Is yoga the key to soothing ulcerative colitis? Will an herb provide relief? Natural remedies for ulcerative colitis may not be your primary treatment approach, but they can help manage symptoms and reduce flares.

Natural Therapies for Ulcerative Colitis

To date, there is no cure for ulcerative colitis (UC), a chronic disease of the large intestine (colon) in which inflammation brought on by a faulty immune response creates sores or ulcers in the lining of the colon. The chronic condition affects nearly 1 million Americans and tends to run in families. Epidemiological research shows that “Westernized” populations and people with diets high in fat are at higher risk for UC, as well as Caucasians and Ashkenazi Jews. But no one has yet uncovered the main cause of the disease.

“Although the official cause of ulcerative colitis has evaded the medical community, it’s important to understand that it results from an interaction of genetic, environmental, and lifestyle factors,” says Benjamin Snider, ND, a naturopathic doctor in private practice in Kitchener, Ontario. Treatments for ulcerative colitis include medications such as nonsteroidal anti-inflammatory drugs, immune system suppressors, and steroids to control inflammation and other symptoms of the condition. Surgery to remove the colon and rectum is another form of treatment if medication doesn’t prove effective.

Herbal and Plant Therapy for Inflammatory Bowel Disease

From 1993 to April 2014, researchers identified 27 clinical studies dealing with herbal therapy in inflammatory bowel disease (IBD). There were 17 studies of herbal therapy in UC and 10 studies in Crohn’s disease, including 1,874 individuals in total. The mean age of subjects was 43 years. No significant differences concerning the number of male and female patients participating in the trials was recorded. The most important of the available data concerning the use of herbals and plants in the treatment of IBD patients are summarized below.

Herbal Therapies for Ulcerative Colitis

So far, a total number of 17 clinical studies related to the treatment of either active or inactive UC with the use of herbal products have been published. The total number of patients included was 1,421. These studies compared the effectiveness of herbal treatment with either drugs used regularly by patients with UC or placebo. In a minority of studies, herbal treatment was tested while the patients were receiving their regular treatment. The number of patients included in each study varied between a few dozen to more than 200. In studies dealing with induction treatment of active disease, the duration of treatment varied between 4 and 12 weeks, while in studies dealing with maintenance treatment fluctuated between 6 and 12 months.

Aloe Vera for Active Ulcerative Colitis

Aloe vera is a herbal preparation with significant anti-inflammatory effects. The leaves of the plant contain an abundance of phytochemical substances including acetylated mannans, polymannans, anthraquinone C-glycosides, anthrones, anthraquinones (emodin), and lectins, most of which are under intense search.

In a double-blind, randomized, placebo-controlled trial, 44 hospital outpatients with mild to moderately active UC were randomly given oral aloe vera gel or placebo, 100 mL b.i.d. for 4 weeks, in a 2:1 ratio. Oral administration of aloe vera produced a clinical response more often than placebo; it also reduced the histological disease activity.

Butyrate for Active Ulcerative Colitis

Butyrate is a short-chain fatty acid that is the main energy source for colonocytes, the cells that line the colon. Butyrate has been found to have anti-inflammatory properties and to promote healing of the intestinal mucosa.

In a randomized, double-blind, placebo-controlled trial, 103 patients with active UC were given either butyrate enemas (100 mL of a 100 mM butyrate solution) or placebo enemas twice daily for 8 weeks. The study found that butyrate enemas were significantly more effective than placebo in inducing remission of active UC.

Tormentil Extract for Active Ulcerative Colitis

Tormentil (Potentilla erecta) is a plant that has been used traditionally to treat diarrhea and inflammation. The rhizome of the plant contains a number of pharmacologically active ingredients, including tannins, flavonoids, and triterpenes.

In a randomized, double-blind, placebo-controlled trial, 100 patients with active UC were given either tormentil extract (360 mg per day) or placebo for 8 weeks. The study found that tormentil extract was significantly more effective than placebo in inducing remission of active UC.

Other Herbal Therapies for Ulcerative Colitis

Other herbs and natural products that have shown promise in the treatment of ulcerative colitis include wheatgrass juice, curcumin (the active ingredient in turmeric), and various probiotic and prebiotic formulations. While the evidence for these therapies is not as strong as for the ones mentioned above, they may still be worth considering as part of a comprehensive approach to managing ulcerative colitis.

6 Ways to Naturally Treat Ulcerative Colitis

Is yoga the key to soothing ulcerative colitis? Will an herb provide relief? Natural remedies for ulcerative colitis (UC) may not be your primary treatment approach, but they can help you manage symptoms and reduce the frequency of flares.

To date, there is no cure for UC, a chronic disease of the large intestine (colon) in which inflammation brought on by a faulty immune response creates sores or ulcers in the lining of the colon.

The chronic condition affects nearly 1 million Americans and tends to run in families. Epidemiological research shows that “Westernized” populations and people with diets high in fat are at higher risk for UC, as well as Caucasians and Ashkenazi Jews. But no one has yet uncovered the main cause of the disease.

“Although the official cause of ulcerative colitis has evaded the medical community, it’s important to understand that it results from an interaction of genetic, environmental, and lifestyle factors,” says Benjamin Snider, ND, a naturopathic doctor in private practice in Kitchener, Ontario.

Treatments for ulcerative colitis include medications such as nonsteroidal anti-inflammatory drugs, immune system suppressors, and steroids to control inflammation and other symptoms of the condition. Surgery to remove the colon and rectum is another form of treatment if medication doesn’t prove effective.

There are still other, nonmedical forms of relief. Research shows that a number of natural treatments, including everything from lifestyle changes to herbal medicine, are effective for colitis. Exercise, stress-reduction techniques such as tai chi and yoga, and a healthier diet full of foods with soluble fiber have all been identified as beneficial to managing UC symptoms. A review article published in July 2014 in the journal PLoS One found that mind-body practices like tai chi, qigong, meditation, and yoga reduced inflammatory markers in the body.

Less is known about other natural treatments, like herbs and supplements. But they’re a valid form of UC therapy that doctors are prescribing more frequently. A review published in October 2014 in the World Journal of Gastroenterology found that herbal therapy in combination with traditional medicine may provide new and better alternatives to ulcerative colitis treatment. The list of herbs that work best include:

• Aloe vera gel
• Butyrate
• Tormentil extract
• Wheatgrass juice
• Curcumin (the active ingredient in turmeric)

Snider stresses that a holistic approach that factors in lifestyle, stress, supplements, and some natural remedies for ulcerative colitis offers the best chance at healing.

Read on to learn about some different kinds of natural therapies.

Herbal and plant therapy in patients with inflammatory bowel disease

From 1993 to April 2014, we identified 27 clinical studies dealing with herbal therapy in IBD. There were 17 studies of herbal therapy in UC and 10 studies in CD, including 1,874 individuals in total (). The mean age of subjects was 43 years. No significant differences concerning the number of male and female patients participating in the trials was recorded.

The most important of the available data concerning the use of herbals and plants in the treatment of IBD patients are summarized below.

UC

So far a total number of 17 clinical studies related to the treatment of either active or inactive UC with the use of herbal products have been published. The total number of patients included was 1421. These studies compared the effectiveness of herbal treatment with either drugs used regularly by patients with UC or placebo. In a minority of studies, herbal treatment was tested while the patients were receiving their regular treatment. The number of patients included in each study varied between a few dozen to more than 200. In studies dealing with induction treatment of active disease, the duration of treatment varied between 4 and 12 weeks, while in studies dealing with maintenance treatment fluctuated between 6 and 12 months.

Treatment of active disease

The total number of studies referring to the treatment of active UC was 11 and the number of patients included was 1008 ().

Aloe vera (Xanthorrhoeaceae)

Aloe vera is a herbal preparation with significant anti-inflammatory effects. The leaves of the plant contain an abundance of phytochemical substances including acetylated mannans, polymannans, anthraquinone C-glycosides, anthrones, anthraquinones (emodin), and lectins, most of which are under intense search.

In a double-blind, randomized, placebo-controlled trial, 44 hospital outpatients with mild to moderately active UC were randomly given oral aloe vera gel or placebo, 100 mL b.i.d. for 4 weeks, in a 2:1 ratio. Oral administration of aloe vera produced a clinical response more often than placebo; it also reduced the histological disease activity and appeared to be safe [3].

This herbal seems to be effective in some proportion of patients with active UC. Further studies are necessary using different doses in larger number of patients.

Triticum aestivum (Poaceae)

Triticum aestivum, common as bread wheat, is an annual grass belonging to the Poaceae family. It can be found in the form of liquid or powder. It contains chlorophyll, aminoacids, vitamins and various enzymes. The plant can be used as food, or as a drug with unique therapeutic potentials for which, however, there is no strong scientific support. It can be found as a fresh product, tablets, frozen juice, or powder.

In a randomized, double-blind, placebo-controlled study, 23 patients with active distal UC were allocated to receive either 100 mL of wheat grass juice (Triticum aestivum), or placebo, daily, for 1 month. Ten of 11 patients in the active treatment showed endoscopic improvement in comparison with 3 of 10 in the placebo group. Treatment was associated with significant reduction in the overall disease activity index and in the severity of rectal bleeding. Apart from nausea, no other serious side effects were noticed [4].

Andrographis paniculata (Acanthaceae)

Andrographis paniculata, a plant belonging to the family of Acanthaceae, grows mainly in India και Sri Lanka, as well as in South and South-Eastern Asia.

A recent randomized, double-blind, placebo-controlled study compared the extract of Andrographis paniculata (HMPL-004) with placebo in 224 adult patients with mild to moderately active UC. Treatment with HMPL-004 in a dose of 1800 mg per day resulted in a statistically significantly better clinical response compared to placebo (60% vs. 40%; P=0.018), although the proportion of remission after 8 weeks did not differ in the two groups [5].

The second study was also a randomized, double-blind, multicenter study of an 8-week duration with parallel groups. The study showed that HMPL-004 had similar effectiveness with mesalazine (response 76% vs. 82%; remission 21% vs. 16%) in patients with mild to moderate UC. In this study, there was no difference in the proportion of endoscopic remission in the two groups after 8 weeks (28% vs. 24%) [6].

Boswellia serrata (Burseraceae)

Boswellia (Boswellia serrata) belongs to the family of trees producing resin that are well-known for their good-smelling oil. Boswellia trees have a thick trunk that produces juice rich in carbohydrates, essential oils and acids called “boswellic acids”. These acids seem to be the active component of the plant being responsible for its therapeutic capabilities.

The initial clinical studies suggested that Boswellia serrata resin could be effective in IBD. In 2002, the European Medicines Agency categorized Boswellia serrata gum resin extract in the category of “orphan drugs”. Serrata gum resin extracts could influence the immune system in many ways. Boswellia serrata represses the formation of leukotriene via inhibition of 5-lipoxygenase with the action of two boswellia acids, namely 11-keto-β-boswellic acid and acetyl-11-keto-β-boswellic acid [7].

In the only available study, 30 patients with UC were randomized to receive either Boswellia serrata resin (900 mg/d in 3 doses, n=20) or sulfasalazine (3 g/d in 3 doses, n=10) for 6 weeks. Remission of the disease was achieved in 14 of 20 patients who received Boswellia gum resin, compared with 4 of 10 who received sulfasalazine [8]. Larger studies are urgently needed.

Jian Pi Ling (JPL)

JPL is considered as one of the current plant treatments in patients with UC. It consists of 9 components and is available in the form of tablets containing 0.75 g of dry herbal.

In a relevant study, 153 patients with UC were randomized in 3 groups. Group I: JPL tablet with Radix Sophorae flavescentis and Flos sophorae decoction; Group II: sulfasalazine and dexamethasone; Group III: placebo and enema decoction as in group I. The rate of remission after 3 months in group 1 was significantly higher (53%) compared with the rate of remission in the two other groups (28% and 19% respectively) [9]. However, the low rate of remission achieved in the two control groups raises questions about the real value of this study’s results.

Tormentil extracts (Tormentilla erecta-Rosaceae) Potentilla erecta (Tormentilla erecta, Potentilla tormentilla widely known as tormentil or septfoil) is a plant belonging to the family of Rosaceae.

Tormentil extracts have antioxidative properties and thus, it might be used as a complementary therapy for chronic IBD. In a relevant study, 16 patients with active UC received Tormentil extracts in escalating doses of 1200, 1800, 2400 and 3000 mg/d for 3 weeks each. During therapy with 2400 mg Tormentil extracts per day, median clinical activity index and CRP improved from 8 (6 to 10.75) and 8 (3 to 17.75) mg/L at baseline to 4.5 (1.75 to 6) and 3 (3 to 6) mg/L, respectively. During therapy, clinical activity index decreased in all patients, whereas it increased during the washout period [10]. Tormentil extracts appeared safe up to 3000 mg/d.

Xilei-san

Xilei-san is a mixture of herbs of Chinese medicine that harbors significant anti-inflammatory properties. It seems to be effective in a number of inflammatory conditions including digestive disorders such as esophagitis.

In an 8-week randomized, double-blind study, the Xilei-san mixture was compared with dexamethasone enema in 35 patients with mild to moderately severe ulcerative proctitis for 12 weeks. A similarly significant clinical, histological and endoscopic response compared with the baseline values in the two groups was achieved [11].

In another controlled study, 30 patients with intractable ulcerative proctitis were randomized to receive either Xilei-san or placebo suppositories for 2 weeks. The number of patients who achieved an improvement in the clinical activity index as well as in the endoscopic and histological index, was higher in the group of Xilei-san compared with the group of placebo (P<0.04) [12]. The rate of recurrence after 6 months was lower in the arm of active treatment.

No significant side effects were observed in both studies.

Anthocyanin-rich bilberry preparation

Anthocyanins, which can be found in large quantities in bilberries (Vaccinium myrtillus) were shown to have antioxidative and anti-inflammatory effects.

In the only available study Biedermann et al [13] explored the possible therapeutic potential of bilberries in active UC. Thirteen patients with mild to moderate UC were treated with a daily standardized anthocyanin-rich bilberry preparation for 9 weeks. At the end of the 6^th week 63.4% of patients achieved remission and 90.9% showed a response. A significant decrease in the Mayo score was also detected in all patients. Interestingly, the fecal calprotectin levels significantly decreased during treatment phase although an increase in the calprotectin levels and disease activity was observed after cessation of bilberry intake. No serious adverse events were observed. The results clearly indicate a therapeutic potential of bilberries in UC.

Fufangkushen colon-coated capsule (FCC)

FCC is a newly developed herbal drug for the treatment of UC patients with Chinese medicine pattern of damp-heat accumulating in the interior, consisted of Sophorae flavescentis, Sanguisorba officinalis L., Indigo naturalis, Bletilla striata and Glycyrrhiza uralensis.

In order to test the efficacy and safety of FCC in patients with active UC Gong et al [14] recently performed a double-blinded, randomized clinical trial comparing FCC with Huidi (HD, mesalazine enteric-coated tablets). In this study 320 active UC patients were assigned to two groups: 240 treated with FCC plus HD placebo treatment and 80 with HD plus FCC placebo for 8 weeks. At the 8^th week, 72.5% of patients in FCC group and 65.0% of patients in HD group achieved a clinical response and 41.5% in FCC group vs. 41.25% in HD group clinical remission (no significant differences). The rate of mucosal healing at week 8 was also similar in the two groups. Similar safety profiles in the 2 groups were also seen. FCC seems to be equally effective and safe in the treatment of active UC compared with mesalazine.

shows the results of the effectiveness of herbal and plant products administration in the response and remission rate of patients with active UC.

Table 2

Studies on herbal and plant product treatment of patients with active ulcerative colitis

Maintenance treatment of UC

So far, a small number of clinical trials have been published concerning the role of plant products in the maintenance treatment of UC patients. These studies are analyzed subsequently.

Curcumin

Curcumin is a biologically active phytochemical substance showing antioxidant, anti-inflammatory, anticarcinogenic, hypocholesterolemic, antibacterial, wound-healing, antispasmodic, anticoagulant, antitumor and hepatoprotective activities. Curcumin inhibits many cytokine pathways including interleukin (IL)-6, concurrently having a favorable safety profile. Its anti-inflammatory and antioxidant effect has been shown in numerous animal models.

Hanai et al [15] evaluated the usefulness of curcumin in 89 patients with quiescent UC. Forty-five patients received 1 g curcumin b.i.d. along with sulfasalazine or mesalamine, and 44 received placebo plus sulfasalazine or mesalamine for 6 months. Curcumin significantly improved both the clinical activity index and the endoscopic index. Recurrence rates were significantly lower in the curcumin group compared with placebo. Curcumin seems to be promising and safe medication for maintaining remission in patients with quiescent UC.

Plantago ovata (Plantaginaceae)

Plantago ovata is a small plant with characteristic flowers. The juice derived from the plant leaves, has been used in the treatment of peptic ulcer and pain accompanying inflammatory conditions. The plant has anti-inflammatory and anti-oxidative properties. It inhibits the protein kinase C, it down-regulates the expression of intercellular adhesion molecule-1 and inhibits the inflammation produced from 5-hydroxy-6,8,11,14-eicosatetraenoic acid and leukotriene B₄. The enzymatic dissolution of the seeds of Plantago ovata results in the production of short chain fatty acids that have favorable effects in patients with patients with UC.

In an open clinical study, 105 patients with UC in remission were randomized to receive either Plantago ovata seeds (10 g b.i.d.), mesalazine (500 mg t.i.d.), and Plantago ovata seeds with mesalazine in the same doses. The rate of recurrence after 6 months did not differ in the three groups (40% vs. 35% vs. 30%) [16]. There were few side effects mainly constipation and abdominal bloating.

Oenothera biennis

Oenothera biennis belongs to the group of Oenothera which can be found in North America and other tropical and subtropical countries. The evening primrose oil is the main product of the plant. The main constituent of Oenothera biennis seeds is the γ-linolenic acid.

The plant has been used as maintenance treatment in patients with UC with moderate results. In a placebo-controlled study, 43 patients with UC were randomized to receive MaxEPA (n=16), super evening primrose oil (n=19), or olive oil as placebo (n=8) for 6 months plus their regular maintenance treatment with 5-aminosalicylates (5-ASA). Treatment with super evening primrose oil increased the concentrations of dihomogamma-linolenic acid (DGLA) of red cell membrane (P<0.05) and the stool form during the first 6 months, compared to MaxEPA and placebo and this difference was continued 3 months after cessation of treatment (P<0. 05). Evening primrose oil could offer some benefit in patients with UC [17].

