According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), between 60 million and 70 million Americans are afflicted with digestive disease. The cumulative effect includes 50 million physician visits and 10 million hospitalizations annually, with a direct and indirect cost on the economy of more than $107 billion.
Increasing numbers of consumers are managing or treating digestive health conditions, according to the Natural Marketing Institute (NMI). The market research firm reports more than 15 percent of households are managing constipation, 14 percent irritable bowel syndrome (IBS) and 4.5 percent stomach ulcer. Consumers do appear to be willing to enhance their digestive health with natural products. NMI found 31 percent of households had used antioxidants, almost 20 percent had used fiber, and more than 10 percent had used acidophilus in managing digestive health in the past year.
But it’s more than digestive disease and dysfunction. Digestive well-being enhances whole body health. “The intestinal tract is a major component in the digestive and immune systems,” said Mary Galloway, R&D manager, Nutrition Now Inc. “When the intestinal tract is healthy, it promotes proper digestion for better nutrient assimilation, provides immune support to prevent illness, and helps protect the body from foreign invaders such as bacteria or large food particles that can trigger allergies.”
Joseph Brasco, M.D., seconded the notion: “Proper digestion and good gastrointestinal health are essential to overall health and well-being. In fact, the gastrointestinal tract may be the single most important element for establishing and maintaining a healthy body, because 75 percent of the body’s immune system cells are located there.”
Food then moves along the esophagus to the stomach. In this environment, the food is churned with powerful enzymes that chemically denature protein and ionize essential minerals. “Interestingly, one of the most common misconceptions in this area is the idea of ‘too much acid’ causing reflux and heartburn,” said Holly Lucille, N.D. “The truth of the matter is that most of the time it is a lack of acid in our gut and a deficiency of enzymes not allowing us to digest the food we eat. Using antacids is a $3 billion a year business, but of ten leads to further alterations of stomach acidity and poor mineral absorption.”
When the stomach’s job is done, the resultant mixture known as chyme enters the small intestine, which digests, absorbs and transports ingested macro and micronutrients. The journey comes to an end, literally, when the unabsorbed substances from the small intestine are transported to the large intestine. In this section of the gastrointestinal (GI) tract, also known as the colon, any remaining essential electrolytes and excess water in the waste material are reabsorbed into the system; the final waste product is then eliminated.
From start to stop, the digestive system works to enhance the body’s wellness. “Without good digestive function, health cannot prevail,” said Stephen Holt, M.D., founder, Nature’s Benefit. “The digestive health system is highly intelligent and contains more nervous tissue than the spinal cord, organized into ‘little brains’. Functional digestive disease is a lack of harmony of the gastrointestinal tract with a major contribution from mind-body linkages.”
Nutritional Support
Basic micro nutrients and macronutrients are a first line of support for gut health. Zinc has a fundamental role in cellular metabolism, with profound effects on the immune system and the intestinal mucosa. Supplementation has shown significant benefits in prevention and treatment of diarrhea and pneumonia,1 leading researchers to suggest zinc should be included in standard case management of acute diarrhea in developing countries as a cost-effective means of enhancing standard management of the illness.2 Zinc may al so prove beneficial for Crohn’s patients, who are susceptible to low antioxidant defenses. Low serum zinc concentrations in Crohn’s sufferers are related to significantly reduced zinc absorption, even with supplementation.3 Italian researchers found in a study of 12 Crohn’s disease patients, supplementation with zinc sulfate (110 mg tid) resolved intestinal permeability alterations in patients in remission.4
A chelate of zinc plus the amino acid L-carnosine (known as Polaprezinc, sold in the United States by Lonza as PepZin GI®) may specifically target infection with Helicobacter pylori. Japanese researchers reported a 12-week intervention study on gerbils with H. pylori-induced gastritis found the zinc-carnosine chelate attenuated development of gastric mucosal injury.5 Follow-up animal work found the compound could inhibit gastric lesion format ion and reduce mucosal oxidative inflammation.6 In addition, in vitro work shows Polaprezinc enhanced healing of gastric lesions,7 and protected the stomach from NSAID induced mucosal injury.8
Vitamin C has been one of the primary compounds investigated for its interaction with H. pylori. Data from 6,746 adults enrolled in the Third National Health and Nutrition Examination Study (NHANES III) showed higher serum levels of ascorbic acid were associated with a decreased incidence of H. py lor i infect ion, suggesting ascorbic acid may positively impact infection rate and the risk for peptic ulcer and gastric cancer.9 A five-year study in children found those with higher levels of vitamin C in the blood, plasma and gastric juice ha d significantly lower risk of severe H.pylori infection and histologic changes in the stomach.10
Vitamin C may al so help reduce inflammation in the GI tract. In vitro work found ascorbic acid reduced PGE-2 expression.11 It may also help to inhibit gastric cell cancer growth, as in vitro work in gastric cell cancer lines with different H. pylori strains found higher levels of ascorbic acid could induce cell cycle arrest in the cancer cells.12
One of the most basic macronutrients for good digestion health is fiber. Insoluble fiber, found in whole grain products and vegetables, helps promote laxation and balances the pH in the intestines. Soluble fiber, found in beans, fruit, oats and barley, dissolves in water, forming a gel that can help prolong stomach emptying time, regulate blood sugar and lower cholesterol levels.
