-IBIS-1.7.6-
tx
digestive system
irritable bowel syndrome
Botanicals
primary herbs
Achillea millefolium: intestinal irritation (Ellingwood F, 355)
Althea officinalis: irritation of mucous membranes (Ellingwood F, 431)
Glycyrrhiza glabra: anti-inflammatory, demulcent (Anderson Geller)
Linum usitatissimum (flax seed): inflamed mucous membranes, constipation; must drink plenty of water in addition (Felter HW, Lloyd JU. 1147)
Mentha piperita: enteric-coated Peppermint oil capsules, 3-6 caps (0.2 ml/cap) per day. (Dew MJ, et al. Br J Clin Pract 1984 Nov-Dec;38(11-12):394, 398.; Rees WD, et al. Br Med J 1979;2(6194):835-836; Leicester RJ, Hunt RH. Lancet 1982;ii:989; Rogers J, et al. Lancet 1988;ii:98-99; Liu JH, et al. J Gastroenterol. 1997 Dec;32(6):765-768; May B, et al. Arzneimittelforschung. 1996 Dec;46(12):1149-1153.)
Plantago ovata, psyllium: dose 5-10 g. after soaking several hours in warm water
(Prior A, Whorwell PJ. Gut 1987;11:1510-1513; Jalihal A, Kurian G. J Gastroenterol Hepatol 1990;5:507-513; Hotz J, Plein K. Med Klin 1994;89:645-651.)
Ulmus spp.: demulcent (Anderson Geller)
Valeriana spp.: for smooth muscle spasm; use large doses, 1-2 dr. (Weiss RF. 64.)
consider: nervines taken as needed: (Anderson Geller)
Humulus lupulus: especially with agitation, anxiety and insomnia
Matricaria chamomilla: carminative; easeds intestinal cramping and irritation, especially with alternating diarrhea and constipation
Scutellaria lateriflora: especially with anxiety and insomnia
complementary herbs
carminative tea: Chamomilla spp. + Carum carvi, at breakfast, midday meal, between evening meal and bedtime, continue at length. Can add Atropa belladonna (toxic) tincture if necessary (Weiss RF, 64.)
Peppermint and caraway combination oil (May B, et al. Arzneimittelforschung. 1996 Dec;46(12):1149-1153.)
Ulmus fulva + Glycyrrhiza glabra + Althea officinalis, powdered. Take 1 tsp., twice daily, in half cup water or make a gruel (Anderson Geller)
footnotes
Achterrath-Tuckermann U, Kunde R, Flaskamp E, Isaac O, Thiemer K. [Pharmacological investigations with compounds of chamomile. V. Investigations on the spasmolytic effect of compounds of chamomile and Kamillosan® on isolated guinea pig ileum.] Planta Med 1980 May;39(1):38-50. [Article in German.]
Dew MJ, Evans BK, Rhodes J. Peppermint oil for the irritable bowel syndrome: A multi-center trial. Br J Clin Pract 1984 Nov-Dec;38(11-12):394, 398.
Ellingwood F. American Materia Medica, Therapeutics and Pharmacognosy, 11th ed. Sandy, OR: Eclectic Medical Publications, 1919, 1998.
Felter HW, Lloyd JU. Kings American Dispensatory, 18th ed. Sandy, OR: Eclectic Medical Publications, 1898, 1983.
Hotz J, Plein K. [Effectiveness of plantago seed husks in comparison with wheat bran no stool frequency and manifestations of irritable colon syndrome with constipation.] Med Klin. 1994 Dec 15;89(12):645-651.
Abstract: BACKGROUND AND AIM: The importance of dietary fibres in treatment of irritable bowel syndrome increased during the last years. Yet the results of clinical studies on the different dietary fibres are not consistent. Therefore we decided to perform a controlled trial with a well defined group of patients to compare the effectiveness of wheat bran to psyllium seeds. PATIENTS AND METHODS: Thirty patients each with irritable bowel syndrome group II to III were treated in an open, not controlled study design either with 3 times 3.25 g psyllium seeds or 3 times 7 g wheat bran daily. All patients entering the study had not been treated for at least 3 weeks before. The study comprised two treatment phases of two weeks each, separated by two weeks without any treatment, thus leading to a study duration of 6 weeks altogether. Parameters for evaluation were stool frequency and consistency and the symptoms pain and abdominal distention, measured by a score (1 to 4). RESULTS: In both treatments groups stool frequency and consistency improved apparently compared to the starting point or the two weeks treatment free time in between. The improvement of stool frequency was statistically significant (p < 0.0001) for both substances. Furthermore the effect of psyllium seeds exceeded that of wheat bran statistically significant in week 1, 2, 3, 5 and 6 (p < 0.005). Other symptoms such as abdominal pain improved too by therapy, psyllium seeds again tending to show better results. A significant difference between both substances could be observed on the symptom abdominal distension. Whereas abdominal distension decreased under treatment with psyllium seeds it increased with wheat brain. This lead to discontinuation of the study in 5 cases, 3 of which could be changed successfully to psyllium seeds. The difference between psyllium seeds and wheat bran concerning the occurrence of abdominal distension was statistically significant (p < 0.01). CONCLUSION: The results of this study demonstrate the effectiveness of psyllium seeds and wheat bran on stool frequency and consistency of patients with irritable bowel syndrome. Psyllium seeds showed to be superior to wheat brain with respect to stool frequency and abdominal distension so that it should be preferred in treatment of irritable bowel syndrome and constipation.
