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Using Herbs for Irritable Bowel Syndrome and Diverticulitis.

by
Dr Dilis Clare MBBCh, DRCOG, BSc (Herbal Medicine)

Irritable Bowel Syndrome.

This is a common disorder causing a wide range of uncomfortable digestive symptoms. According to Prof Eamonn Quigley (Professor of Medicine UCC, president of the World Gastroenterology Assoc.) more than 10% of Irish people could be suffering from this disorder. The common symptoms are bloating, wind, crampy tummy pain and either constipation or diarrhoea. Some people alternate between constipation and diarrhoea. It can come and go often depending on dietary factors or stress levels. It is diagnosed by excluding other more serious digestive conditions. If you have significant disturbance it is important to have a medical check up.

Always have investigations for altered bowel habit particularly if you have bleeding or are over 50 and there is no obvious reason for the change.

Diverticulitis

This is a problem of the large bowel which is very common in the over 50’s. Like most conditions it can present with mild problems from time to time or regular disturbance of the digestion.

There are ‘diverticula’ or pouches, little pockets in the bowel wall that can hold onto stale material. This material lodges in the pockets and can become hardened and act as irritants to the remaining bowel wall, they can also become infected and inflamed. When this happens it feels like a ‘flare up’.

Symptoms include pain and discomfort usually in the lower belly on the left hand side as you look down. It can cause loose stools, crampy pain, change in your normal bowel habit and sometimes even bleeding.

If there is infection there may be fever and chills, pain and again change in normal bowel habit. There is often a feeling of being generally unwell, generalised aches and pains.

The problem is associated with not enough fibre in the diet over the years. There is too much tension in the wall of the large bowel leading to pouches being made in the wall of the gut. Rather like an overblown bicycle inner tube pushing through the weakest point in the tyre forming a pouch through the tyre wall.

Always have investigations for altered bowel habit particularly if you have bleeding or are over 50 and there is no obvious reason for the change.

Herbal treatment

You might wonder why the herbal treatment for both these problems are linked and the reason is because both are linked to increased nervous system ‘tone’ in the walls of the gut. The herbs used are antispasmodic herbs that act to calm and relax the muscles in the wall of the gut. Remember the digestive tract is a tube from mouth to bum. The walls are lined with a mucous membrane and the muscles internal to this relax and contract to ease the contents of the tube gradually from top to bottom of the tube. In Irritable Bowel this action is not coordinated very well even though the structures appear normal. In Diverticulosis there is increased tension often following years of not enough fibre in the diet or constipation due to other causes (including stress).

Antispasmodic Herbs

Chamomile

Chamomile is the most familiar of the helpful herbs for stress, and it is hardly surprising that it is relaxing for the digestion. The actions on the digestion are well documented and well researched. It is a wound healing herb with antimicrobial actions. So these combined actions help in a variety of ways to heal an irritable digestion and prevent complication of diverticulosis.

Fennel (Foeniculum vulgare).

This herb is traditionally used for ‘wind’ as it relaxes the stomach and eases crampy pains. It also has anti-inflammatory effects.

Peppermint (Mentha pip.).

Peppermint in addition to its’ antispasmodic effect (which is due to its volatile oil content) it relaxes the stomach allowing the release of trapped wind upwards ‘burping’. Peppermint also has a gentle effect on increasing bile flow which aids the normal breaking down of foods.

Soothing Herbs

Mallow leaf or root (Althea rad/fol).

Mallow is the original plant source for marshmallow (before it was hijacked by sugar). It is amazingly soft and soothing, exactly what is need by an overworking gut. The irritation is lulled into a sense of security, allowing the wall to relax in response to the antispasmodics.

Slippery Elm (Ulmus fulva).

This is a powder which you mix with warm water or food such as porridge, banana or yoghurt to make paste. It is soft and soothing, also it is nourishing for the gut wall and acts like an internal poultice to encourage healing. It is the internal bark of the tree and as such is a very gentle bulking soluble fibre with the added advantage of acting like blotting paper for a watery stool. A veritable multitasker and one of my favourite herbs for digestive problems.

Pain relief

Meadowsweet (Filipendula spirea) contains natural aspirin. The word aspirin comes from this plant. However the anti-inflammatory aspirin part of the plant is not irritatingto the stomach. In fact the overall effect is relaxing to the stomach in particular,

How do you use Herbs?

When herbs are swallowed by mouth they come directly in contact with the walls of the gut tube there is a direct effect on the trouble spots. Because of this they are particularly helpful for digestive conditions.

I find with patients that it is hard to convince them that herbal infusions (teas) are the best medicine because they are (a) too simple and (b) too cheap!

