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Botanical Supplement Support for the Digestive System

Nature offers many compounds that may be beneficial for alleviating digestive disorders such as IBS, IBD, cancer, ulcers, acid reflux and others. A few of the more widely studied and successfully used natural supplements include: DGL, boswellia, mastica, curcumin, and fiber.

DGL (De-glycyrrhizinated licorice)

Traditionally, licorice has been used throughout history by many cultures for various diseases. It is a key component in syrups and herbal teas and is useful for treating cough and cold symptoms, as well as for a host of gastric issues, the latter due mainly for its demulcent or soothing properties. Unfortunately, while being highly effective as an anti-viral, anti-inflammatory and immune modulator, licorice does have a shortcoming. One of its components, glycyrrhizin, causes sodium retention and thus raises blood pressure. Glycyrrhizin limits the use of licorice as a natural treatment for gastrointestinal symptoms such as heartburn, healing ulcers and pain relief.Over fifty years ago a new form of licorice lacking glycyrrhizin called deglycyrrhized licorice (DGL) was introduced; it showed that the healing powers of licorice were still retained without the side effects of high blood pressure. DGL is thought to work by several mechanisms, firstly by directly inhibiting the bacteria Helicobacter pylori(H. pylori), the bacteria now strongly linked to causing peptic ulcers and stomach cancer. It is thought that DGL directly kills the H pylori.1 Second, DGL assists the healing of the lining of the stomach wall. It does this by increasing the mucus secretion which protects the stomach cells from attack by the acid present in the stomach, as well as by improving blood flow and quicker delivery of nutrients to the cells so as to speed up the healing process. Studies have shown that when DGL is taken along with aspirin there is a significant reduction in stomach bleeding.2Unfortunately, there have been no studies in the last three decades; one of the last studies did show that when DGL was taken together with ranitidine, a standard prescription at the time for treatment of ulcers, the rate of remission was increased.3 Interestingly, DGL was effective in both stomach and duodenal ulcers.2

Boswellia

Boswellia is a herb that has a long and established use in various traditional medicines. The Boswellia plant exudes a gummy like resin that is collected and used in various formulations. It is useful for the treatment of nervous disorders including depression and anxiety, for boosting the immune system, for topical use of wound healing and as an anti-bacterial and anti-fungal. Boswellia is probably best known for its anti-inflammatory activity and its use in a variety of conditions including osteoarthritis, rheumatoid arthritis and other autoimmune disorders. Not surprisingly, Boswellia’s use in digestive health has been a focal point of research for many years. Inflammatory conditions including IBS and IBD (Crohn’s and ulcerative colitis) have shown significant improvements following Boswellia consumption.4 Animal studies have shown that Boswellia reduces the gastric irritation and the subsequent erosion of the gastric lining caused by non-steroidal anti-inflammatory drugs (NSAID’s) like indomethacin and phenylbutazone.5 The result is that there is significantly less bloodloss as detected in the feces, all the more reason to take Boswellia along with any NSAID therapy. Researchers have shown that Boswellia has a protective effect in mice when they are treated with a chemical called dextran sodium sulfate (DSS) that is used for an animal model for IBD that induces damage to the mucosal lining of the gut.6 Boswellia prevents much of the damage as shown in the histology of the mice gut. The active constituent(s) in Boswellia remain the subject of heated debate. Initially, some researchers viewed boswellic acids (a mixture of eight or so different compounds) to be the active component. However, others thought that specific boswellic acid fractions like acetyl-beta-boswellic acid (AKBA) were the most powerful fraction. Still, others regard an entirely different component called incensole acetate to be the key molecule. Whichever molecule turns out to be active, it is likely the synergy between all these components that is the most important factor.

The mechanism of action of Boswellia’s biological effects is via multiple pathways typical of the action of many natural ingredients and includes the following: first, the inhibition of NF-ƙB, a key factor involved in copying the portion of DNA involved in inflammation.7 If the copying of the DNA portion involved with inflammation is inhibited, then inflammation will also be slowed or stopped. Second, Boswellia has a powerful immune stimulating effect locally in the gut. Since the gut is the recipient of all sorts of orally consumed foods, pharmaceutical drugs, toxins like alcohol, carcinogens etc., the body is designed to be able to deal with these unwanted and dangerous intruders immediately, by positioning a portion of the immune system right within the gut. Third, Boswellia has antimicrobial activity against bacteria like Staphylococcus which is responsible for food poisoning, and Candida albicanswhich causes yeast infections.8


Mastic Gum Tree

Mastica (Mastic Gum)

Mastic gum is extracted from the resin of a plant that grows almost exclusively on the Greek island of Chios. It has been traditionally used as a food additive, as an antioxidant to keep foods fresh, and as a gum in combatting various diseases including high cholesterol, weight loss, tooth and gum decay, halitosis and for heartburn and stomach ulcers.