“Fiber products are necessary, especially for people who do not eat enough fibrous vegetables,” Trujillo said. “Since our body can’t break down fiber, it stays in the intestinal tract, absorbs water and keeps us regular. Hydration is also very important in this regard because you have to have fluids for the fiber to absorb. Fiber is also important for trapping toxins and cholesterol, as well as lowering the glycemic level of foods, thus assisting in balancing blood sugar.”
One common source of supplemental fiber is psyllium (Plantago ovata Forsk) seeds, which contain the bioactive mucilage polysaccharide. Psyllium is a soluble gel-forming fiber that has been shown to bind to the bile acids in the gut and prevent their normal reabsorption, helping to lower cholesterol levels.13 Studies have also found psyllium seeds may be as effective as the drug mesalamine in maintaining remission in ulcer ativecolitis (intestinal inflammation).14
Pumping up intake of soluble and insoluble fiber may have complementary benefits. Studies report adults consuming up to 15 g/d of f iber as flax or psyllium can increase fecal bulk, while consumption of f lax bread can stabilize glucose levels compared to lower f iber bread.15 The soluble fiber glucomannan, from the konjac plant, also serves a natural laxative by increasing stool bulk and improving colonic ecology in healthy adults.16
“For people with IBS, a soluble fiber supplement is key to the management of both diarrhea and constipation,” said Heather Van Vorous, founder, Heather’s Tummy Care. Van Vorous formulated Heather’s Tummy Fiber Acacia to deliver soluble fiber with a good GI tolerance. “[Acacia] is much less likely to cause gas and bloating than other types of soluble fiber. It contains no insoluble fiber or psyllium and ferments slowly—not rapidly—in the gut. This increases good gut flora and actively reduces gas and bloating while resolving diarrhea and/or constipation.”
In addition to acacia, other types of fiber also serve as prebiotics— food for beneficial intestinal bacteria. Fructooligosacharides (FOS), for example, occur naturally in a wide variety of plant foods. When FOS reach the colon, they are used by bifidobacteria for growth, enhancing the digestion and absorption of nutrients,17 detoxification and elimination processes, and boosting immunity.18
A specific type of short-chain FOS, NutraFlora® from GTC Nutrition, has been shown to be prone to digestion by beneficial gut bacteria, producing short-chain fatty acids (SCFA).19,20,21 “SCFAs promote protective effects on the gut and host, such as increased gut integrity, enhanced immunity through pathogen inhibition, improved normal bowel function, and improved nutrient metabolism and absorption, without adverse effects,” said Coni Francis, Ph.D., R.D., senior manager of science, marketing and technical services, GTC Nutrition.
