Bot Med - Gastrointestinal Flashcards
Indigestion (dyspepsia) is?
complaints after eating that include: fullness, belching, bloating and gas
Herbal actions to use for indigestion?
- bitter
* carminatives
Herbs to use for indigestion with:
Digestive enzymes?
Bitters?
Carminatives?
Digestive Enzymes • papaya (Carica papaya) • pineapple (Ananas comosus) Bitters • yellow gentian (Gentiana lutea) • wormwood (Artemesia absinthium) Carminatives • chamomile (Matricaria recutita) • peppermint (Mentha piperita) • ginger (Zingiber officinale)
What do digestive enzymes do?
supplemental enzymes that help with digest proteins.
Action of digestive enzymes?
digestive
when would one use digestive enzymes?
indigestion
what herbs are digestive enzymes present in?
- papaya (Carica papaya)
* pineapple (Ananas comosus)
phytochemicals in digestive enzymes?
• proteins (papain, bromelain)
What does a bitter tonic do?
stimulate appetitie, promotes digestion and “tonifies” the digestive tract.
what actions do bitter tonics (and bitter herbs) have?
- stomachic
- cholagogue
- choleretic
- hepatic
what herbs have bitters? iridoid glyosides quinoline alkaloids isoquinoline alkaloids sesquiterpene lactones
Iridoid gycosides • yellow gentian (Gentiana lutea) Quinoline alkaloids • quinine tree (Cinchona officinalis) Isoquinoline alkaloids • greater Celandine (Chelidonium majus) • boldo (Peumus boldus) • goldenseal (Hydrastis canadensis) • barberry (Berberis vulgaris) Sesquiterpen lactones • chicory (Cichorium intybus) • dandelion (Taraxacum officinale) • milk thistle (Silybum marianum)
how do bitters cause the release of digestive juices?
- gastrin - increase stomach acid and sphincter tone
* cholecystokinin (CCK) - increase bile and pancreatic enzyme release
When would bitters be used?
- indigestion (dyspepsia)
- “atonic” stomach
- poor apetite (anorexia)
- hypochlorhydria
Caution regarding bitters?
can aggravate gastritis, ulcers and GERD
What does stomachic do?
tones the stomach and helps support digestion
when would one use stomachics?
- Indigestion
* hypochlorhydria
what herbs have stomachic properties
same as bitters: Iridoid gycosides • yellow gentian (Gentiana lutea) Quinoline alkaloids • quinine tree (Cinchona officinalis) Isoquinoline alkaloids • greater Celandine (Chelidonium majus) • boldo (Peumus boldus) • goldenseal (Hydrastis canadensis) • barberry (Berberis vulgaris) Sesquiterpen lactones • chicory (Cichorium intybus) • dandelion (Taraxacum officinale) • milk thistle (Silybum marianum)
are bitters the only type of stomachics?
no. the main types are bitters but non-bitters exists (cannabis, ginsing, cayenne)
caution concerning stomachics?
can aggravate gastritis, ulcers and GERD
Choloretics do?
increase the production and release of bile from the liver
when would choloretics be used?
- indigestion
- cholestasis
- gall bladder sludge
- gallstones
- detoxification
What herbs have choloretic properties?
same as bitters: Iridoid gycosides • yellow gentian (Gentiana lutea) Quinoline alkaloids • quinine tree (Cinchona officinalis) Isoquinoline alkaloids • greater Celandine (Chelidonium majus) • boldo (Peumus boldus) • goldenseal (Hydrastis canadensis) • barberry (Berberis vulgaris) Sesquiterpen lactones • chicory (Cichorium intybus) • dandelion (Taraxacum officinale) • milk thistle (Silybum marianum)
cholagogue does?
stimulates contraction of the gallbladder and the expulsion of bile
when would cholagogues be used?
- indigestion
- cholestasis
- gall bladder sludge
- gallstones
- detoxification
What herbs are cholagogues found in?
same as bitters: Iridoid gycosides • yellow gentian (Gentiana lutea) Quinoline alkaloids • quinine tree (Cinchona officinalis) Isoquinoline alkaloids • greater Celandine (Chelidonium majus) • boldo (Peumus boldus) • goldenseal (Hydrastis canadensis) • barberry (Berberis vulgaris) Sesquiterpen lactones • chicory (Cichorium intybus) • dandelion (Taraxacum officinale) • milk thistle (Silybum marianum)
caution regardin cholagogue?
gallstones - may increase the risk of bile duct obstruction
What is the action of Yellow Gentian (Gentiana lutea)?
bitter (stomachic, hepatic, cholagogue, choleretic, sialogogue)
when would one use yellow gentian?
