Common Presentation Symptoms

Abdominal bloating and gas after meals, abdominal cramps, abdominal pain - may be chronic, gas - increased intestinal, heartburn, hunger pains - constant, Inconsistent bowel movements, diarrhoea - may be chronic, soft, foul-smelling stools that stick to the bowl, loose stools - chronic, mucus in stools, anal irritation, constipation, constipation or diarrhoea shortly after meals, depleted appetite, depression, excessive flatulence, fatigue - megaloblastic anaemia due to vitamin B12 malabsorption, fevers of unknown origin, malnutrition, nutritional deficiency despite taking supplements, pain, weight loss*

Gut Microbiota in Inflammatory Bowel Disease

Shim JO. Paediatric Gastroenterology, Hepatology & Nutrition 2013 March 16(1): 17-21 http://dx.doi.org/10.5223/pghn.2013.16.1.17

Different genetic, immunologic, and environmental factors are implicated in the pathogenesis of inflammatory bowel disease (IBD). Recent views have suggested that patients with IBD may exhibit an excessive response to components of the gut microbiota. The gut mucosal barrier plays an important role in maintaining a delicate immune homeostasis. An inadequate immune response or overreaction of the immune system against food antigens (Ag) or components of the commensal flora can be a threat to this homeostasis. The human gut contains as many as 1014 individual bacteria, comprising more than 1,000 different species. The most abundant bacteria phyla found in the large intestine of healthy adults are gram-negative Bacteroidetes and gram positive Firmicutes (Seo, 2011). The intestinal microbiota is considered to act as a “metabolic organ”, by deriving energy from nutrients that escape digestion in the upper gut. Moreover, the microbiota is considered to exert a barrier effect against pathogens in the intestinal mucosa. Germ-free animals do not develop enterocolitis when raised under germ-free conditions. However, when the animals are exposed to microbiota, mild to severe enterocolitis develops (Taurog et al., 1994). These results indicate the importance of gut microbiota in the pathogenesis of IBD.*

Both quantitative and qualitative changes in the microbial composition have been reported in IBD. Previous studies have shown decreased diversity and an increased intestinal mucosal-adhesive microbes (Abraham & Medzhitov. 2011, Aldhous. 2012, Thomazini et al., 2011). Manichanh et al. 2006 performed 16S ribosomal ribonucleic acid (rRNA) metagenome analysis of microbiota in faeces of patients with Crohn’s disease. They noted that the most abundant bacteria were Firmicutes and Bacteroidetes; however, the number of ribotypes of Firmicutes was decreased to 13, compared with 43 ribotypes in healthy adult-control individuals. In particular, diversity in Clostridium leptum was decreased predominantly. Seksik et al. 2003 examined intestinal microbiota in IBD according to the disease activity. They reported decreased diversity of Bacteroides in active state Crohn’s disease compared with those in remission state disease and in healthy individuals. A pyrosequencing study in twins has shown that intestinal microbial profiles vary with IBD phenotypes (Manichanh et al., 2006). They reported increased diversity of Firmicutes in patients with colonic Crohn’s disease, and decreased diversity in patients with ileal Crohn’s disease. Decreased diversity of bifidobacteria and lactobacilli in the faeces of patients with IBD has been reported in some studies (Seksik et al., 2003, Willing et al., 2010).*

Dysbiosis is an important immunologic pathogenic process in IBD. Changes of intestinal microbiota through genetics and environment (such as diet, infections or anti).*

Bao Ji Jia Jian

Bao Ji Wan (Po Chai Pills): induces diaphoresis and removes dampness to restore normal functioning of the stomach. The herbal formula is used for gastrointestinal cold, fever and headache, nausea and vomiting, enterogastric upset, abdominal pain and diarrhoea, poor appetite and anorexia, thin and greasy fur of the tongue.*

The invention provides methods for treating medical conditions caused by abnormal chloride ion flux with compositions containing active ingredients isolated from the traditional Chinese medicine Bao-Ji-Wan (BJW). The compositions comprise any one, two, or three of the following: magnolol, honokiol, imperatorin, isoimperatorin or only magnolol, honokiol, imperatorin, isoimperatorin and a physiologically acceptable carrier. In preferred embodiments, the medical conditions include disorders of the gastrointestinal tract, such as diarrhoea and constipation.*

Gou Teng/Uncaria Cumcis

Effects on smooth muscle

Gou Teng decoction at the dosage of 17mg/kg could lower the tension of isolated ileum muscle within a short period, but meanwhile, it could significantly increase the contraction range.*