Germinated barley foodstuff (GBF)

GBF represents the final product of dryness and fermentation of barley. It is based on recipes of traditional Chinese medicine having many beneficial physiological effects. GBF, which mainly consists of dietary fiber and glutamine-rich protein, is essentially a prebiotic that can reduce the clinical activity of UC over long-term as well as short-term administration [18].

In a relevant study, 59 patients with UC in remission were divided into two groups, control group (n=37) who received conventional treatment for 12 months and GBF group (n=22) who received conventional treatment plus 20 g of GBF daily. Significantly better activity index values were seen in the GBF group at 3, 6, and 12 months compared with control group. The cumulative recurrence rate in the GBF group with steroid tapering treatment was significantly lower compared with the value in the control group. No side effects related to GBF were noticed [19].

It seems that GBF is an effective and safe herbal in the maintenance treatment of UC having also the ability to taper steroid treatment.

Extract of myrrh, dry extract of chamomile flowers and coffee charcoal

It is well known that the herbal mixture of myrrh, dry extract of chamomile flowers and coffee charcoal has anti-inflammatory and antidiarrheal properties.

In the only one so far available randomized, double-blind, double-dummy study 96 patients with inactive UC were randomized to receive either the herbal preparation or mesalazine over a 12-month period. There was no significant difference in the relapse rate between the two groups (45% in the mesalazine group and 53% in the herbal group). No significant differences were also shown in relapse-free time, endoscopy and fecal biomarkers [20]. The herbal preparation was well tolerated and showed a good safety profile.

shows the results of clinical trials with plant products of patients with UC in remission.

Table 3

Clinical trials with plant products in patients with ulcerative colitis in remission

Active CD

Chios mustic gum (Pistacia lentiscus-Anacardiaceae)

Pistacia lentiscus var Chia belongs to the family of Pistacia. This tree is unique in the world because it produces a special resin (mastic gum). The mastic tree belongs to the family of Anacardiaceae. Mastic gum is a natural product produced by trees growing exclusively in the Greek island of Chios. Its aromatic and therapeutic characteristics are well-known for centuries. It contains a large number of antioxidant substances, most of which have been recently identified.

In a relevant study, the effectiveness of mastic on the clinical course and plasma inflammatory mediators of patients with active CD was evaluated. Recruited to a 4-week treatment with mastic caps (6 caps/d, 0.37 g/cap) were 10 patients and 8 controls. It was found that mastic treatment significantly decreased the CD activity index (CDAI) and the plasma levels of IL-6 and CRP [21].

In a subsequent study, the same group of investigators noticed that treating CD patients with mastic resulted in the reduction of TNF-α secretion. Migration inhibitory factor release was also significantly increased, meaning that random migration and chemotaxis of monocytes/macrophages were inhibited. It seems that mastic acts as an immunomodulator on peripheral blood mononuclear cells, acting as a TNF-α inhibitor and a migration inhibitory factor stimulator [22].

We strongly suggest that larger, double-blind, placebo-controlled studies are required in order to further clarify the role of this significant natural product in the treatment of patients with active CD.

Wormwood herb (Artemisia absinthium-Asteraceae)

Absinth wormwood is a herbaceous perennial plant with a distinctive smell of sage. It has traditionally been used to treat various digestive disorders. It is traditionally made by a distillation of neutral alcohol, various herbs, spices and water. The European Union permits a maximum thujone level of 35 mg/kg in alcoholic beverages where Artemisia species is a listed ingredient, and 10 mg/kg in other alcoholic beverages.

So far, two studies have been published concerning the possible therapeutic results of this herbal in patients with active CD. In the first one, 40 patients with CD receiving 40 mg of prednisone daily for at least 3 weeks were administered a herbal blend containing wormwood herb (3×500 mg/day) or placebo for 10 weeks. After 8 weeks, there was almost complete clinical remission in 65% patients as compared to none in the placebo group. This remission persisted until the end of the observation period. It was also noticed that wormwood had a steroid sparing effect and a positive effect on the quality of life of patients [23].

In the second study, 20 patients with active CD received dry powder of wormwood or placebo while being on their previous regular treatment. After 6 weeks, 8 of 10 (80%) of patients receiving wormwood and 2 of 10 (20%) receiving placebo achieved remission. Clinical response was noticed in 6 of 10 of the group of wormwood compared to none of the group of placebo [24]. The available data so far concerning this plant seem to be promising.

Cannabis (Cannabis sativa L. – Cannabaceae)

Cannabis sativa is an annual herbaceous plant in the Cannabis genus, a species of the Cannabaceae family. Although the main psychoactive constituent of Cannabis is tetrahydrocannabinol, the plant contains almost 60 cannabinoids. Differences in the chemical composition of Cannabis varieties may produce different effects in humans. The marijuana plant cannabis is known to improve inflammatory processes, while experimental evidence suggests that the endogenous cannabinoid system inhibits colonic inflammation, leading to the conclusion that cannabis may have a therapeutic role in IBD.

In a retrospective observational study, disease activity, use of medication, need for surgery and hospitalization rate before and after cannabis use in 30 patients (26 males) with CD was investigated. Of the 30 patients, 21 significantly improved after treatment while the need for other medication was significantly reduced. Fifteen of the patients had 19 surgeries during an average period of 9 years before cannabis use, but only 2 required surgeries during an average period of 3 years of cannabis use [25]. In another study, a comparable proportion of UC and CD patients reported lifetime or current cannabis use [26].

During the forthcoming years, the plant might be widely used in the treatment of IBD patients. Changes in the relevant legislation, as well as the use of the plant after the patients’ informed consent, would play a significant role in the adoption of this kind of treatment. It is, however, necessary to accurately confirm the safety and effectiveness of the plant by performing large clinical studies.

Boswellia serrata extract

Pilot clinical studies support the potential of Boswellia serrata gum resin extract for the treatment of IBD. Extracts from the gum resin of Boswellia serrata affect the immune system in different ways. It could suppress leukotriene formation via inhibition of 5-lipoxygenase by two boswellic acids, 11-keto-β-boswellic acid and acetyl-11-keto-β-boswellic acid.

In a randomized double-blind study, 102 patients with active CD randomized to receive Boswellia serrata extract (h25) or mesalazine. The mean reduction in the CDAI was 90 for h25 and 53 for mesalazine [27].

Tripterygium wilfordii Hook F

Τhe traditional Chinese drug Tripterygium wilfordii Hook F (TWHF), a diterpene triepoxide, represents the main constituent of an extract obtained from Tripterygium wilfordii. Triptolide has multiple pharmacological properties (anti-inflammatory, immune modulating, antiproliferative and antiapoptotic).

In a study exploring the potential benefit of Tripterygium wilfordii, 20 patients with active CD received tablets containing T2 for 12 weeks. CDAI was significantly reduced during the first 8 weeks, while endoscopic improvement was noticed after 12 weeks. The inflammatory indices including CRP were also reduced [28].

shows the results of the clinical studies regarding the role of plant therapy of active CD.

Table 4

Clinical studies of plant treatment of patients with active Crohn’s disease

CD: maintenance treatment

Again a small number of studies have investigated the role of plant treatment in the prevention of recurrences in patients with CD.

Boswellia serrata

In a double-blind, placebo controlled study investigating the efficacy of Boswelan in maintaining remission in CD, 82 patients were randomized to either Boswelan (n=42, 3×2 capsules/day; 400 mg each) or placebo (n=40). No differences in the two groups concerning the remission rates were noticed. Regarding safety, no disadvantages of taking the drug compared to placebo were observed [29]. This trial confirmed the good tolerability of Boswelan, although there were no significant differences versus placebo in maintenance of remission.

Tripterygium wilfordii

Two placebo controlled studies and one prospective, single-blind study, investigated the role of Tripterygium wilfordii in the prevention of postsurgical relapses in patients with CD.

In the first one 45 patients with CD were randomized to receive either Tripterygium wilfordii or mesalazine. No relapse was noticed three months after operation. Again in 6 and 12 months after the operation the clinical relapse rate did not differ in the two groups (18% vs. 22% and 32% vs. 39%, respectively). No significant differences were observed in the rate of endoscopic recurrence after 12 months (46% vs. 61%) [30].

In the second study, 39 patients with CD were randomized two weeks after enterectomy to receive either Tripterygium wilfordii (n=21) or sulfasalazine (n=18). Clinical recurrence was noticed in 6% in the Tripterygium wilfordii group compared with 25% in the group of sulfasalazine. Again, endoscopic recurrence was observed in 22% in the group of Tripterygium wilfordii compared with 56% in the group of sulfasalazine. It seems that at least numerically, Tripterygium wilfordii is superior compared with sulfasalazine in the prevention from postsurgical recurrences of CD [31].

In the third study postoperative CD patients in remission were randomized to receive 1 mg/kg Tripterygium wilfordii polyglycoside daily, orally, or 4 g 5-ASA daily, orally, for 52 weeks. Twenty-one patients received Tripterygium wilfordii polyglycoside and 18 5-ASA [32]. The results showed that clinical and endoscopic recurrences were less common in the Tripterygium wilfordii polyglycoside group (n=4) versus the 5-ASA group (n=9).

Taking into account the results of the above mentioned studies it seems that Tripterygium wilfordii polyglycoside appears to be an effective, well-tolerated drug superior to oral 5-ASA, for preventing clinical and endoscopic recurrence in postsurgical CD.

shows the results of the studies investigating the role of herbal treatment in the prevention of relapses of CD.

Table 5

Clinical studies of plant treatment of patients with Crohn’s disease in remission

Herbal and plant therapy in patients with inflammatory bowel disease

From 1993 to April 2014, we identified 27 clinical studies dealing with herbal therapy in IBD. There were 17 studies of herbal therapy in UC and 10 studies in CD, including 1,874 individuals in total (). The mean age of subjects was 43 years. No significant differences concerning the number of male and female patients participating in the trials was recorded.

The most important of the available data concerning the use of herbals and plants in the treatment of IBD patients are summarized below.

UC

So far a total number of 17 clinical studies related to the treatment of either active or inactive UC with the use of herbal products have been published. The total number of patients included was 1421. These studies compared the effectiveness of herbal treatment with either drugs used regularly by patients with UC or placebo. In a minority of studies, herbal treatment was tested while the patients were receiving their regular treatment. The number of patients included in each study varied between a few dozen to more than 200. In studies dealing with induction treatment of active disease, the duration of treatment varied between 4 and 12 weeks, while in studies dealing with maintenance treatment fluctuated between 6 and 12 months.

Treatment of active disease

The total number of studies referring to the treatment of active UC was 11 and the number of patients included was 1008 ().

Aloe vera (Xanthorrhoeaceae)

Aloe vera is a herbal preparation with significant anti-inflammatory effects. The leaves of the plant contain an abundance of phytochemical substances including acetylated mannans, polymannans, anthraquinone C-glycosides, anthrones, anthraquinones (emodin), and lectins, most of which are under intense search.

In a double-blind, randomized, placebo-controlled trial, 44 hospital outpatients with mild to moderately active UC were randomly given oral aloe vera gel or placebo, 100 mL b.i.d. for 4 weeks, in a 2:1 ratio. Oral administration of aloe vera produced a clinical response more often than placebo; it also reduced the histological disease activity and appeared to be safe [3].

This herbal seems to be effective in some proportion of patients with active UC. Further studies are necessary using different doses in larger number of patients.

Triticum aestivum (Poaceae)

Triticum aestivum, common as bread wheat, is an annual grass belonging to the Poaceae family. It can be found in the form of liquid or powder. It contains chlorophyll, aminoacids, vitamins and various enzymes. The plant can be used as food, or as a drug with unique therapeutic potentials for which, however, there is no strong scientific support. It can be found as a fresh product, tablets, frozen juice, or powder.

In a randomized, double-blind, placebo-controlled study, 23 patients with active distal UC were allocated to receive either 100 mL of wheat grass juice (Triticum aestivum), or placebo, daily, for 1 month. Ten of 11 patients in the active treatment showed endoscopic improvement in comparison with 3 of 10 in the placebo group. Treatment was associated with significant reduction in the overall disease activity index and in the severity of rectal bleeding. Apart from nausea, no other serious side effects were noticed [4].

Andrographis paniculata (Acanthaceae)

Andrographis paniculata, a plant belonging to the family of Acanthaceae, grows mainly in India και Sri Lanka, as well as in South and South-Eastern Asia.

A recent randomized, double-blind, placebo-controlled study compared the extract of Andrographis paniculata (HMPL-004) with placebo in 224 adult patients with mild to moderately active UC. Treatment with HMPL-004 in a dose of 1800 mg per day resulted in a statistically significantly better clinical response compared to placebo (60% vs. 40%; P=0.018), although the proportion of remission after 8 weeks did not differ in the two groups [5].

The second study was also a randomized, double-blind, multicenter study of an 8-week duration with parallel groups. The study showed that HMPL-004 had similar effectiveness with mesalazine (response 76% vs. 82%; remission 21% vs. 16%) in patients with mild to moderate UC. In this study, there was no difference in the proportion of endoscopic remission in the two groups after 8 weeks (28% vs. 24%) [6].

Boswellia serrata (Burseraceae)

Boswellia (Boswellia serrata) belongs to the family of trees producing resin that are well-known for their good-smelling oil. Boswellia trees have a thick trunk that produces juice rich in carbohydrates, essential oils and acids called “boswellic acids”. These acids seem to be the active component of the plant being responsible for its therapeutic capabilities.

The initial clinical studies suggested that Boswellia serrata resin could be effective in IBD. In 2002, the European Medicines Agency categorized Boswellia serrata gum resin extract in the category of “orphan drugs”. Serrata gum resin extracts could influence the immune system in many ways. Boswellia serrata represses the formation of leukotriene via inhibition of 5-lipoxygenase with the action of two boswellia acids, namely 11-keto-β-boswellic acid and acetyl-11-keto-β-boswellic acid [7].

In the only available study, 30 patients with UC were randomized to receive either Boswellia serrata resin (900 mg/d in 3 doses, n=20) or sulfasalazine (3 g/d in 3 doses, n=10) for 6 weeks. Remission of the disease was achieved in 14 of 20 patients who received Boswellia gum resin, compared with 4 of 10 who received sulfasalazine [8]. Larger studies are urgently needed.

Jian Pi Ling (JPL)

JPL is considered as one of the current plant treatments in patients with UC. It consists of 9 components and is available in the form of tablets containing 0.75 g of dry herbal.

In a relevant study, 153 patients with UC were randomized in 3 groups. Group I: JPL tablet with Radix Sophorae flavescentis and Flos sophorae decoction; Group II: sulfasalazine and dexamethasone; Group III: placebo and enema decoction as in group I. The rate of remission after 3 months in group 1 was significantly higher (53%) compared with the rate of remission in the two other groups (28% and 19% respectively) [9]. However, the low rate of remission achieved in the two control groups raises questions about the real value of this study’s results.

Tormentil extracts (Tormentilla erecta-Rosaceae) Potentilla erecta (Tormentilla erecta, Potentilla tormentilla widely known as tormentil or septfoil) is a plant belonging to the family of Rosaceae.

Tormentil extracts have antioxidative properties and thus, it might be used as a complementary therapy for chronic IBD. In a relevant study, 16 patients with active UC received Tormentil extracts in escalating doses of 1200, 1800, 2400 and 3000 mg/d for 3 weeks each. During therapy with 2400 mg Tormentil extracts per day, median clinical activity index and CRP improved from 8 (6 to 10.75) and 8 (3 to 17.75) mg/L at baseline to 4.5 (1.75 to 6) and 3 (3 to 6) mg/L, respectively. During therapy, clinical activity index decreased in all patients, whereas it increased during the washout period [10]. Tormentil extracts appeared safe up to 3000 mg/d.

Xilei-san

Xilei-san is a mixture of herbs of Chinese medicine that harbors significant anti-inflammatory properties. It seems to be effective in a number of inflammatory conditions including digestive disorders such as esophagitis.

In an 8-week randomized, double-blind study, the Xilei-san mixture was compared with dexamethasone enema in 35 patients with mild to moderately severe ulcerative proctitis for 12 weeks. A similarly significant clinical, histological and endoscopic response compared with the baseline values in the two groups was achieved [11].

In another controlled study, 30 patients with intractable ulcerative proctitis were randomized to receive either Xilei-san or placebo suppositories for 2 weeks. The number of patients who achieved an improvement in the clinical activity index as well as in the endoscopic and histological index, was higher in the group of Xilei-san compared with the group of placebo (P<0.04) [12]. The rate of recurrence after 6 months was lower in the arm of active treatment.

No significant side effects were observed in both studies.

Anthocyanin-rich bilberry preparation

Anthocyanins, which can be found in large quantities in bilberries (Vaccinium myrtillus) were shown to have antioxidative and anti-inflammatory effects.

In the only available study Biedermann et al [13] explored the possible therapeutic potential of bilberries in active UC. Thirteen patients with mild to moderate UC were treated with a daily standardized anthocyanin-rich bilberry preparation for 9 weeks. At the end of the 6^th week 63.4% of patients achieved remission and 90.9% showed a response. A significant decrease in the Mayo score was also detected in all patients. Interestingly, the fecal calprotectin levels significantly decreased during treatment phase although an increase in the calprotectin levels and disease activity was observed after cessation of bilberry intake. No serious adverse events were observed. The results clearly indicate a therapeutic potential of bilberries in UC.

Fufangkushen colon-coated capsule (FCC)

FCC is a newly developed herbal drug for the treatment of UC patients with Chinese medicine pattern of damp-heat accumulating in the interior, consisted of Sophorae flavescentis, Sanguisorba officinalis L., Indigo naturalis, Bletilla striata and Glycyrrhiza uralensis.

In order to test the efficacy and safety of FCC in patients with active UC Gong et al [14] recently performed a double-blinded, randomized clinical trial comparing FCC with Huidi (HD, mesalazine enteric-coated tablets). In this study 320 active UC patients were assigned to two groups: 240 treated with FCC plus HD placebo treatment and 80 with HD plus FCC placebo for 8 weeks. At the 8^th week, 72.5% of patients in FCC group and 65.0% of patients in HD group achieved a clinical response and 41.5% in FCC group vs. 41.25% in HD group clinical remission (no significant differences). The rate of mucosal healing at week 8 was also similar in the two groups. Similar safety profiles in the 2 groups were also seen. FCC seems to be equally effective and safe in the treatment of active UC compared with mesalazine.

shows the results of the effectiveness of herbal and plant products administration in the response and remission rate of patients with active UC.

