoid Active physical activity around traffic congestion because the deeper you breathe during exercise, the larger consumption of toxins inhaled such as the care fumes.
  • Avoid both passive and active smoking  Passive and active smoking have been known for several years now to be cancer causing agents, however a sensitive GAPS person will be more vulnerable to these toxins due to their impaired detoxification system overload.  Avoid exposure to where ever possible.
  • Avoid Aluminium, Teflon coated or copper cookware When heated the chemicals contained within are released into our food source.  Buy stainless steel and cast iron only.
  • Avoid oral contraceptives, antibiotics and vaccinations Dr N. Campbell-McBride goes to great lengths to outline the reasons for avoiding the contraceptive pill, antibiotics and vaccinations.  All three wipe out the beneficial bacteria allowing opportunities for pathogenic bacteria to grow and overpopulate the gut.  The in-balance of beneficial gut flora depletes the immune system and contributes to the continuing vicious cycle whilst impacting on the detoxification pathways.  Please refer to her book for further detail.
  • Avoid Microwaves  Microwave’s denature the protein and depletes the nutrient contents.
  • Avoid pesticides, herbicides and insecticides around the home
  • Avoid X-rays due to obvious radiation damage.
  • Avoid Fluoride in your toothpaste and drinking water.  Fluoride causes fluorosis which damages teeth and bones.  The first sign of this poisoning presents with white or brownish scarring of tooth enamel.  In 2008 Queensland introduced fluoride into the communities drinking water and on May the 1st 2009, Brisbane homes received a fluoride overdose set at the rate of 30 to 31 milligrams per litre when the rate of fluoride contained in the water should have been 0.8 mg/L (0.8 parts per million).  Fluoride is known to disrupt thyroid function, bone cancer in boys and poor kidney function.  Fluoride in water can be toxic for the nervous system and researchers are regarding it as an ‘emerging neurotoxin’ lowering IQ in children.

Detox Interventions – Reducing the toxic load

  • Epsom Salt and Apple Cider Vinegar Baths: will assist during Detox and provide the body with a natural way to draw toxins and heavy metals from the body.  Stress drains the body from magnesium and magnesium helps the body to produce adequate amounts of serotonin, a mood elevated chemical in the brain that promotes relaxation to relieve stress.  Epsom Salts are also known to relieve aching limbs and muscle strain. Other detox bath remedies to consider include apple cider vinegar. Alternating baths with Epsom salts and apple cider vinegar will help to normalise the pH of the skin and encourage the growth of beneficial skin flora.  The use of soap should be avoided as this strips the skin from its beneficial flora.
  • Safely remove amalgamated fillings:   Some of the most common signs and symptoms of Mercury exposure include: irritability, anger outbursts, lack of energy, fatigue, low self esteem, memory loss, depression, anxiety and insomnia.
  • Sauna:  A Far infrared Sauna has wonderful detoxifying capabilities and stimulates the immune system.  The difference with this type of sauna is that it heats your body not the air and it is safer because it is the same technology used to keep newborns warm in hospital.  In the old sauna, a person would sweat out 3% of body toxins and 97% of water, however the far infrared sauna assists you to rid of 20% of toxins whilst seating a reduced amount of 80% of water which is a 7 to 10 times more efficient system.

Dr N. Campbell McBride commented on an interesting concept at a Wise Traditions conference in 2008 explaining that when an autistic child’s body temperature rises in a sauna they seem to become more lucid until their temperature drops down again.  If you have access to a far infrared sauna, I highly recommend it.