Ye Ju Hua/ Flos Chrysanthemi indici

Chronic ulcerative colitis

Ye Ju Ku Shen Tang was used for retention enema in the treatment of chronic ulcerative colitis. Formula: ye ju hua 30g, hai er cha 10g, ku shen 20g, shi liu pi 15g, chun gen bai pi 20g, shan zha 20g, made into 150ml water decoction, once daily, 20 days as a course of treatment. The total effective rate was 96.19%.*

Zhi Ke/Fructus Citri aurantii amarae

Effects on gastrointestinal smooth muscles

Decoction of zhi ke could excite gastrointestinal smooth muscles, the contraction frequency of gastrointestinal movement increased.*

Tian Hua Fen/Trichosanthes

Habitual constipation

Tong Jing San: tian hua fen, dang gui, xuan shen, 15g; lai fu zi 30g. The formula was made into powder and the dosage was 6g, tid, 10 days as a course of treatment. The method was used to treat 96 cases of habitual constipation, 86 were cured, 7 effective and 3 ineffective.*

Bai Zhi/Angelica Daihurica

Anti-gastric ulcer action

The furanocoumarins have an anti-gastric ulcer action. Experiments with rats showed that bergapten and pimpinellin afforded reasonable protection against experimental gastric ulcer (Khadzhai et al., 1965). Breast cancer in rats caused by chemicals was apparently inhibited by scopoletin(Wattenberg et al., 1979).*

Huo Xiang/Agastache

Effects on digestive system

Huo Xiang could promote the secretions of gastric juice and increase the digestive function. It could also inhibit the spasm of gastrointestinal tract smooth muscles.*

Infantile diarrhoea

Huo Ma Ping Wei Tang (huo xiang, cang zhu, 6g each; ye ma cao 15g; che qian zi 9g; hou po, chen pi 4.5g; fen gan cao 3g; sheng jiang 3 pieces, da zao 5~7 pieces) was used to treat 112 cases of infantile diarrhoea and all were cured.*

Yi Yi Ren/Coix

Effects on intestines

Coix seed oil showed exciting effect on isolated rabbit intestines at low dosages, but showed inhibitory effect at high dosages.*

Bai Ji Li/Tribuli

Infantile autumn diarrhoea

30~40g ci ji li for children under 2 years old and 40~60g ci ji li for children over 2 years old was decocted to 500ml juice which was used to wash the limbs below knees. Rub and knead the soles, insteps and calves during the washing. 15~20 minutes every time, once in the morning and once in the evening. 30 cases were treated, the time for fever allaying was 2.31¡À0.85 days, for diarrhoea checking was 3.11¡À0.51 days, for abdominal distension relieving was 3.51¡À0.89 days.*

Bo He/Mentha

Effects on digestive system

Peppermint oil could inhibit the contraction of intestinal smooth muscle. It could also strengthen gastric functions. Azulene obtained from peppermint oil distilling had therapeutic effect on experimental gastric ulcer in rats.*

Gastritis and ulcer

The basic formula consisting of bo he geng, pei lan geng, 15g each; jiu xiang chong, chao zhi ke, 10g each; wa leng ke 20g; bai dou kou 4~12g was used to treat 210 cases of gastritis, gastric and duodenal ulcer, 1 dose every day. Results: 160 cases were markedly effective, 40 effective and 10 ineffective, the total effective rate was 95.2%.*

Hou Po Hua/Magnolia Flower

Pungent to the taste, warm in nature, and distributes to the Lung and Stomach Channels. It is indicated in sinusitis and headache, accompanied with obstruction of the nose, purulent nasal discharge, loss of smelling; usually it is regarded as a medicine especially for the treatment of sinusitis. For the treatment of nose sinusitis due to invasion by wind-cold, it may be combined with Radix Angelicae Dahuricae, Herba Asari, etc, for that due to wind-heat, it may be combined with Herba Menthae, Radix Scutellariae, and etc. Stimulates Gastrin production.*

Cang Zhu/Atractylodes

Anti-ulcerative effect

Cang Zhu had significant preventing effect on mucus membrane ulcer induced by pylorus ligation, aspirin and overmuch gastric acid.*

Bacillary dysentery

chao cang zhu 90g; zhi da huang, zhi cao wu, chao xing ren and chuan qiang huo 30g were grounded into fine powder, 1,5g bid. The method was used to treat 96 cases of bacillary dysentery. Results: 62 cases were cured, 28 improved and 6 ineffective.*