Table 2

Studies on herbal and plant product treatment of patients with active ulcerative colitis

Maintenance treatment of UC

So far, a small number of clinical trials have been published concerning the role of plant products in the maintenance treatment of UC patients. These studies are analyzed subsequently.

Curcumin

Curcumin is a biologically active phytochemical substance showing antioxidant, anti-inflammatory, anticarcinogenic, hypocholesterolemic, antibacterial, wound-healing, antispasmodic, anticoagulant, antitumor and hepatoprotective activities. Curcumin inhibits many cytokine pathways including interleukin (IL)-6, concurrently having a favorable safety profile. Its anti-inflammatory and antioxidant effect has been shown in numerous animal models.

Hanai et al [15] evaluated the usefulness of curcumin in 89 patients with quiescent UC. Forty-five patients received 1 g curcumin b.i.d. along with sulfasalazine or mesalamine, and 44 received placebo plus sulfasalazine or mesalamine for 6 months. Curcumin significantly improved both the clinical activity index and the endoscopic index. Recurrence rates were significantly lower in the curcumin group compared with placebo. Curcumin seems to be promising and safe medication for maintaining remission in patients with quiescent UC.

Plantago ovata (Plantaginaceae)

Plantago ovata is a small plant with characteristic flowers. The juice derived from the plant leaves, has been used in the treatment of peptic ulcer and pain accompanying inflammatory conditions. The plant has anti-inflammatory and anti-oxidative properties. It inhibits the protein kinase C, it down-regulates the expression of intercellular adhesion molecule-1 and inhibits the inflammation produced from 5-hydroxy-6,8,11,14-eicosatetraenoic acid and leukotriene B₄. The enzymatic dissolution of the seeds of Plantago ovata results in the production of short chain fatty acids that have favorable effects in patients with patients with UC.

In an open clinical study, 105 patients with UC in remission were randomized to receive either Plantago ovata seeds (10 g b.i.d.), mesalazine (500 mg t.i.d.), and Plantago ovata seeds with mesalazine in the same doses. The rate of recurrence after 6 months did not differ in the three groups (40% vs. 35% vs. 30%) [16]. There were few side effects mainly constipation and abdominal bloating.

Oenothera biennis

Oenothera biennis belongs to the group of Oenothera which can be found in North America and other tropical and subtropical countries. The evening primrose oil is the main product of the plant. The main constituent of Oenothera biennis seeds is the γ-linolenic acid.

The plant has been used as maintenance treatment in patients with UC with moderate results. In a placebo-controlled study, 43 patients with UC were randomized to receive MaxEPA (n=16), super evening primrose oil (n=19), or olive oil as placebo (n=8) for 6 months plus their regular maintenance treatment with 5-aminosalicylates (5-ASA). Treatment with super evening primrose oil increased the concentrations of dihomogamma-linolenic acid (DGLA) of red cell membrane (P<0.05) and the stool form during the first 6 months, compared to MaxEPA and placebo and this difference was continued 3 months after cessation of treatment (P<0.05). Evening primrose oil could offer some benefit in patients with UC [17].

Germinated barley foodstuff (GBF)

GBF represents the final product of dryness and fermentation of barley. It is based on recipes of traditional Chinese medicine having many beneficial physiological effects. GBF, which mainly consists of dietary fiber and glutamine-rich protein, is essentially a prebiotic that can reduce the clinical activity of UC over long-term as well as short-term administration [18].

In a relevant study, 59 patients with UC in remission were divided into two groups, control group (n=37) who received conventional treatment for 12 months and GBF group (n=22) who received conventional treatment plus 20 g of GBF daily. Significantly better activity index values were seen in the GBF group at 3, 6, and 12 months compared with control group. The cumulative recurrence rate in the GBF group with steroid tapering treatment was significantly lower compared with the value in the control group. No side effects related to GBF were noticed [19].

It seems that GBF is an effective and safe herbal in the maintenance treatment of UC having also the ability to taper steroid treatment.

Extract of myrrh, dry extract of chamomile flowers and coffee charcoal

It is well known that the herbal mixture of myrrh, dry extract of chamomile flowers and coffee charcoal has anti-inflammatory and antidiarrheal properties.

In the only one so far available randomized, double-blind, double-dummy study 96 patients with inactive UC were randomized to receive either the herbal preparation or mesalazine over a 12-month period. There was no significant difference in the relapse rate between the two groups (45% in the mesalazine group and 53% in the herbal group). No significant differences were also shown in relapse-free time, endoscopy and fecal biomarkers [20]. The herbal preparation was well tolerated and showed a good safety profile.

shows the results of clinical trials with plant products of patients with UC in remission.

Table 3

Clinical trials with plant products in patients with ulcerative colitis in remission

Active CD

Chios mustic gum (Pistacia lentiscus-Anacardiaceae)

Pistacia lentiscus var Chia belongs to the family of Pistacia. This tree is unique in the world because it produces a special resin (mastic gum). The mastic tree belongs to the family of Anacardiaceae. Mastic gum is a natural product produced by trees growing exclusively in the Greek island of Chios. Its aromatic and therapeutic characteristics are well-known for centuries. It contains a large number of antioxidant substances, most of which have been recently identified.

In a relevant study, the effectiveness of mastic on the clinical course and plasma inflammatory mediators of patients with active CD was evaluated. Recruited to a 4-week treatment with mastic caps (6 caps/d, 0.37 g/cap) were 10 patients and 8 controls. It was found that mastic treatment significantly decreased the CD activity index (CDAI) and the plasma levels of IL-6 and CRP [21].

In a subsequent study, the same group of investigators noticed that treating CD patients with mastic resulted in the reduction of TNF-α secretion. Migration inhibitory factor release was also significantly increased, meaning that random migration and chemotaxis of monocytes/macrophages were inhibited. It seems that mastic acts as an immunomodulator on peripheral blood mononuclear cells, acting as a TNF-α inhibitor and a migration inhibitory factor stimulator [22].

We strongly suggest that larger, double-blind, placebo-controlled studies are required in order to further clarify the role of this significant natural product in the treatment of patients with active CD.

Wormwood herb (Artemisia absinthium-Asteraceae)

Absinth wormwood is a herbaceous perennial plant with a distinctive smell of sage. It has traditionally been used to treat various digestive disorders. It is traditionally made by a distillation of neutral alcohol, various herbs, spices and water. The European Union permits a maximum thujone level of 35 mg/kg in alcoholic beverages where Artemisia species is a listed ingredient, and 10 mg/kg in other alcoholic beverages.

So far, two studies have been published concerning the possible therapeutic results of this herbal in patients with active CD. In the first one, 40 patients with CD receiving 40 mg of prednisone daily for at least 3 weeks were administered a herbal blend containing wormwood herb (3×500 mg/day) or placebo for 10 weeks. After 8 weeks, there was almost complete clinical remission in 65% patients as compared to none in the placebo group. This remission persisted until the end of the observation period. It was also noticed that wormwood had a steroid sparing effect and a positive effect on the quality of life of patients [23].

In the second study, 20 patients with active CD received dry powder of wormwood or placebo while being on their previous regular treatment. After 6 weeks, 8 of 10 (80%) of patients receiving wormwood and 2 of 10 (20%) receiving placebo achieved remission. Clinical response was noticed in 6 of 10 of the group of wormwood compared to none of the group of placebo [24]. The available data so far concerning this plant seem to be promising.

Cannabis (Cannabis sativa L. – Cannabaceae)

Cannabis sativa is an annual herbaceous plant in the Cannabis genus, a species of the Cannabaceae family. Although the main psychoactive constituent of Cannabis is tetrahydrocannabinol, the plant contains almost 60 cannabinoids. Differences in the chemical composition of Cannabis varieties may produce different effects in humans. The marijuana plant cannabis is known to improve inflammatory processes, while experimental evidence suggests that the endogenous cannabinoid system inhibits colonic inflammation, leading to the conclusion that cannabis may have a therapeutic role in IBD.

In a retrospective observational study, disease activity, use of medication, need for surgery and hospitalization rate before and after cannabis use in 30 patients (26 males) with CD was investigated. Of the 30 patients, 21 significantly improved after treatment while the need for other medication was significantly reduced. Fifteen of the patients had 19 surgeries during an average period of 9 years before cannabis use, but only 2 required surgeries during an average period of 3 years of cannabis use [25]. In another study, a comparable proportion of UC and CD patients reported lifetime or current cannabis use [26].

During the forthcoming years, the plant might be widely used in the treatment of IBD patients. Changes in the relevant legislation, as well as the use of the plant after the patients’ informed consent, would play a significant role in the adoption of this kind of treatment. It is, however, necessary to accurately confirm the safety and effectiveness of the plant by performing large clinical studies.

Boswellia serrata extract

Pilot clinical studies support the potential of Boswellia serrata gum resin extract for the treatment of IBD. Extracts from the gum resin of Boswellia serrata affect the immune system in different ways. It could suppress leukotriene formation via inhibition of 5-lipoxygenase by two boswellic acids, 11-keto-β-boswellic acid and acetyl-11-keto-β-boswellic acid.

In a randomized double-blind study, 102 patients with active CD randomized to receive Boswellia serrata extract (h25) or mesalazine. The mean reduction in the CDAI was 90 for h25 and 53 for mesalazine [27].

Tripterygium wilfordii Hook F

Τhe traditional Chinese drug Tripterygium wilfordii Hook F (TWHF), a diterpene triepoxide, represents the main constituent of an extract obtained from Tripterygium wilfordii. Triptolide has multiple pharmacological properties (anti-inflammatory, immune modulating, antiproliferative and antiapoptotic).

In a study exploring the potential benefit of Tripterygium wilfordii, 20 patients with active CD received tablets containing T2 for 12 weeks. CDAI was significantly reduced during the first 8 weeks, while endoscopic improvement was noticed after 12 weeks. The inflammatory indices including CRP were also reduced [28].

shows the results of the clinical studies regarding the role of plant therapy of active CD.

Table 4

Clinical studies of plant treatment of patients with active Crohn’s disease

CD: maintenance treatment

Again a small number of studies have investigated the role of plant treatment in the prevention of recurrences in patients with CD.

Boswellia serrata

In a double-blind, placebo controlled study investigating the efficacy of Boswelan in maintaining remission in CD, 82 patients were randomized to either Boswelan (n=42, 3×2 capsules/day; 400 mg each) or placebo (n=40). No differences in the two groups concerning the remission rates were noticed. Regarding safety, no disadvantages of taking the drug compared to placebo were observed [29]. This trial confirmed the good tolerability of Boswelan, although there were no significant differences versus placebo in maintenance of remission.

Tripterygium wilfordii

Two placebo controlled studies and one prospective, single-blind study, investigated the role of Tripterygium wilfordii in the prevention of postsurgical relapses in patients with CD.

In the first one 45 patients with CD were randomized to receive either Tripterygium wilfordii or mesalazine. No relapse was noticed three months after operation. Again in 6 and 12 months after the operation the clinical relapse rate did not differ in the two groups (18% vs. 22% and 32% vs. 39%, respectively). No significant differences were observed in the rate of endoscopic recurrence after 12 months (46% vs. 61%) [30].

In the second study, 39 patients with CD were randomized two weeks after enterectomy to receive either Tripterygium wilfordii (n=21) or sulfasalazine (n=18). Clinical recurrence was noticed in 6% in the Tripterygium wilfordii group compared with 25% in the group of sulfasalazine. Again, endoscopic recurrence was observed in 22% in the group of Tripterygium wilfordii compared with 56% in the group of sulfasalazine. It seems that at least numerically, Tripterygium wilfordii is superior compared with sulfasalazine in the prevention from postsurgical recurrences of CD [31].

In the third study postoperative CD patients in remission were randomized to receive 1 mg/kg Tripterygium wilfordii polyglycoside daily, orally, or 4 g 5-ASA daily, orally, for 52 weeks. Twenty-one patients received Tripterygium wilfordii polyglycoside and 18 5-ASA [32]. The results showed that clinical and endoscopic recurrences were less common in the Tripterygium wilfordii polyglycoside group (n=4) versus the 5-ASA group (n=9).

Taking into account the results of the above mentioned studies it seems that Tripterygium wilfordii polyglycoside appears to be an effective, well-tolerated drug superior to oral 5-ASA, for preventing clinical and endoscopic recurrence in postsurgical CD.

shows the results of the studies investigating the role of herbal treatment in the prevention of relapses of CD.

Table 5

Clinical studies of plant treatment of patients with Crohn’s disease in remission

Herbal and plant therapy in patients with inflammatory bowel disease

From 1993 to April 2014, we identified 27 clinical studies dealing with herbal therapy in IBD. There were 17 studies of herbal therapy in UC and 10 studies in CD, including 1,874 individuals in total (). The mean age of subjects was 43 years. No significant differences concerning the number of male and female patients participating in the trials was recorded.

The most important of the available data concerning the use of herbals and plants in the treatment of IBD patients are summarized below.

UC

So far a total number of 17 clinical studies related to the treatment of either active or inactive UC with the use of herbal products have been published. The total number of patients included was 1421. These studies compared the effectiveness of herbal treatment with either drugs used regularly by patients with UC or placebo. In a minority of studies, herbal treatment was tested while the patients were receiving their regular treatment. The number of patients included in each study varied between a few dozen to more than 200. In studies dealing with induction treatment of active disease, the duration of treatment varied between 4 and 12 weeks, while in studies dealing with maintenance treatment fluctuated between 6 and 12 months.

Treatment of active disease

The total number of studies referring to the treatment of active UC was 11 and the number of patients included was 1008 ().

Aloe vera (Xanthorrhoeaceae)

Aloe vera is a herbal preparation with significant anti-inflammatory effects. The leaves of the plant contain an abundance of phytochemical substances including acetylated mannans, polymannans, anthraquinone C-glycosides, anthrones, anthraquinones (emodin), and lectins, most of which are under intense search.

In a double-blind, randomized, placebo-controlled trial, 44 hospital outpatients with mild to moderately active UC were randomly given oral aloe vera gel or placebo, 100 mL b.i.d. for 4 weeks, in a 2:1 ratio. Oral administration of aloe vera produced a clinical response more often than placebo; it also reduced the histological disease activity and appeared to be safe [3].

This herbal seems to be effective in some proportion of patients with active UC. Further studies are necessary using different doses in larger number of patients.

Triticum aestivum (Poaceae)

Triticum aestivum, common as bread wheat, is an annual grass belonging to the Poaceae family. It can be found in the form of liquid or powder. It contains chlorophyll, aminoacids, vitamins and various enzymes. The plant can be used as food, or as a drug with unique therapeutic potentials for which, however, there is no strong scientific support. It can be found as a fresh product, tablets, frozen juice, or powder.

In a randomized, double-blind, placebo-controlled study, 23 patients with active distal UC were allocated to receive either 100 mL of wheat grass juice (Triticum aestivum), or placebo, daily, for 1 month. Ten of 11 patients in the active treatment showed endoscopic improvement in comparison with 3 of 10 in the placebo group. Treatment was associated with significant reduction in the overall disease activity index and in the severity of rectal bleeding. Apart from nausea, no other serious side effects were noticed [4].

Andrographis paniculata (Acanthaceae)

Andrographis paniculata, a plant belonging to the family of Acanthaceae, grows mainly in India και Sri Lanka, as well as in South and South-Eastern Asia.

A recent randomized, double-blind, placebo-controlled study compared the extract of Andrographis paniculata (HMPL-004) with placebo in 224 adult patients with mild to moderately active UC. Treatment with HMPL-004 in a dose of 1800 mg per day resulted in a statistically significantly better clinical response compared to placebo (60% vs. 40%; P=0.018), although the proportion of remission after 8 weeks did not differ in the two groups [5].

The second study was also a randomized, double-blind, multicenter study of an 8-week duration with parallel groups. The study showed that HMPL-004 had similar effectiveness with mesalazine (response 76% vs. 82%; remission 21% vs. 16%) in patients with mild to moderate UC. In this study, there was no difference in the proportion of endoscopic remission in the two groups after 8 weeks (28% vs. 24%) [6].

Boswellia serrata (Burseraceae)

Boswellia (Boswellia serrata) belongs to the family of trees producing resin that are well-known for their good-smelling oil. Boswellia trees have a thick trunk that produces juice rich in carbohydrates, essential oils and acids called “boswellic acids”. These acids seem to be the active component of the plant being responsible for its therapeutic capabilities.

The initial clinical studies suggested that Boswellia serrata resin could be effective in IBD. In 2002, the European Medicines Agency categorized Boswellia serrata gum resin extract in the category of “orphan drugs”. Serrata gum resin extracts could influence the immune system in many ways. Boswellia serrata represses the formation of leukotriene via inhibition of 5-lipoxygenase with the action of two boswellia acids, namely 11-keto-β-boswellic acid and acetyl-11-keto-β-boswellic acid [7].

In the only available study, 30 patients with UC were randomized to receive either Boswellia serrata resin (900 mg/d in 3 doses, n=20) or sulfasalazine (3 g/d in 3 doses, n=10) for 6 weeks. Remission of the disease was achieved in 14 of 20 patients who received Boswellia gum resin, compared with 4 of 10 who received sulfasalazine [8]. Larger studies are urgently needed.

Jian Pi Ling (JPL)

JPL is considered as one of the current plant treatments in patients with UC. It consists of 9 components and is available in the form of tablets containing 0.75 g of dry herbal.

In a relevant study, 153 patients with UC were randomized in 3 groups. Group I: JPL tablet with Radix Sophorae flavescentis and Flos sophorae decoction; Group II: sulfasalazine and dexamethasone; Group III: placebo and enema decoction as in group I. The rate of remission after 3 months in group 1 was significantly higher (53%) compared with the rate of remission in the two other groups (28% and 19% respectively) [9]. However, the low rate of remission achieved in the two control groups raises questions about the real value of this study’s results.

Tormentil extracts (Tormentilla erecta-Rosaceae) Potentilla erecta (Tormentilla erecta, Potentilla tormentilla widely known as tormentil or septfoil) is a plant belonging to the family of Rosaceae.

Tormentil extracts have antioxidative properties and thus, it might be used as a complementary therapy for chronic IBD. In a relevant study, 16 patients with active UC received Tormentil extracts in escalating doses of 1200, 1800, 2400 and 3000 mg/d for 3 weeks each. During therapy with 2400 mg Tormentil extracts per day, median clinical activity index and CRP improved from 8 (6 to 10.75) and 8 (3 to 17.75) mg/L at baseline to 4.5 (1.75 to 6) and 3 (3 to 6) mg/L, respectively. During therapy, clinical activity index decreased in all patients, whereas it increased during the washout period [10]. Tormentil extracts appeared safe up to 3000 mg/d.