  • Enemas: It is important to be prepared for an enema if the GAPS patient has a tendency to get constipated.  Dr Campbell-McBride advises not to leave a patient constipated for more than 36 hours as this will be very toxic for the body.  Click here for more information on enemas and where you can receive support.
  • Plastics and BPA Australians use more than 1.3 million tonnes of plastic each year which is more than 71kg per person.  Storage containers for our food and drink sources come in contact with plastic everyday, but not all plastics are safe.  Studies have shown how chemicals leach from certain types of plastics when they come in contact with food, especially if they are heated like when a water bottle is left in a hot car. Try to avoid plastics where ever you can and use glass or stainless steel containers for food storage including lunch boxes.  I have come across several plastic thermoses sold in Australia containing plastics that are not considered safe.  You should make an effort to become familiar with the code numbers on the bottom of the plastic products or steer clear all together.  You can access a plastic use code number reference chart at here
  • Pure water or water filter The GAPS protocol requires filtered water which can be consumed from bottled mineral water or from your home if you have installed a water filter system.  You can install a ‘One water filter’ system made right here in Australia that has the ability to remove fluoride and numerous toxins and chemicals.  I like this system because you do not need to install it under your sink, because it is installed outside to filter all you’re the water in your home including your bath and laundry water.  Having a system available to filter the bath and shower water is ideal for GAPS people because we absorb all these toxins through our skin as well.  Eczema can also be so severe that clothing washed in these everyday tap water chemicals can cause a problem.  Choose a water filter that you can afford – GAPS is about reducing the toxic load where ever you can, it does not mean that you have to have the best water filter on the market.

Educate yourself   

Always educate yourself, don’t just assume that just because a product is on the shelf and claims to be organic that it is GAPS allowable or safe at all.  Some organics are not certified so make sure you check for the Certified Organic label. If you can’t find it, it is not certified.  In addition to this we also have contradictions with certified organic authorities because organic farmers still have the discretion to exercise their right (under organic certification guidelines) to use “allowable” certified organic chemical inputs.

As a consumer, we all trust that organic means no chemicals. But that isn’t always the case in organic meat practices. For example, there is an organically certified sheep dip called Extinosad which is commonly used in organic lamb production.  With the organic certification you are allowed a certain percentage of “allowable inputs”. This can also include the use of vaccines or certified chemicals.

It is always best to contact the farmers and ask them questions directly.  So far I have found only one meat supplier that impresses beyond the organically certified practices and this is at Mitchell Grass Meats.  Here they have established a direct link between producer and consumer, bypassing the middle men along the way which cuts the costs significantly. They like their customers to be confident with the practices used in producing and storing their meat and happy to provide feedback with all questions thrown at them.

I recently learnt of an Australian certified organic poultry farmer who feeds his chickens and ducks soy because it is cheaper and this is another product we are trying very hard to avoid.  High levels of soy reduce assimilation of calcium, magnesium, copper, iron and zinc.  Soy foods also contain chemicals, stunt growth, increase the bodies need for vitamin D and interferes with protein digestion causing pancreatic disorders.  The list of harmful effects from soy are exhaustive and you can find more information at the Western A. Price Foundation…

The following is a list compiled by Anna at Mitchell Grass Meats which will assist you in knowing what questions to ask organic farmers or suppliers when seeking the best quality meat products for your family.

  • What allowable inputs do you use in your meat production?
  • Does grass fed mean 100% fed on your property? Or do you use supplementary feeding at times?
  • Is the grass natural or has the country been sown with an introduced grass? Does this grass require fertiliser? What organic fertiliser do you use?
  • Do you use vaccines?

At Mitchell Grass Meats they use no chemicals, vaccines, supplementary feeding, fertilisers etc. Just 100% grass, sunshine, artesian water, salt for dipping and good care.

Choose organic   Choosing organic eliminates the use of growth hormones, antibiotics, and genetically engineered drugs and feeds in livestock.

The role of Juicing as a detoxification remedy

Juicing provides a means to detoxify the body from heavy metals and other harmful poisons and chemicals naturally.  The wonderful thing about juicing is how easy it is to digest and assimilate the body.  Fibre from fruit and vegetables can aggravate an already sensitive GAPS digestive system and impair absorption of many nutrients, however the juicing procedure removes the fibre from the fruit and vegetables which results in absorption occurring within 20 minutes.  If you eat one carrot (with all its fibre) your body will absorb 1% of beta carotene whilst the remaining remains trapped in the fibre, however if you juice one carrot, the beta carotene assimilated by the body increases more than 90%  Daily juicing provides direct absorption of  many live enzymes, amino acids and necessary vitamins and minerals.

