Natural Remedies for Digestive Disorders
Natural Remedies for Digestive Disorders
Thirty weeks into her pregnancy,
Stephanie began to feel an intense burning sensation in her throat shortly
after eating meals. Friends told her she was experiencing heartburn, which she
never had before.
She avoided taking over-the-counter
medications for fear they might harm her baby.
At her next prenatal appointment with
her midwife, Stephanie mentioned the heartburn and asked whether there were any
natural remedies she could take to treat it.
She left the office with a recommendation
to take slippery elm lozenges and went on to become mostly heartburn free for
the rest of her pregnancy.
Like Stephanie, more clients and
patients are looking for ways to treat their digestive disorders with natural
medicines sold over the counter. According to a 2007 National Institutes of
Health– funded survey on the use of complementary and alternative medicines in
the United States, roughly 38% of adults use natural remedies, such as
diet-based therapies (eg, gluten-free diets) and herbs, among others.1 Also in
2007, it was estimated that nearly $34 billion was spent on complementary and
alternative medicines, including about $15 billion on “nonvitamin, nonmineral, natural
products.” Remarkably, this is equivalent to about one third of out-of-pocket
dollars spent on prescription drugs.
Despite the fact that many alternative
treatments have been poorly studied and are loosely regulated, their popularity
continues to grow. According to a market overview report by Natural Foods
Merchandiser, total natural product industry sales for 2012 were nearly $81
billion, almost a 10% increase over 2011.2 With expected increases in drug and
health care costs and ongoing issues concerning uninsured or underinsured
Americans, using alternative treatments sold over the counter is expected to become
even more attractive to clients and patients.
Healing
Herbs and Spices
For centuries, various herbs and spices
have been promoted as healers for the body. For instance, in Chinese and
Ayurvedic medicine, both herbs and spices comprise the majority of treatments.
Through thousands of years of use,
medicinal substances have been identified and categorized to treat digestive
and other common disorders. Despite the fact that many prescriptions
Drugs are fashioned after naturally
occurring herbs, limited research has been done on their efficacy and safety
when used alone or in combination for specific digestive problems.
Unlike prescription medications, natural
remedies aren’t regulated by the FDA and therefore are more at risk of being adulterated
or contaminated during processing. When clients
Ask about herbal and other natural therapies,
it’s best to educate them about the ones that have been scientifically studied,
caution them about those that don’t have much science behind
Them, and suggest they use them under
the supervision of their primary care physicians, especially if they’re taking
prescription drugs for other health issues.
The following is a review of the most
common natural remedies clients may be using to treat digestive disorders and
advice on how to counsel them.
Ginger
Ginger (Zingiber officinale) has
a distinct and pungent flavor, and is known for relieving nausea. Denine
Rogers, RD, LD, president of HEPSA Living Healthy, recommends raw ginger or
ginger tea to clients as a natural remedy. “I’ve had multiple clients with cancer
who have benefited from chewing raw ginger or drinking ginger tea during their
treatments,” she says.
A study published in the May 2013 issue
of Neurogastroenterology & Motility supported the use of ginger to
alleviate nausea in cancer patients receiving chemotherapy3; however,
the National Center for Complementary and Alternative Medicine (NCCAM)
reports that
The research is mixed on ginger’s
effectiveness in this area.
A meta-analysis published in the January
2006 issue of the American Journal of Obstetrics & Gynecology showed
that ginger was effective for preventing and reducing postoperative nausea and
vomiting.
Kate Scarlata, RDN, a Boston-based
dietitian and author of The Complete Idiot’s Guide to Eating Well With IBS and
co-author of 21-Day Tummy, recommends ginger for nausea and gastric emptying.
She suggests patients take 1- to 1.2-g capsules to boost the frequency of
antral contractions and accelerate gastric emptying to reduce nausea and
symptoms of gastroparesis.
“My clients who have ongoing nausea or
gastroparesis have noted a benefit from ginger tea in that it quells their
symptoms—perhaps taking a break from a hectic day with a warm cup of nurturing
tea provides additional GI-calming benefits,” Scarlata says.