Similarly, inulin, a term applied to a heterogeneous blend of fructose polymers found widely distributed in nature,22 is considered a prebiotic because it is a non-digestible food ingredient that selectively stimulates growth and/or activity of a number of potentially health-stimulating intestinal bacteria.23 Inulin is well proven as a conjunctive therapy to probiotics24,25 due to its actions stimulating bifidobacteria growth in the intestine.26
Larch Arabinogalactan (LAG), as FiberAid® from Lonza, a naturally occurring, soluble dietary fiber extracted from larch (L. occidentalis) tree, offers a concentrated form of arabinogalactan. According to Joanne Slavin, Ph.D., R.D., a professor at the University of Minnesota, Rochester, LAG demons t rated broad physiological benefits including increased anaerobes in the gut and improved bowel habits. The results from Slavin’s research have shown LAG provides digestive health benefits with minimal gas and bloating commonly associated with other dietary fiber ingredients; LAG also enhances a healthy colon by acting as a food source for the growth of friendly bacteria.27
Maintaining Friendly Cultures
Recently, there has been increased awareness among consumers of the potential of probiotic and prebiotic therapies to restore balance to the GI tract and reduce intestinal inflammation. “One of the biggest misconceptions among consumers is that all bacteria are bad,” said Lisa Peterson- Love, Nutri -Health. “Many Americans cannot conceive of good bacteria. Yet, good bacteria are one of the pillars of digestive and overall health. Without enough good bacteria in the small and large intestine, food is not digested properly, we don’t absorb nutrients, we are more vulnerable to negative bacteria and viruses, our immune system doesn’t work well, we may have constipation or diarrhea, our gut lining is vulnerable to inflammation and damage, and more.”
Although the native “culture” in the colon is relatively stable throughout adulthood, age-related changes in the GI tract, diet and immune system inevitably affect microflora culture composition. Probiotics are microbial supplements capable of re-colonizing the bowel with nonpathogenic strains of bacteria or yeast. Together with prebiotics, they may offer a new therapeutic option for the treatment of inflammatory bowel disease (IBD)28,29 and improve bowel function by increasing stool frequency and stool weight.
S.K. Dash, Ph.D., founder of UAS Laboratories, addressed various digestive conditions and various benefits of probiotics in A Consumer’s Guide to Probiotics: “A number of factors are responsible for the lack of friendly cultures in our intestinal tract. Beneficial microflora are reduced by excessive use of antibiotics, chlorinated water, food preservatives, junk foods, and pollution in our environment.” But the right probiotic recipe for good gut health is very specific, he said: “A probiotic supplement can only be effective if it contains the right strain(s), in the right number (potency), in the right condition (viable) and the right formulation.”
Research shows the strength of probiotics lies in their ability to break down lactose and produce lactic acid to help acidify the GI tract; deconstruct protein to free up amino acids; and regulate the digestive motion of peristalsis, thus aiding bowel movements and improving nutrient absorption. The array of activities probiotics are involved in includes preventing diarrhea30 and constipation.31 In the upper digestive tract, probiotics play a role in balancing H.pylori bacteria levels to keep peptic ulcers at bay by minimizing or eradicating H. pylori bacteria in the stomach.32 Researchers out of Dresden, Germany, even supposed in unclear cases of halitosis (bad breath) an increased formation of intestinal gases from unbalanced gut bacteria should also be considered.33
As a finished product, probiotic tablets (as Immunobiotics®, BioScientifics) using the probiotic blend LiveBac® from Nutraceutix Inc., were shown in an unpublished clinical study to support immunity by enhancing phagocytosis by monocytes and neutrophils in a healthy adult human population. Tim Gamble, vice president sales and marketing, Nutraceutix Inc., added: “Delivery technologies are also critical for biological payloads like probiotics, enzymes and proteins. BIO-tract® from Nutraceutix is a patented delivery technology utilized for a variety of applications including gastric acid bypass and buffering, as well as extended release.”
Probiotics also aid in controlling IBDs such as ulcerative colitis,34 chronic recurrent or refractory pouchitis,35 and IBS.36 Richard M. Fedorak, M.D., of the University of Alberta, Canada, explained at a symposium during Digestive Week 2000: “In IBD, bacteria adhere to the lining of the colon like icing on a cake. Probiotics are able to negotiate through this layer and prevent bacteria from adhering to or crossing the epithelium.” The pathogenic role of certain microorganisms of intestinal flora has been demonstrated in experimental colitis in animals and strongly suspected in IBDs in humans, especially in Crohn’s disease (inflammation of the small intestine) and pouchitis.37,38
Other ailments probiotics combat include diarrhea and constipation. One study using Lactobacilli and S. boulardii significantly reduced stool frequency, duration of the illness and vomiting compared to placebo.39 Another benefit of probiotics is preventing overgrowth of yeast (Candida albicans) in the digestive tract, a condition often caused by use of antibiotics. In a pilot clinical study from Wakunaga, manufacturers of the Kyo-Dophilus® line of probiotics, 89 percent of 36 patients infected with Candida had lower symptom scores after taking Lactobacillus acidophilus and Bifidobacterium bifidum (from Wakunaga). In addition, of those supplemented, 72 percent had a greater than 25-percent improvement in symptom scores, 33 percent had a more than 50-percent improvement in scores, and two patients became completely symptom free after one month without undergoing any changes in diet or other treatments.
