The Digestive Path Well-Traveled

Dietary supplements that may keep the burps, bends and other digestive bumps at bay

Constipation · Diarrhea· Excess Gas· Heartburn· Nausea and Vomiting· Aloe & Cascara Update· Herbal Aids for Digestion · The Path Well-Traveled References

Images of digestive enzymes courtesy of Forsyth, Mo. - based National Enzyme Co.

The holidays are just around the corner, as well as the opportunity to eat thousands of calories and hundreds of fat grams relatively guilt-free and consumed under the misguided notion of "keeping with the holiday spirit"--that is, if the holiday spirit includes gas attacks and diarrheic episodes.

Indigestion, also known as dyspepsia, affects approximately one in four people at some point in their lives, according to the American Academy of Family Physicians. This means that the number of people looking for digestive health products is around 100 million strong.

When the digestive system is working properly, life is beautiful. Nutrients are being absorbed as they should be, aiding in eyesight, cognitive function, heart health and numerous other bodily functions. However, the gastrointestinal (GI) tract is subjected to an extensive amount of foreign stimuli on a daily basis in the form of food and microbes. When the digestive tract gets off course for whatever reason, the body no longer is the well-oiled machine it once was, and discomfort and even poor health may result.

If all is working right in the digestive tract, the journey a piece of food takes from the mouth until it is passed during a bowel movement is smooth and linear. However, digestive disharmony can occur when a person is sick or stressed, not to mention if he eats poorly. If that food runs into problems--be it a malfunctioning sphincter muscle in the esophagus (heartburn) or a virus (which may cause diarrhea)--trouble ensues. Constipation, diarrhea, gas, heartburn, nausea and vomiting are just some of the uncomfortable--not to mention inconvenient--effects from a troubled digestive system.

Indigestion occurs when a person eats too much, eats too quickly, eats high-fat foods or eats under stress. Smoking, drinking too much alcohol, using medications that irritate the stomach lining and being tired can make indigestion worse. People may also have persistent indigestion that is not related to any of these factors but instead may be caused by a problem with the muscular movement of the stomach that pushes food along the winding digestive tract.

Problems such as excess gas and nausea are not always stand-alone symptoms, but rather indicators of a disorder within the digestive tract. An estimated 60 million to 70 million people suffer from some sort of digestive disorder, according to data from the National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK). These include peptic ulcers, caused by the Helicobacter pylori (H. pylori) bacterium or by nonsteroidal anti-inflammatory drugs (NSAIDS) that interfere with the stomach's natural defenses against its own acids. Peptic ulcers cause heartburn, nausea, vomiting, loss of appetite and weight loss.

Ulcerative colitis, on the other hand, is a chronic inflammatory disease of the colon, characterized by frequent abdominal pain and bloody diarrhea, as well as nausea and fatigue. It is one of two forms of inflammatory bowel disease (IBD). Crohn's disease, the other type of IBD, most often affects the end of the small intestine and beginning section of the colon; it often leads to bloody stools and malabsorption problems. More than 1 million Americans have colitis or Crohn's, and currently researchers do not know what exactly causes IBD, although immune response, genes and environmental factors may have a role.

Irritable Bowel Syndrome (IBS) is a common GI problem and is not related to IBD. Typical symptoms of IBS include bloating, gas, diarrhea and constipation. An estimated 35 million Americans have IBS, an annoying but otherwise non-life-threatening disease.

Not everyone has these disorders, but many Americans suffer from some of the same digestive complaints shared by these ailments, be it gas or nausea. As a retailer of dietary supplements, are you aware of which products offer the most benefits for digestive upsets? If not, brush up on the vitamins, minerals, herbs, fibers and nutraceuticals that help keep a person's digestion on track.

"People are sometimes house-bound with these ailments," said Mairi Ross, product specialist for Cottonwood, Ariz.-based Sedona Labs, maker of the probiotic product iFlora™. "When they go to a doctor's office, the doctor is often baffled as to how to treat these non-medical conditions."

Constipation

In preparation for a bowel movement, the colon absorbs water when forming waste products (stool). Muscle contractions in the colon push the stool toward the rectum, and by the time it is ready to be passed, most of the water has been absorbed and the stool has become a solid. However, if the colon absorbs too much water because the stool has moved too slowly through the organ, too little water is left for the stool-making process, and constipation can result. A customer who has had constipation persist for more than three weeks may need to see his health care provider right away, especially if blood is appearing in the stool.

