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Complimentary medicinal support for Gastrointestinal Health

Digestion, Inflammation | March 22, 2016 | Author: The Super Pharmacist

Inflammation, Digestion

Complimentary medicinal support for Gastrointestinal Health

Many peoples who have not had results from conventional medical cures for gastrointestinal disorders (GI) will often turn to complementary and alternative medicine (CAM). Unfortunately, research regarding the use of CAM in the treatment of gastrointestinal disorders has been scarce. Of the limited studies that do exist, they are often characterised by weak study design, small patient samples, and significant bias.

Additionally, the concept of CAM is largely based on individualised care as opposed to disease based treatment making the testing of individual products to treat gastrointestinal disorders hard to evaluate from a study design perspective.

Complementary Medicine for Gastrointestinal Disorders

Despite some of the challenges in evidencing their efficacy, there are a number of complementary medicines that are growing in use as patients seek alternative treatment solutions. These include:

Mastic Tree

Mastic Tree (a common name for several plants used as CAM treatments) has been used to treat gastrointestinal disorders for thousands of years. There are records in Ancient Greece of mastic tree being used to treat stomach disorders as early as the 2nd Century, and its antibacterial and antifungal properties mean it is regularly used in a number of preparations and ointments, as well as sticking plasters. It is also commonly used across the Mediterranean in a variety of foods and drinks such as flavoured spirits, chewing gum, cakes, pastries and cheese. Although it has a long history as an alternative treatment for stomach ulcers, there is no formal evidence base to support its use.

Aloe Vera

Complementary Medicine for Gastrointestinal¬†DisordersAloe Vera, a tropical plant that grows wild in many countries, is commonly cultivated for both agricultural and medicinal purposes and has been used to treat gastrointestinal disorders in many indigenous cultures for centuries. Its extracts are widely used across both the cosmetic and alternative medicine industries, but the evidence for its efficacy and safety is limited and frequently contradictory.

Whilst some studies have found it to be beneficial in the treatment of gastrointestinal disorders, other organisations, such as The US Office of Environmental Health Hazard Assessment, consider it harmful enough in certain forms (orally ingested non-decolorised leaf extract) to be listed as a ‘chemical known to cause cancer or reproductive toxicity’.

The large majority of research concerning the use of aloe vera has not been carried out on adults: the majority of studies available in the evidence base concern its application in the use of various experiments on rats. Of the limited evidence that does exist in favour of aloe vera, much of it focuses on its potential for reducing blood glucose in diabetic patients and lowering blood lipid levels.
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Slippery Elm

Slippery Elm (Ulmus rubra) is an elm tree native to North America. Its inner bark has been used throughout history as a demulcent (a substance that relieves inflammation and irritation), although again there are few formal studies to verify these properties in the specific treatment of gastrointestinal discomfort.

Pectin

Pectin is another demulcent that is commonly used in the treatment of gastroenteritis and it is commonly used against constipation and diarrhoea due to its role as a stabilizer and thickening agent. It is also used in various drug delivery forms such as gastro-retensive systems and controlled release systems due to its intoxicity and low production costs.

Curcumin

Curcumin, a substance found inside turmeric (best known as a spice), has been used in many countries for thousands of years due to a belief in its anti-inflammatory and antioxidant properties.

CurcuminThere has been a large amount of research on the solubility of curcumin and its efficacy as a supplement, with much of it highlighting the poor bioavailability of curcumin as a substance – it is not very soluble in water, has a poor absorption rate, low levels in plasma and tissues, and is rapidly excreted.

As such, theracumin (a water-dispersible cumin) is available as a complementary product with a very good bioavalability for absorbtion.

There is no standard dosage for curcumin and it is generally considered to be safe, although high doses have been associated with some incidents of nausea and diarrhoea, and pregnant women are advised not to take curcumin supplements due to uncertainty over some of its properties.
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Bioflavinoids

Bioflavinoids, distributed widely in plants and foods such as parsley, blueberries, black tea and peanuts, are also used to treat stomach complaints. Citrus bioflavoinoids (hesperidin, quercitrin, rutin and tangeritin) are well known for providing Vitamin C, but there is currently no evidence to support their use in the treatment of a wide range of gastrointestinal complaints.

Glutamine

Glutamine, an amino acid that is used in the biosynthesis of protein and the most abundant amino acid in human blood, has been mooted as having benefits for patients with gastrointestinal problems. Again there is no formal evidence to support this, but its use in other medical fields is well established – it is commonly added as a component of oral supplementation that reverses muscle wastage in patients with advanced cancer, and has been evidenced to reduce the risk of systemic infections that originate in the gut. 
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References:

Tillisch K (2006) Complementary and alternative medicine for functional gastrointestinal disorders Gut 55(5):593-596

Langmead L, Chitnis M, Rampton DS (2002) Use of complementary therapies by patients with IBD may indicate psychosocial distress Inflamm Bowel Dis (8)174–179

Bensoussan A, Talley NJ, Hing M. et al (1999) Treatment of irritable bowel syndrome with Chinese herbal medicine: A randomized controlled trial. JAMA 28(1)1585–1589

Hutton J (2005) Cognitive behaviour therapy for irritable bowel syndrome Eur J Gastro Hepatol 17(1):11-4

Proposition 65. Chemicals Listed Effective December 4, 2015 as Known to the State of California to Cause Cancer: Aloe Vera, Non-Decolorized Whole Leaf Extract and Goldenseal Root Powder. U.S. Office of Environmental Health Hazard Assessment (December 4, 2015)

Vogler BK, Ernst E (1999) Aloe vera: a systematic review of its clinical effectiveness Br J Gen Pract 49 (447): 823–8

Tingshuang Yi, Jun Wen, Golan-Goldhirsh A, Parfitt DE (2008) Phylogenetics and reticulate evolution in PISTACIA (Anacardiaceae) American Journal of Botany 95(2):241–251

Devassy JG, Nwachukwu ID, Jones PJ (2015) Curcumin and cancer: barriers to obtaining a health claim Nutrition Reviews 73(3):155-65

May PE, Barber A, D'Olimpio JT, Hourihane A, Abumrad NN (2002) Reversal of cancer-related wasting using oral supplementation with a combination of beta-hydroxy-beta-methylbutyrate, arginine, and glutamine American journal of surgery 183(4) 471–9

Rapin JR, Wiernsperger N (2010) Possible links between intestinal permeability and food processing: A potential therapeutic niche for glutamine Clinics 65(6): 635–43

Brown JV, Moe-Byrne T, McGuire W (2014) Glutamine supplementation for young infants with severe gastrointestinal disease. The Cochrane database of systematic reviews 12: CD005947

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