In a review from the NCCAM, ginger is
considered safe and causes few side effects in most people; however, in large
doses, it can cause stomach upset.
Turmeric
Another herb used to treat common digestive
disorders is turmeric (Curcuma longa). The active component in turmeric
is curcumin, the substance that gives turmeric its yellow color. Turmeric frequently
is used in Chinese and Ayurvedic medicine to aid digestion and liver function,
along with a host of other nondigestive ailments.
The World Health Organization supports
the use of curcumin to treat acid reflux, flatulence, or atonic dyspepsia.
Research has shown that turmeric has
anti-inflammatory effects, which may explain its effectiveness in preventing relapses
of ulcerative colitis. In one randomized controlled Trial, fewer patients experienced
relapse when taking turmeric with conventional treatment. However, there was no
difference between the groups after one year.
Researchers are in the process of
examining ways to overcome turmeric’s reduced bioavailability after consumption.
Like the researchers in the study,
Scarlata recommends taking 2 g of turmeric to treat ulcerative colitis. “I
encourage my clients to use turmeric for its potential anti-inflammation and GI-calming
impact in their recipes. Widely used in Indian cuisine, turmeric adds a bright
yellow color and a nice earthy taste to rice dishes, soups, and stews,” she
says.
But while turmeric may be an effective
treatment for some, it may not be safe for everyone. For example, turmeric may worsen
gall bladder issues; it may cause stomach upset and exacerbate gastroesophageal
reflux disease (GERD) symptoms in some people. It’s recommended that those scheduled
for surgery, discontinue using turmeric at least two weeks in advance, as it may
slow blood clotting.
Milk Thistle
Native to Europe, milk thistle (Silybum
marianum) has long been used as food and medicine.11 Currently, it’s used
to treat alcoholic hepatitis, liver cirrhosis, liver poisoning, and viral
hepatitis and to protect the liver from the damaging effects of toxins.
Cristina Caro, MBA, RD, LD, a consultant
dietitian and adjunct faculty member at Chattahoochee Technical College in
Atlanta, recommends milk thistle to clients who experience sluggish digestion
and metabolism and to keep liver cells healthy. She suggests patients take a
175- to 200-mg capsule of milk thistle per day for 60 days (standardized to
contain 70% to 80% silymarin) to support the regeneration of liver cells. However,
it’s important to know that while milk thistle has been shown to protect the
liver from toxins in animal studies, human studies have-not demonstrated this,
according to NYU
Langone Medical Center.
In general, milk thistle is well
tolerated, although GI side effects have been noted as well as its tendency to
lower blood sugar, so caution should be used for anyone at risk of
Hypoglycemia.
Slippery Elm
As the name suggests, slippery elm (Ulmus
rubra) contains a gel-like substance called mucilage that coats the
esophagus. It’s this substance that may make slippery elm an effective natural treatment
for GERD. The herb is available as a lozenge, capsule, tincture, or tea to
treat digestive distress.
According to the University of Maryland
Medical Center, the doses healthcare practitioners may recommend to clients
will vary based on the preparation. Typical doses may include 4 g of powdered
bark dissolved in 2 cups of hot water three times per day or 400 to 500 mg in
capsule form three to four times per day for four to eight weeks.
Although slippery elm appears to have no
serious side effects, its coating effect may reduce the absorption of certain medications,
so it’s important to tell clients to take it separately From medications they may take for other
illnesses. As with all herbal remedies, pregnant or breastfeeding women should
discuss the use of slippery elm with their health care provider.
The efficacy of slippery elm, is widely
reported, though no clinical trials have been found to support its use.
Pineapple Extract
“As a teen, I worked in a health food
store and learned about eating pineapple to manage an upset stomach, and it’s
worked for me since then,” says Cindy Culver, MS, RD, LD, a school nutrition professional
in Smyrna, Georgia.