All fruit and vegetable juices must be freshly pressed at home, from ripe (preferably) organic local produce.  60% of the active oxidation power and enzymes within fresh pressed juice is lost within half an hour, therefore it is essential to drink the juice immediately.

The GAPS Protocol suggests adhering to two glasses of freshly pressed juice a day for optimum results.  It is important to remember to drink Juice on an empty stomach, 20 – 25 minutes before food and 2 – 2 ½ hrs after a meal.

Ensuring you get plenty of fresh air will also assist your body to detoxify.  This can be emphasised during a family leisure activity that you find both rewarding and enjoyable.  Open your windows and doors and air your home regularly to allow a good circulation of fresh air.

Supplying many house plants are also beneficial in reducing toxins within the home as they naturally convert toxins into oxygen and other beneficial substances within the environment. Dr N. Campbell Mc Bride recommends certain types of plants within her book on p.208.

Detox & Retracing

Why you feel worse when you implement an optimal nutrition program

By Linda Paterson BHSc

The more food is presented in its natural raw state in which it grows, without any modifications made to it, the easier it is to digest.  Food in its natural state maintains all its enzymes, amino acids, vitamins, minerals and other trace elements, therefore allowing the body to use these resources to replenish and develop healthy tissue.

When people change their diet for the better and eat natural easy to digest foods they often ask “why do I seem to feel worse when I am eating better”?  To answer this question we need to look at what the body is doing when this occurs.  The body starts to identify the lower grade materials and tissues and rids of them in order to make room for the superior ones derived from the higher grade food coming into the body to renew healthier tissues.

During this process, the body goes through a process of ‘retracing’ which presents with a variety of different symptoms that people associate with feeling unwell or worse than they were before they had started.  The new improved diet forces the body to deal with accumulated toxins stored in the tissues of our body by excreting them through the skin, bile and urine.

As these toxins are being discarded from the body, they release their poisons which cause a die off reaction .  The severity of the symptoms depends on the amount of toxins stored in the body and range from headaches, fever, cold/flu, skin eruptions, either constipation or diarrhoea, lethargy, depression, irritability, frequent urination, vomiting, leg cramps and tummy pain.  Although these symptoms can be quite abrupt for some people, it is imperative that the retracing process is not interrupted or stopped by the use of medications or other alternative means.

Many people confuse these symptoms with allergies or food sensitivities within the first two to three days and attempt to stop the healing process before it is concluded and consequently not allowing the first important phase to complete its task to recuperate.  The body should allow at least 10 days for the first phase to complete and this can be longer for others who have more severe conditions.

Dr Campbell-Mc Bride proposes that phenols found in food, act as a natural detoxifier and play their part by cleaning up the toxins throughout the body.  Although it may be true that many GAPS patients are sensitive to phenols, it is imperative not to avoid them unless you have a true allergy (anaphylactic) because they play an important role during detox and retracing.  Whilst the detox reaction from phenols may cause a variety of concerning symptoms, they do subside if the steps are followed through correctly and clinical experience has shown that generally, as the gut heals, the sensitivity to phenols changes and the reaction goes away.

The first stage of detoxification requires plenty of rest so that the body can use all its energy and power to work on reconstructing the injured sites.  If any attempt is made to avoid the body’s signals (lethargy) to rest, the process of retracing will take longer.  Rest and sleep will provide the body with more energy to rebuild the body’s important organs and cells.  The less energy used by the body’s muscles during this phase the better dispersion of power and energy to restore the much needed internal regions.

When a person practices patience during this phase, their strength will progressively return and improve beyond that of which it had been before implementing the diet.  There are two important points here to remember: plenty of rest and avoid the use of drugs to assist in the relief of symptoms during the retracing phase.

