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Posted: So I got my monthly issue of Contemporary Pediatrics and in it is an article on herbs used in GI complaints (For those of you interested: Gardiner PD, Kemper KJ. "For GI Complaints Which Herbs and Supplements Spell Relief?" Contemporary Pediatrics. Aug 2005. 22:8 50-55).
I found it interesting for two reasons: 1) I'm glad to see more signs of mainstream medicine embraing the potential that herbs have to offer while holding them to the same standards to which we hold medicines and 2) It's interesting and useful stuff. I'll summarize some of what the article says here:
Herbs for Chronic Abdominal Pain
Chamomile (Matricaria recutita)
May be used in infants to treat colic.
Used as a home remedy, sometimes with peppermint, star anise, or fennnel for stomaches, gas, indigestion, and bloating. May be used as a mild anxiolytic (anti-anxiety agent) or sedative-hypnotic (for sleep). Activity is due to constitutent water-soluble flavonoids such as apigenin and volatile oils such as alpha-bisapolol and chamazulene. Apigenin and the volatile oils are anti-inflammatory and apigenin binds to the same receptors in the brain as do benzodiazepene drugs such as diazepam (VALIUM) or lorazepam (ATIVAN). In a prospective, double-blind, randomized parallel group study of 79 children younger than 6 years with uncomplicated diarrhea, a combination of chamomile and pectin led to significantly shorter duration of symptoms. Another study used a mixture of herbs, including chamomile, and found the mixture significantly better than placbo at relieving colic in infants, but it is difficult to say what part chamomile played in this mixture. Chamomile is on the GRAS (Generally Recognized As Safe) list. Adverse effects can include allergic reactions ranging from skin reactions to frank anaphylaxis.
Lemon Balm (Melissa officinalis)
. Helpful for dyspepsia (sour stomach), nausea, and nervous stomach. Recommended by German Commission E for sleep disorders and "functional" GI complaints. Has been shown by double-blind, randomized, placebo-controlled trials to be helpful for adults with functional dyspepsia (chronic stomach pain of non-organic nature).
Herbs used to treat colic
Usually contains sodium bicarbonate and dill seed oil. A common remedy in Britain. In Sheffield, England 64% of mothers gave their babies gripe water in the first month of life. Is banned in the US because the formulation fits the definition of a "new drug."
Chinese Star Anise (Illicium verum)
Given as an herbal tea to treat colicky infants, especially in Caribbean and Latino traditions. Long considered safe and non-toxic, but contains toxic compounds called veranisatins, which can cause neurologic symtpoms in younger infants. Some cases of adulteration of Chinese Star Anise with Japanese Star Anise (Illicium anisatum) which contains potent neurotoxins. Because of these concerns, star anise is not recommended for colic.
Fennel seed oil
Composed largely of trans-anethole with smaller amounts of fenchone, estragole, and other constituents. In a large double-blind, placebo-controlled trial in Russia of 125 infants, infants treated with 5-20ml of fennel seed oil up to four times per day had 65% elimination of colic symptoms compared to only 23.7% in the control group. No side effects were reported. Rare adverse effects are allergic in nature and caution should be used in individuals with allergies to carrot, celery, mugwort, or other plants in the Apiaceae family. Fennel is GRAS, however.
The many uses of peppermint (Mentha piperita)
Used to treat newborn colic, flatulence, diarrhea, indigestion, nausea and vomiting, gas, cramping, and bloating. Modern uses include treatment of irritable bowel syndrome (IBS). Primary constituent of the essential oil is menthol. Peppermint causes relaxation of smooth muscle and slows the transit of food through the small intestines. Enteric-coated capsules have shown generally positive results in studies of adults with IBS and studies of children with recurrent chronic abdominal pain. Peppermint should be avoided in patients with gastro-esophageal reflex because it decreases the tone of the lower esophageal sphincter (the sphincter between the esophagus and stomach) and increases the risk of reflux of stomach contents into the esophagus.
Nausea and Vomiting: Ginger (Zingiber officinalis)
Has been used for centuries as an anti-emetic (anti-nausea/vomiting agent). Active components include gingerol and galanolactone, which act on serotonin receptors in the GI tract. Is a GRAS anti-nausea agent, even in pregnancy. In one study of 28 children aged 4-8 who were prone to motion sickness ginger was compared to the antihistamine dimenhydrinate. The ginger group had 100% relief of symtpoms compared to 31% in the dimenhydrinate group. Side-effects were not reported in the ginger group, but included vertigo, increased salivation, stomache, nausea, dry mouth, pallor, and cold sweats in the dimenhydrinate group. May be purchased as capsules, taken as whole or ground, dried root, or prepared as a tea by boiling chopped root for 20 minutes and sweetening as desired. Commercial ginger ales do not contain real ginger. In large doses may cause abdominal discomfort, bloating, and heartburn. The taste is objectionable to some (although I love it!)
Typically species such as Lactobacillus, Bifidobacterium, Streptococcus thermophilus, and Saccharomyces. Common uses include prevention of antibiotic-associated diarrhea (pseudomembranous colitis), traveler's diarrhea, newborn colic, necretozing enterocolitis, dental caries, food allergies, eczema, diarrhea, ulcerative colitis, and IBS. The mechanism is more complex than simply "replacing bad bacteria with good bacteria" and is the subject of active research. It may have something to do with secretion of antimicrobial compounds from the gut, production of mucus, bacterial adherence to the mucosa, and production of antibodies. There is evidence that probiotics benefit children with acute gastroenteritis ("stomach flu") and mild diarrhea, especially in rotavirus infection. Also, probiotics prevent antibiotic-associated diarrhea. Risks in severely ill patients includ sepsis with the probiotic bacteria. But otherwise, even in very young infants side-effects are comparable to placebo. Caution is probably warranted in very premature infants. Most major yogurt brands on the market now have live cultures and are good sources of probiotics. Higher doses are available in commerically available supplements.
Psyllium seed (Plantago ovata)
Contains soluble fiber
No studies have evaluated its efficacy or safety in children, but it is very safe, although not considered GRAS. It is very safe, but it is contraindicated in patients with allergy to psyllium, intestinal obstruction, fecal impaction, esophageal narrowing, or Crohn's disease. Must be taken with adequate fluid as it absorbs water in the gut and inadequate fluid intake may lead to dehydration and/or impaction of the fiber in the gut. Side-effects include transient flatulence, abdominal pain, diarrhea, constipation, and nausea.
Cascara sagrada (Rhamni purshiana) and senna (Sennae folum)
Both are stimulant laxatives, which work by stimulating the gut to move and to secrete fluids. Approved by the FDA for children over age 2. Should be used sparingly to treat only acute constipation that does not respond to fiber. Not recommended for long-term use because of a potential for dependence. May cause abdominal discomfort and *extreme* urgency ranging to loss of continence.
Hope you found this helpfu! Be well!
Certified Mad Doctor and HoP High Priest of Nutella
Are they being tested properly? Human have a nasty tendency to presume that 'natural' or 'herbal' is the same as safe. It is true that many herbs contain chemicals which are of benifit in certain ailments. But at the same time many will contain chemicals which are harmful.
That said, if everything checks out, then it may well be cheaper than refined medicines. I'll keep an eye on it.
(little footnote: Some herbal stuff has benificail effects, but a lot is just snake oil. Keep your wits about you and don't believe every damn thing you read)
According to Heisenberg's Uncertainty Principle of Quantum Dynamics, we may already be making love right now...