Disease States and Natural Products to Treat These Disease states
In preparation for this talk, I went to a publication called Lawrence
Review of Natural Products. It is put out by the same company that publishes
Facts and Comparisons, which is the main reference for most pharmacists.
The Lawrence Review of Natural Products has in it several hundred natural
products with either proported or ascertained uses in this country.
This is a loose-leaf publication with between two and five updates on
new products given every month. I went through the disease index at
the back of the book, and weāll be going through in alphabetical order
those particular ailments that may manifest themselves as symptoms of
either ulcerative colitis or Crohnās disease.
I. Abdominal cramping.
(a) Poppy seeds. The poppy seed, of course, is the source of opiates
that have been used traditionally and illicitly for a number of years.
It is the narcotic preparation from these seeds that seems to exert
its GI influence by slowing GI motility.
II. Abdominal gas.
(a) Charcoal is the only natural product on the market used in the
treatment of abdominal gas. It is well recognized that charcoal has
a large surface area that is useful for absorbing both chemicals and
gas onto its surface. It is the mainstay of poison prevention centers
in being put into a personās stomach via an NG tube to help neutralize
poisonous and injurious chemicals that a person has ingested.
III. Abdominal pain.
(a) In this category, we have one lone entry - peppermint. However,
there is a fair amount of written material with regard to this product.
Historically, peppermint and its oil have been used in eastern and western
traditional medicines as an aromatic antispasmodic and antiseptic and
in treating indigestion, nausea, sore throat, colds, toothaches, cramps,
and cancer. The chemistry of peppermint oil is complex. More than one
hundred components have been found in the oil and the relative concentrations
vary between cultizars and geographic location. Medically peppermint
has been found to exhibit an antispasmodic activity on smooth muscles.
Commercial preparations are available for use in the treatment of irritable
bowel abdominal pain and related symptoms. When administered orally,
these peppermint containing drugs appear to be effective. Generally
administered as an enteric coated capsule, these preparations release
their contents in the large intestine and colon. Peppermint oil appears
to act directly on the smooth muscle. The antispasmodic activities relate
to the menthal content and it has been demonstrated that this activity
is due to the calcium antagonist effect of menthol. In addition, flavinoids
in peppermint leaves reportedly have a choleretic (bile) stimulating
effect in dogs. A caution on this product is that because of the oilās
ability to relax gastrointestinal smooth muscle people with hiatal hernias
may experience a worsening of their symptoms.
IV. The next rather large group of natural products are the antispasmodics.
These natural products would be used to treat any type of smooth muscle
spasticity. I will first mention those products with an historical basis
but with no current found scientific backing. They are as follows: aletaris,
blue cohosh, hawthorn, lavender, lemon verbena, lemon grass, myrrh,
nettles, peppermint, perilla, rosemary, rue, woodruff sweet, and yew.
(a) Calamus. It has been used in traditional medicine for the
treatment of digestive disorders and childhood colic. In low doses,
calamus oil has an acetylcholine-like action of smooth muscles; at higher
doses it has an antispasmodic and relaxant effect. When tested in
vitro, calamus oil abolished drug-induced restrictions of isolated
animal intestine, aorta, and uterus. Its action was about ten times
less potent than that of papaverine. A drawback to this product is that
it does show some strong sedative action which appears related, chemically
at least, to the activity of the phenothiazine tranquilizers.
(b) Chamomile. Known since Roman times for their medicinal properties,
the plants have been used as antispasmodics and sedatives. In the full
treatment of digestive and rheumatic disorders, some strengths of M.
chamomilla showed significant antispasmodic effects in vitro.
The essential oils of the plants have a papaverine and antispasmodic
effect. This product has a very significant antispasmodic effect in
the GI tract, and the potential for delayed absorption from the gut
of other medications should be considered.
(c) Dongquai. This is an aromatic herb widely distributed throughout
the Orient. The root of this plant is used medicinally. Approximately
six coumarin derivatives have been isolated from Dongquai. It is the
coumarin derivatives that give Dongquai its proported antispasmodic
activity.
(d) Sage. Sage extracts and teas have been used to treat digestive
disorders with an a tonic and antispasmodic activity through the ages.
It has been directly proven that sage oil has an antispasmodic effect
in laboratory animals and this is likely related to its effect as a
gastrointestinal antispasmodic. Beyond this, little formal work has
been done on sage.
(e) Pansy. This has been used extensively in traditional medicines
and as a popular herb for centuries despite its recognized potential
toxicity. As little as ten drops of the oil may be lethal (not unlike
nicotine). The dried leaves are said to be an effective insect repellent
and an antispasmodic. There is little medical evidence to support the
use of pansy for any pharmacological indications.
(f) Vallerian. This was used traditionally for many years to
treat a variety of symptoms, one of which was abdominal muscle spasms.
The two active ingredients that proportedly helped cause this was valerenec
acid and valeranone. There are no well controlled studies that would
show any benefit to this in the treatment of GI symptoms.
V. Catarrh. This old term is from centuries past and may have
originated in Egypt. It refers to products that are supposed to have
anti-secretory anti-inflammatory properties. There are five natural
products listed in the treatment of catarrh, but all of these have only
historical note with no known proven medical value to them. However,
for the sake of this article they are agrimony, burdock, golden seal,
marijuana, and pokeweed.