Infantile diarrhoea

20 cases of infantile diarrhoea were treated with powder of chao cang zhu, jiao shan zha, che qian zi, 5 shares and ying su ke 25 shares. All cases were cured after 2 days' administration.*

Ge Gen/Radix Puerariae

Fungal enteritis

The main formula consisting of ge gen, wu mei, he ye, chuan huang lian, jin yin hua, bian dou yi, shi liu pi and sheng gan cao was made into 1:1 concentrated medical juice. Children were treated at the dosage of 5ml/kg, in three times. 40 cases of fungal enteritis were treated, and all were cured.*

Huang Lian/Rhizoma Coptis

Effects on the smooth muscle

Intravenous injection of berberine to small dogs could excite gastrointestinal smooth muscles.*

Bacillary dysentery

The therapeutic effect of huang lian on bacillary dysentery was quite certain. Usually it could be cured within 5~7 days. The oral dosage: small dosage was 2~3g, large dosage was 8~12g, averagely 6g daily.*

Chronic atrophic gastritis

Supplemented Huang Lian Tang (huang lian 9g, zhi gan cao 6g, gan jiang 9g, gui zhi 9g, dang shen 10g, ban xia 12g, da zao 12 pieces, chai hu 18g, san leng 15g), 1 dose daily. The formula was used to treat 98 cases of chronic atrophic gastritis, and 16 were clinically cured, the total effective rate was 98.97%.*

Peptic ulcer

Berberine 0.4g, qid, 4~6 weeks as a course of treatment. The method was used to treat peptic ulcer and the curative rate was 70%. During the treatment, only mild constipation and bitter taste were reported in very few patients.*

Mu Xiang/Radix Saussureae lappae

Effects on digestive system

Decoction of mu xiang could decrease the gastric emptying time from 142.4¡À5.6 minutes to 83¡À14.8 minutes. The plasma gastrin was significantly increased 30 minutes after administration of mu xiang decoction. These indicated that mu xiang had gastric emptying improving effect. Decoction of mu xiang could increase intestinal peristalsis in vivo of rabbits, the contraction range and frequency of intestinal muscle increased too. Volatile oil had inhibitory effect on isolated intestines of rabbit, it could decrease the frequency and range, and the contraction became irregular too.*

Flexure syndrome

Xing Qi Zheng Chang Tang: mu xiang, hou po, da fu pi, bing lang pian, lai fu zi, zhi ke, 30g each; cheng xiang 15g. 1 dose every day, 2 weeks as a course of treatment. 200 cases were treated for 2 courses, 145 were cured, 52 improved and 3 ineffective.*

Adhesive ileus

Mu xiang, zhi ke, chi shao, yuan hu, chuan lian zi, yu li ren, sheng da huang (decocted later), mang xiao 5g each; hou po, huang bo, chao lai fu zi, gan cao 3g each; dang gui 6g; gua lou 10g. 1 dose every day, administrated through stomach tube. 33 cases were treated, and 30 were cured.*

Pu Tao Zi/Grapefruit Seed

Influence of plant-originated gastroprotective and anti-ulcer substances on gastric mucosal repair.

Zayachkivska OS, Konturek SJ, Drozdowicz D, Brzozowski T, Gzhegotsky MR. Fiziol Zh. 2004;50(6):118-27.

Fundamental basis of cellular and molecular mechanisms involved in mucosal injury and repair in gastrointestinal tract helps to develop new therapeutic approaches to various gut mucosal injury- related diseases. The study was aimed to assess the relations between plant-originated substances and their bioactivity measured in terms of antioxidant, cytoprotective and anti-ulceric activities and to determinate if these effects are capable of affecting the gastric mucosal lesions induced by absolute ethanol applied intra-gastrically. The following plant-originated substances were considered: Solon, capsaicin, grapefruit-seed extract and amaranth. The area of gastric mucosa lesions and gastric blood flow were measured in rats with ethanol-induced lesions without (control) and with one of the tested substances without and with capsaicin denervation of afferent nerves or administration of L-nitro-arginine (L-NNA), an inhibitor of nitric oxide synthase (NOS).*

MATERIAL/METHODS: male Wistar rats, weighing 180-220 g fasted for 24 h before the study, 100% ethanol was applied in to induce gastric lesions, whose area was determined by planimetry. Gastric blood flow was assessed using electrolytic regional blood flow meter.*

RESULTS: All tested plant-originated substances afforded gastro protection against ethanol-induced damage and this was accompanied by an increase in gastric microcirculation, both changes being reversed by pretreatment with neurotoxic dose of capsaicin or by pretreatment-with L-NNA.*

CONCLUSIONS: Plant-originated substances are highly gastro-protective probably due to enhancement of the expression of NOS I, NO release and an increase in gastric microcirculation.*

Grapefruit-seed extract attenuates ethanol-and stress-induced gastric lesions via activation of prostaglandin, nitric oxide and sensory nerve pathways.

