Gastrointestinal disorders include disease along of gastrointestinal tract starting from mouth disorder moving through gastro intestinal tract reaching stomach, intestine, liver, pancreas, perianal tissue ending with hemorrhoids and anal fissures. Gastro intestinal disorder containing condition as constipation, diarrhea, irritable bowel syndrome, perianal abscesses, perianal infection, colitis, anal fistulas, hemorrhoids and anal fissures. Most of gastrointestinal disorders came from defect of enzyme (secreted by stomach, pancreas, and small intestine), lack of mucus that produce by intestinal gland (which lubricate and protect digestive tract), slow of peristalsis (GIT movement) and poor digestive health (result from infection, stress, anxiety and insufficient or excessive digestive secretion). We can used different herbs for management and treatment of gastrointestinal disorders. Herbs derived from Greek word ‘herba’, which mean a non-woody plant. Different parts of plant (fruit, seed, stem, bark, flower, leaf, stigma and root) used as source of medicine and play important role in world health and can be used for treatment of gastrointestinal diseases, especially in developing countries which depend mainly on herbs and medicinal plant. Herbs and medicinal plants have been used by ancient civilization and still used nowadays; about 500 herbs are still employed with in conventional medicine, and many of plants used as starting material for isolation or synthesis of conventional drug, so we can summary that medicinal plants or herbs are plants that commonly used for prophylaxis and treatment of disease. China and some of Asia countries still use herbal medicine for treatment of gastrointestinal diseases. Herbal medicine can be used in gastrointestinal diseases by improving the function of the digestive organ by different ways: acting as stomatic, anti-kinetosis, eupeptic, antacid, laxative, anti-diarrhea, as well as herbal medicine useful in treatment of irritable bowel syndrome.
The purpose of this paper is figure out the different herbs and techniques for management and treatment of gastrointestinal disorders, include disease along of gastrointestinal tract, starting from mouth disorder, moving through gastro intestinal tract, reaching stomach, intestine, liver, pancreas, perianal tissue, ending with hemorrhoids and anal fissures.
Stomatitis, Gingivitis and Glossitis
The mucus secreted by salivary gland in mouth cavity has protective function, so decrease of saliva may lead to infection to mouth as stomatitis, gingivitis or glossitis. Many herbs used as anti-inflammatory for infection and irritation in oral cavity like herbs that containing essential oil, tannins and high content of mucilage on the example of herbs: marshmallow, propolis, myrrh, aloe, chamomile, echinacea, marigold, sage and arnica. Marshmallow contain mucilage starch and pectin which used as anti-inflammatory and demulcent. Propolis, which resinous dark material collected by honey bees from buds of certain plants mixed with bee wax and salivary secretion, used as anti-inflammatory, anti-fungal, anti-viral, anti-bacterial and promote local leukocytes. Myrrh consists of ole gum resin, contains of volatile oil, sesquiterpenes, gum and resin; used as astringent, anti-bacterial, anti-inflammatory and promote leukocytes. Aloe gel, a gelatinous material, contains mucilage and anthraquinones; used as anti-inflammatory, immunomodulation and anti-bacterial. Chamomile contains flavonoid, mucilage and volatile oil used mainly as anti-inflammatory. Echinacea contains polysaccharide, flavonoid and caffeic acid derivatives; used mainly as immune-enhancing and anti-inflammatory. Marigold contains alcohol flavonoid and volatile oil used as anti-septic and anti-inflammatory. Sage contains volatile oil and caffeic acid derivatives used as anti-inflammatory. Arnica contains sesquiterpene lactone and volatile oil and used as anti-inflammatory.
Dyspepsia
Dyspepsia is a syndrome with unknown cause characteristic with nausea, bloating, cramp pain and epigastric pressure. Many herbs used for management of dyspepsia as herbs contain better substance (e.g., quassia, gentian and bitter orange peel), carminatives (e.g., caraway, fennel and anise) and other herbs (e.g., capsicum). Bitter herbs help with gastric juice secretion and facilitate digestion by induce secretion of gastrin (a hormone that stimulate HCL secretion) and facilitate saliva secretion for 20-30 minute, so it’s better to take before meal. Carminative works by prevent the formation or cause the expulsion of gas in the alimentary tract, the example of carminative are peppermint, fennel, anise, and caraway. Peppermint is the most reachable of carminatives. Clinical trials show peppermint improves symptoms in patients suffering from irritable bowel syndrome, dyspepsia, and relieves abdominal pain, peppermint contain menthol (volatile oil), which reduce intragastric pressure and proximal phase contractility. Caraway containing carvone (volatile oil) which can be used alone or synergic with peppermint used for dyspeptic complaints. Anise and fennel both contain volatile oil (anethole and fenchone), which used with dyspeptic complaints. The other plant used for dyspepsia is capsicum which contain capsaicin (pungent alkaloid), alkaloid and volatile oil, capsicum inhibit the activity of sensory fibers desensitization which result in attenuation of sensitivity to pain.