During the preceding months, you may experience a ‘recovery regression’ where out of the blue, you develop a rash or become quite irritable.  This flare up is the body’s consistent progression towards healing.  The skin for example, is becoming more stimulated and toxins are released through sweat glands in the skin presenting a rash or igniting a pre-existing state of eczema which could last for ten days or more until it progressively heals.  A few months after this another flare up is experienced but this time it may not be as severe as the last and take less time to recover.  Recovery regressions occur as a part of the recovery cycle.

If you identify that the GAPS patient is particularly sensitive to a certain food, you may take it out for about 4 – 6 weeks and slowly reintroduce it from small progressive amounts.  Worsening of symptoms may also occur during the introduction of new foods or Probiotic foods like sauerkraut or yoghurt/kefir.  The best thing to do is to determine the smallest amount tolerated and slowly increase the amount over time.  Some people attempt to avoid probiotic foods thinking that they make them ill or are sensitive to them and some believe they are not ready for them; however this is generally because they are unaware of how Probiotic foods assist in detoxifying the body.

Probiotic foods are full of beneficial enzymes and friendly bacteria and when consumed they repopulate the gut with beneficial flora that kills the pathogenic flora.  When these pathogens die, they release an accumulation of stored toxins which are then released through the body causing a die off reaction.  This is why fermented Probiotic foods should be introduced gradually and progressively at a pace that the individual can tolerate.

Remember this: successful completion of the first phase of retracing will equip your body with the ammunition to avoid future disease whilst allowing the body to heal from previous conditions that lead you to optimal nutritional changes in the first place.  Whilst the walk through GAPS detox is exhausting to say the least, the trade off in enhanced quality of life is well and truly worth it.

Healing the gut takes time, especially for those with more serious digestive abnormalities.  Some people claim to have noticed more digestive discomfort after sneaking foods from their previous diet like bread or rice.  These people then ask why am I more sensitive now than I was before I started improving my diet?

Basically, the gut wall had not had sufficient enough time to heal and whilst the body was busy focusing on rebuilding the integrity of the gut wall and restoring the microvilli covering the enterocytes, the forbidden food goes back to work in destroying the new enterocytes and disrupts the whole healing process, amounting in subsequent discomfort and return of symptoms.  Most people never noticed their symptoms before they attempted to change their diet and did not realise the full extent of their condition until they attempt to clean it up.

The gut wall began a journey of healing and the duration of this journey will be different for each individual.  A period of 2.5 years is the optimal recommendation for GAPS patients, however this will be dependent on how well the person has adhered to the protocol and how severe their digestive abnormalities were to begin with.


Dr. N. Campbell-McBride MD, MMed Sci (neurology), MMed Sci (nutrition), Gut and Psychology Syndrome, Natural treatments for Autism, Dyslexia, Depression, Dyspraxia, ADD, ADHD, Schizophrenia.

Dr. Stanley S. Bass, Symptoms to Expect When You Improve Your Diet,  3119 Coney Island Ave, Brooklyn,  NY 11235
(718) 648-1500.

GAPS Supplementation Protocol

Dr N. Campbell-McBride emphasises nutrition as the core intervention for the GAPS protocol and successful management of GAPS digestive disorders.  Supplements alone can not achieve the healing response that the GAPS diet does.  Too many supplements can irritate an already inflamed and damaged gut lining and interrupt with the healing process.  Whilst some supplements are important for some people and recommended by qualified practitioners, Dr N. Campbell-McBride advocates keeping supplements to a minimum whilst giving the digestive tract a chance to heal.

‘The GAPS™ Supplementation Guide’ Coming Soon!

This guide will help  you make your selection of GAPS Supplements that meet the GAPS Supplementation Criteria with recommended dosage for therapeutic use with all ages.  It will also provide you with additional information on other targeted supplementation for GAPS.