Brzozowski T, Konturek PC, Drozdowicz D, Konturek SJ, Zayachivska O, Pajdo R, Kwiecien S, Pawlik WW, Hahn EG. World J Gastroenterol. 2005 Nov 7;11(41):6450-8.

AIM: Grapefruit-seed extract (GSE) containing flavonoids, possesses antibacterial and antioxidative properties but whether it influences the gastric defence mechanism and gastro protection against ethanol- and stress-induced gastric lesions remains unknown.*

METHODS: We compared the effects of GSE on gastric mucosal lesions induced in rats by topical application of 100% ethanol or 3.5 h of water immersion and restraint stress (WRS) with or without (A) inhibition of cyclooxygenase (COX)-1 activity by indomethacin and rofecoxib, the selective COX-2 inhibitor, (B) suppression of NO-synthase with L-NNA (20 mg/kg ip), and (C) inactivation by capsaicin (125 mg/kg sc) of sensory nerves with or without intragastric (ig) pretreatment with GSE applied 30 min prior to ethanol or WRS. One hour after ethanol and 3.5 h after the end of WRS, the number and area of gastric lesions were measured by planimetry, the gastric blood flow (GBF) was assessed by H2-gas clearance technique and plasma gastrin levels and the gastric mucosal generation of PGE2, superoxide dismutase (SOD) activity and malonyldialdehyde (MDA) concentration, as an index of lipid peroxidation were determined.*

RESULTS: Ethanol and WRS caused gastric lesions accompanied by the significant fall in the GBF and SOD activity and the rise in the mucosal MDA content. Pretreatment with GSE (8-64 mg/kg i g) dose-dependently attenuated gastric lesions induced by 100% ethanol and WRS; the dose reducing these lesions by 50% (ID50) was 25 and 36 mg/kg, respectively, and this protective effect was similar to that obtained with methyl PGE2 analog (5 microg/kg i g). GSE significantly raised the GBF, mucosal generation of PGE2, and SOD activity and plasma gastrin levels while attenuating MDA content. Inhibition of PGE2 generation with indomethacin or rofecoxib and suppression of NO synthase by L-NNA or capsaicin denervation reversed the GSE-induced protection and the accompanying hyperemia. Co-treatment of exogenous calcitonine gene-related peptide (CGRP) with GSE restored the protection and accompanying hyperemic effects of GSE in rats with capsaicin denervation.*

CONCLUSION: GSE exerts a potent gastro protective activity against ethanol and WRS-induced gastric lesions via an increase in endogenous PG generation, suppression of lipid peroxidation and hyperemia possibly mediated by NO and CGRP released from sensory nerves.*

A Wei/Asafoetida (Ferula Foetida) Gum Resin (Devil's Dung)

Anti-asthmatic; Antispasmodic; Carminative; Expectorant; Laxative; Sedative.

The name originates with the Persian word aza, which means, "resin", and the Latin word fetida, which means "smelly"; therefore it is 'stinking gum'. Asafoetida has long been used as a food flavouring and medicinal herb. It is still sometimes used in modern herbalism where it is especially valued in the treatment of hysteria, some nervous conditions, bronchitis, asthma and whooping cough.*

Medicinally, asafoetida is used in Middle Eastern and Indian herbal medicine for simple digestive problems such as gas, bloating, indigestion and constipation. It has been used for respiratory problems such as bronchitis, asthma and whooping cough. Like garlic, asafoetida's volatile oil contains components such as disulphides that leave the body via the respiratory system and aid in the coughing up of congested mucus. Asafoetida has also been used as a sedative.*

The gum resin is antispasmodic, carminative, and expectorant, laxative, sedative. The volatile oil in the gum is eliminated through the lungs, making this an excellent treatment for asthma.*