VI. Colitis. In the treatment of this, there are six natural
products listed; however, three of them are of historical note only
with no known proven medical value. These three products are catās claw,
ginseng, and yucca. There are, however, three products with limited
merit to them.
(a) Bee pollen is the first product. However, in reading the
monograph on this, Iām not sure how anybody could have come up with
the fact that this had any medical merit at all. There seem to be no
studies at all to back up its use.
(b) Dandelion. Dandelion is the next product, but in reading
the technical literature, it is believed to have a high pectin content
and this could be the only reason I could see where it could be used
as an anti-diarrheal. I believe this is somewhat far fetched.
(c) Witch Hazel. This is the last product in this group but
again, like the others, in reading the technical information available
there seems to be no basis for its use in the treatment of colitis.
VII. Crohnās Disease. In the treatment of Crohnās Disease, only
one product is listed and that is the ever-interesting oil of evening
primrose oil.
(a) Evening primrose oil is a product which has gained a lot
of lay press and has been the subject of a lot of research in recent
years. There are a number of medical conditions for which evening primrose
has been associated with clinical benefits for patients. Linoleic acid
can reduce serum cholesterol, it seems to reduce breast tumor size growth,
it can be used in PMS, and it is definitely useful in treating rheumatoid
arthritis. It has been written up in anecdotal reports of small groups
of patients that it is useful in the treating of ulcerative colitis.
The mechanism by which evening primrose oil is helpful in ulcerative
colitis is due to a high content of gamma-linolenic acid (GLA). Hopefully,
researchers will do further studies on evening primrose oil in the treatment
of ulcerative colitis. Although there are no large scale studies, it
is my opinion the few anecdotal reports are worth pursuing.
VIII. In the treatment if diarrhea, there are a number of products
that are listed out on the market these days. There are a number of
natural products that only have historical indications, but there is
no sound scientific basis for their use. The products are as follows:
alchemilla, aletris, allspice, avocado, bayberry, catās claw, gentian,
labrador tea, linden, mace, sage, schinandra, storax. There are a number
of natural products that have some medical basis in treating diarrhea,
but since a couple of these have already been discussed, I will just
mention them and not fully discuss them again.
(a) Alchemilla. This is also known by its more common name,
lady mantle. This has been indicated for a number of disease states
including muscular spasms of the GI tract. No significant toxicological
studies appear to have been carried on lady mantle, and long use for
various purposes seem to be safe in low doses.
(b) Apple. Apple has been used for a number of years to treat
a variety of problems including dysentery. The therapeutic effectiveness
appears to be related to the fruitās pectin content. Pectin absorbs
water in the GI tract and swells to a gummy mass. As such, it can provide
bulk and moisture to hardened stools or aid in producing formed stools
by adding bulk to the presence of diarrhea.
(c) Bilberry Fruit. This product seems to have more to commend
it for anti-diarrheals than most natural products. The historical use
of the dried bilberry fruit include being supportive treatment for its
use in acute nonspecific diarrhea when administered as a tea. The fresh
fruit does not contain the anti-diarrheal effect and, therefore, must
be dried to obtain the tannins which come from the condensation of monomeric
tannin precursors during the drying process.
(d) Fenugreek. This product has been used in folklore for the
treatment of diarrhea. The only clinical case listed is when a boy was
presented to the emergency room with acute toxicity when his mom had
given him fenugreek tea to treat his diarrhea.
(e) Honey. While listed as having proven clinical values, when
I read through the text, I could not find any particular clinical studies
for the use of honey in the treatment of diarrhea.
(f) Poppy. Already discussed in this earlier.
(g) Savory. Savory is also an old product long used in Europe
to treat a variety of problems including intestinal problems. Summer
savory has been reported to have a spasmolytic effect on the isolated
smooth muscles and may have an anti-diarrheal effect due to the phenolic
components in the oil and the tannins contained in the plant.
(h) Tragacanth. One of the products any good pharmacist fifty
years ago would have certainly had in the easy-to-reach section on the
shelf, but is very rarely used these days except by pharmacists who
still compound. Tragacanth partially dissolves and partially swells
in water yielding a biscus cabid. The maximum viscosity is obtained
only after 24 hours at room temperature. The viscosity of these solutions
is generally considered to be the highest among the plant gums. This
product does an excellent job of absorbing intestinal fluid. Although
gum tragacanth swells to increase stool rate and decrease GI transient
time, it appears to have no effect on things like cholesterol like most
other fibers do.
(i) Witch Hazel. The last product is witch hazel which we have
already discussed.
IX. In the treatment of diverticulitis, there are no known products
with any known therapeutic effect. The only product mentioned in the
U.S. natural products is catās claw which is of historical note which
seems to have no known clinical backup to this.
X. In the treatment of dysentery, the products are listed the same
in the natural products as those that are treated in diarrhea, so I
will not visit this section.
XI. In the treatment of gastritis, there are five products listed but
they are all of historical note with no known clinical trials to back
them up. For the sake of argument, these five historical products are:
catās claw, corn cockle, potato, sage, and St. Johnās wart. In the other
half a dozen or so gastrointestinal ailments listed, there is only one
product listed. This product was proven in clinical reports as chamomile.
This product has already been discussed earlier, and I will not discuss
it again
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