The GAPS Supplementation Protocol Criteria

The essential supplementation Protocol for GAPS advised by Dr Natasha Campbell-McBride follows:

1. An effective therapeutic strength Probiotic

2. Essential fatty acids

►  A good seed or nut oil blend in the ratio of 2:1 omega 3 to omega 6 fatty acids

►  A good Cod Liver Oil

►  Fish Oil with a higher ratio of EPA to DHA

3. Vitamin A & D in the form of Cod Liver Oil

4. Digestive Enzymes only for some

5. Vitamin, Mineral and Amino Acid Supplements

Dr. Campbell-McBride does not recommend any vitamin or mineral supplementation at the beginning of the program until the digestive system shows signs of improvement. Some patients may require targeted supplementation but this is a matter for a qualified practitioner to decide and should be avoided where possible so that it does not interfere with the healing process.

If you are going to use supplements:
► Choose supplements without any ingredients which may aggravate the gut condition.
► Choose supplements with added fulvic acid ensuring a high absorption rate.
► Keep supplements to an absolute minimum.

Stage Progression

Healing Crisis

A healing crisis usually occurs in stage one on day two or three.  During the first few days in implementing the GAPS protocol, the body begins cleaning up its toxins.  The healing crisis occurs when the pathogenic microbes die off and release their toxins.  These toxins are the cause of the GAPS patient’s mental health characteristics and a regression is usually presented.  Whatever symptoms the child or adult has such as self harming or obsessive compulsive disorder, these symptoms may get worse before they get better.  The body needs time to detoxify before this gets better and this could take weeks or months.  Many of the symptoms include headaches (migraines), vomiting, nausea, muscle aches, depression, bloating, constipation, diarrhoea, extreme fatigue, listlessness or an increase in any symptom the person may have experienced in the past.  Read more about the Healing Crisis and what to expect here

Stage Progression Indicators

Stage progression is dependent upon the individual.  Some people may remain in stage one and two for a few days and others may take several weeks before moving onto the next.  Your patient may be able to move through the Introduction Diet faster or slower depending on two factors: typical symptoms and stool changes.  Generally if you are constipated, you will move faster through the first 2 stages and rest at stage 3 for a week or so until you have managed to introduce the food in each step comfortably.  If you have profuse watery diarrhoea, you will need to stay in the 1st and 2nd stage longer and this could be weeks.  Some people have to take vegetables out all together for a while until diarrhoea clears.  Please refer to ‘the GAPS Companion’ for a more in-depth discussion on Stage progression indicators and specific modifications for the diet.

Typical Symptoms

The first indicator identifies when the healing crisis subsides and other typical symptoms improve.  These symptoms could range from anything that you noticed that got worse during the healing crisis like a specific behaviour (obsessions, irritability, crying etc) or noticeable reactions like headache, bloating or rashes.  It becomes a personal observation for the individual; however each stage should not be rushed or you run a risk of returning to that stage.

The GAPS patient’s stool needs to have firmed up to either a 3 or 4 on the Bristol Stool Chart.  The general rule is: do not move on until diarrhoea has improved and the stool has become more solid.  Do not be mistaken by stools that have squeezed out of an excess fecal compaction which greatly increases toxicity in the body – this is when the stool shape has a slightly jiggered edge or unusual  appearance instead of a stool that presents with smooth round sides.  Constipation and an overflow squeezing through fecal compaction is very toxic for the whole body.  An enema will assist in resolving this problem and Dr Natasha advises that no child should be left constipated for more than 36 hours.

The Bristol Stool Chart

The Bristol Stool Scale or Bristol Stool Chart is a medical aid designed to classify the form of human stools into seven groups.  It was developed by Heaton and Lewis at the University of Bristol and was first published in the Scandinavian Journal of Gastroenterology in 1997.  The form of the stool depends on the time it spends in the colon

Type 1 has spent the longest time in the colon and type 7 has spent the least.  Stools at the lumpy end of the scale are hard to pass and often require a lot of straining.  Stools at the loose or liquid end of the spectrum can be too easy to pass – the need to pass them is urgent and accidents can happen.  The ideal stools are types 3 and 4, especially type 4, as they are most likely to glide out without any fuss.