Asafoetida: for digestive weakness, food allergies and candida

Dr. Michael Tierra. https://planetherbs.com/specific-herbs/asafoetida.html

Asafoetida (Ferula foetida), also known as Narthex or Hing. Recognized by its overwhelming odour, which has given rise to at least one of its many popular names, "devil's dung". A member of the umbelliferae plant family, it originally was a native of Persia, Afghanistan and neighbouring regions where the plant is greedily eaten with relish by the native people and sheep of the region. The gum resin consists of the milky sap obtained from an incision of the green matured root. It is possible that the resin in commerce may be derived from several related species, although the best quality and most productive is from the official plant. The major biochemical agent responsible for its characteristic odour is an organic sulphur compound found as part of the essential oil which makes it very similar to the essential oil of garlic (allyl, allyl persulphide and two turpenes) for which it is commonly substituted in food preparations.*

According to Indian Materia Medica by Nadkarani in Ayurvedic medicine, it is regarded as a valuable condiment and spice and "a valuable remedy for hysteria, nervous disorders of women and children, flatulence, flatulent colic and spasmodic affections of the bowels especially when connected with hysteria, in fainting and emotional states, nervous palpitations, hypochondriasis and other affections due to hysteria, in the spasmodic, and the obstinate coughs of childhood remaining after attacks of inflammation and also in the advanced stages of whooping cough, pneumonia and bronchitis of children, in the chronic bronchitis and asthma of adults." It is also regarded in Ayurvedic, Chinese and Western medicine as an effective remedy for worms and other intestinal parasites. This source also goes on to warn that it must be fried before use, as raw and unfried asafoetida will cause nausea and vomiting. The recommended does of the powder is 1 to 2 grain-pill.*

Another preparation is made by grinding 5 teaspoons of asafoetida in a pint of water in a mortar to make a milky emulsion. Half to one ounce of this is taken at a time.*

References

Abraham C, Medzhitov R. Interactions between the host innate immune system and microbes in inflammatory bowel disease. Gastroenterology. 2011;140:1729–1737. 

Aldhous MC. Gene-environmental interactions in inflammatory bowel disease: microbiota and genes. Frontline Gastroenterol. 2012;3:180–186.

Andersson U, Wang H, Palmblad K, Aveberger AC, Bloom O, Erlandsson-Harris H, et al. High mobility group 1 protein (HMG-1) stimulates proinflammatory cytokine synthesis in human monocytes. J Exp Med. 2000;192:565–570.

Khadzhai YI et al. Chemical Abstracts 1965 63:7530h.

Lapaquette P, Glasser AL, Huett A, Xavier RJ, Darfeuille-Michaud A. Crohn's disease-associated adherent-invasive E. coli are selectively favoured by impaired autophagy to replicate intracellularly. Cell Microbiol. 2010;12:99–113. 

Manichanh C, Rigottier-Gois L, Bonnaud E, Gloux K, Pelletier E, Frangeul L, et al. Reduced diversity of faecal microbiota in Crohn's disease revealed by a metagenomic approach. Gut. 2006;55:205–211. 

Seksik P, Rigottier-Gois L, Gramet G, Sutren M, Pochart P, Marteau P, et al. Alterations of the dominant faecal bacterial groups in patients with Crohn's disease of the colon. Gut. 2003;52:237–242. 

Seo JK. Pediatric inflammatory bowel disease (IBD): Phenotypic, genetic and therapeutic differences between early-onset and adult-onset IBD. Korean J Pediatr Gastroenterol Nutr. 2011;14:1–25.

Taurog JD, Richardson JA, Croft JT, Simmons WA, Zhou M, Fernández-Sueiro JL, et al. The germfree state prevents development of gut and joint inflammatory disease in HLA-B27 transgenic rats. J Exp Med. 1994;180:2359–2364. 

Thomazini CM, Samegima DA, Rodrigues MA, Victoria CR, Rodrigues J. High prevalence of aggregative adherent Escherichia coli strains in the mucosa-associated microbiota of patients with inflammatory bowel diseases. Int J Med Microbiol. 2011;301:475–479. 

Willing BP, Dicksved J, Halfvarson J, Andersson AF, Lucio M, Zheng Z, et al. A pyrosequencing study in twins shows that gastrointestinal microbial profiles vary with inflammatory bowel disease phenotypes. Gastroenterology. 2010;139:1844–1854.e1.

Wattenberg LM et al. Cancer Research 1979 39(5): 1651.

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.