L. acidophilus DDS-1 is a particularly valuable strain, as its acid, bile and alkaline stability allow it to survive the harsh environment in the stomach and proliferate in the intestines. In one study done by Nebraska Cultures, L. acidophilus DDS- 1 was able to bind to intestinal cell lines, with a capability to displace the harmful bacterium E. coli; the researchers noted the strain’s antimicrobial activity might help to alleviate diarrhea and other intestinal infections.
Brasco recommends his patients take “a probiotic supplement with a high CFU count and broad range of probiotic strains including Homeostatic™ Soil Organisms (HSOs), as found in Garden of Life’s Primal Defense®. These soil-based organisms help support a healthy lactic acid bacteria count and healthy pH levels in the gut.”
Enzyme Mediators
The process of digestion relies heavily on enzymes, which break down the major food components—protein, carbohydrates, fats—into smaller particles; enzymes also help maintain gut pH and protect against pathogens. “Every natural-state food inherently contains the enzymes within it needed to digest that food,” said John R. Taylor, N.D., founder, Natural Wellness Centers of America Inc. “But because we eat so much cooked and processed foods now, we’re not getting the enzymes through our food, and our bodies are suffering the consequences.”
The major categories of digestive enzymes are proteases to digest protein, amylases for carbohydrates and lipases that break down fat. Supplemental enzymes can be sourced from animals (pancreatin) or vegetables, or produced through bacterial fermentation. Fruit sources of enzymes include papaya, which contains the proteinases papain, caricain, chymopapain and glycine endopeptidase; and pineapple, a traditional digestive aid used by South and Cent ral Americans that is a source of the enzyme bromelain.40 Papaya and pineapple enzymes are thought to be particularly effective in lowering intestinal inflammation, as they become active in higher temperatures associated with the inflammatory response.
“Digestive enzymes are vital, and you want to make sure the base product contains both plant and animal enzymes,” Lucille said. “Plant enzymes are able to survive a broader range of pH differences and provide a wider range of activity because they are more sensitive to pH extremes.”
The majority of supplemental enzymes are produced through fermentation techniques. National Enzyme Co. used proprietary techniques to develop its Biocore™ line of enzymes, including lipases designed to target digestive problems associated with the high fat content of a fast food diet, enzymes designed to improve assimilation of carbohydrates, and products geared toward specific GI and digestive conditions such as lactose intolerance.
While broad spectrum enzyme products have been available at retail for years, many companies are now debuting more targeted formulations. Flora, for example, developed a line of vegetarian age- or lifestyle-specific enzyme products under its Udo’s Choice brand. Trujillo noted: “The ‘teen’ blend is formulated with a high content of amylase for a diet heavy in processed carbohydrates, yet still contains the protein and fat enzymes. The adult blend is formulated for those on a restricted diet and is very high in protein and low in carbs, while the ‘advance adult’ product is for seniors or individuals with compromised digestion. This formula is high in all types of enzymes to maximize digestion and nutrient value from all foods.”
Taylor developed a broad spectrum chewable digestive enzyme for children, using various proteases, amylases and lipases, as well as lactase to help children digest the lactose found in dairy products. “Parents want to be sure their children are getting all the nutrients they require for proper growth and development, but circumstances make this an increasingly difficult task,” he said. “Enzymes with each meal must be a core program and will increase the bio-accessibility of the nutrients in all of the foods they consume.” The Ultra-Enzyme Support® chewable was developed with Taylor’s LEADS® (Live Enzyme Activated Delivery System) protocol, which incorporates patented chelated minerals from Albion Advanced Nutrition to provide the enzymes with the co-factor minerals necessary for optimal performance.