Xilei-san

Xilei-san is a mixture of herbs of Chinese medicine that harbors significant anti-inflammatory properties. It seems to be effective in a number of inflammatory conditions including digestive disorders such as esophagitis.

In an 8-week randomized, double-blind study, the Xilei-san mixture was compared with dexamethasone enema in 35 patients with mild to moderately severe ulcerative proctitis for 12 weeks. A similarly significant clinical, histological and endoscopic response compared with the baseline values in the two groups was achieved [11].

In another controlled study, 30 patients with intractable ulcerative proctitis were randomized to receive either Xilei-san or placebo suppositories for 2 weeks. The number of patients who achieved an improvement in the clinical activity index as well as in the endoscopic and histological index, was higher in the group of Xilei-san compared with the group of placebo (P<0.04) [12]. The rate of recurrence after 6 months was lower in the arm of active treatment.

No significant side effects were observed in both studies.

Anthocyanin-rich bilberry preparation

Anthocyanins, which can be found in large quantities in bilberries (Vaccinium myrtillus) were shown to have antioxidative and anti-inflammatory effects.

In the only available study Biedermann et al [13] explored the possible therapeutic potential of bilberries in active UC. Thirteen patients with mild to moderate UC were treated with a daily standardized anthocyanin-rich bilberry preparation for 9 weeks. At the end of the 6^th week 63.4% of patients achieved remission and 90.9% showed a response. A significant decrease in the Mayo score was also detected in all patients. Interestingly, the fecal calprotectin levels significantly decreased during treatment phase although an increase in the calprotectin levels and disease activity was observed after cessation of bilberry intake. No serious adverse events were observed. The results clearly indicate a therapeutic potential of bilberries in UC.

Fufangkushen colon-coated capsule (FCC)

FCC is a newly developed herbal drug for the treatment of UC patients with Chinese medicine pattern of damp-heat accumulating in the interior, consisted of Sophorae flavescentis, Sanguisorba officinalis L., Indigo naturalis, Bletilla striata and Glycyrrhiza uralensis.

In order to test the efficacy and safety of FCC in patients with active UC Gong et al [14] recently performed a double-blinded, randomized clinical trial comparing FCC with Huidi (HD, mesalazine enteric-coated tablets). In this study 320 active UC patients were assigned to two groups: 240 treated with FCC plus HD placebo treatment and 80 with HD plus FCC placebo for 8 weeks. At the 8^th week, 72.5% of patients in FCC group and 65.0% of patients in HD group achieved a clinical response and 41.5% in FCC group vs. 41.25% in HD group clinical remission (no significant differences). The rate of mucosal healing at week 8 was also similar in the two groups. Similar safety profiles in the 2 groups were also seen. FCC seems to be equally effective and safe in the treatment of active UC compared with mesalazine.

shows the results of the effectiveness of herbal and plant products administration in the response and remission rate of patients with active UC.

Table 2

Studies on herbal and plant product treatment of patients with active ulcerative colitis

Maintenance treatment of UC

So far, a small number of clinical trials have been published concerning the role of plant products in the maintenance treatment of UC patients. These studies are analyzed subsequently.

Curcumin

Curcumin is a biologically active phytochemical substance showing antioxidant, anti-inflammatory, anticarcinogenic, hypocholesterolemic, antibacterial, wound-healing, antispasmodic, anticoagulant, antitumor and hepatoprotective activities. Curcumin inhibits many cytokine pathways including interleukin (IL)-6, concurrently having a favorable safety profile. Its anti-inflammatory and antioxidant effect has been shown in numerous animal models.

Hanai et al [15] evaluated the usefulness of curcumin in 89 patients with quiescent UC. Forty-five patients received 1 g curcumin b.i.d. along with sulfasalazine or mesalamine, and 44 received placebo plus sulfasalazine or mesalamine for 6 months. Curcumin significantly improved both the clinical activity index and the endoscopic index. Recurrence rates were significantly lower in the curcumin group compared with placebo. Curcumin seems to be promising and safe medication for maintaining remission in patients with quiescent UC.

Plantago ovata (Plantaginaceae)

Plantago ovata is a small plant with characteristic flowers. The juice derived from the plant leaves, has been used in the treatment of peptic ulcer and pain accompanying inflammatory conditions. The plant has anti-inflammatory and anti-oxidative properties. It inhibits the protein kinase C, it down-regulates the expression of intercellular adhesion molecule-1 and inhibits the inflammation produced from 5-hydroxy-6,8,11,14-eicosatetraenoic acid and leukotriene B₄. The enzymatic dissolution of the seeds of Plantago ovata results in the production of short chain fatty acids that have favorable effects in patients with patients with UC.

In an open clinical study, 105 patients with UC in remission were randomized to receive either Plantago ovata seeds (10 g b.i.d.), mesalazine (500 mg t.i.d.), and Plantago ovata seeds with mesalazine in the same doses. The rate of recurrence after 6 months did not differ in the three groups (40% vs. 35% vs. 30%) [16]. There were few side effects mainly constipation and abdominal bloating.

Oenothera biennis

Oenothera biennis belongs to the group of Oenothera which can be found in North America and other tropical and subtropical countries. The evening primrose oil is the main product of the plant. The main constituent of Oenothera biennis seeds is the γ-linolenic acid.

The plant has been used as maintenance treatment in patients with UC with moderate results. In a placebo-controlled study, 43 patients with UC were randomized to receive MaxEPA (n=16), super evening primrose oil (n=19), or olive oil as placebo (n=8) for 6 months plus their regular maintenance treatment with 5-aminosalicylates (5-ASA). Treatment with super evening primrose oil increased the concentrations of dihomogamma-linolenic acid (DGLA) of red cell membrane (P<0.05) and the stool form during the first 6 months, compared to MaxEPA and placebo and this difference was continued 3 months after cessation of treatment (P<0.05). Evening primrose oil could offer some benefit in patients with UC [17].

Germinated barley foodstuff (GBF)

GBF represents the final product of dryness and fermentation of barley. It is based on recipes of traditional Chinese medicine having many beneficial physiological effects. GBF, which mainly consists of dietary fiber and glutamine-rich protein, is essentially a prebiotic that can reduce the clinical activity of UC over long-term as well as short-term administration [18].

In a relevant study, 59 patients with UC in remission were divided into two groups, control group (n=37) who received conventional treatment for 12 months and GBF group (n=22) who received conventional treatment plus 20 g of GBF daily. Significantly better activity index values were seen in the GBF group at 3, 6, and 12 months compared with control group. The cumulative recurrence rate in the GBF group with steroid tapering treatment was significantly lower compared with the value in the control group. No side effects related to GBF were noticed [19].

It seems that GBF is an effective and safe herbal in the maintenance treatment of UC having also the ability to taper steroid treatment.

Extract of myrrh, dry extract of chamomile flowers and coffee charcoal

It is well known that the herbal mixture of myrrh, dry extract of chamomile flowers and coffee charcoal has anti-inflammatory and antidiarrheal properties.

In the only one so far available randomized, double-blind, double-dummy study 96 patients with inactive UC were randomized to receive either the herbal preparation or mesalazine over a 12-month period. There was no significant difference in the relapse rate between the two groups (45% in the mesalazine group and 53% in the herbal group). No significant differences were also shown in relapse-free time, endoscopy and fecal biomarkers [20]. The herbal preparation was well tolerated and showed a good safety profile.

shows the results of clinical trials with plant products of patients with UC in remission.

Table 3

Clinical trials with plant products in patients with ulcerative colitis in remission

Active CD

Chios mustic gum (Pistacia lentiscus-Anacardiaceae)

Pistacia lentiscus var Chia belongs to the family of Pistacia. This tree is unique in the world because it produces a special resin (mastic gum). The mastic tree belongs to the family of Anacardiaceae. Mastic gum is a natural product produced by trees growing exclusively in the Greek island of Chios. Its aromatic and therapeutic characteristics are well-known for centuries. It contains a large number of antioxidant substances, most of which have been recently identified.

In a relevant study, the effectiveness of mastic on the clinical course and plasma inflammatory mediators of patients with active CD was evaluated. Recruited to a 4-week treatment with mastic caps (6 caps/d, 0.37 g/cap) were 10 patients and 8 controls. It was found that mastic treatment significantly decreased the CD activity index (CDAI) and the plasma levels of IL-6 and CRP [21].

In a subsequent study, the same group of investigators noticed that treating CD patients with mastic resulted in the reduction of TNF-α secretion. Migration inhibitory factor release was also significantly increased, meaning that random migration and chemotaxis of monocytes/macrophages were inhibited. It seems that mastic acts as an immunomodulator on peripheral blood mononuclear cells, acting as a TNF-α inhibitor and a migration inhibitory factor stimulator [22].

We strongly suggest that larger, double-blind, placebo-controlled studies are required in order to further clarify the role of this significant natural product in the treatment of patients with active CD.

Wormwood herb (Artemisia absinthium-Asteraceae)

Absinth wormwood is a herbaceous perennial plant with a distinctive smell of sage. It has traditionally been used to treat various digestive disorders. It is traditionally made by a distillation of neutral alcohol, various herbs, spices and water. The European Union permits a maximum thujone level of 35 mg/kg in alcoholic beverages where Artemisia species is a listed ingredient, and 10 mg/kg in other alcoholic beverages.

So far, two studies have been published concerning the possible therapeutic results of this herbal in patients with active CD. In the first one, 40 patients with CD receiving 40 mg of prednisone daily for at least 3 weeks were administered a herbal blend containing wormwood herb (3×500 mg/day) or placebo for 10 weeks. After 8 weeks, there was almost complete clinical remission in 65% patients as compared to none in the placebo group. This remission persisted until the end of the observation period. It was also noticed that wormwood had a steroid sparing effect and a positive effect on the quality of life of patients [23].

In the second study, 20 patients with active CD received dry powder of wormwood or placebo while being on their previous regular treatment. After 6 weeks, 8 of 10 (80%) of patients receiving wormwood and 2 of 10 (20%) receiving placebo achieved remission. Clinical response was noticed in 6 of 10 of the group of wormwood compared to none of the group of placebo [24]. The available data so far concerning this plant seem to be promising.

Cannabis (Cannabis sativa L. – Cannabaceae)

Cannabis sativa is an annual herbaceous plant in the Cannabis genus, a species of the Cannabaceae family. Although the main psychoactive constituent of Cannabis is tetrahydrocannabinol, the plant contains almost 60 cannabinoids. Differences in the chemical composition of Cannabis varieties may produce different effects in humans. The marijuana plant cannabis is known to improve inflammatory processes, while experimental evidence suggests that the endogenous cannabinoid system inhibits colonic inflammation, leading to the conclusion that cannabis may have a therapeutic role in IBD.

In a retrospective observational study, disease activity, use of medication, need for surgery and hospitalization rate before and after cannabis use in 30 patients (26 males) with CD was investigated. Of the 30 patients, 21 significantly improved after treatment while the need for other medication was significantly reduced. Fifteen of the patients had 19 surgeries during an average period of 9 years before cannabis use, but only 2 required surgeries during an average period of 3 years of cannabis use [25]. In another study, a comparable proportion of UC and CD patients reported lifetime or current cannabis use [26].

During the forthcoming years, the plant might be widely used in the treatment of IBD patients. Changes in the relevant legislation, as well as the use of the plant after the patients’ informed consent, would play a significant role in the adoption of this kind of treatment. It is, however, necessary to accurately confirm the safety and effectiveness of the plant by performing large clinical studies.

Boswellia serrata extract

Pilot clinical studies support the potential of Boswellia serrata gum resin extract for the treatment of IBD. Extracts from the gum resin of Boswellia serrata affect the immune system in different ways. It could suppress leukotriene formation via inhibition of 5-lipoxygenase by two boswellic acids, 11-keto-β-boswellic acid and acetyl-11-keto-β-boswellic acid.

In a randomized double-blind study, 102 patients with active CD randomized to receive Boswellia serrata extract (h25) or mesalazine. The mean reduction in the CDAI was 90 for h25 and 53 for mesalazine [27].

Tripterygium wilfordii Hook F

Τhe traditional Chinese drug Tripterygium wilfordii Hook F (TWHF), a diterpene triepoxide, represents the main constituent of an extract obtained from Tripterygium wilfordii. Triptolide has multiple pharmacological properties (anti-inflammatory, immune modulating, antiproliferative and antiapoptotic).

In a study exploring the potential benefit of Tripterygium wilfordii, 20 patients with active CD received tablets containing T2 for 12 weeks. CDAI was significantly reduced during the first 8 weeks, while endoscopic improvement was noticed after 12 weeks. The inflammatory indices including CRP were also reduced [28].

shows the results of the clinical studies regarding the role of plant therapy of active CD.

Table 4

Clinical studies of plant treatment of patients with active Crohn’s disease

CD: maintenance treatment

Again a small number of studies have investigated the role of plant treatment in the prevention of recurrences in patients with CD.

Boswellia serrata

In a double-blind, placebo controlled study investigating the efficacy of Boswelan in maintaining remission in CD, 82 patients were randomized to either Boswelan (n=42, 3×2 capsules/day; 400 mg each) or placebo (n=40). No differences in the two groups concerning the remission rates were noticed. Regarding safety, no disadvantages of taking the drug compared to placebo were observed [29]. This trial confirmed the good tolerability of Boswelan, although there were no significant differences versus placebo in maintenance of remission.

Tripterygium wilfordii

Two placebo controlled studies and one prospective, single-blind study, investigated the role of Tripterygium wilfordii in the prevention of postsurgical relapses in patients with CD.

In the first one 45 patients with CD were randomized to receive either Tripterygium wilfordii or mesalazine. No relapse was noticed three months after operation. Again in 6 and 12 months after the operation the clinical relapse rate did not differ in the two groups (18% vs. 22% and 32% vs. 39%, respectively). No significant differences were observed in the rate of endoscopic recurrence after 12 months (46% vs. 61%) [30].

In the second study, 39 patients with CD were randomized two weeks after enterectomy to receive either Tripterygium wilfordii (n=21) or sulfasalazine (n=18). Clinical recurrence was noticed in 6% in the Tripterygium wilfordii group compared with 25% in the group of sulfasalazine. Again, endoscopic recurrence was observed in 22% in the group of Tripterygium wilfordii compared with 56% in the group of sulfasalazine. It seems that at least numerically, Tripterygium wilfordii is superior compared with sulfasalazine in the prevention from postsurgical recurrences of CD [31].

In the third study postoperative CD patients in remission were randomized to receive 1 mg/kg Tripterygium wilfordii polyglycoside daily, orally, or 4 g 5-ASA daily, orally, for 52 weeks. Twenty-one patients received Tripterygium wilfordii polyglycoside and 18 5-ASA [32]. The results showed that clinical and endoscopic recurrences were less common in the Tripterygium wilfordii polyglycoside group (n=4) versus the 5-ASA group (n=9).

Taking into account the results of the above mentioned studies it seems that Tripterygium wilfordii polyglycoside appears to be an effective, well-tolerated drug superior to oral 5-ASA, for preventing clinical and endoscopic recurrence in postsurgical CD.

shows the results of the studies investigating the role of herbal treatment in the prevention of relapses of CD.

Table 5

Clinical studies of plant treatment of patients with Crohn’s disease in remission

Herbal and plant therapy in patients with inflammatory bowel disease

From 1993 to April 2014, we identified 27 clinical studies dealing with herbal therapy in IBD. There were 17 studies of herbal therapy in UC and 10 studies in CD, including 1,874 individuals in total (). The mean age of subjects was 43 years. No significant differences concerning the number of male and female patients participating in the trials was recorded.

The most important of the available data concerning the use of herbals and plants in the treatment of IBD patients are summarized below.

UC

So far a total number of 17 clinical studies related to the treatment of either active or inactive UC with the use of herbal products have been published. The total number of patients included was 1421. These studies compared the effectiveness of herbal treatment with either drugs used regularly by patients with UC or placebo. In a minority of studies, herbal treatment was tested while the patients were receiving their regular treatment. The number of patients included in each study varied between a few dozen to more than 200. In studies dealing with induction treatment of active disease, the duration of treatment varied between 4 and 12 weeks, while in studies dealing with maintenance treatment fluctuated between 6 and 12 months.

Treatment of active disease

The total number of studies referring to the treatment of active UC was 11 and the number of patients included was 1008 ().

Aloe vera (Xanthorrhoeaceae)

Aloe vera is a herbal preparation with significant anti-inflammatory effects. The leaves of the plant contain an abundance of phytochemical substances including acetylated mannans, polymannans, anthraquinone C-glycosides, anthrones, anthraquinones (emodin), and lectins, most of which are under intense search.

In a double-blind, randomized, placebo-controlled trial, 44 hospital outpatients with mild to moderately active UC were randomly given oral aloe vera gel or placebo, 100 mL b.i.d. for 4 weeks, in a 2:1 ratio. Oral administration of aloe vera produced a clinical response more often than placebo; it also reduced the histological disease activity and appeared to be safe [3].

This herbal seems to be effective in some proportion of patients with active UC. Further studies are necessary using different doses in larger number of patients.

Triticum aestivum (Poaceae)

Triticum aestivum, common as bread wheat, is an annual grass belonging to the Poaceae family. It can be found in the form of liquid or powder. It contains chlorophyll, aminoacids, vitamins and various enzymes. The plant can be used as food, or as a drug with unique therapeutic potentials for which, however, there is no strong scientific support. It can be found as a fresh product, tablets, frozen juice, or powder.

In a randomized, double-blind, placebo-controlled study, 23 patients with active distal UC were allocated to receive either 100 mL of wheat grass juice (Triticum aestivum), or placebo, daily, for 1 month. Ten of 11 patients in the active treatment showed endoscopic improvement in comparison with 3 of 10 in the placebo group. Treatment was associated with significant reduction in the overall disease activity index and in the severity of rectal bleeding. Apart from nausea, no other serious side effects were noticed [4].

Andrographis paniculata (Acanthaceae)

Andrographis paniculata, a plant belonging to the family of Acanthaceae, grows mainly in India και Sri Lanka, as well as in South and South-Eastern Asia.

A recent randomized, double-blind, placebo-controlled study compared the extract of Andrographis paniculata (HMPL-004) with placebo in 224 adult patients with mild to moderately active UC. Treatment with HMPL-004 in a dose of 1800 mg per day resulted in a statistically significantly better clinical response compared to placebo (60% vs. 40%; P=0.018), although the proportion of remission after 8 weeks did not differ in the two groups [5].