There are currently over seventy known components in mastic gum and no one molecule is considered active on its own, hence there is no standardization for the raw material. A 2010 study from Greece looked at 52 patients divided into four groups.9Two groups were given a 350mg dose of mastica three times a day, and one was untreated; a fourth group was given conventional antibiotic and prescription therapy for H. pylori. H. pylori is an invasive bacterium that burrows into the stomach lining and is a common cause of stomach ulcers. Five out of the 13 people in the mastica group recovered completely, compared with zero in the untreated group. However, the antibiotic/prescription therapy resulted in complete improvement in 10 out of 13 patients.A 2009 study utilizing the standard animal model of IBD using the DSS in mice, once again confirmed the activity of mastica in relieving the symptoms of IBD.10

Curcumin

Curcumin is by far the most dominant of the three biologically active components present in the spice turmeric collectively called curcuminoids, the other two being demethoxy and bisdemethoxy curcumin. Curcumin has traditionally been used in the Indian subcontinent for gastric health, treating periodontal disease, ulcers of the mouth, duodenal and peptic ulcers, various protozoal diseases from amebiasis to dysentery, various inflammatory conditions and much more. Curcumin is probably the most well researched natural product on the market, and its biological effects on the gut are well documented. Typically, turmeric spice has been added to hot milk and taken orally in copious amounts. There is a reason why curcumin is given in this manner: this is due to the poor bioavailability of the curcumin or the amount that reaches the active site, in this case the gastrointestinal tract. Hot milk improves the delivery of the curcumin molecule, and researchers attribute this increased activity to the various milk proteins and peptides that form a “coating” or miscelle-like structures that are quickly taken up into the blood.Test tube studies, animal studies, and human clinical studies have shown the following: first, curcumin is poorly absorbed due to its rapid elimination from the body, and hence the need for more bioavailable forms. Second, doses of up to 8000 mg of curucmin per day are safe.11 Third, curcumin has been used in conjunction with other therapies especially in the treatment of various forms of cancer such as pancreatic, stomach, colon and oral cancers in conjunction with chemotherapy and radiation.12 Fourth, curcumin works through multiple pathways rather than exhibiting one specific mechanism which is typical of many pharmaceuticals.Colon cancer is the third leading cause of death in North America. The incidence varies over 20 fold, from the highest in North America to the lowest in India. Population studies suggest that the regular intake of foods such as turmeric may partly be responsible for the lower rates.13 Since curcumin works through more than one pathway, it offers an alternative and an attractive approach to combatting colon cancer.Numerous human studies have shown that curcumin is a good candidate for various forms of cancer as well as inflammatory conditions like BD, but studies require larger numbers of subjects to be able to draw any meaningful significance. An exciting area of research is the development of more bioavailable curcumin products. One approach has been to use piperine (from black pepper) as an adjunct, since it prevents curcumin elimination by “knocking out” the phase II enzymes that the body uses as a detoxification system to protect itself. However, this may not be safe in that if the phase II enzymes are inactivated, this may allow entry of other toxins and carcinogens along with the curcumin.Alternative and better delivery systems have been developed; one such system is the solid lipid nanoparticle (SLP) developed using natural technology and patented by the researchers at University of California at Los Angeles (UCLA) under the trade name Longvida®. Longvida® is the most bioavailable curcumin ingredient on the market, and has been shown in clinical study to be over 100 times more bioavailable than regular curcumin. In addition, unlike many of the other products on the market claiming higher bioavailabilities, Longvida® compares the blood levels of free curcumin rather than some other detoxified compound that other companies measure. Longvida® curcumin products provide a truly enhanced delivery system.

