Natural Supplements in Gastroenterology

Natural Supplements in Gastroenterology—An overview
Presentation by: Victor S. Sierpina, MD

W.D. and Laura Nell Nicholson Professor of Integrative Medicine
Family Medicine Department
University of Texas Medical Branch

Learning Objectives

* Describe common categories and examples of natural products for gastroenterology
* Describe indications and rationale for use of probiotics in clinical care
* Outline integrative approaches to irritable bowel syndrome, inflammatory bowel syndrome, chronic hepatitis
* List reliable references for evidence in the use of natural supplements in gastroenterology

Categories of GI herbals with examples
Some popular Hispanic herbs for GI complaints

* Basil/Albahaca
* Chamomile/Manzanilla
* Cumin/Comino
* Rue/Ruda
* Sage/Chia
* Spearmint/Yerba buena



Probiotics/Prebiotics
* Lactobacillus GG
* Lactobacillus casei
* Lactobacillus acidophilus
* Lactobacillus planatarum
* Lactobacillus reuteri
* Bifidobacterium bifidum/longum
* Saccharomyces boulardii
* Streptococcus therpophlus

Mechanisms of Action of Probiotics
* Colonization resistance
* Production of antibacterial substances
* Competition for nutrients
* Competitive inhibition at bacterial adhesion sites
* Enhancement of the immune defense system

Roles and indications of probiotics

* Dysbiosis
* Diarrhea (anitbx, e.g. H. Pylori tx, viral, traveler’s, infantile, AIDS related)
* Lactose intolerance
* Immunomodulatory effects
* Altered gut permeability (leaky gut)
* Inflammatory disorders
* Colon cancer prevention
* Atopy/food allergy

How to prescribe probiotics

* Occur naturally in many foods: yogurt, milk, miso, tempeh, kefir, sauerkraut, some cheeses
* Even non-viable organisms may have benefit (block bacterial adherence)
* Take on an empty stomach
* Space 3-4 hrs after antibx (2 weeks post tx)
* At least 1 billion organisms per dose
* Length of intake uncertain for many conditions


Peppermint
Herbal approach to IBS--carminatives

* Enteric coated peppermint (Mentha piperita):1-2 capsules (0.2ml) tid between meals
* Ginger (Zingiber officinale): 0.25-1 g tid
* Fennel (Foeniculum vulgare): ½-1 tsp seeds pp, 0.03-0.2 ml oil qd, alcoholic extract 0.5-2 ml/d
* Chamomile (Matricaria recutita): tea/infusion with 2-3 g of flowers; 1-4 ml tincture (1:5) tid
* Caraway:1-2 tsp seeds in tea/infusion, or alcoholic extract

Fennel
Herbal approach to IBS—stool agents

Other options
Inflammatory bowel disease

Hepatitis

Anti-viral, anti-inflammatory, anti-fibrotic
Selected References—Hispanic Herbs


Natural Supplements in Gastroenterology