The second study was also a randomized, double-blind, multicenter study of an 8-week duration with parallel groups. The study showed that HMPL-004 had similar effectiveness with mesalazine (response 76% vs. 82%; remission 21% vs. 16%) in patients with mild to moderate UC. In this study, there was no difference in the proportion of endoscopic remission in the two groups after 8 weeks (28% vs. 24%) [6].

Boswellia serrata (Burseraceae)

Boswellia (Boswellia serrata) belongs to the family of trees producing resin that are well-known for their good-smelling oil. Boswellia trees have a thick trunk that produces juice rich in carbohydrates, essential oils and acids called “boswellic acids”. These acids seem to be the active component of the plant being responsible for its therapeutic capabilities.

The initial clinical studies suggested that Boswellia serrata resin could be effective in IBD. In 2002, the European Medicines Agency categorized Boswellia serrata gum resin extract in the category of “orphan drugs”. Serrata gum resin extracts could influence the immune system in many ways. Boswellia serrata represses the formation of leukotriene via inhibition of 5-lipoxygenase with the action of two boswellia acids, namely 11-keto-β-boswellic acid and acetyl-11-keto-β-boswellic acid [7].

In the only available study, 30 patients with UC were randomized to receive either Boswellia serrata resin (900 mg/d in 3 doses, n=20) or sulfasalazine (3 g/d in 3 doses, n=10) for 6 weeks. Remission of the disease was achieved in 14 of 20 patients who received Boswellia gum resin, compared with 4 of 10 who received sulfasalazine [8]. Larger studies are urgently needed.

Jian Pi Ling (JPL)

JPL is considered as one of the current plant treatments in patients with UC. It consists of 9 components and is available in the form of tablets containing 0.75 g of dry herbal.

In a relevant study, 153 patients with UC were randomized in 3 groups. Group I: JPL tablet with Radix Sophorae flavescentis and Flos sophorae decoction; Group II: sulfasalazine and dexamethasone; Group III: placebo and enema decoction as in group I. The rate of remission after 3 months in group 1 was significantly higher (53%) compared with the rate of remission in the two other groups (28% and 19% respectively) [9]. However, the low rate of remission achieved in the two control groups raises questions about the real value of this study’s results.

Tormentil extracts (Tormentilla erecta-Rosaceae) Potentilla erecta (Tormentilla erecta, Potentilla tormentilla widely known as tormentil or septfoil) is a plant belonging to the family of Rosaceae.

Tormentil extracts have antioxidative properties and thus, it might be used as a complementary therapy for chronic IBD. In a relevant study, 16 patients with active UC received Tormentil extracts in escalating doses of 1200, 1800, 2400 and 3000 mg/d for 3 weeks each. During therapy with 2400 mg Tormentil extracts per day, median clinical activity index and CRP improved from 8 (6 to 10.75) and 8 (3 to 17.75) mg/L at baseline to 4.5 (1.75 to 6) and 3 (3 to 6) mg/L, respectively. During therapy, clinical activity index decreased in all patients, whereas it increased during the washout period [10]. Tormentil extracts appeared safe up to 3000 mg/d.

Xilei-san

Xilei-san is a mixture of herbs of Chinese medicine that harbors significant anti-inflammatory properties. It seems to be effective in a number of inflammatory conditions including digestive disorders such as esophagitis.

In an 8-week randomized, double-blind study, the Xilei-san mixture was compared with dexamethasone enema in 35 patients with mild to moderately severe ulcerative proctitis for 12 weeks. A similarly significant clinical, histological and endoscopic response compared with the baseline values in the two groups was achieved [11].

In another controlled study, 30 patients with intractable ulcerative proctitis were randomized to receive either Xilei-san or placebo suppositories for 2 weeks. The number of patients who achieved an improvement in the clinical activity index as well as in the endoscopic and histological index, was higher in the group of Xilei-san compared with the group of placebo (P<0.04) [12]. The rate of recurrence after 6 months was lower in the arm of active treatment.

No significant side effects were observed in both studies.

Anthocyanin-rich bilberry preparation

Anthocyanins, which can be found in large quantities in bilberries (Vaccinium myrtillus) were shown to have antioxidative and anti-inflammatory effects.

In the only available study Biedermann et al [13] explored the possible therapeutic potential of bilberries in active UC. Thirteen patients with mild to moderate UC were treated with a daily standardized anthocyanin-rich bilberry preparation for 9 weeks. At the end of the 6^th week 63.4% of patients achieved remission and 90.9% showed a response. A significant decrease in the Mayo score was also detected in all patients. Interestingly, the fecal calprotectin levels significantly decreased during treatment phase although an increase in the calprotectin levels and disease activity was observed after cessation of bilberry intake. No serious adverse events were observed. The results clearly indicate a therapeutic potential of bilberries in UC.

Fufangkushen colon-coated capsule (FCC)

FCC is a newly developed herbal drug for the treatment of UC patients with Chinese medicine pattern of damp-heat accumulating in the interior, consisted of Sophorae flavescentis, Sanguisorba officinalis L., Indigo naturalis, Bletilla striata and Glycyrrhiza uralensis.

In order to test the efficacy and safety of FCC in patients with active UC Gong et al [14] recently performed a double-blinded, randomized clinical trial comparing FCC with Huidi (HD, mesalazine enteric-coated tablets). In this study 320 active UC patients were assigned to two groups: 240 treated with FCC plus HD placebo treatment and 80 with HD plus FCC placebo for 8 weeks. At the 8^th week, 72.5% of patients in FCC group and 65.0% of patients in HD group achieved a clinical response and 41.5% in FCC group vs. 41.25% in HD group clinical remission (no significant differences). The rate of mucosal healing at week 8 was also similar in the two groups. Similar safety profiles in the 2 groups were also seen. FCC seems to be equally effective and safe in the treatment of active UC compared with mesalazine.

shows the results of the effectiveness of herbal and plant products administration in the response and remission rate of patients with active UC.

Table 2

Studies on herbal and plant product treatment of patients with active ulcerative colitis

Maintenance treatment of UC

So far, a small number of clinical trials have been published concerning the role of plant products in the maintenance treatment of UC patients. These studies are analyzed subsequently.

Curcumin

Curcumin is a biologically active phytochemical substance showing antioxidant, anti-inflammatory, anticarcinogenic, hypocholesterolemic, antibacterial, wound-healing, antispasmodic, anticoagulant, antitumor and hepatoprotective activities. Curcumin inhibits many cytokine pathways including interleukin (IL)-6, concurrently having a favorable safety profile. Its anti-inflammatory and antioxidant effect has been shown in numerous animal models.

Hanai et al [15] evaluated the usefulness of curcumin in 89 patients with quiescent UC. Forty-five patients received 1 g curcumin b.i.d. along with sulfasalazine or mesalamine, and 44 received placebo plus sulfasalazine or mesalamine for 6 months. Curcumin significantly improved both the clinical activity index and the endoscopic index. Recurrence rates were significantly lower in the curcumin group compared with placebo. Curcumin seems to be promising and safe medication for maintaining remission in patients with quiescent UC.

Plantago ovata (Plantaginaceae)

Plantago ovata is a small plant with characteristic flowers. The juice derived from the plant leaves, has been used in the treatment of peptic ulcer and pain accompanying inflammatory conditions. The plant has anti-inflammatory and anti-oxidative properties. It inhibits the protein kinase C, it down-regulates the expression of intercellular adhesion molecule-1 and inhibits the inflammation produced from 5-hydroxy-6,8,11,14-eicosatetraenoic acid and leukotriene B₄. The enzymatic dissolution of the seeds of Plantago ovata results in the production of short chain fatty acids that have favorable effects in patients with patients with UC.

In an open clinical study, 105 patients with UC in remission were randomized to receive either Plantago ovata seeds (10 g b.i.d.), mesalazine (500 mg t.i.d.), and Plantago ovata seeds with mesalazine in the same doses. The rate of recurrence after 6 months did not differ in the three groups (40% vs. 35% vs. 30%) [16]. There were few side effects mainly constipation and abdominal bloating.

Oenothera biennis

Oenothera biennis belongs to the group of Oenothera which can be found in North America and other tropical and subtropical countries. The evening primrose oil is the main product of the plant. The main constituent of Oenothera biennis seeds is the γ-linolenic acid.

The plant has been used as maintenance treatment in patients with UC with moderate results. In a placebo-controlled study, 43 patients with UC were randomized to receive MaxEPA (n=16), super evening primrose oil (n=19), or olive oil as placebo (n=8) for 6 months plus their regular maintenance treatment with 5-aminosalicylates (5-ASA). Treatment with super evening primrose oil increased the concentrations of dihomogamma-linolenic acid (DGLA) of red cell membrane (P<0.05) and the stool form during the first 6 months, compared to MaxEPA and placebo and this difference was continued 3 months after cessation of treatment (P<0.05). Evening primrose oil could offer some benefit in patients with UC [17].

Germinated barley foodstuff (GBF)

GBF represents the final product of dryness and fermentation of barley. It is based on recipes of traditional Chinese medicine having many beneficial physiological effects. GBF, which mainly consists of dietary fiber and glutamine-rich protein, is essentially a prebiotic that can reduce the clinical activity of UC over long-term as well as short-term administration [18].

In a relevant study, 59 patients with UC in remission were divided into two groups, control group (n=37) who received conventional treatment for 12 months and GBF group (n=22) who received conventional treatment plus 20 g of GBF daily. Significantly better activity index values were seen in the GBF group at 3, 6, and 12 months compared with control group. The cumulative recurrence rate in the GBF group with steroid tapering treatment was significantly lower compared with the value in the control group. No side effects related to GBF were noticed [19].

It seems that GBF is an effective and safe herbal in the maintenance treatment of UC having also the ability to taper steroid treatment.

Extract of myrrh, dry extract of chamomile flowers and coffee charcoal

It is well known that the herbal mixture of myrrh, dry extract of chamomile flowers and coffee charcoal has anti-inflammatory and antidiarrheal properties.

In the only one so far available randomized, double-blind, double-dummy study 96 patients with inactive UC were randomized to receive either the herbal preparation or mesalazine over a 12-month period. There was no significant difference in the relapse rate between the two groups (45% in the mesalazine group and 53% in the herbal group). No significant differences were also shown in relapse-free time, endoscopy and fecal biomarkers [20]. The herbal preparation was well tolerated and showed a good safety profile.

shows the results of clinical trials with plant products of patients with UC in remission.

Table 3

Clinical trials with plant products in patients with ulcerative colitis in remission

Active CD

Chios mustic gum (Pistacia lentiscus-Anacardiaceae)

Pistacia lentiscus var Chia belongs to the family of Pistacia. This tree is unique in the world because it produces a special resin (mastic gum). The mastic tree belongs to the family of Anacardiaceae. Mastic gum is a natural product produced by trees growing exclusively in the Greek island of Chios. Its aromatic and therapeutic characteristics are well-known for centuries. It contains a large number of antioxidant substances, most of which have been recently identified.

In a relevant study, the effectiveness of mastic on the clinical course and plasma inflammatory mediators of patients with active CD was evaluated. Recruited to a 4-week treatment with mastic caps (6 caps/d, 0.37 g/cap) were 10 patients and 8 controls. It was found that mastic treatment significantly decreased the CD activity index (CDAI) and the plasma levels of IL-6 and CRP [21].

In a subsequent study, the same group of investigators noticed that treating CD patients with mastic resulted in the reduction of TNF-α secretion. Migration inhibitory factor release was also significantly increased, meaning that random migration and chemotaxis of monocytes/macrophages were inhibited. It seems that mastic acts as an immunomodulator on peripheral blood mononuclear cells, acting as a TNF-α inhibitor and a migration inhibitory factor stimulator [22].

We strongly suggest that larger, double-blind, placebo-controlled studies are required in order to further clarify the role of this significant natural product in the treatment of patients with active CD.

Wormwood herb (Artemisia absinthium-Asteraceae)

Absinth wormwood is a herbaceous perennial plant with a distinctive smell of sage. It has traditionally been used to treat various digestive disorders. It is traditionally made by a distillation of neutral alcohol, various herbs, spices and water. The European Union permits a maximum thujone level of 35 mg/kg in alcoholic beverages where Artemisia species is a listed ingredient, and 10 mg/kg in other alcoholic beverages.

So far, two studies have been published concerning the possible therapeutic results of this herbal in patients with active CD. In the first one, 40 patients with CD receiving 40 mg of prednisone daily for at least 3 weeks were administered a herbal blend containing wormwood herb (3×500 mg/day) or placebo for 10 weeks. After 8 weeks, there was almost complete clinical remission in 65% patients as compared to none in the placebo group. This remission persisted until the end of the observation period. It was also noticed that wormwood had a steroid sparing effect and a positive effect on the quality of life of patients [23].

In the second study, 20 patients with active CD received dry powder of wormwood or placebo while being on their previous regular treatment. After 6 weeks, 8 of 10 (80%) of patients receiving wormwood and 2 of 10 (20%) receiving placebo achieved remission. Clinical response was noticed in 6 of 10 of the group of wormwood compared to none of the group of placebo [24]. The available data so far concerning this plant seem to be promising.

Cannabis (Cannabis sativa L. – Cannabaceae)

Cannabis sativa is an annual herbaceous plant in the Cannabis genus, a species of the Cannabaceae family. Although the main psychoactive constituent of Cannabis is tetrahydrocannabinol, the plant contains almost 60 cannabinoids. Differences in the chemical composition of Cannabis varieties may produce different effects in humans. The marijuana plant cannabis is known to improve inflammatory processes, while experimental evidence suggests that the endogenous cannabinoid system inhibits colonic inflammation, leading to the conclusion that cannabis may have a therapeutic role in IBD.

In a retrospective observational study, disease activity, use of medication, need for surgery and hospitalization rate before and after cannabis use in 30 patients (26 males) with CD was investigated. Of the 30 patients, 21 significantly improved after treatment while the need for other medication was significantly reduced. Fifteen of the patients had 19 surgeries during an average period of 9 years before cannabis use, but only 2 required surgeries during an average period of 3 years of cannabis use [25]. In another study, a comparable proportion of UC and CD patients reported lifetime or current cannabis use [26].

During the forthcoming years, the plant might be widely used in the treatment of IBD patients. Changes in the relevant legislation, as well as the use of the plant after the patients’ informed consent, would play a significant role in the adoption of this kind of treatment. It is, however, necessary to accurately confirm the safety and effectiveness of the plant by performing large clinical studies.

Boswellia serrata extract

Pilot clinical studies support the potential of Boswellia serrata gum resin extract for the treatment of IBD. Extracts from the gum resin of Boswellia serrata affect the immune system in different ways. It could suppress leukotriene formation via inhibition of 5-lipoxygenase by two boswellic acids, 11-keto-β-boswellic acid and acetyl-11-keto-β-boswellic acid.

In a randomized double-blind study, 102 patients with active CD randomized to receive Boswellia serrata extract (h25) or mesalazine. The mean reduction in the CDAI was 90 for h25 and 53 for mesalazine [27].

Tripterygium wilfordii Hook F

Τhe traditional Chinese drug Tripterygium wilfordii Hook F (TWHF), a diterpene triepoxide, represents the main constituent of an extract obtained from Tripterygium wilfordii. Triptolide has multiple pharmacological properties (anti-inflammatory, immune modulating, antiproliferative and antiapoptotic).

In a study exploring the potential benefit of Tripterygium wilfordii, 20 patients with active CD received tablets containing T2 for 12 weeks. CDAI was significantly reduced during the first 8 weeks, while endoscopic improvement was noticed after 12 weeks. The inflammatory indices including CRP were also reduced [28].

shows the results of the clinical studies regarding the role of plant therapy of active CD.

Table 4

Clinical studies of plant treatment of patients with active Crohn’s disease

CD: maintenance treatment

Again a small number of studies have investigated the role of plant treatment in the prevention of recurrences in patients with CD.

Boswellia serrata

In a double-blind, placebo controlled study investigating the efficacy of Boswelan in maintaining remission in CD, 82 patients were randomized to either Boswelan (n=42, 3×2 capsules/day; 400 mg each) or placebo (n=40). No differences in the two groups concerning the remission rates were noticed. Regarding safety, no disadvantages of taking the drug compared to placebo were observed [29]. This trial confirmed the good tolerability of Boswelan, although there were no significant differences versus placebo in maintenance of remission.

Tripterygium wilfordii

Two placebo controlled studies and one prospective, single-blind study, investigated the role of Tripterygium wilfordii in the prevention of postsurgical relapses in patients with CD.

In the first one 45 patients with CD were randomized to receive either Tripterygium wilfordii or mesalazine. No relapse was noticed three months after operation. Again in 6 and 12 months after the operation the clinical relapse rate did not differ in the two groups (18% vs. 22% and 32% vs. 39%, respectively). No significant differences were observed in the rate of endoscopic recurrence after 12 months (46% vs. 61%) [30].

In the second study, 39 patients with CD were randomized two weeks after enterectomy to receive either Tripterygium wilfordii (n=21) or sulfasalazine (n=18). Clinical recurrence was noticed in 6% in the Tripterygium wilfordii group compared with 25% in the group of sulfasalazine. Again, endoscopic recurrence was observed in 22% in the group of Tripterygium wilfordii compared with 56% in the group of sulfasalazine. It seems that at least numerically, Tripterygium wilfordii is superior compared with sulfasalazine in the prevention from postsurgical recurrences of CD [31].

In the third study postoperative CD patients in remission were randomized to receive 1 mg/kg Tripterygium wilfordii polyglycoside daily, orally, or 4 g 5-ASA daily, orally, for 52 weeks. Twenty-one patients received Tripterygium wilfordii polyglycoside and 18 5-ASA [32]. The results showed that clinical and endoscopic recurrences were less common in the Tripterygium wilfordii polyglycoside group (n=4) versus the 5-ASA group (n=9).

Taking into account the results of the above mentioned studies it seems that Tripterygium wilfordii polyglycoside appears to be an effective, well-tolerated drug superior to oral 5-ASA, for preventing clinical and endoscopic recurrence in postsurgical CD.

shows the results of the studies investigating the role of herbal treatment in the prevention of relapses of CD.

Table 5

Clinical studies of plant treatment of patients with Crohn’s disease in remission

5 Spices You Should Be Adding Right Now To Your IBD Diet

5 Seasonings That Will Spice Up Your IBD Diet

1. Oregano is good for gastrointestinal health. According to a review published in April 2019 in the International Journal of Nutrition, oregano extract and oregano oil may help with reducing inflammatory markers that trigger inflammation in the GI tract. Webb adds, “Oregano oil supplements are used to help fight small intestinal bacterial overgrowth, a condition commonly found in people with Crohn’s disease and inflammatory bowel disease.” More studies are needed to determine in these same effects can be observed in dishes cooked with dried or fresh oregano. The spice pairs well with chicken, lamb, and egg dishes.