Fiber

We all know that fiber is good for us, yet the subject is never a part of any polite conversation. All too often fiber is still being thought of as a laxative, yet fiber offers so much more than just being an excellent laxative. Its health benefits go way beyond digestive health. Fiber is a remarkable nutrient that has wide ranging physiological and health benefits including heart health, cholesterol control, glycemic control, insulin response and sensitivity, gut health, satiety, immune enhancement, and as a particularly strong preventative of colon cancer. Indeed, fiber could possibly be one of the most important arsenals in every household to ward off a host of diseases. In fact, the clinical evidence on fiber is more robust than many other nutritional intervention molecules such as vitamins, minerals and many herbs.The Institute of Medicine (IOM) recommends that a daily intake of fiber should be 38g for males, and 25g for females, women requiring more during pregnancy and nursing. However, the average North American adult consumes around half that figure, despite the heavy promotion of the health benefits by the government. Over 90% of North American adults view digestive health as a top priority, yet less than half think that they need more fiber in their diets. Clearly greater education on the role of fiber is required for consumer awareness.


Figure 1. H. pylori Burrowing Into Stomach Lining

What is Fiber?

Dietary fiber is the indigestible portion of the plant which usually requires much more chewing, hence the synonymous word “roughage”. Fiber is abundant in various fruits and vegetables and is commonly found in roots, stems and nuts. Fiber types range from cellulose, the main component of the vegetable kingdom to pectin found in apples and grapefruit, to beta-glucan derived from oats and yeast.Fiber is a collective term used to describe a large and diverse variety of plant constituents that are resistant to breakdown by gastrointestinal enzymes in the small intestines, but which undergo fermentation in the large intestines. Dietary fiber is classified as water soluble or water insoluble, though plants usually contain some combination of the two.Water insoluble fibers are chiefly derived from cellulose and are abundant in vegetables and cereal grains like wheat and corn. Water insoluble fibers easily absorb water and help to regulate bowel movement by increasing bulk, softening stools, and quickening the time of passage through the intestinal tract.Soluble fibers are generally gel forming, highly viscous, and include pectins, mucilage and various gums like guar and xanthan. Dried beans, oats, and barley are major sources of this type of fiber. The soluble fibers are carried to the large intestines where they are broken down by the gut bacteria to release various beneficial components.

SoluFibre – A Clear Solution to Your Daily Fiber Needs.

Recently, the Japanese company Taiyo has taken the large molecules of guar gum and broken them down to much smaller units that become completely soluble in water and other beverages within two to three minutes. This process leaves an odourless, taste-free and clear solution. The product is called SoluFibre; it has distinct advantages over other fibers that don’t dissolve and often have a distinctive taste. The complete solubility of SoluFibre makes the product very user friendly

What Are the Benefits of SoluFibre?

1. Production of short chain fatty acids (SCFA) – Fiber is not digested in the small intestines, but once in the colon it is broken down by the specific bacteria residing there. Various by-products are produced, such as SCFA’s including butyrate, as well as other compounds. Butyrate is an energy source for the colon cells. In addition, SCFA’s regulate the pH thus making the environment inhospitable to various pathogens.

2. Promoting weight loss – Fiber provides few calories, but it does give one the feeling of fullness or satiety unlike many processed foods which are energy dense (lots of calories) yet provide little or no feeling of satiety. Some studies show that fiber significantly reduces body fat in animals and humans, while others report no weight loss effect. Women consuming at least one serving of whole grain had a significantly lower mean body mass index (BMI) and waist circumference than women not taking the whole grain.

3. Nutrient absorption – Fiber also enhances mineral absorption of calcium, magnesium, zinc and so on. This effect is particularly useful for pre-teens as well as postmenopausal women.

4. Prebiotic effect – The breakdown product of fiber which occurs via fermentation in the large intestines generates many by-products. The metabolites provide food and nourishment for the friendly bacteria which colonize there. This is called the prebiotic effect. Support and well-being for these bacteria is critical, as these bacteria have an important role to play in various biological pathways such as immune stimulation, nutrient breakdown, synthesizing vitamins, and in preventing the colonizing of unfriendly bacteria.

5. Improves digestive health – Besides alleviating constipation, a high fiber diet may prevent stress induced diarrhea by preventing the release of various hormones produced by the body which normally quicken the passage of food through the small intestines which results in diarrhea.6. Fiber and Inflammation – Recent studies show significant reductions in inflammation in subjects consuming high fiber diets. Reduction of inflammatory markers, especially C-Reactive Protein (CRP), has been frequently reported. One of these mechanisms might be the generation of butyrate which is particularly anti-inflammatory.