Flatulence
The feeling of abdominal fullness of gas in the stomach or in the intestine (from swallowed air and normal break down of ingested food containing sugar, starches and fiber). Approximately 15-23% of Asians and 15-30% of Americans suffer from flatulence. Flatulence treated with changing of diet, decrease the amount of swallowed air, taking digestive enzyme or herbal treatment like carminatives (anise, fennel, caraway and peppermint).
Gastritis and Peptic Ulcer
Gastritis is an inflammation of mucosal lining the stomach, while peptic ulcer is a discrete mucosal damage of stomach and duodenum. The gastritis can be treated by atropine and scopolamine alkaloids, which inhibit gastric acid secretion (little used now due to undesirable side effect). Peptic ulcer treated by alternative mucilaginous plants like chamomile, gum, and liquorice. Liquorice can be used for gastritis as anti-inflammatory and for ulcer as plant with mucilage to protect gastric wall.
Motion Sickness
Nausea and vomiting when traveling can be treated by scopolamine (not preferable used due to side effect), anti-histamine and ginger, which act as anti-emetic agent.
Constipation
Constipation is delayed transit of less than usual volume feces or straining at time of bowel movement with expulsion of stool with a hard consistency. Treatment of constipation by herbs can be done with least side effect and can be used chronic constipation with modulation of patient diet. The herbs work at different ways as improve liver function, which is done by choleretic and cholagogue herbs, increase stool bulk, which is done by psyllium and ulmus, improve motor function by chamomile and menthol, improve gastrointestinal lubrication as linseed, and laxatives, which induce and facilitate defecation such as bulk laxative (bran, psyllium and agar), stimulant laxative (anthraquinone, like in senna and cascara) and sugar containing herbs (cassia, tamarind and plum).
Diarrhea
Diarrhea is frequent liquid or semi-liquid fecal emission, diarrhea could be treated by herbal containing tannins with caution because over dose will be irritant to gastric wall and chronic misused is danger, as it can inhibit digestive enzyme, inhibit absorption of metals and the react with thiamin, decreasing their absorption, the example of tannins are green tea, black tea, oka, black berry, agrimony and oolong tea.
Irritable Bowel Syndrome
IBS is condition in which the patient have episodes of constipation and diarrhea with abdominal pain. The cause is may due to stress or genetic. The management of disorder can be done by administration of herbs of constipation and diarrhea, but the herb of choice is peppermint, which containing menthol (volatile oil) with Ca channel blocking properties). The mechanism of action is the anti-spasmodic action decrease the pain. It decreases Ca influx into muscle cells leading to relaxation of GIT smooth muscle.
Hemorrhoids
General treatment of hemorrhoids is achieved by eating more fiber, mucilage containing herb (psyllium and ulmus), treatment of constipation, oral treatment using herbs to improve venous connective tissue tone (aesculus and ruscus), reduce tissue congestion by flavonoids (crategus and melilotus) and topical astringent and anti-inflammatory herbs (hamamelis and calendula).
Liver Disorder
The acute infection of hepatitis (A) treatment can lead to rapid recovery and protect against post hepatitis syndrome, in case of hepatitis (B & C) herbal treatment will prevent disease to became chronic. Diaphoretics are indicated in all acute infection hepatitis (A, B & C), for example, tilia and achillea best taken as infusion. Diaphoretics are usually taken with ginger. There are other plants taken as anti-viral agent (e.g., hypericum), immune-enhancing herbs (e.g., echinacea and picrorrhiza) and hepatoprotective agent which decrease liver damage (e.g., silybium, dandelion root, picrorrhiza and Cynara ‘artichoke’). Cynara ‘artichoke’ is drug of choice because it contains flavonoid, cynaropicrin (bitter sesquiterpene lactone), and cynarin (caffeic acid derivatives), used for treatment of liver and gall bladder complains, has an anti-hepatotoxic effect and it can also be used as anti-diabetic, anti-lipidemic and cholagogue activity (indigestion and dyspepsia). The chronic viral hepatitis usually results from infection of hepatitis (B or C). The treatment is similar to acute infection, as we use immune enhancing agent (e.g., echinacea, picrorrhiza and astraglus), anti-viral agent (e.g., hypericum and thuja) and hepatoprotective agent (e.g., silybum and schisandra). Schisandra used in traditional chines medicine to treat chronic persistent hepatitis.
Conclusion
Gastrointestinal disorders, including mouth, stomach, intestine and liver disorder, can be treated by herbal plants. Herbal plants are effective with low side effect, used safely by elder people with chronic condition. Traditional Chinese medicine using different herbs and techniques for management of gastrointestinal disorders.
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