2. Ginger may help ease many gastrointestinal symptoms, including nausea, vomiting, and gas — all common for people living with Crohn’s disease or ulcerative colitis. “Some people find ginger helps settle their symptoms,” says Medlin. Brew up some ginger tea by adding a few slices of fresh ginger to boiling water and then letting it steep for 10 minutes. Grate ginger on rice or use it in baked goods. You can also add it to sautéed or roasted veggies. Webb says it’s especially tasty on roasted carrots.

3. Turmeric is a common ingredient in curry and other Asian foods. According to Medlin, turmeric — and its main component, curcumin — reduces inflammation when it’s in contact with the bowel wall. According to a review published in the International Journal of Molecular Sciences in 2019, curcumin has anti-inflammatory and anti-microbial properties that are protective against chronic inflammation in the intestines. So how much turmeric do you need in order to reap the benefits? “Fortunately, a little bit of turmeric goes a long way, so people with Crohn’s can benefit without making the dish too spicy,” Webb says. The next time you find yourself scratching your head on how to flavor a pot of rice, consider adding ¼ teaspoon of turmeric. You may also want to sprinkle turmeric over veggies, meat, fish, and beans.

4. Cumin is a spice created from the seeds of a plant in the parsley family. According to a review published in 2018 in the Journal of Medicinal Plant Studies, cumin has antioxidant properties, which help protect your cells from damage. Cumin essential oil has also been shown to have anti-inflammatory effects. The Cleveland Clinic suggests cooking with ground cumin for better absorption of its vitamins and minerals, including vitamin B1, iron, calcium, and magnesium. Try adding cumin as an extra earthy flavor in taco seasoning or guacamole.

5. Cinnamon is a seasoning with antimicrobial and anti-inflammatory properties, and a great source of antioxidants. “Eastern medicine has long incorporated it to help heal colds, indigestion, and gastrointestinal issues,” Webb says. Although there are many varieties of this spice, cassia cinnamon is the one you will most likely find on grocery store shelves, notes the National Center for Complementary and Integrative Health (NCCIH). And a little bit goes a long way, Simon says. At breakfast, consider topping off your oatmeal or yogurt with cinnamon instead of sugar. At lunch, sprinkle over roasted butternut squash or sweet potatoes, which are normally well-tolerated even during a Crohn’s disease flare-up. For dinner, add cinnamon sticks to sauces and stews.

Additional reporting by Jocelyn Solis-Moreira.

Herbs For Health: Bowel Conditions – Mother Earth Living

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You have a waste removal system in your house; you also have one in your car. Chances are, they work pretty well most of the time. But it’s also a pretty sure bet that the waste disposal system in your body doesn’t always work the way it’s supposed to. Nothing’s ever simple, is it?

Bowel problems trouble most people from time to time. But if your stomach starts to ache after almost every meal, if you have gas that’s painful, frequent, and/or uncontrollable, and you either have diarrhea or are constipated, you may have a bowel disease. Bowel diseases, including irritable bowel syndrome (IBS), ulcerative colitis, and Crohn’s disease, are responsible for nearly half of the visits to digestive tract specialists in the United States.

Functional versus chronic bowel disorders

IBS is a functional disorder–meaning that it’s defined by dysfunction, not by signs of disease or damage to organs themselves. In layman’s terms, IBS means your bowels aren’t working properly (no news flash for people who have the condition). In contrast, Crohn’s disease and ulcerative colitis form a cluster of chronic disorders that are characterized by inflammation or ulceration in the small and large intestines. These two conditions are also sometimes referred to as colitis, enteritis, ileitis, or proctitis, depending on the location of the symptoms. The term colitis simply means inflammation of the colon and is another term for inflammatory bowel disease.

More than five million Americans have IBS, and more than three and a half million office visits per year are devoted to it. Crohn’s disease and ulcerative colitis affect more than a million people in the United States and are responsible for more than 700,000 doctor’s office visits per year.

Together, three bowel diseases-irritable bowel syndrome, ulcerative colitis, and Crohn’s disease-affect up to six million people in the United States alone. 

Interestingly, most bowel diseases are found to the greatest degree in developed countries; the higher the standard of living, the greater the occurrence of the disease. Ulcerative colitis is almost nonexistent in sub-Saharan African populations that consume a largely traditional diet. The few recorded cases were among urban individuals who ate a more typical Western diet. A 1998 Dutch study demonstrated that bowel disease is highly associated with a modern lifestyle.

Irritable bowel syndrome This common intestinal disorder produces constipation in some people and diarrhea in others. A third group experiences both symptoms. People with IBS may pass mucus with their bowel movements; they may have cramps and want to move the bowels but be unable to do so. But perhaps the most distressing thing about IBS is its notorious ability to cause symptoms that come and go. Attacks are frequently so unpredictable that patients fear to stray far from home.

IBS is known by many names–colitis, mucous colitis, spastic colon, spastic bowel, and functional bowel disease–but this syndrome doesn’t involve inflammation and shouldn’t be confused with ulcerative colitis. Instead, experts call IBS a functional disorder because when they examine the colon of a person who has it, there’s usually no sign of disease. Although IBS is extremely uncomfortable and distressing to those who have it (symptoms can range from mildly annoying to disabling), the syndrome does no permanent injury to the intestines and does not cause intestinal bleeding or a serious disease such as cancer.

Symptoms of IBS usually occur after a trigger. Eating, distention from gas or food in the colon, particular medicines, or specific foods may trigger spasms. Among food triggers, frequent culprits include chocolate, milk products, fatty food, or alcohol. Women with IBS have more symptoms during their menstrual periods, implying that reproductive hormones may play a role. Many people have increased symptoms when they are under stress. Those with IBS are particularly likely to suffer loose stools from caffeine.

Treating irritable bowel syndrome

IBS is a vague and confounding disorder. To treat it effectively, herbalists usually examine the specific symptoms that a patient is suffering from. Those symptoms typically fall into three categories:

•diarrhea, frequently without pain.
•chronic abdominal pain, possibly with constipation.
•constipation alternating with diarrhea.

One of the most commonly recommended herbal remedies for IBS is enteric-coated peppermint oil. It helps relax the muscles of the intestinal wall, fending off cramps. The enteric coating on the capsule delays the release of the oil until the remedy reaches the lower digestive tract, where it’s most needed. In one clinical trial in Taiwan, four out of every five IBS victims experienced reduced symptoms when given enteric-coated peppermint oil. People who take peppermint in this way often experience relief of all their symptoms.

Caraway oil has similar properties, relaxing the gut wall and reducing diarrhea episodes. In 1999, a German study used peppermint and caraway oils on 223 IBS patients. The combination caused a significant reduction in pain. Another recent German study confirmed that a combination of peppermint and caraway oils effectively reduced the speed of intestinal movement. The subjects took the oils daily, not just when symptoms appeared. (It takes about four hours for the capsules’ contents to reach the large intestine.)

Depending on your symptoms, you may also want to explore herbs from each of the categories listed below. For example, you may need antispasmodic herbs to relax bowel cramps, antibacterial herbs, laxatives, antidiarrheal herbs, or others. Your best bet is to work with a qualified herbalist or naturopathic doctor to build a customized program.

I’ve also successfully helped people with IBS with an Ayurvedic remedy called triphala. A combination of the fruits amalaki, haritaki, and bibitaki, triphala works as a gentle internal cleanser. In low doses, (1 g per day), triphala slows diarrhea. In higher doses (up to 5 g per day) it treats constipation in a very slow, gentle way, toning the walls of the gut while it works. Triphala is a powder; it can be taken in capsules.

In addition, psyllium seed, a common bulk fiber laxative, can help balance bowel function and relieve pain in people with IBS. Psyllium’s capacity to absorb fluids means that it’s useful for treating diarrhea, a common IBS symptom. As it travels through the gut, psyllium also adds mucilage, which soothes irritation and may relieve cramping. Studies suggest that an optimum dose for IBS patients is 20 g per day.

Finally, check your diet. Evidence suggests that some people with IBS cannot absorb lactose, or milk sugar, properly. Lactose malabsorption can cause symptoms indistinguishable from those of IBS. Work with a nutritionist who can help you examine your diet. You’ll probably want to keep a food diary to help you identify what may be triggering attacks for you. Adding fiber to your diet–just enough so that you have soft, easily passed, and painless bowel movements–usually helps. So does eating more frequent, smaller meals.

Ulcerative colitis

Inflammatory bowel diseases are different from IBS in that they’re produced by inflammation and can result in actual damage to internal organs. And their symptoms are generally consistent and repeated. If you experience frequent diarrhea, bloody stools, or stools with mucus, cramps, and abdominal pain, see your physician to receive a diagnosis. Both ulcerative colitis and Crohn’s disease can mimic other bowel diseases, such as infectious conditions and irritable bowel syndrome. It’s important that you obtain a clear initial diagnosis.

Ulcerative colitis causes open sores and inflammation of the inner lining of the colon and rectum. The inflammation typically happens in the rectum and lower part of the colon, but it can affect the entire colon. This bowel disease seldom affects the small intestine except for the organ’s lower section, known as the ileum.The inflammation of ulcerative colitis causes the colon to empty frequently, resulting in diarrhea. Where the inflammation has killed cells, ulcers form, producing pus and mucus.

People with ulcerative colitis often have other health problems, including joint pain, eye inflammation, liver dysfunction, osteoporosis, skin rashes, anemia, or kidney stones. No one knows exactly what the connection between the conditions or symptoms is. Some experts think these complications occur because the immune system is triggering inflammation in other body parts in addition to the digestive tract. Such symptoms are usually mild, however, and clear up when the ulcerative colitis is treated.

Patients whose ulcerative colitis is spread over much of the colon have a greater risk of colon cancer, but they can reduce this risk by taking folic acid.

About one in four ulcerative colitis patients eventually undergoes surgery for removal of the colon because of massive bleeding, chronic debilitating illness, perforation of the colon, or the risk of cancer, usually after medical management of the disease has failed.

Drug or surgical treatment for emergency ulcerative colitis–cases involving life-threatening blood loss and fluid loss from diarrhea–is often necessary. But such treatments can usually only partially heal the disorder and frequently involve major side effects. Because of these limitations, many ulcerative colitis sufferers lean on natural medicine.

Crohn’s disease

Crohn’s disease is distinguished by inflammation that extends deeper into the layers of the intestinal tissue. Crohn’s disease most often affects the small intestine, typically the ileum. In any individual, however, it may also involve the colon, mouth, esophagus, stomach, duodenum, appendix, or anus. It tends to produce sharp, severe pain in isolated areas of the gut.

Crohn’s disease is a chronic condition. It often recurs at intervals during a lifetime. Patients can have long periods of remission, living symptom free, some for years. There is no medically accepted method to predict when a remission may take place or when symptoms will recur.

Crohn’s disease affects males and females equally and seems to run in some families. About one in five Crohn’s disease patients has a blood relative with some form of bowel disease. Smoking makes Crohn’s disease worse.

There is no medical cure for Crohn’s disease, although several medications are used to control symptoms. The goals of conventional therapy usually are to correct nutritional deficiencies, control inflammation, and relieve abdominal pain, diarrhea, and rectal bleeding.

Published on Nov 1, 2000

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Green first aid kit: herbs and infusions to eliminate digestive problems | Proper nutrition | Health

Are you healthy?

Gastroenterologists say that now there are practically no people who would not suffer from this or that disorder in the organs of the digestive system. These diseases are aggravated, then subside for a while, in order to remind themselves again under unfavorable circumstances.

One of these circumstances is the return from vacation.During rest, there is a change not only in the climate, but also in the nature of the diet. Moreover, the shorter the vacation, the more rapid these changes. From homemade food you go to the “buffet”, and the digestive organs do not have time to adapt to it – as they have to rebuild again. The digestive system cannot withstand such a regime, and therefore, with the onset of autumn, the number of diseases of the gastrointestinal tract is rapidly increasing.

Their treatment takes time, and a lot. Therefore, preference is often given to medicinal herbs.

Herbal preparations in comparison with synthetic ones have a milder effect, and side effects, if any, are mild. In addition, plants have a comprehensive effect on the entire digestive system, simultaneously strengthening it.In some cases, herbs alone cannot be dispensed with. But even then, when used in combination with drugs, they expand the therapeutic effect.

Helping herbs

To eliminate digestive problems, it is worth stocking up on such medicinal plants.

St. John’s wort

Possesses a wide spectrum of action; it is used for almost any gastrointestinal ailments. It gives a general strengthening effect, relieves inflammation and spasms, restores the mucous membrane of the stomach and intestines.Indispensable for nausea and heartburn. Apply it in the form of an infusion.

Linen

A decoction from the seeds of this plant has an enveloping property and enhances intestinal motility. Moreover, the effect of this plant develops gently, gradually. Also used as an anti-inflammatory and pain reliever.

Oak bark

Astringent and essential for indigestion. Oak is also used to stop bleeding in the intestines.

Dill seeds

Decoctions based on dill (or fennel) seeds are an indispensable remedy for bloating, which is given even to babies with colic. Dill seed relieves heartburn, reduces the activity of hydrochloric acid.

Celandine

It is known for its analgesic and antispasmodic properties; in terms of the strength of its effect, it is compared with antispasmodic drugs. Indispensable as an antimicrobial agent. In large doses, it can be dangerous, so it should be used with caution.

Pharmacy chamomile

It is widely known for its anti-inflammatory properties, promotes regenerative and wound healing processes in the stomach. Stimulates the secretion of the digestive glands, relieves intestinal smooth muscle spasms.

Cinquefoil

Due to the high content of tannins, it helps well with enterocolitis and indigestion. It is used as an anti-inflammatory, wound healing and hemostatic agent.

What’s in the garden?

For the prevention of diseases of the digestive system, the menu should contain fresh salads, vinaigrettes, fruits. They enhance the secretory function of the stomach. Many vegetables and fruits have medicinal effects.

For example, carrot and beet juice lower the acidity of the stomach. As well as chokeberry juice, which also has an astringent effect.

Cabbage juice has a choleretic effect, relieves stomach pains, nausea, and is recommended even for ulcers.

A potato juice relieves spasms and reduces gastric acid secretion.

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Intestinal inflammation: alternative treatment

Abdominal pain can be caused by many reasons, therefore, for inflammation of the intestines, alternative treatment offers many time-tested recipes. Today we’ll talk about which herbs for intestinal inflammation will help effectively eliminate pain, bloating, diarrhea, cramps, nausea and dysbiosis.

Intestinal inflammation: treatment with folk remedies

Abdominal pain can cause many reasons: colitis, enteritis, dysbiosis, etc. If you know what kind of ailment haunts you, then you can easily pick up the necessary folk remedies for intestinal inflammation.

What to choose for intestinal inflammation: treatment with drugs or folk remedies? It’s up to you, most importantly, do not forget to consult with a specialist! The best natural methods are rightfully considered:

Important! A decoction of oak bark works well for diarrhea, but buckthorn bark has the opposite effect.

How to relieve inflammation of the colon – treatment with folk remedies

Inflammation of the lining of the large intestine is called colitis. To get rid of unpleasant symptoms and eliminate pain, experts advise the following recipes:

• oatmeal decoction;
• infusion of raspberry leaves;
• decoction of dried pomegranate peels.

With inflammation of the mucous membrane of the large intestine, treatment with folk remedies also implies antimicrobial therapy.They will help to implement it:

• garlic clove tincture;
• cranberries;
• chamomile.

Interesting! For colitis, flaxseed is also recommended.

What herbs to drink in case of intestinal inflammation in an adult

Diseases of the gastrointestinal tract are accompanied by many unpleasant symptoms. The following gut herbs soothe and relieve pain from inflammation:

When bloated, you should use herbs for the intestines: wormwood, parsley, cumin, dandelion root, thyme, chamomile.They help eliminate flatulence, improve peristalsis, relieve pain and spasms. You can also buy a flatulence and gas collection, which contains all the necessary ingredients, or take care of your health yourself.

Herbs that relieve intestinal inflammation

In what herbs relieve inflammation in the intestines, experts are unanimous:

• infusion of licorice, anise, fennel and buckthorn;
• yarrow, sage, oregano, mint, nettle, plantain;
• infusion of ginger;
• chamomile;
• marshmallow;
• plantain, etc.

Recommended herbs for diarrhea and intestinal inflammation are burnet, elecampane, oak bark, calendula, yarrow.

Interesting! To improve peristalsis and normalize stool, some recommend drinking a teaspoon of onion juice once a day.

You will find the best selection of medicinal plants in the PhytoContinent online store. Our expansive pantry contains some of the most effective and sustainable traditional medicines to help you regain health and relieve digestive problems.

Review

Alexey Romantsov, 48 years old, Kopeysk

I was diagnosed with colitis the year before last. I had to go on a strict diet and quit smoking. At the slightest breakdown, terrible pains bothered, once even with bleeding rushed to the hospital. When I was discharged, I decided that I needed to seriously deal with the sore. I re-read a bunch of articles on the Internet, went to several specialists and eventually developed my own scheme, which literally put me on my feet.Three months of treatment, and for half a year I have practically lived without pain and bloody diarrhea. Fasting days oatmeal on the water, jelly. And be sure to drink a decoction of plantain leaves, the longer the better! I brew a glass of boiling water for three tablespoons of herb. Insist half an hour and drink a third of a glass before meals for about 30 minutes. It helps a lot! The pain went away literally in a couple of weeks from the start of treatment, but for prevention, I periodically repeat the course.

90,000 13 most beneficial plants for digestive problems

1.Calamus
2. Aloe
3. Peppermint
4. Plantain
5. St. John’s wort
6. Fennel
7. Flax seeds
8. Thyme
9. Oak bark
10. Sage
11. Chamomile
12. Yarrow
13. Dill seeds
How much to take and when will the effect be
When not herbs will help, but only a doctor

Herbal treatment has been practiced by our ancestors since ancient times. For literally every disease, you can find a plant that will help, or even more than one. Today we will tell you which herbs are good for the intestines.

Gastrointestinal tract organs are easily treated with herbal infusions and decoctions. But still, before resorting to their use, especially if you are going to use the whole course, it is important to consult a doctor, establish an accurate diagnosis and find out the permitted dose of the drug. Otherwise, there is a risk of turning the disease into a chronic one.