Approaching a Tough Topic
As important as GI health is, it may not be something customers are comfortable discussing in the middle of the aisle. “Cultural conditioning results in certain incapacitating beliefs that keep people from being able to address many different types of issues that harm their well-being,” Trujillo said. “Retailers can empower consumers with the knowledge they need to make informed buying decisions by providing product and condition specific literature as well as audio programs.” He recommended using informational tools from manufacturers to help customers find products for specific health needs. Nutri-Health, for example, produced a humorous CD on digestive health, enzymes and probiotics to overcome the reluctance to talk about gut health. And NEC developed Enzyme University.com, an educational Web site about enzymes and how they work.
If the talk is limited to conditions such as diarrhea or constipation, shoppers may not be forthcoming. “Recognize that this may be a sensitive subject for them,” Galloway said. “Focus on the ‘non-traditional’ topics such as immune support, nutrient absorption and allergy reduction. If you are at ease with the conversation and are sensitive to your customers’ attitudes, you can share your knowledge and experiences in a supportive way that encourages customers to try new products.”
Another option is to provide staff education and consumer seminar programs on digestive health. “There are certain health issues that are more difficult for consumers to speak about, and digestive health is one of those,” Trujillo said. Many companies, including Flora, can help with staff and consumer training, providing experts to discuss digestive health and important nutritional ingredients for wellness.
Additional reporting by Erika Camardella.
1. Bhatnagar S, Natchu UC. “Zinc in child health and disease.” Indian J Pediatr. 2004 Nov;71(11):991-5. http://www.ijppediatricsindia.org/
2. Sturniolo GC et al. “Zinc supplementation tightens ‘leaky gut’ in Crohn’s disease.” Inflamm Bowel Dis. 7, 2:94-8, 2001. www.ccfa.org/physician/table7.htm
3. Griffin IJ et al. “Zinc metabolism in adolescents with Crohn’s disease.” Pediatr Res. 56, 2:235-9, 2004. www.pedresearch.org.
4. Sturniolo GC et al. Op cit.
5. Ishihara R et al. “Polaprezinc attenuates Helicobacter pylori-associated gastritis in Mongolian gerbils.” Helicobacter. 7, 6:384-9, 2002.
6. Suzuki H et al. “Polaprezinc attenuates the Helicobacter pylori-induced gastric mucosal leucocyte activation in Mongolian gerbils—a study using intravital videomicroscopy.” Aliment Pharmacol Ther. 15, 5:715-25, 2001.
7. Korolkiewicz R et al. “Polaprezinc exerts a salutary effect on impaired healing of acute gastric lesions in diabetic rats.” Dig Dis Sci. 45, 6:1200-9, 2000.
8. Naito Y et al. “Effects of polaprezinc on lipid peroxidation, neutrophil accumulation, and TNF-alpha expression in rats with aspirin-induced gastric mucosal injury.” Dig Dis Sci. 46, 4:845-51, 2001.
9. Simon JA, Hudes ES, Perez-Perez GI. “Relation of serum ascorbic acid to Helicobacter pylori serology in U.S adults: the Third National Health and Nutrition Examination Survey.” J Am Coll Nutr. 22, 4:283-9, 2003. www.jacn.org
10. Sasazuki S et al. “The effect of 5-year vitamin C supplementation on serum pepsinogen level and Helicobacter pylori infection.” Cancer Sci. 94,4:378-82, 2003.
11. Smith GV, Farthing MJ. “The effect of ascorbic acid on Helicobacter pylori-induced cyclooxygenase 2 expression and prostaglandin E2 production by gastric epithelial cells in vitro.” Helicobacter. 10, 1:83-9, 2005.