- digestive complaints
- dyspepsia
- hypochlorhydria
- gallstones
what phytochemicals are in yellow gentian?
- secoiridoids (e.g. amarogentin)
* alkaloids
cautions regarding yellow gentian?
Contraindications: Pregnancy and lactation (uterine stimulant).
Caution: May aggravate gastritis, hiatal hernia, peptic ulcers, GERD.
how can aggravation be prevented?
concomitant ingestion of demulcent herbs
What is colic?
• cramping pain that results from smooth muscle spasms (e.g. biliary colic,
intestinal colic, renal colic)
what herbal actions are used to treat colic?
- carminative
* antispasmotic
what herb is used to treat colic?
“Gripe water” - contains many carminative herbs and is used for infantile
colic
Carminatives do?
promote digestion and relieves gas and bloating
When would carminatives be used?
- indigestion
- colic
- flatulence
what herbs have carminative properties?
- peppermint (Mentha piperita),
* lemon balm (Melissa officinalis)
what phytochemicals are present in carminatives?
essential oils
What other two actions do carminatives have?
- Increase blood flow to intestines
* relax smooth muscles (sphincters) & normalizes peristalsis
Caution regarding carminatives?
can aggravate GERD
What actions does peppermint possess?
- carminative
- antispasmodic
- antiemetic
when would one use peppermint?
- indigestion (dyspepsia)
- bloating & gas
- flatulence
- colic
- irritible bowel syndrome (IBS)
- nausea
- motion sickness
what phytochemicals are in peppermint?
volatile oils (menthol)
What is an aromatic bitter?
Taste less bitter than “pure bitters” and have less tonic effect but the
presence of essential oils (i.e. carminatives) increases the local effects.
what actions do aromatic bitters have?
- bitter (stomachic, hepatic, cholagogue, choleretic, sialogogue)
- carminative
when would aromatic bitters be used?
• atonic stomach conditions (e.g. indigestion, annorhexia,hypochlorhydria,
dyspepsia)
• colic
• gall blader complaints
what herbs contain aromatic bitters?
- garden angelica (Angelica archangelica)
* wormwood (Artemisia absinthium)
Actions of Garden angelica (angelica archangelica)?
- aromatic bitter
- carminative
- antispasmodic
when would garden angelica be used?
- digestive complaints
- colic
- bloating & gas
what phytochemicals are in garden angelica?
- coumarins, pthalides, furanocoumarin
* phenolic acids
caution regarding garden angelica?
• Photosensitization (due to furanocoumarins)
Actions of Wormwood (artenesia absinthium)?
- bitter (stomachic, hepatic, cholagogue, choleretic, sialogogue)
- carminative
- antispasmodic
When would one use wormwood?
- gallbladder disease
* digestive complaints
what phytochemicals are in wormwood?
- sesquiterpene lactone dimer (absinthin)
* monoterpene (thujone)
caution regarding wormwood?
• Neurotoxin - thujone acts as stimulant of neurons (GABA antagonist).
Essential oil causes seizures and death.
• pregnancy & lactation - contra-inidication (abortifacient)
wormwood significance in absinthe and vermouth?
- absinthe - made of anise, fennel and wormwood.
* vermouth - sometimes includes wormwood
what are gallstones?
stones made of cholesterol and/or bilirubin found in the gallbladder,
usually caused by cholestasis and/or infection.
herbal action to treat gallstones?
- antilithic
- bitters
- cholagogue
- choloretic
- antispasmodics
herbs used to treat gallstones?
- Boldo (Peumus boldus)
- Greater Celandine (Chelidonium majus)
- Barberry (Berberis vulgaris)
- Peppermint (Mentha piperita)
Biliary colic (aka gall bladder attack) occurs when?
occurs when stones irritate the
smooth muscles of gall bladder and/or bile duct.
Antilithic does?
Prevent and aid in the expulsion of liths (i.e. stones) from the body.
when would one use antilithics?
- gallstones
* kidney stones
what herb has antilithic properties?
Boldo (peumus boldus)
What actions does boldo (peamus boldos) have?
- antilithic
- bitter
- carminative
when would one use boldo?
- gallstones
- poor gall bladder function
- indigestion
what phytochemicals are in boldo?
- Isoquinoline alkaloid (e.g. boldine)
* essential oil
antispasmodics do?