Herbs for the stomach and intestines in the pharmacy can be bought ready-made collections – there is a composition for any problem. We will analyze them separately and name the most effective ones.

1Air

The plant has antiseptic, antibacterial properties.It eliminates the effects of intestinal inflammation – most often it is recommended to take it for this. A decoction of calamus stimulates the smooth muscles of the intestines, improves secretion.

Take 1 tbsp. a spoonful of crushed raw materials, pour a glass of boiling water. Place in a water bath for 25 minutes. Then strain, drink 50 ml 3 times a day, 15 minutes before meals.

2Aloe

This medicinal plant does not even need to be brewed. Its fresh juice or gel is very beneficial. Aloe is taken for ulcers, gastritis, impaired intestinal secretory function, normalization of digestion.It also promotes the elimination of toxins, improves appetite.

To prepare the juice, rinse the leaves, grind them in a blender, and strain the resulting mass. In order to get the gel, simply cut the leaf in half, the pulp can be scooped up with a spoon. The resulting product must be stored in the refrigerator, but not more than 2 weeks. It is better to store the leaves themselves and make fresh juice and gel from them every time.

3 Peppermint

Europeans’ favorite remedy for irritable bowel syndrome is peppermint oil capsules.In our country, the leaves themselves are actively used. Peppermint reduces the intensity of muscle cramps and prevents indigestion.

An effective option – mint tea: pour 1 tbsp. a spoonful of dry leaves with a cup of boiling water, leave for 30 minutes. Drink 3 glasses a day.

4 Plantain

A special kind of plantain grows in India (it reaches a height of up to 40 cm), but ours, a small one for the treatment of the gastrointestinal tract, is quite enough. Its seeds are rich in fiber, which ensures good motility and relieves constipation.Plantain seeds are found in many laxatives.

Pour 2 tbsp with a glass of hot water. tablespoons of dry or fresh leaves, hold in a water bath for 30 minutes, strain and drink.

5 St. John’s wort

One of the most effective intestinal herbs for inflammation and bloating, as well as for nausea and heartburn. Relieves spasms, restores mucous membranes.

Used, as a rule, in the form of an infusion. Get it by brewing 1 tbsp. spoon with a cup of boiling water. The mixture must be insisted for 15 minutes, strain and drink 3 times a day before meals for a quarter of a glass.

6Fennel

The infusion is drunk to relieve spasms and pains, to reduce flatulence, with constipation (since it has a laxative effect).

To prepare the infusion, pour boiling water (1 glass) over 1 teaspoon of the herb, let it brew for half an hour. Drink half a glass three times a day 30 minutes before meals.

7 Flax seeds

They are effective for gastritis, ulcers, colitis, enteritis. The broth has an enveloping effect, relieves inflammation, irritation, and reduces damage to the walls of the stomach.

Seed infusion is drunk before each meal. But it is important not to store it for a long time, because it quickly loses its usefulness. To make it, take a bottle with a cork, put 1 teaspoon of seeds there, pour a glass of boiling water, shake the mixture for half an hour until mucus forms. Process the resulting mass. You need to take exactly the mucous liquid, half an hour before meals, 3 times a day.

8 Thyme

Thyme helps with flatulence, relieves spasms, relieves pain. It also possesses antiseptic and antibacterial properties (due to the Tinol, which is part of the substance), tones up and strengthens the stomach.

Grind the plant, pour 1 teaspoon of powder with a glass of boiling water. The broth must be insisted for 15 minutes. You can drink 1 – 2 times a day.

9 Oak bark

This is not a herb, but a part of a plant, and very useful for the normalization of the intestines, so we could not miss it. Tannins, essential oils and flavonoids help reduce gas formation, restore the correct microflora, and normalize bowel function. Infusion from the bark can even be given to children, as it acts very gently and safely.

To make a decoction, pour a glass of boiling water over 2 teaspoons of chopped bark. Boil in a water bath for half an hour, then strain with a fraction of water to a total volume of 300 ml. Drink 3 times a day.

10 Sage

A decoction of sage leaves actively fights against the bacterium Helicobacter pylori, namely, it most often causes intestinal disorders and disrupts its microflora. The plant is used for gas, pain, to normalize digestion.

For brewing, take half of the art.tablespoons of leaves and half a glass of boiling water. Cover the flooded leaves with a lid, leave for 1 hour. You can drink 3 times a day.

11 Pharmacy chamomile

This flower has a very wide range of beneficial properties, and the most important among them is the ability to treat stomach problems. Chamomile has anti-inflammatory, healing properties. She fights colitis, irritable bowel syndrome, dysbiosis.

To prepare the infusion, pour 2 tbsp. tablespoons of chopped chamomile with a glass of boiled water.Let it brew for 25 minutes, strain, dilute with water until you get the desired portion. Take half a glass 2 to 3 times a day with or after meals. The course of admission is 1 – 3 months.

12 Yarrow

This medicinal plant promotes the production of digestive enzymes and helps the stomach to regenerate. It can be drunk with gastritis, pain in the intestines. You can squeeze the juice from the leaves or make an infusion: pour 1 tbsp. a spoonful of herbs with a glass of boiling water, take 3 times a day, 100 ml.

13 Dill seeds

Dill water is given even to babies with intestinal colic, so the benefits of the plant in the fight against stomach problems are very well known.Broths are drunk with bloating, heartburn, high acidity. It is also one of the herbs for colon cleansing.

The easiest way to brew is to pour 2 teaspoons with a glass of water, cook for 20 minutes over low heat. Cool, strain and can be taken 5 – 6 times a day.

How much to take and when will the effect be
If you use anti-inflammatory herbs for the intestines in a course to treat a disease, then tune in to the fact that you will not see the full result at once. Of course, the acute symptoms will go away immediately, and the cure will come at least 1 – 2 weeks later.A full course usually lasts at least a month. The main thing is to drink the funds regularly (and at the same time to establish nutrition, give up alcohol and smoking), then you will really see the result.

However, it is important to remember that such a long-term intake can be carried out only with the permission of a doctor, some plants with long, uncontrolled use are ways to reverse the effect and worsen your condition.

When not herbs help, but only a doctor
Treatment with folk remedies can be effective, but a doctor’s consultation is always needed.In some cases, herbs should not be taken, but you need to immediately consult a doctor:

For acute, recurring pain. Some plants only provide temporary pain relief, but frequent use in such cases can be dangerous.
If you do not know the diagnosis. If painful sensations recur, it is necessary to consult a doctor, make an accurate diagnosis, and a prescription. Before that, it is not even possible to start the course, the application can blur the clinical picture. In addition, herbs are usually used as a complementary treatment, not as a primary one.

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90,000 Medicinal plants used for intestinal diseases

Medicinal plants used for intestinal diseases

Medicinal plants are used for both acute and chronic diseases of the gastrointestinal tract. In the initial stages of the disease, medicinal herbs are often the main means of treatment due to their mild action and low toxicity. In the midst of illness, they are important for maintaining the body’s defenses, enhancing the effect of essential drugs and reducing their side effects.

Under the influence of long-term drug therapy, the phenomena of dysbiosis are often intensified. Medicinal herbs do not have such a detrimental effect on the normal intestinal microflora. On the contrary, by destroying pathogens and viruses, medicinal herbs promote the growth of beneficial intestinal flora.

Herbs are prescribed to each patient individually, taking into account their therapeutic effects and the nature of the course of the disease. At the beginning of treatment, it is advisable to use individual medicinal plants or collections of two or three components, in the future – collections of a complex composition.

Herbal treatment requires their long-term use, especially for chronic bowel diseases.

Attention! If clinical symptoms of allergy appear – itching, rash on the body, dry cough, vomiting – the use of herbs should be stopped immediately!

Common calamus. Calamus root has an antispasmodic and anti-inflammatory effect. Promotes increased appetite and improved digestion, enhances the reflex separation of gastric juice.Used for gastric ulcer and duodenal ulcer, chronic colitis, to regulate digestion and stimulate appetite. The infusion is prepared from a dessert spoon of calamus rhizomes and a glass of water, take 1/2 cup 2-3 times a day before meals.

Elongated quince. Quince fruits have anti-inflammatory, regenerating and immunostimulating effects. Used for colitis, accompanied by frequent diarrhea, dysentery, acute intestinal infections. Quince juice is taken 1/2 cup 2 times a day before or during meals.Lotions with quince juice are good for the treatment of hemorrhoids, fissures and prolapse of the rectum.

Arboreal aloe. The biologically active components that make up aloe have anti-inflammatory, antibacterial effects, stimulate the restoration of the damaged intestinal mucosa, enhance the secretion of the digestive glands, improve appetite and digestion. Aloe also has a laxative effect, stimulates the body’s defenses. Aloe leaf juice is used for chronic colitis, peptic ulcer disease and prolonged constipation.

Take 5-6 juicy aloe leaves, spin them through a meat grinder or pass through a juicer. Take 1 dessert spoon 3 times a day 30 minutes before meals. The juice can be stored in the refrigerator for no more than 2-3 days, otherwise it loses its biological activity.

Althea officinalis. Marshmallow root has anti-inflammatory, antispasmodic, enveloping and astringent effects, promotes the early healing of ulcers in the intestinal walls, reduces intestinal colic.Used for ulcerative colitis, Crohn’s disease, chronic enteritis, dysentery. The broth is prepared from 2 tablespoons of crushed dried marshmallow root and a glass of water. The resulting broth is taken warm in 1/2 cup 30 minutes after meals.

Common anise. Anise increases the motor activity of the intestines, has an antiseptic and antispasmodic effect, normalizes the secretory function of the stomach, liver and pancreas. It is used for the syndrome of impaired digestion, flatulence, chronic inflammatory diseases of the small and large intestines.The broth is prepared from 2 teaspoons of anise seeds and 1 glass of water. Take 3-4 tablespoons 3 times a day before meals.

Valerian officinalis. Preparations of valerian roots and rhizomes have a significant sedative and antispasmodic effect. They relieve spastic pain in the intestines, reduce the phenomena of flatulence. It is used for spastic enterocolitis, digestive disorders on the nervous soil, and with symptoms of flatulence. The infusion is prepared from 1 teaspoon of valerian rhizomes and a glass of water, take 1 tablespoon 3 times a day.Valerian tincture is prescribed 20-30 drops 2 times a day.

Meadow geranium. The plant contains tannins and alkaloids in the flowering phase. Geranium herb has anti-inflammatory, antiseptic, analgesic and astringent effects. A decoction of meadow geranium is used for diarrhea, dysentery, acute and chronic enterocolitis. The infusion is prepared from 1 teaspoon of geranium herb and a glass of water. Take 1 dessert spoon 4 times a day.

Snake Highlander (cancerous necks). Knotweed roots have a pronounced anti-inflammatory, hemostatic and astringent effect. Used in the treatment of acute and chronic diarrhea, duodenal ulcer, Crohn’s disease, intestinal bleeding, hemorrhoids. A decoction of the mountaineer snake is prepared from 1 tablespoon of roots with rhizomes and a glass of water, take 1/4 cup 2 times a day before meals.

Walnut. Walnut leaves have an antiseptic, anti-inflammatory and restorative effect, improve metabolism and digestion processes.Used for enterocolitis, as well as an astringent for diarrhea. The infusion is prepared from 1 dessert spoon of dry crushed walnut leaves and a glass of water. Take 1/4 cup 3 times a day 15 minutes before meals. A large amount of fiber and oils in ripe walnuts enhances intestinal motility, which is very useful for older people with a tendency to constipation, as well as in chronic colitis. Walnut is also used as an anthelmintic.

Common oregano. The herb infusion enhances the secretion of the digestive glands and intestinal motility, has a calming effect. In addition, oregano has antimicrobial, analgesic and anti-inflammatory effects. It is used for atonic states of the intestine, flatulence, enterocolitis, habitual constipation. The infusion is prepared from 1 dessert spoon of oregano herb and a glass of water. Take 1/4 cup 3-4 times daily before meals.

Joster laxative. In medical practice, the plant is used as a laxative for atonic and spastic constipation.The broth is prepared from 1 tablespoon of joster fruit and 1 glass of water. Take 1/2 glass 3-4 times a day.

St. John’s wort. St. John’s wort has a pronounced antimicrobial property, mainly against gram-negative microbes, but does not suppress the normal intestinal microflora, stimulates the regeneration of intestinal tissues. St. John’s wort has a choleretic effect, helps to restore destroyed liver cells, normalizes digestion, reduces nausea and vomiting.The broth is prepared from 2 tablespoons of St. John’s wort and a glass of water. Take 1/4 cup 4 times a day 30 minutes before meals.

Calendula (medicinal marigold). Calendula has a pronounced anti-inflammatory effect on the intestinal wall. It speeds up the healing process of diseased cells. Under the influence of calendula, a new healthy layer of intestinal cells forms faster. Calendula also has a choleretic effect. Helps with stomach cramps, constipation, nausea and vomiting.The infusion is prepared from 1 dessert spoon of calendula flower baskets and a glass of water. Take 1 tablespoon 2-3 times daily before meals.

Medicinal Burnet. Burnet roots have antihemorrhagic, astringent, analgesic and antispastic effects. They have a pronounced antimicrobial and anti-inflammatory effect. Used for dysentery, acute intestinal infections, ulcerative colitis. The broth is prepared from 1 tablespoon of crushed burnet roots and a glass of water.Take 1 tablespoon 5-6 times a day.

Buckthorn fragile. Buckthorn has a mild laxative effect that appears after 8-10 hours. It is indicated for colitis, enteritis, accompanied by chronic constipation. Helps with hemorrhoids, as it promotes liquefaction of feces and thereby prevents injury to the walls of the rectum and anus. The broth is prepared from 1 tablespoon of chopped buckthorn bark and 1 glass of water. Take 1/2 cup at night as a laxative for chronic constipation.The tincture is taken 30-40 drops 2 times a day.

Erect cinquefoil (galangal). Contains tannins and antispasmodics, organic and fatty acids. It has a bactericidal, astringent, anti-inflammatory and hemostatic effect, and also stimulates digestion. Used for duodenal ulcer disease, intestinal inflammation, intestinal colic of a spastic nature, diarrhea, dysentery. The broth is prepared from 1 teaspoon of Potentilla rhizomes and a glass of water.Take 1 tablespoon 4 times a day 30 minutes before meals.

Marjoram. Marjoram herb helps to improve digestion and the formation of bile. It also has a calming effect. It is used in the treatment of irritable bowel syndrome, chronic enteritis, dysbiosis. The infusion is prepared from 5 teaspoons of chopped marjoram herb and a glass of water. Take 1/4 cup 3-4 times a day 10 minutes before meals.

Mother and stepmother. The plant has anti-inflammatory, antibacterial and enveloping properties.Due to the presence of mucus in it, it protects the intestinal walls from the action of irritating substances. Reduces inflammation, gas and bloating. It is used in the treatment of duodenal ulcer, flatulence, enterocolitis. The infusion is prepared from 1 dessert spoon of leaves and flower baskets and a glass of water. Take 1/4 cup 3-4 times a day.

Alder. Has an astringent and hemostatic effect. An infusion of alder leaves helps to reduce the inflammatory process in the intestines.It helps well with diarrhea, especially in children. It is also used as a hemostatic agent for ulcerative colitis and hemorrhoids. Alder can help relieve symptoms such as bad breath, excess gas, rumbling and bloating. Used for dysbiosis. The infusion is prepared from 2 tablespoons of alder leaves and a glass of water. Take 1/4 cup 3-4 times a day 30 minutes before meals.

Shepherd’s bag. The herb of shepherd’s purse has an astringent and hemostatic effect, helps to increase the tone of the muscular wall of the intestine, and stimulates its peristalsis.Shepherd’s purse herb is used for acute and chronic inflammatory bowel diseases, especially if they are accompanied by bleeding. Due to the presence in the plant of a number of useful macro- and microelements (copper, zinc, manganese, potassium, chromium, iron, magnesium, calcium), shepherd’s purse decoction is successfully used in the complex treatment of malabsorption syndrome. The broth is prepared from 1 tablespoon of shepherd’s purse herb and a glass of water. Take 1 tablespoon 4 times a day 20-30 minutes before meals.

Garden parsley. The plant has an antispasmodic, choleretic, antiseptic and detoxifying effect. Parsley is effective for digestive disorders, bloating and intestinal colic. The broth is prepared from 1 tablespoon of raw materials (both herbs, seeds, leaves and roots of parsley) and a glass of water. Take 2-3 tablespoons 3-4 times daily before meals.

Common tansy. Tansy has anti-inflammatory, antimicrobial, antihelminthic, choleretic and astringent effects.Infusion of tansy is used in inflammatory diseases of the small and large intestines, as well as in the treatment of ascariasis and enterobiasis. The infusion is prepared from 1 tablespoon of tansy flower baskets and a glass of water. Take 2 tablespoons 3-4 times daily before meals.

Large plantain. Plantain leaves have anti-inflammatory, antiseptic and enveloping effects. In addition, plantain has a mild laxative effect and is suitable for regular use as a prevention of constipation; improves the regeneration of the intestinal mucosa and is used in the treatment of ulcerative colitis and duodenal ulcers.The infusion is prepared from 1 tablespoon of plantain leaves and a glass of water. Take 1/4 cup 3-4 times a day 15 minutes before meals.

Common wormwood (Chernobyl). The plant improves metabolism, regulates digestion processes, reduces convulsive syndrome. Wormwood is used as a sedative for pain and spasms in the intestines, gastric and intestinal dyspepsia. The infusion is prepared from 1 dessert spoon of wormwood herb and 1 glass of water. Take 2 tablespoons 4 times a day 30 minutes before meals.An infusion of wormwood roots is prepared from 1/2 teaspoon of roots and 1 glass of water. Drink 1 dessert spoon 3 times a day.

Medicinal chamomile. Chamomile flowers have a pronounced anti-inflammatory and anti-allergic effect. The biologically active substances that make up chamomile relax the smooth muscles of the intestines, prevent spasms and intestinal colic. Chamomile infusion is used to treat acute and chronic colitis, pain in irritable bowel syndrome.In addition, chamomile reduces the severity of fermentation processes in the intestines with dysbiosis and malabsorption syndrome, relieves spasms and swelling of the intestinal mucosa, promotes healing of ulcers in ulcerative colitis. The infusion is prepared from 1 tablespoon of chamomile flower baskets and a glass of water. Take 1/2 cup in the morning and evening between meals. It is useful to add chamomile flowers to tea, especially for people suffering from flatulence and food allergies.