12. Zhang ZW, Abdullahi M, Farthing MJ. “Effect of physiological concentrations of vitamin C on gastric cancer cells and Helicobacter pylori.” Gut. 50, 2:165-9, 2002. http://gut.bmjjournals.com
13. Petchetti L et al. Cardiology Rev. 2007, 15(3):116-122, May/June. www.cardiologyinreview.com
14. Fernandez-Banares F et al. “Randomized clinical trial of Plantago ovata seeds (dietary fiber) as compared with mesalamine in maintaining remission in ulcerative colitis. Spanish Group for the Study of Crohn’s Disease and Ulcerative Colitis (GETECCU).” Am J Gastroenterol. 1999, 94(2):427-33. www.amjgastro.com
15. Dahl WJ et al. “Effects of flax fiber on laxation and glycemic response in healthy volunteers.” J Med Food. 2005 Winter;8(4):508-11.
16. Cheng H et al. “Konjac acts as a natural laxative by increasing stool bulk and improving colonic ecology in healthy adults.” Nutrition, 2006, 22(11-12):1112-1119. DOI:10.1016/j.nut.2006.08.009
17. Tahiri M et al. “Effect of short-chain fructooligosaccharides on intestinal calcium absorption and calcium status in postmenopausal women: a stable-isotope study.” Am J Clin Nutr. Feb 2003;77(2):449-57. www.ajcn.org
18. Boehm G et al. “Prebiotics in infant formulas.” J Clin Gastroenterol. Jul 2004, 38(6):S76-9.
19. Swanson KS, Grieshop CM. “Fructooligosaccharides and Lactobacillus acidophilus Modify Bowel Function and Protein Catabolites Excreted by Healthy Humans.” J Nutr. 2002, 132: 3042–3050. http://jn.nutrition.org
20. Hidaka H. et al. “Proliferation of Bifidobacteria by Oligosaccharides and their Useful Effect on Human Health.” Bifidobacteria Microflora. 1990, 10(1):65-79.
21. Sandra JM et al. “Dietary Fructooligosaccharides Affect Intestinal Barrier Function in Healthy Men” Am J Clin Nutr. 2004, 80:1658–64. www.ajcn.org
22. Niness KR. “Inulin and Oligofructose: What Are They?” J Nutr. 1999;129:1402S-1406S. http://jn.nutrition.org
23. Gibson GR, Roberfroid MB. “Dietary modulation of the human colonic microbiota—introducing the concept of prebiotics.” J Nutr. 1995;125:1401-12. http://jn.nutrition.org
24. Djouzi Z, Andrieux C. “Compared effects of three oligosaccharides on metabolism of intestinal microflora in rats inoculated with a human faecal flora.” Br J Nutr. 1997;78:313-324
25. Gibson GR, Roberfroid MB. Op cit.
26. Niness KR. Op cit.
27. Slavin, Joanne, Department of Food Science and Nutrition at the University of Minnesota. Proprietary study sponsored by Lonza.
28. Hopkins MJ et al. “Nondigestible oligosaccharides enhance bacterial colonization resistance against Clostridium difficile in vitro.” Appl Environ Microbiol. 2003, 69(4):1920-7. http://aem.asm.org
29. Kanauchi O et al. “Modification of intestinal flora in the treatment of inflammatory bowel disease.” Curr Pharm Des. 2003, 9(4):333-46.www.bentham.org/cpd
30. Gaon D et al. “Effect of Lactobacillus strains (L. casei and L. Acidophillus Strains cerela) on bacterial overgrowth-related chronic diarrhea.” Medicina (B Aires). 2002, 62(2):159-63, 2002. www.medicinabuenosaires.com/index2.htm
31. Koebnick C et al. “Probiotic beverage containing Lactobacillus casei Shirota improves gastrointestinal symptoms in patients with chronic constipation.” Can J Gastroenterol. 2003, 17(11):655-9. www.pulsus.com/Gastro/home2.htm
32. Oh Y et al. “Folk Yogurt kills H. pylori.” J Appl Nutr. 41:50-64, 1989.
33. Henker J et al. “Successful treatment of gut-caused halitosis with a suspension of living non-pathogenic Escherichia coli bacteria--a case report.” Eur J Pediatr. 2001, 160(10):592-4.
34. Guslandi M et al. “A pilot trial of Saccharomyces boulardii in ulcerative colitis.” Eur J Gastroenterol Hepatol. 2003 15(6):697-8. www.eurojgh.com
35. Böhm SK, Kruis W. “Probiotics: do they help to control intestinal inflammation?” Ann N Y Acad Sci. 2006 Aug;1072:339-50. DOI:10.1196/annals.1326.005
36. Kim HJ et al. “A randomized controlled trial of a probiotic, VSL#3, on gut transit and symptoms in diarrhoea-predominant irritable bowel syndrome.” Aliment Pharmacol Ther. 2003, 17(7):895-904.