Prevents and relieves spasms and cramping of smooth muscles
when would one use antispasmodics?
- intestinal colic (gas)
* biliary colic (gallstones)
what herbs have antispasmodic properties?
- greater celandine (Chelidonium majus)
- deadly nightshade (Atropa belladona)
- opium poppy (Papaver somniferum)
what phytochemicals are in antispasmodics?
- essential oil
- alkaloids (isoquinoline & tropane)
- coumarin & phladies
Actions of Greater celandine (chelidonium majus)?
- antispasmodic
- bitter
- stomachic
- hepatic
- cholagogue
- choleretic
when would one use greater celandine?
- gallbladder spasm (biliary colic)
- biliary dyskinesia
- gallstones
- indigestion
- irritible bowel syndrome (IBS)
phytochemical in greater celandine
isoquinoline alkaloids (chelidonine, berberine)
Greater celandine similar to __ and primarily used for __?
Similar constituents and actions to Hydrastis canadensis and Sanguinaria
canadensis; primarily used for spastic digestive discomfort e.g. gallbladder
spasms.
Caution regarding greater celandine?
• Contra-indications: Pregnancy and lactation (uterine stimulant);
berberine is considered teratogenic.
• Long-term use: Hepatotoxicity; monitor liver function.
• Drug-induced hepatitis: Reported cases (due to isoquinoline alkaloid
exposure).
herbal actions useful for treating nausea and vomiting?
- antiemetic
* carminative
herbs useful in treating nausea and vomiting?
- ginger (Zingiber officinales)
- German chamomile (Matricaria recutita)
- peppermint (Mentha piperita)
antiemetics do?
Relieves nausea and vomiting.
when would one use antiemetics?
- nausea and vomiting
- morning sickness
- sea sickness
- side-effects of medications (e.g chemotherapy)
herbs with antiemetic properties?
- ginger (Zingiber officinale)
* peppermint (Mentha piperita)
caution regarding antiemetics?
• Ginger has been established to be safe during pregnancy. Other
antiemetic herbs should not be avoided or used with caution (e.g.
peppermint, chamomile, deadly night shade)
Actions of ginger (zingiber officinale)?
- antiemetic
- pungent bitter
- carminative
- antispasmodic
- antiinflammatory
when would one use ginger?
- nausea
- morning sickness (pregnancy)
- motion sickness
- side-effects of chemotherapy
- indigestion
phytochemicals of ginger?
- essential oils
* phenolic (e.g. Gingerol)
caution regarding ginger?
- Heartburn - may aggravate it
* Anticogulant drugs - may potentiate them (antithrombotic)
herbal actions useful for treating dry mouth?
- silagogue
- bitter
- parasympathomimetic
herbs useful for treating dry mouth?
- yellow Gentian (Gentiana lutea)
- ginger (Zingiber officinale)
- cayenne (Capsicum frutescens)
Silagogue does?
stimulates salivation
when would one use silagogue?
indigestion
herbs with silagogue properties?
- yellow Gentian (Gentiana lutea)
- ginger (Zingiber officinale)
- cayenne (Capsicum frutescens)
what is heartburn?
burning pain in the epigastric region caused by stomach acid travelling up the esophagus
herbal actions useful to treat heartburn?
- demulcent
- vulnerary
- bitters* (controversial)
herbs useful to treat heartburn?
demulcents?
bitters?
antiulcerogenics?
Demulcents • licorice (Glycyrrhiza glabra) • marshmallow (Althea officinalis) • slippery elm (Ulmus rubra) Bitter • yellow Gentian (Gentiana lutea) Antiulcerogenic • meadowsweet (Filipendula ulmaria)
cautions regarding heartburn?
- Carminatives can aggravate GERD
* Bitters - not recommended in many texts but can increae LES tone
other things to consider regarding heartburn?
- do not overeat
- work with gravity
- avoid: carminatives, spicy food, coffee and alcohol
- lose weight
- increase soluble fiber in the diet
demulcents do?
soothes irritated mucous membranes
when would one use demulcents?
- heartburn
- esophagitis
- gastritis
- colitis
- bronchitis
- cystitis
what herbs contain demulcents?
- marshmallow (Althaea officinalis)
- licorice (Glycherrhiza glabra)
- slippery elm (Ulmus rubra)
- ground flax (Linum usitatissimum) seeds
- oatmeal (Avena sativa)
caution regarding demulcents?
creates slimy mucilage and/or stimulates the production of mucous
actions of marshmellow (althea officinalis)?
- demulcent
- expectorant
- emollient