The American Society of Colon and Rectal Surgeons report 80 percent of the population has suffered from constipation at one time or another, and it is the most common GI complaint in the United States. Constipation usually describes infrequent bowel movements, but it can also refer to a decrease in the volume or weight of stool, straining during a bowel movement, incomplete evacuation of stool, or the need for enemas, suppositories or laxatives in order to stay "regular."

And what constitutes being regular? The American Gastroenterological Association (AGA) reports it can mean having anywhere from three movements per day to three per week--or less. It all depends on a person's plumbing. A common fallacy associated with constipation, according to AGA, is that if a person does not have a daily bowel movement, waste begins to be absorbed by the body. "These misconceptions have led to a marked overuse and abuse of laxatives," AGA reported. "Every year, Americans spend $725 million on laxatives. Many are not needed, and some are harmful."

Constipation may occur due to inadequate fiber or fluid intake, a sedentary lifestyle or a change in environment, as well as due to travel, pregnancy or a change in diet. Constipation may also occur from taking antidepressants, pain killers, blood pressure medication, diuretics, and even iron and calcium supplements. A condition known as "imaginary constipation" is also very common, in which a person's misconceptions about what constitutes a normal bowel movement keeps him from having one.

Physicians frequently suggest fiber as a first step for treating constipation and even IBS. NIDDK recommends several types of laxatives for constipation, such as bulk-forming and stimulating. Bulk-forming laxatives, also known as fiber supplements, include wheat bran, psyllium, larch arabinogalactan, inulin and oligofructose. Dietary fiber is different from other nutrients in that it is not digested in the small intestine (it is resistant to digestive enzymes), but rather works its magic in the large intestine. Fiber is mostly carbohydrate and is considered a non-starch polysaccharide. It provides no calories or energy to the body. The Institute of Medicine recently set an adequate intake (AI) for fiber at 38 g/d for men and 25 g/d for women in order to maximize fiber's primary benefit--reducing the risk of coronary heart disease.

Fiber is classified as soluble or insoluble. Soluble fibers include gums, mucilages, some pectins and some hemicelluloses coming from oats, barley, legumes and certain vegetables. Insoluble fibers include lignan, cellulose, and some hemicelluloses and pectins, which absorb water, making them good "bulking" agents that speed up waste elimination. (It should be noted that taking in too much fiber within a short time period may cause gas, bloating and intestinal cramps.)

In an American Dietetic Association report, researchers stated that a high-fiber diet may not be enough to promote regularity. "Even with a fiber-rich diet, a supplement may be needed to bring fiber intakes into a range adequate to prevent constipation," said Judith A. Marlett, Ph.D., R.D., a professor at the University of Wisconsin, Madison, and co-author of the report.¹

The range of available fiber options can be confusing, especially when "fiber" covers a spectrum of ingredients. For example, maltodextrin-like oligosaccharide (as Fibersol-2™, manufactured by Decatur, Ill.-based Matsutani America) is a dietary fiber. In vitro, Fibersol-2 fermentation increased total short-chain fatty acid production compared with gum arabic. In an animal experiment, researchers noted Fibersol-2 supplementation led to higher total fecal weight and increased fecal concentrations of Bifidobacteria, the most predominant intestinal flora.²

"While a universally accepted definition for dietary fiber does not exist, it is generally agreed that this term includes saccharides and lignans that are not hydrolyzed or absorbed in the upper part of the GI tract," stated researchers from Vero Beach, Fla.-based Flamm Associates in a review of fiber.

Which fiber is the best for constipation? According to the American Council on Science and Health (ACSH), wheat bran in particular has been shown to help with maintaining regularity. ACSH also reported that wheat bran works best because it absorbs water while traveling through the digestive tract, increasing the bulk of stool. In addition, fiber supplements made from psyllium-seed fiber, methylcellulose or polycarbophil may also help with chronic constipation. However, psyllium has been shown to increase stool frequency but not alter colonic transit time.³

Larch arabinogalactan (LA) has also been approved by the Food and Drug Administration (FDA) as a source of dietary fiber. Reportedly, it works like regular fiber in that it increases the production of short-chain fatty acids. It also decreases the generation and absorption of ammonia, which may act to improve colon health. LA also increases the levels of Bifidobacteria, particularly Bifidobacterium longum, which exists in the large and small intestines. LA has also been found, in tests conducted on dogs, to benefit digestive physiology and immunological characteristics.⁴

Bulking agents also include inulin and oligofructose, both extracted from chicory root. They are not digested in the upper GI tract nor are they absorbed and metabolized in the glycolytic pathway; instead, they are fermented by microflora in the colon, producing a bulking effect.⁵ Both inulin and oligofructose have also been shown to be effective prebiotics because of their ability to help the gut's Bifidobacteria attack gut pathogens and prevent acute infections.⁶

According to Phoenix-based Naturally Vitamins, maker of the inulin product Inuflora®, inulin is a complex carbohydrate that is transported to the colon and serves as a natural substrate for beneficial bacteria, allowing them to grow and dislodge harmful bacteria that might colonize in the intestine.