Culver found eating pineapple (Ananas
comosus) helpful because it contains digestive enzymes that have been
touted as a treatment for heartburn and indigestion. Many alternatives and complementary medicine specialists
promote bromelain (extracted from pineapple), one of the digestive enzymes, as
a treatment for various conditions, and there’s some support that it may be effective as an anti-inflammatory
to treat arthritis and muscle soreness. However, little evidence exists to
support its use for digestive disorders.
Large doses of bromelain may cause
stomach upset, and it’s recommended that individuals stop using it at least two
weeks before surgery because it may increase the risk of bleeding.
Probiotics
Probiotics are heavily marketed as a way
to help regulate digestion. They’re a well-known treatment for
antibiotic-induced diarrhea, and the use of probiotics containing bacterial
strains such as Saccharomyces boulardii and
Lactobacillus rhamnosus GG are supported in the literature.
It’s important to recognize that of the
many different probiotics products available, not all bacterial strains they
contain have been studied for efficacy. Clients must choose the right type of probiotic
for them and concern themselves with whether the bacteria they ingest can
withstand stomach acid and make it into the intestines alive to be of any
benefit.
Tracy Smith, RD, LD, a Bariatric dietetics
specialist, recommends probiotics to treat both diarrhea and constipation to
her clients. However, a recent meta-analysis considers their use for constipation
investigation and not yet supported by research.
Rather than supplementing, Connie Crawley,
MS, RD, a University of Georgia Cooperative Extension nutrition and health
specialist, recommends kefir milk to treat GERD. “I use it because of the probiotics. It has 10
[strains of bacteria] vs. The normal two in yogurt,” she says. She suggests
clients drink at least a 1⁄2 cup per day, but says a 1⁄2 cup per meal is even
better. To increase its palatability, she recommends mixing half of the kefir milk
with nonfat milk or choosing a flavored variety.
Food
First
Dietitians know that altering the diet
using medical nutrition therapy and eating specific foods can help treat the
symptoms of transient digestive discomfort and chronic disease. The following are
a couple of additional foods dietitians can recommend to clients to treat
common digestive disorders:
• Milk: Drinking a glass of milk has long been
recognized as a home remedy to treat heartburn. In fact, Rogers recommends it
and reports success with her clients who suffer from GERD.
It’s believed that milk may serve as a
temporary buffer for stomach acid. The fat in milk may cause additional
discomfort, but clients can avoid this by drinking fat-free or low-fat
varieties.
Anecdotal reports support the use of
milk to treat GERD, but not much clinical evidence exists.
• Honey: In a 2002 BMJ letter, Indian
researchers reported success using honey to treat heartburn, noting it’s
commonly used in Ayurvedic medicine. 17 It’s believed that the viscosity of honey
coats the upper gastroesophageal tract, preventing the stomach acid from
rising. There appears to be no significant support for this in the literature, yet
the combination of milk and honey to treat heartburn remains popular.
No
Silver Bullet
Many natural remedies for digestive
disorders are relatively harmless, and some may provide simple, inexpensive
treatment for transient conditions, but they’re no magic cure for the more
Serious digestive disorders. It’s important
for dietitians make recommendations with the research (or lack of research)
in mind and inform clients of the evidence for or against such remedies.
In addition, RDs should rule out more
severe disease by taking an interdisciplinary health care team approach to
helping clients with chronic digestive discomfort.
Regardless of an individual’s digestive
disorder, modifying his or her diet by eliminating offending foods and reducing
overheating is key. Lifestyle changes such as increasing physical activity and
stopping smoking also are essential since obesity, smoking, and stress is known to increase GI distress.
Helping a client develop a nutrient-rich
diet and overall healthful lifestyle are important tasks for the dietitian,
despite other therapies the patient may be using. According to Patsy Catsos,
MS, RDN, LD, a consultant dietitian at
Nutrition Works and the author of IBS — Free at Last! “A whole foods
diet that’s well matched to the patient’s needs is the best natural remedy.”
All Fitness __ Natural Remedies for Digestive Disorders
By Sherry Coleman Collins, MS,
RDN, LD, is an Atlanta-based
Nutrition consultant, writer,
and dietitian in private practice,
Specializing in food
allergies and digestive disorders.
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