Swamp dryers. The dried cane enhances the regeneration processes and promotes the restoration of inflamed intestinal cells. In addition, it is used for constipation because it helps to shrink the intestinal walls and move the stool. The infusion is prepared from 2 tablespoons of dried herbs and a glass of water. Take 1/2 cup warm 3 times a day 15 minutes before meals.

Cumin. Fresh caraway seeds have an antispasmodic, enveloping and anticonvulsant effect. Infusion of caraway seeds is very effective for constipation, colitis, flatulence and nausea.The infusion is prepared from 1 teaspoon of caraway seeds and 1 glass of water. Take 1 tablespoon 4-6 times a day.

Pumpkin. Pumpkin seeds are used as an anthelmintic for tapeworms. Pumpkin pulp is used as a mild laxative for constipation. Consumed daily 2-3 times a day.

Common yarrow. Yarrow herb has a pronounced anti-inflammatory and antimicrobial effect. Promotes faster regeneration of intestinal tissue, stimulates the body’s immunological reactivity, improves digestion processes.Used to treat colitis, duodenal ulcers, to stimulate appetite. The infusion is prepared from 1 tablespoon of herbs and 1 glass of water. Take 1/4 cup 3-4 times a day 15 minutes before meals. A 20% tincture of yarrow is taken 15–20 drops 3 times a day.

Blueberry. The plant has an astringent, anti-inflammatory, antispasmodic and analgesic effect. Blueberries are used for disorders of the gastrointestinal tract, diarrhea in children and acute enterocolitis.Infusion of blueberries is prepared at the rate of 1 tablespoon of dry berries in a glass of water. Take 1/2 cup 3 times a day before meals (anti-inflammatory drug). Blueberries can also be eaten fresh, especially for chronic bowel disorders.

Sowing garlic. Garlic kills viruses and protozoa that can cause colitis, is an excellent anthelmintic, enhances intestinal contractility and helps to treat and prevent constipation.Garlic is recommended for intestinal atony, flatulence, dysbacteriosis with increased fermentation processes in the intestine, for inflammatory bowel diseases – enteritis and colitis. Use with caution in case of intestinal ulcer. It is consumed fresh, adding it as a seasoning to various dishes.

Dense sorrel. Sorrel is used as an astringent for diarrhea and dysentery, as well as for colitis, enterocolitis and hemorrhoidal bleeding. The broth is prepared from 1 dessert spoon of sorrel roots and rhizomes and 1 glass of water.Take 1/4 cup 3 times a day.

Orchis. Orchis tubers are rich in mucus and therefore have a good enveloping effect on the intestinal walls, which helps to reduce inflammation. They have a fixing effect for diarrhea. Orchis is used in the treatment of enterocolitis and duodenal ulcer. The broth is prepared from 1 dessert spoon of crushed orchis tubers and a glass of water. Take 2 tablespoons 3 times a day 15-20 minutes before meals.

This text is an introductory fragment.

Continuation for liters

90,000 Tea for inflammation of the intestines for and against

With the arrival of McDonald’s, Burger Kings and other fast food, environmental degradation, problems with the digestive system are not uncommon.In this article, we will consider which tea is most effective for intestinal inflammation. Inflammation can cause pathological processes, and we will not delve into this, we will consider exclusively the methods of treatment. Causes, symptoms, respectively, for such information, go to the medical portal. It will not be possible to recover quickly, this is not a headache. The use of folk remedies, including tea, decoctions, refers to auxiliary therapy aimed at improving well-being, reducing inflammation.The doctor is able to accurately diagnose diseases and prescribe the necessary medications. Claims that green tea is the best option for intestinal inflammation is incorrect. For a number of diseases, such as colitis, green tea with honey is even recommended, but weakly brewed. A strong infusion, of any kind, on the contrary, will bring pre. Herbal infusions are much more effective, safer.

Herbal decoctions for intestinal inflammation

For example, with enteritis, the following composition is popular: 1/5 of the frequency, 2/5 of the inflorescence of chamomile and St. John’s wort.Oat broth is considered the most useful for the gastrointestinal tract. It is often used in milk. Dignity, intestinal lining, intestinal protection. In addition, the following herbs are popular:

• burdock – removes toxins, has an antibacterial effect;
• caraway – is part of a number of fees, has a sedative effect in case of intestinal irritation;
• centaury – relieves spasms, eliminates flatulence;
• chamomile – reduces gas, soothes the intestines;
• mint – has a sedative effect, normalizes digestive processes;
• fennel – colic fighter;
• plantain – have a positive effect on the secretory function of the stomach, relieves pain.

These types of herbs are much more effective than tea for inflammation of the intestines. But in any case, it is necessary to be examined by a doctor, a neglected disease is sometimes much more difficult to cure, there is a risk of complications. Strong tea is definitely contraindicated, a high caffeine content will only harm.

Medicinal properties of chamomile

Chamomile has long been used as an anti-inflammatory, hemostatic agent, as well as in the treatment of various diseases.The most pronounced medicinal properties of chamomile pharmacy. The effectiveness of other varieties is lower and therefore they are used less often. The plant is found in meadows, along roads, as a medicine it is specially grown in the garden.

Chamomile Treatment

Homemade chamomile formulations help to cope with viruses, colds, inflammation, eliminate spasms, allergies, convulsions, and relieve pain. Chamomile formulations help in case of violation of the secretion of the digestive glands, with gastritis, stomach ulcers and duodenal ulcers, relieve swelling of the gastric mucosa.They are used for inflammation of the liver, for the prevention and elimination of stagnation of bile, for the treatment of cholecystitis, cystitis, nephritis, for flatulence, hemorrhoids, in case of violations of the female cycle, uterine bleeding. The medicinal properties of chamomile are used to normalize the strength of heart contractions, provide a calming effect on the nervous system, with significant intellectual stress, hysterical illness, neurosis.

Pharmacy chamomile

The medicinal plant received its characteristic name, which means “mother herb” in translation, because of its widespread use in the treatment of female diseases.This variety is almost never found in nature; it has to be specially grown in a garden or vegetable garden. The root is thin, taproot. Branched stem reaches 40cm. The leaves are cut into two or three narrow slices. The inflorescence consists of white and yellow petals. Flowering begins in June and ends in August-September. When rubbing the hollow inside of the flower, a strong pleasant aroma of fresh apples is felt.

Fragrant chamomile

The medicinal properties of this variety are less pronounced.As a rule, the plant is recommended for use as an external agent, for rinsing, compresses, lotions, enemas, hair masks. This variety should not be consumed inside. Outwardly, the plant differs from chamomile in short pedicels, which have to be found among the leaves. The flowers are green, fragrant, and the medicines have a spicy taste. This variety does not contain chamazulene essential oil.

Healing composition of flowers

Chamomile flower baskets are rich in matricin, a source of chamazulene, which gives the essential oil its blue color and provides various medicinal properties.Hamazulen accelerates tissue regeneration, has anti-inflammatory and anti-allergic effects, partially destroyed by boiling. In addition, the composition of the essential oil of the plant includes glycosides of oleic, palmitic, stearic, linoleic acids, as well as gums, mucus, flavonoids, coumarins, carotene, vitamin C. Trace elements are represented by potassium, copper, zinc, selenium.

Procurement and Storage

Chamomile acquires the maximum medicinal properties from mid-June.Flowers are plucked on a warm, dry morning, when the white petals have taken a horizontal position and the plant has a maximum of useful properties. Yandex.Direct Reduced pressure. Treatment. Use the latest treatment at home. First result in 12 minutes. mir-zdravi.ru Before drying, the raw materials are sorted out, wilted flowers, insects, lumps of earth are removed. Raw materials are scattered on paper with a layer of 2-3 cm, dried in the open air or in a room with good ventilation. It is allowed to use dryers with a set temperature not higher than + 40C.After drying, chamomile loses up to 80% of its mass. Underdried flowers, during storage, quickly change color, begin to deteriorate. Overdried ones turn into dust that does not have useful properties. Healing chamomile flowers are stored in cloth or paper bags in a dry room for up to a year.

Chamomile infusion, decoction, infusion, tea

To extract its medicinal properties, chamomile is exposed to heat. For example, under the action of steam, matricin is converted into chamazulenecarboxylic acid, then into chamazulene.Hamazulen is quite easily destroyed, therefore, when preparing medicines, they should not be boiled over an open fire, but only use a water bath.

Infusion

The first method: to prepare chamomile infusion, brew 1c. L. dried raw materials with a glass of boiling water, close the lid. Strain after half an hour.

The second method: place the dried flowers in a glass or enamel container, pour ten parts of lukewarm boiled water, close the lid and simmer in a water bath for 20 minutes, strain after 30 minutes.

Decoction

Pour plant materials with boiled water at room temperature, simmer in a water bath for 30 minutes. Let it brew for 10 minutes, drain. Add boiled water to the original volume.

Tincture

Place the crushed flowers in a glass container, pour five parts of vodka, close tightly. Insist in a dark place for a week, shaking the container every day. Squeeze and extract the raw materials, strain the chamomile tincture into a clean dark glass dish, add vodka to the original volume.Insist for another week in a cool, dark place, filter at the end. Correctly prepared tincture is transparent, with a chamomile aroma. The drug has a strong therapeutic effect, so it can only be taken after consulting a doctor and no longer than within two weeks.

Chamomile tea

Brew 1 tsp. dried flowers with a glass of boiling water, leave for 5-10 minutes. Taken in the evening with honey, chamomile tea eliminates insomnia, helps to fall asleep, and cope with fatigue.Tea for flatulence: mix 3 parts of chamomile flowers, 2 parts of valerian root, 0.5 parts of cumin. Brew 1c l. mixture with a glass of boiling water, leave for 20-30 minutes, drain. Take half a glass in the morning and in the evening.

Chamomile treatment for colds, runny nose, sore throat

Cold

Prepare an infusion at the rate of 2c. L. flowers in a glass of boiling water. After half an hour, add 1 liter of boiling water. Cover the pan with a towel, inhale the steam alternately through your mouth and nose. Get treated every day.

Runny nose

Brew in a thermos for 1 hour.l. vegetable raw materials with a glass of boiling water, leave for 4 hours. In warm form, use for compresses in the area of ​​\ u200b \ u200bthe bridge of the nose.

Angina

Brew with a glass of boiling water a mixture of 1c. L. chamomile and 1c.l. celandine, simmer in a water bath for 15 minutes, drain. Add boiled water to the original volume. Dilute with infusion with water and gargle 5-7 times a day.

Treatment of polyps in the nose

Grind, mix and place in a glass jar 1c.l. celandine herbs, 2 pp. mother-and-stepmother root, 4 pp. Hypericum perforatum, 4 pp. calendula flowers, 3 pp. chamomile flowers. Pour 0.5 l of olive oil over the vegetable raw materials. Insist in a dark, warm place for a month, periodically shaking the container, strain at the end. Instill 3-4 drops of oil tincture in each nostril four times a day.

Toothache

Brew the mixture 1c. L. chamomile flowers and 1c.l. sage with a glass of boiling water, leave for 15 minutes, drain.Rinse your mouth warm while keeping the infusion in your mouth for as long as possible. The toothache goes away very soon.

Chamomile treatment of diseases of the heart and blood vessels

Arrhythmia

Stir in 2c l. valerian root, fennel fruits, caraway seeds, mint, chamomile. Brew 1c l. a glass of boiling water, leave for 15 minutes, drain. Take a glass at night.

Atherosclerosis

Stir 3c. L. hawthorn fruits, chokeberry fruits, 1c.l. buckthorn bark, corn stigmas, lingonberry, string, motherwort, chamomile flowers. Brew 2c l. mixture with a glass of boiling water, leave for 15 minutes, drain. Take for the treatment of blood vessels in half a glass after meals.

Treatment of stomach diseases

The medicinal properties of chamomile are useful in case of increased acidity of gastric juice, the plant normalizes its secretion. Chamomile infusion eliminates fermentation processes, gas formation, relieves spasm and swelling of the mucous membrane, promotes wound healing.

Gastritis

Stir 3c. L. mint, chamomile flowers, 2 pp. fruits of fennel, calamus marsh, valerian rhizomes. Brew 2 tsp. a glass of boiling water, simmer in a water bath for 10 minutes, let cool, drain. Take a glass three times a day.

Stomach and duodenal ulcer

Brew 1c l. flowers with a glass of boiling water, leave for 10 minutes, drain. Take half a glass warm one hour before meals and at night, but not earlier than two hours after meals.To be treated for a month. In order for the medicinal properties of chamomile to have the maximum effect, after taking it, it is useful to lie down, alternately turning on the left and right side.

Treatment of the liver and biliary tract

To relieve inflammation, eliminate spasm of the bile ducts, stimulate the separation of bile: pour 2 glasses of water at room temperature, 1 tsp. chamomile, mint, wormwood, yarrow, 2 tsp. cumin. Insist for 8-12 hours, bring to a boil, let cool, drain.Take half a glass one hour after meals.

Healing properties of chamomile for eyes

In case of inflammation of the eyelids, intense visual work during the day: brew 1 s. L. chamomile with a glass of boiling water, leave for 10 minutes, drain. Store in the refrigerator no longer than 2-3 days. In the evening, for 15 minutes, place cotton or gauze swabs moistened with warm infusion on closed eyelids. For the treatment of conjunctivitis: brew a glass of boiling water 3c. L. chamomile flowers, leave for an hour, drain. Rinse your eyes several times a day with warm infusion.

Treatment of female diseases

In case of inflammation of the female genital organs, symptoms of endometritis, you should consult a doctor. It is useful to combine the prescribed treatment with douching with chamomile infusions, which reduce inflammation and pain: Pour 2c l. chamomile flowers with a liter of water, bring to a boil over low heat. Cover, let cool. Mix 1 part oak bark, 3 parts nettle, 3 parts chamomile, 5 parts knotweed herb. Brew 2c l. mixture with a liter of boiling water, simmer for 5 minutes over low heat, let cool, strain.Douching should be carried out at an infusion temperature of + 37C.

Healing properties of chamomile for men

Recipe for prostatitis: stir 2 tsp. St. John’s wort, 1 tsp. celandine, 1 tsp. linden flowers, 1 tsp. chamomile. Brew 1c l. mixture with a glass of boiling water, leave for an hour, drain. Take half a glass twice a day for three weeks.

Contraindications

Chamomile and formulations prepared from its flowers can be harmful in the case of anacid gastritis, when there is almost no hydrochloric acid in the stomach, as well as in case of individual intolerance.Overdose is manifested by cough, hoarseness, dizziness, headache, nausea, diarrhea. In women, painful sensations are aggravated during menstruation. Pregnant and lactating women are allowed to use chamomile only as directed by a doctor. Pregnant and lactating women are allowed to use chamomile only as directed by a doctor.

A source:
http://www.silazdorovya.ru/lechebnye-svojstva-romashki/

90,000 Kefir improves the intestinal microflora. Scientific Proof

January 31, 2017

Photo Caption,

Dr. Michael Moseley found out what actually affects our gut

Can the food we eat improve our gut health? Dr. Michael Moseley decided to figure out which foods and drinks are more effective in improving the microflora.

The gut microbiome – the diverse collection of bacteria that inhabit our intestines – has become a popular scientific topic in recent years.

Almost every day, you can stumble upon a headline claiming that the microbiome turns out to affect our health in some new, even more amazing way – whether it is weight loss, mood or our ability to resist infections.

So it’s no surprise that supermarkets and health food stores, given this increased interest in our internal ecosystem, are selling a variety of foods and dietary supplements containing live microcultures – probiotics that can supposedly improve the health of our gut.But is it really so?

To find out the program “Believe me, I’m a doctor!” (“Trust me, I’m A Doctor”) decided to conduct an experiment in the Scottish city of Inverness with the help of the local branch of the National Health Service (NHS Highland) and 30 volunteers and scientists drawn from around the country.

Three groups

Photo author, Science Photo Library

Photo caption,

One of the most important lactic acid bacteria – Lactobacillus casei, which can be found both in our mouth and in the intestines

We divided our volunteers into three groups and asked each of them individually to try on themselves for four weeks any one of those methods that seem to improve our microbiome.

Our first group began to drink a probiotic drink sold in grocery stores from the category of those that usually contain one or two bifidobacteria that can survive the journey through the acidic environment in the stomach and go directly to the intestines.

The second group switched to kefir, produced by conventional fermentation and containing a set of bacteria and yeast.

The third group had to eat food rich in inulin – a natural polysaccharide that is a dietary supplement, prebiotic.

Prebiotics are substances that feed the “good” bacteria already living in our intestines, and inulin is found in foods such as Jerusalem artichoke (ground pear), chicory root, onions, garlic and leeks.

A glass of kefir instead of?

Photo author, iStock

Photo caption,

Earthen pear is a useful prebiotic

At the end of our experiment, we discovered an amazing thing.

The group that drank the probiotic drink slightly increased the bacteria that is good for weight maintenance – Lachnospiraceae, although these changes were not statistically significant.

The other two groups showed more marked changes.

The group that ate food rich in prebiotic seriously increased the presence in the gut of the type of bacteria that is good for the health of our gut – the same result has been shown by other scientists.

However, the biggest change occurred in the group that drank kefir.

The volunteers from this group had a dramatic increase in the colony of lactobacilli, which, as we know, have a positive effect on our intestines and help in cases such as lactose intolerance and tourist diarrhea (diarrhea that can occur in humans when changing climate, water, etc. food – that is, when faced with unusual microbes).

“Fermented [fermented] foods are inherently quite acidic, so these microbes had to evolve to adapt to this kind of environment and withstand the acidic environment,” explains Dr. Paul Cotter of Teagasc Research Center in Cork. who helped us in our research. “That is why they pass through the stomach and can influence the formation of the environment in the intestines.”

Photo author, iStock

Photo caption,

Yes, kefir is sold in Britain, although not at every step

Where to get it?

We decided to continue our study of fermented foods and beverages to understand where to choose if you want to improve your gut environment.

With the help of Dr. Cotter and Rowhampton University scientists, we selected a range of home-made or store-bought fermented foods and beverages and sent them to the laboratory.

The difference was enormous: while many homemade or traditional fermented foods did contain large amounts of bacteria, some industrially produced foods contained almost no beneficial bacteria.

“Typically, commercial products must be pasteurized after cooking to protect them and extend their shelf life, which kills bacteria, but homemade food doesn’t happen,” explains Dr. Cotter.

So, if you want to improve bowel function and replenish your microbiome with beneficial bacteria, then it is best to buy those foods that are prepared in the traditional way, or even make them yourself.