Inulin, along with fructooligosaccharides (FOS), a non-digestible class of carbohydrates, stimulates bacterial growth and fermentation.⁷ Inulin-type fructans appear to exert the best prebiotic effects, according to a researcher from the Belgium-based Universite Catholique de Louvain, because Bifidobacteria and other gut flora adapt well to utilizing these indigestible oligosaccharides.⁸ Prebiotics as a whole have mild laxative effects, but they are so mild that this has been difficult to prove in human studies; a side effect from taking these supplements may be gas.⁹

Prebiotics such as oligofructose, inulin, fructose and sprouted mung bean are not only natural fibers--but also sweet. SomerSweet™, a new sweetener from health guru Suzanne Somers, not only sweetens foods, but also helps increase flora in the digestive track. "The fibers in the product are included because they are not only an added health benefit, but they contribute to the overall flavor profile and provide the bulk needed for baking," Somers said. "Users of the product will also experience a mild laxative effect to keep things moving."

Besides the bulking agents of fiber and prebiotics, there are also stimulating ingredients such as senna that help with constipation and generally work within six to 12 hours. Senna has been shown to be a useful treatment for constipation, mainly due to the purgative action caused by its sennosides A and B.¹⁰

Even probiotics have shown benefits in easing constipation. In a study conducted in Finland, the probiotic Lactobacillus rhamnosus (L. rhamnosus) and Propionibacterium freudenreichii, a bacteriocin, produced a 24-percent increase in defecation frequency compared to supplementation with another probiotic, Lactobacillus reuteri (L. reuteri), or a placebo.¹¹

Diarrhea

Normal bouts of diarrhea are characterized by symptoms of loose, watery stool occurring more than three times in one day and lasting a day or two. This condition may be caused by temporary problems--such as a bacterial or viral infection, food intolerances, medicine--or a chronic issue, such as intestinal disease. However, in many cases of diarrhea, the reason behind this uncomfortable ailment cannot be found.

Diarrhea is usually accompanied by abdominal cramps, bloating, nausea or the urgent need to visit the restroom. Diarrhea can be acute or chronic, with most people (10 percent of the U.S. population) experiencing the acute version at some point over the course of a year. Acute diarrhea may last for less than three weeks and is usually related to bacterial, viral or parasitic infection, while chronic lasts for a longer time and is related to disorders such as IBS, IBD or celiac disease (an intolerance to grain). Consumers should see a medical professional if diarrhea lasts for more than three days, if there is a fever of 102 F or more, or if stool is black or bloody.

Zinc deficiency may lead to acute and persistent diarrhea, as has been shown in malnourished children in impoverished countries. In a Norwegian study investigating 1,792 cases of acute diarrhea in children, zinc terminated diarrhea in 26 percent of the children and reduced prolonged diarrhea (longer than seven days) in 47 percent.¹² In particular, zinc has been shown to help with the severity and duration of diarrhea¹³ and improving mucosal repair in patients with diarrhea, as well as having implications for helping IBD sufferers.¹⁴

Zinc in combination with the probiotic L. reuteri has also been shown to decrease diarrhea severity.¹⁵ Diarrhea causes beneficial bacteria in the gut to deplete, and probiotics and prebiotics replenish the bacterial balance.

"Replacing the friendly bacteria is the foundation for treating these recalcitrant problems," Ross said. "We know that you have to have good bacteria for the body to work well, so that is where I suggest people start. Without friendly bacteria, negative bacteria and yeasts can get overgrown in the intestinal tract and cause diarrhea and other problems."

Probiotics have a strong background in improving intestinal microbial balance, although the performance of different probiotic strains differs. In a research review by scientists at the University of Reading in England, it was reported that probiotics are a preventive approach in maintaining the microflora balance in the intestine. However, those strains that are strong enough to withstand gastric acid, bile and resident microflora work best. Probiotics appear to promote lactate, immunity and antimicrobial agents, and may maintain the remission of inflammatory conditions and ulcerative colitis. However, the English researchers reported that combining prebiotics with probiotics, known as synbiotics, may be the best approach.¹⁶

Lactobacillus acidophilus NCFM (L. acidophilus) was shown to survive the GI tract transit in both healthy and diseased people, and it may decrease the incidence of pediatric diarrhea and reduce the risk of colon cancer.¹⁷ "L. acidophilus stabilizes the weak acid environment [in the GI tract] by fermenting lactic acid," said Kate Jones, vice president of marketing at Vancouver, Wash.-based Nutrition Now, maker of the acidophilus supplement PB 8®. "If Lactobacilli are absent, the pH value moves to the alkaline side and disturbs the function of digestive enzymes."