37. Belkahla N, Maamouri N. “Role of intestinal flora in inflammatory bowel disease and probiotics place in their management” Tunis Med. 2005 Mar;83(3):132-6.
38. Meier R, Steuerwald M. “Place of probiotics.” Curr Opin Crit Care. 2005 Aug;11(4):318-25.
39. Gaon D et al. Op cit.
40. Howell E. Enzyme Nutrition: The Food Enzyme Concept. Avery Publishing Group Wayne, NJ, 1985, p. 3.
41. Cichoke A. Bromelain: The active enzyme that helps us make the most of what we eat. Keats Publishing Inc., New Canaan, CT, 1998, p.10.
Botanical Breakthroughs
Plants offer more to the gut than just nutrients—many botanicals also supply healing compounds to address digestive dysfunction.
Aloe vera, for example, may help lower intestinal inflammation,1 alleviate symptoms of ulcerative colitis,2 and promote the healing of gastric ulcers.3 A small open-label study supported by Aloecorp using its ACTIValoe™ found Aloe vera juice could serve as a gastrointestinal (GI) “tonic”, stabilizing GI pH, facilitating gastric motility, normalizing gut flora composition, reducing intestinal putrefaction, facilitating protein digestion, and preventing gastric and systemic inflammation.4
Peppermint leaf and peppermint oil have a long history of use for digestive disorders. Recent evidence suggests enteric-coated peppermint oil may be effective in relieving some of the symptoms of inflammatory bowel syndrome (IBS).5 Heather Von Vorous developed Heather’s Tummy Tamers, peppermint oil capsules with 50- percent more enteric coating for people with IBS, as they can be more prone to heartburn and reflux; she said: “This helps ensure the capsules reach the small intestines before they dissolve, as that’s where they have the strongest effect on the gut.”
Ginger (Zingiber officinale) is often advocated as beneficial for nausea and vomiting. A recent systematic review and meta-analysis of trials using ginger for nausea and vomiting found “a fixed dose of at least 1 g of ginger is more effective than placebo for the prevention of postoperative nausea and vomiting.”6 Ginger may ameliorate nausea by preventing development of gastric dysrhythmias and elevation of plasma vasopressin, a hormone released to preserve body water.7
References
1. Langmead L, Makins RJ, Rampton DS. “Anti-inflammatory effects of aloe vera gel in human colorectal mucosa in vitro.” Aliment Pharmacol Ther. 19, 5:521-7, 2004.
2. Langmead L et al. “Randomized, double-blind, placebo-controlled trial of oral Aloe vera gel for active ulcerative colitis.” Aliment Pharmacol Ther. 2004 19:739-747.
3. Eamlamnam K et al. “Effects of Aloe vera and sucralfate on gastric microcirculatory changes, cytokine levels and gastric ulcer healing in rats.” World J Gastroenterol. 2006 Apr 7;12(13):2034-9.
4. Bland J. “Effect of orally consumed Aloe vera juice on gastrointestinal function in normal humans.” Non-peer reviewed excerpt from Linus Pauling Institute of Science and Medicine. 1985.
5. Cappello G et al. “Peppermint oil (Mintoil® in the treatment of irritable bowel syndrome: A prospective double blind placebo-controlled randomized trial.” Dig Liver Dis. 2007 Jun;39(6):530-536. Epub 2007 Apr 8. doi:10.1016/j.dld.2007.02.006
6. Chaiyakunapruk N, et al. “The efficacy of ginger for the prevention of postoperative nausea and vomiting: A meta-analysis” Am J Obstet Gynecol. January 2006, 194(1); 95-99. DOI:10.1016/j.ajog.2005.06.046
7. Lien HC et al. “Effects of ginger on motion sickness and gastric slow-wave dysrhythmias induced by circular vection.” Am J Physiol Gastrointest Liver Physiol. 284, 3:G481-9, 2003 http://ajpgi.physiology.org/