Yet they have the advantage of being sipped intermittently throughout the day giving continual relief. Infusions are ‘medicinal water’ taken hot or cold (not to be confused with your ‘teabreak’ tea which has its own ritual stress ‘let down’.

When you make any digestive tea with a strong aroma (like chamomile, fennel or peppermint) put a saucer on the cup as it brews so that the oils are kept in the tea as these are the most antispasmodic ingredients and you don’t want them to escape!

Herbs can also be taken as tinctures (liquid preparations extracted and preserved in alcohol).

These are a few of the many herbs used for digestive problems, but they address some of the commonest problems. If you have mild to moderate disturbance they may be all you need. If you have prolonged or serious discomfort, or you have tried these simple remedies for at least six weeks it is best to seek expert advice. For a well qualified medical herbalist in your area (BSc Herbal Medicine) contact the Irish Institute of Medical Herbalists www.iimh.org .

All of these herbs work in their own right, they need to be of good quality and loose teas work better than teabags (as a general rule). I have blended herbs together for convenience which may be useful and practical. Alternatively you can buy 50gms of each herbs and blend yourself. Store in a canister or paper or foil bag and use within 6 months.

Digestive Tea Blend- Contains: Chamomile, Fennel , Marshmallow root, Peppermint. Caution: Avoid in pregnancy, and allergy to any of the ingredients.

Digestive Tonic- This is formulated as a Herbal Tincture and contains a small amount of alcohol as preservative. Contains: Chamomile, Fennel, Marshmallow leaf, Peppermint, Meadowsweet. Caution: Avoid in pregnancy and breastfeeding, and with allergy to any ingredients.

You can use either the tea or the tonic. The tonic is more convenient for people on the go, especially those who don’t have a regular routine or those who refuse to contemplate herb teas!

You can also combine both, using the tea regularly but taking the tonic for convenience if away from home or out of routine. If symptoms are particularly bad you can use both together for a couple of weeks but if not settling see a medical or herbal practitioner. If you are stressed you can combine the tea with Valerian Relax Blend. If you are regularly stressed make sure you are including the foods containing Essential Fatty Acids in your diet.

Supplements:

Digestive Enzymes: The body produces its own digestive enzymes which mix with the digestive contents in the small intestine (just after the stomach). However for people with IBS the timing may not be ideal and ‘intestinal hurry’ means the enzymes are too late to mix in with the ‘food’. Think of it as ‘missing the bus’. The digestive enzymes help to break the food into simple ‘building blocks’. Taking digestive enzymes does not correct the problem but it can make you more comfortable in the short term. Also by breaking food down more efficiently it can avoid irritation by larger molecules. Try using them before or with meals according to your level of comfort. For instance you may only need them for large meals, if eating out, particularly rich food or if eating late in the evening.

Probiotics: A whole bookcould be written on this alone! Think of this supplement as good gardening! If you clear a flower bed and leave it, weeds quickly grow. Similarly if you create a healthy space in the gut with healing herbs you want to plant helpful ‘bugs’ that aid digestion. These are probiotics and they help maintain normal digestion. If you have had years of Irritable Bowel and or Diverticulitis I generally suggest taking probiotics for at least three months initially, thereafter take a course for 4-6 weeks three or four times a year for ‘good gardening’ for the gut. Always take Probiotics with and after taking antibiotics. Taking antibiotics has the effect of ‘strip mining’ the normal bowel flora, helpful ‘Flora’ plugs are particularly relevant (take in between doses of antibiotics).

A note on Fibre

Patients are often told to increase fibre for these conditions. They go home and have high fibre breakfast cereal, coarse wholegrain bread and maybe lentil soup. They are doubled over with ‘wind’ and discomfort for a few days. Not only do they lose heart but they are at a loss as to what to do next.

There are soluble and insoluble fibres which have different qualities.

Insoluble fibre: (wholegrains, pulses, nuts and seeds including linseeds/flax seeds and the skins of fruit and vegetables) can act like a scouring brush on the gut wall and the ‘irritable bowel’ and diverticulous gut can go into spasm hence the effect. Sometimes people cannot get healthy amounts of fruit and vegetable because of discomfort, try peeling them and you may do better. As your digestion improves gradually include the skins.

Soluble fibre: What is more respectful is soluble fibre; oats and oatbran, slippery elm and psyllium husks. Oats and slippery elm are also mucilaginous and nourishing, I always like ‘3 for the price of 1’ shopping. Psyllium is the ingredient in Fybogel sachets but you can buy it as just the raw herb without the orange dye and sweetener!.

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