Diarrhea usually accompanies the use of antibiotics, which causes an imbalance in intestinal flora. For antibiotic-associated diarrhea, researchers in London reported Saccharomyces boulardii, also known as Brewer's yeast, and Lactobacilli prevented diarrhea better than placebo.¹⁸ In terms of treating diarrhea, one study from the Universidad de Buenos Aires indicated that of the Lactobacilli Lactobacillus casei (L. casei) and L. acidophilus, L. casei was more effective in treating bacterial overgrowth in chronic diarrhea.¹⁹ And certain Lactobacilli, such as L. rhamnosus and L. reuteri, have been found to be effective in reducing the duration of diarrhea (79 hours for the treatment group versus 139 hours for the placebo group) caused by the rotavirus, a virus spread through contact and ingestion, and the most common cause of childhood diarrhea.²⁰

A prebiotic is a dietary carbohydrate that is selectively metabolized by probiotics. Prebiotics are nondigestible ingredients that alter the intestinal flora and stimulate the growth of healthy bacteria, and they selectively stimulate the growth of Bifidobacteria and Lactobacilli in the gut, increasing the body's natural resistance to pathogens. Prebiotics may also strengthen the body's resistance to invading pathogens, thereby preventing episodes of diarrhea.²¹

In terms of botanicals, Brewer's yeast is used in Europe to prevent diarrhea caused by antibiotics. Croton lechleri, an herb from Peru's Sangre de drago, has been shown to have anti-microbial and anti-inflammatory activity in the GI tract.²²

Colostrum is another digestive aid that is produced in mammals during the final weeks of pregnancy. This fluid is found in relatively small amounts in pregnant women, but larger amounts are found in pregnant cows. Colostrum's immunoglobulins, which function as antibodies in the immune system, may work to combat viruses such as rotavirus that cause diarrhea. In fact, colostrum was shown to inhibit Escherichia coli (E. coli), another cause of diarrhea.²³

However, in serious instances of diarrhea, such as shigellosis, colostrum showed no benefits in reducing stool frequency, duration or severity.²⁴ Colostrum usually contains lactose, a sugar found in dairy products, and a variety of oligosaccharides, which are prebiotics.

Ames, Iowa-based Proliant Inc. reported that in research using its ImmunoLin®, which consists of natural bovine immunoglobulins, the ingredient improved diarrhea while enhancing intestinal permeability.²⁵

Excess Gas

The average amount of gas a person produces throughout the day varies--it can be between a pint and half a gallon. The average number of times a person passes gas during the day is around 14 to 23.

Digestive gas is primarily made up of odorless vapors such as carbon dioxide, oxygen, nitrogen, hydrogen and methane. The unpleasant odor of flatulence is caused by bacteria in the large intestine that release sulfur-containing gas.

The most common source of upper intestinal gas is swallowed air via post-nasal drip, chewing gum, smoking or eating too fast. Or, it could be from foods such as cauliflower, brussels sprouts and bran--none of which are digested completely in the small intestine--or drinking carbonated beverages. Gas is either absorbed to some extent by the small intestine, or it travels to the colon (large intestine), where it awaits to be passed through the rectum, causing flatulence. Gas that is still in the stomach may come out as a belch.

Sometimes, the gas does not pass through the body easily because it can collect in some parts of the digestive tract, causing bloating and discomfort. Often, it collects on the left side of the colon, and the pain is sometimes confused with heart pangs.

There are various herbs that manufacturers are using to combat excess gas. Naturally Vitamins' Gas Zzap™, containing fennel, ginger root, chamomile and other GI-friendly botanicals, helps the body overcome excessive belching and flatulence. Fennel acts to release excess gas from the stomach; ginger root aids gastric motility; and chamomile soothes the stomach while relieving gas in the lower abdomen.

Gluten intolerance, caused by a protein found in wheat and some other grains, may cause gas. Artificial sweeteners such as sorbitol and mannitol found in some sugar-free products may also make gas. This is when digestive enzymes come into play, helping break down the nutrients that cause flatulence.