What type of stool is best?

  • The feeling you need to go is definite but not irresistible  
  • Once you sit down on the toilet there is no delay  
  • No conscious effort or straining is needed  
  • The stool glides out smoothly and comfortably
  • Afterwards there is only a pleasant feeling of relief
  • All this is most likely if the stool is Bristol Stool Form Scale, type 4

Foods to Avoid

• Sugar and anything that contains it.

• Molasses, maple syrup, corn syrup, any other syrup.

• Aspartame in any form, it is a potent neurotoxin (brain toxin).

• Sweets, cakes, biscuits, chocolates, ice – creams.

• All alcoholic beverages. An adult can have good quality wine with meals occasionally but not beer or spirits.

•Tinned and processed foods, always read the ingredients label, beware of sugar, lactose, maltose, starch, corn flour, preservatives, flavourings, colours, yeast. It is best not to buy processed foods at all.

• Grains: rice, corn, rye, oats, wheat and anything made of wheat flour (breads, pasta, biscuits, cakes and anything from the bakery, anything with bread crumbs or batter), buckwheat, quinoa, millet, couscous, spelt, semolina, tapioca, etc. After about 1 – 1.5 years you may be able to slowly re-introduce buckwheat, millet and quinoa (fermented to start with), but not wheat, rye or rice.

• Breakfast cereals are highly processed products with virtually no nutritional value, they are full of sugar, salt, trans-fatty acids and other harmful substances. They should be out of the diet forever.

• Starchy vegetables and anything made out of them: potato, parsnips, yams, Jerusalem artichoke and sweet potato. In about 1 – 1.5 years you may be able to introduce new potatoes.

• Milk should be out at this stage. However, the GAPS person can have soured milk products, such as natural hard cheese, live natural yoghurt and kefir, crème fresh or soured cream, butter and ghee. There are many substances in milk, which could cause trouble, such as milk sugar lactose, casein, immune complexes, etc. Soured milk products do not contain lactose and are pre-digested by the fermenting microbes, which makes fermented milk products very easy to digest for us. I would recommend using only organic milk products and introduce them one at a time, starting from small amounts. If you were not able to introduce any dairy in the Introduction Diet, then please look at page 95 in the GAPS book, it will explain how to introduce dairy safely. If you have introduced homemade yoghurt, kefir and ghee as a part of the Introduction Diet, then gradually introduce fermented cream and butter. When that is well tolerated try natural mature cheeses. You may want to try goat’s or sheep’s milk products first as they are often better tolerated by the GAPS people, than cow’s. In about 1,5 -2,5 years and when all fermented dairy products are introduced, your patient may be able to drink raw unpasteurised organic milk. Introduce it gradually starting from 1-2 teaspoons a day. A GAPS person must never have pasteurised milk!

• Fruit juices apart from freshly pressed. Unfortunately fruit juices (not freshly pressed by you) are a source of processed sugars and can contain a lot of fungi and moulds in them, which your GAPS patient might react to.

• Beans and pulses are generally hard to digest. The two varieties that your patient can have are white (navy) beans also called haricot beans, fermented and cooked at home, and fresh green beans. Commercially available baked beans have almost 40% sugar and should be avoided. You can make your own baked beans at home (please, look in the recipe section).

• Coffee is a strong irritant for the digestive tract, try to avoid it. Strong tea is not advisable either. Natural herbal teas (no flavourings added) and ginger tea are fine. Ginger tea is a well-known folk remedy for digestive problems.

• Soft drinks are not allowed at all, they are full of sugar and various chemicals, which are very damaging for GAPS people.

• Anything with colours, preservatives, flavourings and other chemicals.

• Soya and anything made out of it. It interferes with thyroid function in the body and negatively affects hormonal balance, as it contains oestrogen – like compounds. It is important to avoid all synthetic oestogens, such as from soya, contraceptive pill, many other drugs, domestic cleaning chemicals, laundry detergents, toiletries, etc.