Jalihal A, Kurian G. Ispaghula therapy in irritable bowel syndrome: improvement in overall well-being is related to reduction in bowel dissatisfaction. J Gastroenterol Hepatol 1990;5:507-513.
Leicester RJ, Hunt RH. Peppermint oil to reduce colonic spasm during endoscopy. Lancet 1982;ii:989. (Letter)
Liu JH, Chen GH, Yeh HZ, Huang CK, Poon SK. Enteric-coated peppermint-oil capsules in the treatment of irritable bowel syndrome: a prospective, randomized trial. J Gastroenterol. 1997 Dec;32(6):765-768.
Abstract: To determine the efficacy and tolerability of an enteric-coated peppermint-oil formulation (Colpermin), we conducted a prospective, randomized, double-blind, placebo-controlled clinical study in 110 outpatients (66 men/44 women; 18-70 years of age) with symptoms of irritable bowel syndrome. Patients took one capsule (Colpermin or placebo) three to four times daily, 15-30 min before meals, for 1 month. Fifty-two patients on Colpermin and 49 on placebo completed the study. Forty-one patients on Colpermin (79%) experienced an alleviation of the severity of abdominal pain (29 were pain-free); 43 (83%) had less abdominal distension, 43 (83%) had reduced stool frequency, 38 (73%) had fewer borborygmi, and 41 (79%) less flatulence. Corresponding figures for the placebo group were: 21 patients (43%) with reduced pain (4 were pain-free), 14 (29%) with reduced distension, 16 (32%) with reduced stool frequency, 15 (31%) with fewer borborygmi, and 11 (22%) with less flatulence. Symptom improvements after Colpermin were significantly better than after placebo (P < 0.05; Mann-Whitney U-test). One patient on Colpermin experienced heartburn (because of chewing the capsules) and one developed a mild transient skin rash. There were no significant changes in liver function test results. Thus, in this trial, Colpermin was effective and well tolerated.
May B, Kuntz HD, Kieser M, Kohler S. Efficacy of a fixed peppermint/caraway oil combination in non-ulcer dyspepsia. Arzneimittelforschung. 1996 Dec;46(12):1149-1153.
Abstract: The efficacy and safety of the standardized herbal combination preparation of Enteroplant, consisting of peppermint oil (90 mg) and caraway (50 mg) in an enteric coated capsule, have been studied in a double-blind, placebo-controlled multicentre trial in patients with non-ulcer dyspepsia. A total of 45 patients were included in the trial after thorough physical and gastro-enterological examination. The primary outcome variables were the change in the intensity of pain and the global clinical impression (Clinical Global Impression [CGI], Item 2), which were evaluated for 39 patients (test preparation: 19, placebo: 20). After four weeks of treatment both target parameters were significantly improved for the group of patients treated with the peppermint oil/caraway oil combination compared to the placebo group (p = 0.015 and 0.008, respectively). Before the start of treatment all patients in the test preparation group reported moderate to severe pain, while by the end of the study 63.2% of these patients were free of pain. The pain symptoms had improved in a total of 89.5% of the patients in the active treatment group. After 4 weeks the Clinical Global Impressions were improved for 94.5% of the patients treated with the peppermint oil/caraway oil combination. The trial medication was also superior to placebo with respect to pain frequency, medical prognosis, the severity of the disorder and the efficacy index (CGI, Items 1 and 3), which were adopted as secondary end-points for evaluation of efficacy. There were similarly favourable findings for the herbal combination, compared with placebo, with respect to the reduction of other gastrointestinal symptoms. The combination preparation was found to be excellently tolerated. There was a total of 7 adverse events (test preparation: 4, placebo: 3), with a causal association with the treatment being ascribed in one case for the test preparation group and one case for the placebo group.
Nash P, Gould SR, Barnardo DE. Peppermint oil does not relieve the pain of irritable bowel syndrome. Br J Clin Pract 1986;40:292-293.
Prior A, Whorwell PJ. Double blind study of ispaghula irritable vowel syndrome. Gut 1987;11:1510-1513.
Rees WD, Evans BK, Rhodes J. Treating irritable bowel syndrome with peppermint oil. Br Med J 1979;2(6194):835-836.
Rogers J, Tay HH, Misiewicz JJ. Peppermint oil. Lancet 1988;ii:98-99. (Letter)