"The enzymes we used to get naturally, we really don't get anymore," said Gabrielle Sill, a spokesperson for Chino, Calif.-based Specialty Enyzmes and Biochemicals Co., maker of various enzyme supplements. "Our diet stinks these days, and we're all getting older. So our bodies are not making as [many enzymes] as they used to, and we're not getting anything from any other source."

Digestive enzymes, which help maintain the proper pH in the GI tract, also act as a barrier against pathological organisms. These enzymes include protease, which breaks long protein chains into amino acids; amylase, which reduces large carbohydrates into disaccharides that include lactose and sucrose; and lipase, which digests fats into free fatty acids and glycerol. There is also cellulase, which is not found in the human system, that breaks down fiber. Enzymes can be extracted from animals (e.g., oxbile and pepsin) or plants (e.g., bromelain from pineapple and papain from papaya).

According to Donna Werner, DC, director of technical services at Parkville, Mo.-based Enzymes Inc., maker of Nutri-Essence Gas Ease, enzymes help the body more fully digest food, thereby reducing excess gas and belching and even normalizing the colon, leading to more regular bowel movements. "A full spectrum enzyme ... provides the enzymes necessary to fully digest all the major food groups," she said.

A common cause of lower intestinal gas is lactose intolerance. The condition is caused by a deficiency in the enzyme lactase, which is usually produced by cells lining the small intestine. In the enzyme's presence, lactose--a sugar found in dairy products--is broken into glucose and galactose, which are absorbed into the blood stream. If the sugar passes undigested into the colon, as is the case for those who are lactose intolerant, bacteria ferments, which in turn causes excessive flatulence, as well as nausea, cramps, bloating and diarrhea. Interestingly, lactase production in a child declines after being weaned. Lactose intolerance, in turn, may develop over time, usually after the age of two.

Approximately 50 million American adults are lactose intolerant, although certain ethnicities are more prone to the condition. As many as 75 percent of African-American, Jewish, Mexican-American and Native American adults are lactase deficient, as are 90 percent of Asian-Americans, according to AGA.

Hope for the lactose intolerant comes in the form of lactase supplements. At Nagoya University in Japan, researchers compared two lactase preparations derived from Aspergillus orizae (a fungus) and Penicillinase (a bacteria-derived enzyme). Lactase-deficient volunteers were found to have a better reaction to drinking milk when taking the lactase preparations right before milk intake. Researchers concluded that the digestion of lactose benefited by the higher pH provided by the buffering action of milk.²⁶

Lactose intolerance may not be solved through lactase alone. "Most people, when they find they can't digest milk products and experience bloating and such, believe that they're lactose intolerant," said Rohit Medhekar, Ph.D., technical resources manager at Forsyth, Mo.-based National Enzyme Co. "But that's only half the problem. A lot of these same people who think they're lactose intolerant could also be intolerant to beta-lactoglobulin, a dairy protein." The company introduced Dairyzimes™ earlier this year, containing lactase and a proprietary blend of proteases that breaks down beta-lactoglobulin.

However, one journal article reported that lactose, the bane of lactose sufferers, may promote lactic acid-producing bacteria, which selectively consume prebiotics. Summarily, lactose may be relevant in preventing the pathogenesis of diseases such as colorectal cancer and IBD through prebiotic actions.²⁷

Probiotics may also benefit lactose intolerance, such as L. acidophilus. There are several strains of L. acidophilus, each with different healing properties. The DDS® strain, trademarked by Minnetonka, Minn.-based UAS Laboratories, produces enzymes such as proteases that digest proteins and lipases that digest fat.

In one study, addition of either L. acidophilus or a mixture of 12 Lactobacillus strains was found to aid intestinal beta-glucosidase, an enzyme that breaks down sugar.²⁸ L. acidophilus NCFM has also been found to facilitate lactose digestion in lactose-intolerant subjects.²⁹ Probiotics are also thought to promote intestinal Bifidobacteria, which are believed to metabolize sugar to produce lactase.

However, individuals should be checked out by their medical care professional to see whether the symptoms they have are actually being caused by lactase deficiency. Researchers from Rome reported that sufferers of lactose intolerance and IBS may suffer the same types of symptoms.³⁰

Those who are lactose intolerant should be aware of a possible calcium deficiency. The Dietary Reference Intake (DRI) for calcium is 1,000 mg/d, but many lactose sufferers may not be receiving enough calcium to offset osteoporosis later in life. In one study involving 26 African-American, lactose-intolerant women, the average daily intake of calcium was 150 mg/d.³¹

Heartburn

Heartburn is the most common symptom of gastroesophageal reflux disease (GERD), also known as acid reflux. Heartburn occurs when the sphincter muscle located at the end of the esophagus grows lax and allows stomach acid to back up into the esophagus, causing heartburn.