References

1. Larkworthy W, Holgate PF, McIllmurray MB, et al. Deglycyrrhizinated liqourice duodenal ulcer. Br Med J 1977; 6095: 1123-1126

2. van Marle J, Aarsen PN, Lind A et al. Deglycyrrhizinated liquorice (DGL) and the renewal of stomach epithelium. Eur J Pharmacol 1981; 72: 219-225

3. Morgan AG, Pacsoo C, Taylor P, et al. Does Caved S decrease the gastric ulcer relapse rate during maintenance treatment with ranitidine? Aliment Pharmacol Ther. 1897; 1: 633-638

4. Anthoni C, Laukoetter MG, Rijcken E et al. Mechanisms underlying the anti-inflammatory effects of boswellic acids in experimental colitis. Am J Physiol Gastrointest Liver Physiol. 2006; 290: G1131-G1137

5. Gupta I, Parihar A, Malhotra P, et al. Effects of gum resin of boswellia serrate in patients with choronic colitis. Planta Med. 2001; 67: 391-395

6. Moussaief A and Mechoulam R. Boswellia resin: from religious ceremonies to medical uses; a review of in-vitro, in-vivo and clinical trials. J of Pharmacy and Pharmacology 2009; 61: 1281-1293

7. . Poeckel D, Werz O. Boswellic acids: biological actions and molecular targets. Curr Med Chem. 2006; 13: 3359-3369

8. . Moussaieff A, Shohami E, Kashman Y et al. Incensole acetate; a novel anti-inflammatory compound isolated from Boswellia resin, inhibits nuclear factor kappa B activation. Mol Pharmacol. 2007; 72: 267-273

9. Dabos KJ, Sfika E, Vlatta LJ et al. The effect of mastic gum on Helicobacter pylori: a randomized pilot study. Phytomedicine. 2010; 17: 296-299

10. Paraschos S, Mitakou S, Skaltsounis AL et al. Chios gum mastic: A review of its biological activities. Curr Med Chem. 2010: 19: 2292-2302

11. Cheng AL, Hsu CH, Lin JK. Phase I clinical trial of curcumin, a chemopreventive agent, in patients with high risk or pre-malignant lesions. Anticancer Res 2001; 21: 2895-2900

12. Rao CV, Rivenson A, Simi B et al. Chemoprevention of colon carcinogenesis by dietary curcumin, a naturally occurring plant phenolic compound. Cancer Res 1995; 55: 259-266

13. . Sharma RA, McLelland HR, Hill KA et al. Pharmacodynamic and pharmacokinetic study of oral curcumin in patients with colorectal cancer. Clin Cancer Res 2001; 7: 1894-1900Additional References:Pylkas AM, Juneja LR, Slavin JL et al “Comparison of different fibers for in-vitro production of short chain fatty acids by intestinal microflora” J of Med Foods 2005; 8: 113-116Topping D L and Clifton P M “Short chian fatty acids and human colonic function: Roles of resistant starch and non starch polysaccharides” Physiol Rev 2001: 81: 1031-1064King DE, Egan BM, Woolson RF, et al. Effectof a high fiber diet vs. a fiber supplemented diet on C-reactive protein level. Arch Intern Med. 2007; 167: 502-506Huang MT, Lou YR, Ma W, et-al. Inhibitory effects of dietary curcumin on forestomach, duodenal, and colon cancer in mice. Cancer Res 1994; 54: 5841-5847Ammon HP. Boswellic acids in chronic inflammation. Planta Med. 2006; 12: 1100-1116Asl MN and Hosseinzadeh H. Review of pharmacological effects of Glycyrrhizia sp. And its bioactive components. Phytother Res. 2008; 6: 709-724Huwez FU, Thirlwell D, Cockayne A, et al. Mastic gum kills Helicobacter pylori. N Engl J Med. 1998; 339: 1946-1948Hyun-Jo Kim and Neophytou C. Natural anti-inflammatory compounds for the management and adjuvant therapy of Inflammatory Bowel Disease and its drug delivery system. Arch Pharm Res. 2009, 22: 997-1004Triantafyllou A, Chaviaras N, Sergentanis TN et al. Chios mastic gum modulates serum biochemical parameters in a human population. J Ethanopharmacol. 2007: 111: 43-49

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