Heartburn is very common. According to NIDDK, more than 60 million American adults experience GERD and heartburn at least once per month, while 25 million experience heartburn on a daily basis.

Acid reflux sometimes causes more serious complications, such as esophageal bleeding or ulcers. Or, it may cause a change in the cells at the bottom of the esophagus, increasing the risk of developing cancer.

Those prone to heartburn are advised to stay away from chocolate, coffee, alcohol, fried and fatty foods, mint products, carbonated beverages, tomato-based products, mustard, vinegar and aspirin. Also, keeping a handle on stress levels and maintaining a healthy weight have also been shown to reduce the onset of GERD.

Heartburn can be treated over-the-counter (OTC) with calcium carbonate antacids such as Tums®, although they can cause another digestive problem--constipation.

H. pylori has been shown to cause peptic ulcer disease, with heartburn being one of its symptoms. The probiotic L. acidophilus appears to decrease H. pylori levels in the human stomach, especially in peptic ulcer patients. In a study using LC-1 from Nestle Research Center in Switzerland, L. acidophilus had an inhibitory effect on H. pylori in 13 out of 15 patients, leading researchers to conclude that the probiotic could enhance antibiotic therapy in eradicating H. pylori.³²

However, when in the form of a functional food, probiotics may not be as effective against H. pylori. In women who tested positive for the bacteria, yogurt infused with L. acidophilus, L. casei and Lactobacillus bulgaricus had no effect on diminishing H. pylori levels.³³

Nausea and Vomiting

Nausea and vomiting are sometimes experienced during pregnancy, after chemotherapy or following food poisoning, and are symptoms of motion sickness. There is a portion of the brain that receives signals from multiple places in the body that causes the stomach to have reduced motility. This instigates gastric reflux, which is when the stomach relaxes, the passage between the stomach and intestine constricts, and contractions expel gastric contents.

The timing of the urge to vomit can sometimes indicate the cause. For example, if vomiting occurs within an hour after eating, it may be because of a mental disorder or a peptic ulcer. Or, if it takes place one to eight hours after a meal, it may indicate food poisoning. Sometimes, nausea and vomiting can indicate more serious problems, such as a heart attack, liver disorder or brain tumor. Adults should see a doctor if vomiting lasts longer than 24 hours.

Pregnancy is one of the most common reasons behind these two digestive problems. Reportedly, 50 percent to 90 percent of pregnant women experience nausea and another 25 percent to 55 percent experience vomiting. Even though these ailments usually occur during the first few months of pregnancy, as many as 20 percent of pregnant women continue to experience nausea or vomiting into their third trimester. According to a report in the Journal of the American Dietetic Association, 50,000 women are hospitalized in the United States each year because conventional therapies for nausea and vomiting, and the dehydration that results from these conditions, fail to work.³⁴

Stanford researchers Richard Blum, M.D., and LeRoy Heinrichs, M.D., authors of Nausea and Vomiting: Overview, Challenges, Practical Treatments and New Perspectives (Whurr, 2000), reported that feelings of nausea are healthy and may indicate that a woman is less likely to miscarry. Reportedly, a healthy placenta (which lines the uterus and envelops a developing fetus) produces estrogen in the early part of pregnancy, causing a woman's sense of smell to heighten; if extra estrogen is not produced, there may be a problem with the pregnancy. "Women tend not to take their nausea and vomiting to a doctor," Blum said in an interview with the Stanford Report, "and probably for good reason, because there's not much a doctor can do."

The University of Iowa reported that many pregnant women do not ask for conventional therapy to ease their nausea or vomiting, partly because of their fear that medication will harm the fetus.³⁵ In a 2002 survey by the Motherisk Program in Toronto, 61 percent of respondents reported using complementary and alternative medicine (CAM) to help aid nausea and vomiting when pregnant. Women who did not use CAM during pregnancy said they would if there was more information about the safety behind these modalities. The top therapies reported by respondents included ginger and vitamin B6.³⁶

Supplements and teas containing ginger have been found to help ease the discomfort of both nausea and vomiting, especially for those who are pregnant or get motion sick. In a study conducted in Thailand, women who were given 1 g/d of ginger for four days experienced a more significant decrease in nausea and vomiting (28 out of 32 women) than those in the placebo group (10 out of 35 women).³⁷ "Ginger has been used in Traditional Chinese Medicine as a digestive aid for thousands of years," said Susan Beck, MTCM, senior manager of herbal science at Santa Cruz, Calif.-based Rainbow Light, maker of prenatal supplements. She added that dried ginger is contraindicated during pregnancy and only fresh ginger should be used, as is reported in the Botanical Safety Handbook from the American Herbal Products Association (AHPA).

Another supplement that has been shown to decrease nausea and vomiting is vitamin B6, or pyridoxine, especially in pregnant women. Scientists in Bristol, England, reported that in a review of methods pregnant women utilize in combating nausea and vomiting, pyridoxine appeared to be the most effective of the newer treatments to reduce nausea severity.³⁸

Digestive problems can happen to anyone at anytime, not just to sufferers of ulcers, IBD or Crohn's disease. Keeping abreast of how individual ingredients can help particular symptoms such as diahrrhea, gas or nausea could lead to happier customers--and more repeat business.

The Path Well-Traveled References

1. Marlett JA et al. “Position of the American Dietetic Association: Health implications of dietary fiber.” J Am Diet Assoc, 102, 7:993-1000, 2002.

2. Flickinger EA et al. “Glucose-based oligosaccharides exhibit different in vitro fermentation patterns and affect in vivo apparent nutrient digestibility and microbial populations in dogs.” J Nutr, 130:1267-73, 2000.

3. Wiesel PH et al. “Management of faecal incontinence and constipation in adults with central neurological diseases.” Cochrane Database Syst Rev, 4:CD002115, 2001.

4. Grieshop CM et al. “Oral administration of arabinogalactan affects immune status and fecal microbial populations in dogs.” J Nutr, 132, 3:478-82, 2002.

5. Flamm G et al. “Inulin and oligofructose as dietary fiber: A review of the evidence.” Crit Rev Food Sci Nutr, 41, 5:353-62, 2001.

6. Kolida S et al. “Prebiotic effects of inulin and oligofructose.” Br J Nutr, 87, Suppl 2:S193-7, 2002.

7. Cummings JH et al. “Prebiotic digestion and fermentation.” Am J Clin Nutr, 73, Suppl 2:415S-420S, 2001.

8. Roberfroid MB. “Prebiotics: Preferential substrates for specific germs?” Am J Clin Nutr, 73, Suppl 2:406S-409S, 2001.

9. Cummings JH et al. “Gastrointestinal effects of prebiotics.” Br J Nutr, 87, Suppl 2:S145-51, 2002.

10. Shah SA et al. “Estimation of individual sennosides in plant materials and marketed formulations by an HPTLC method.” J Pharm Pharmacol, 52, 4:445-9, 2000.

11. Ouwehand AC et al. “Effect of probiotics on constipation, fecal azoreductase activity and fecal mucin content in the elderly.” Ann Nutr Metab, 46, 3-4: 159-62, 2002.

12. Strand TA et al. “Effectiveness and efficacy of zinc for the treatment of acute diarrhea in young children.” Pediatrics, 109, 5:898-903, 2002.

13. Fontaine O. “Effect of zinc supplementation on clinical course of acute diarrhea.” J Health Popul Nutr, 19, 4:339-46, 2001.

14. Sturniolo GC et al. “Effect of zinc supplementation on intestinal permeability in experimental colitis.” J Lab Clin Med, 139, 5:311-5, 2002.

15. Kelleher SL et al. “Supplementation of infant formula with the probiotic Lactobacillus reuteri and zinc: Impact on enteric infection and nutrition in infant rhesus monkeys.” J Pediatr Gastroenterol Nutr, 35, 2:162-8, 2002.

16. Gibson GR et al. “Probiotics as modulators of the gut flora.” Br J Nutr, 88, Suppl 1:39-49, 2002.

17. Sanders ME et al. “Invited review: The scientific basis of Lactobacillus acidophilus NCFM functionality as a probiotic.” J Dairy Sci, 84, 2:319-31, 2001.

18. D’Souza AL et al. “Probiotics in prevention of antibiotic associated diarrhea: Meta-analysis.” BMJ, 324, 7350:1361, 2002.

19. Gaon D et al. “Effect of lactobacillus strains L. casei and L. acidophilus on bacterial overgrowth-related chronic diarrhea.” Medicina (B Aires), 62, 2:159-63, 2002.

20. Rosenfeldt V et al. “Effect of probiotic lactobacillus strains on acute diarrhea in a cohort of nonhospitalized children attending day-care centers.” Pediatr Infect Dis J, 21, 5:417-9, 2002.

21. Cummings JH et al. “Gastrointestinal effects of prebiotics.” Br J Nutr, 87, Suppl 2:S145-51, 2002.

22. Williams JE. “Review of antiviral and immunomodulating properties of plants of the Peruvian rainforest with a particular emphasis on Una de Gato and Sangre de Grado.” Altern Med Rev, 6, 6:567-79, 2001.

23. Palmeira P et al. “Inhibition of enteropathogenic Eschierichia coli adherence to Hep-2 cells by bovine colostrum and milk.” Allergol Immunopathol, 29, 6:229-37, 2001.

24. Ashraf H et al. “Hyperimmune bovine colostrum in the treatment of shigellosis in children: a double-blind, randomized, controlled trial.” Acta Paediatr, 90, 12:1373-8, 2001.

25. Hunt E et al. “Oral bovine serum concentrate improves cryptosporidial enteritis in calves.” Pediatr Res, 51, 3:370-6, 2002.

26. Gao KP et al. “Effect of lactase preparations in asymptomatic individuals with lactase deficiency--Gastric digestion of lactose and breath hydrogen analysis.” Nagoya J Med Sci, 65, 1-2:21-8, 2002.

27. Szilagyi A. “Lactose--a potential prebiotic.” Aliment Pharmacol Ther, 16, 9:1591-602, 2002.

28. Jin LZ et al. “Digestive and bacterial enzyme activities in broilers fed diets supplemented with Lactobacillus cultures.” Poult Sci, 79, 6:886-91, 2000.

29. Sanders ME et al. “Invited review: The scientific basis of Lactobacillus acidophilus NCFM functionality as a probiotic.” J Dairy Sci, 84, 2:319-31, 2001.

30. Vernia P et al. “Lactose malabsorption, irritable bowel syndrome and self-reported milk intolerance.” Dig Liver Dis, 33, 3:234-9, 2001.

31. Buchowski MS et al. “Dietary calcium intake in lactose maldigesting intolerant and tolerant African-American women.” J Am Coll Nutr, 21, 1:47-54, 2002.

32. Vilaichone RK et al. “Inhibitory effect of Lactobacillus acidophilus on Helicobacter pylori in pepetic ulcer patients: in vitro study.” J Med Assoc Thai, 85, Suppl 1:S79-84, 2002.

33. Wendakoon CN et al. “Lack of therapeutic effect of a specially designed yogurt for the eradication of Helicobacter pylori infection.” Digestion, 65, 1:16-20, 2002.

34. Hintlian C et al. “Morning sickness: Myths, miseries and management.” J Am Diet Assoc, 93, Suppl 5:1993.

35. Niebyl JR et al. “Overview of nausea and vomiting of pregnancy with an emphasis on vitamins and ginger.” Am J Obstet Gynecol, 185, 5 Suppl:S253-5, 2002.

36. Hollyer T et al. “The use of CAM by women suffering from nausea and vomiting during pregnancy.” BMC Complement Altern Med, 2, 1:5, 2002.

37. Vutyavanich T et al. “Ginger for nausea and vomiting in pregnancy: randomized, double-masked, placebo-controlled trial.” Obstet Gynecol, 97, 4:577-82, 2001.

38. Jewell D et al. “Interventions for nausea and vomiting in early pregnancy.” Cohrane Database Syst Rev, 1:CD000145, 2002.

39. Landmead L et al. “Review article: Herbal treatment in gastrointestinal and liver disease--benefits and dangers.” Aliment Pharmacol Ther, 15, 9:1239-52, 2001.

40. Spirling LI et al. “Botanical perspectives on health peppermint: More than just an after-dinner mint.” J R Soc Health, 121,1:62-3, 2001.

41. May B et al. “Efficacy and tolerability of a fixed combination of peppermint oil and caraway oil in patients suffering from functional dyspepsia.” Aliment Pharmacol Ther, 14, 12:1671-7, 2000.

42. PDR for Herbal Medicines, Medical Economics Company, 1998.

43. PDR for Herbal Medicines, Medical Economics Company, 1998.

44. Fukai T et al. “Anti-Helicobacter pylori flavonoids from licorice extract.” Life Sci, 71, 12:1449-63, 2002.

45. Ma J et al. “Apoptosis induced by isoliquiritigenin in human gastric cancer MGC-803 cells.” Planta Med, 67, 8:754-7, 2001.

Share this article: Email, Slashdot, Digg, Del.icio.us, Yahoo!MyWeb, Windows Live Favorites, Furl
Add this article feed to: RSS, My Yahoo, Newsgator, Bloglines