From The December 2000 Issue of Natural Foods Merchandiser
by Catherine Monahan
Antacids sold by the gross, travel packs filled with chalky pills and fizzing tablets... Indigestion is universal, and any pharmacy worth its salt devotes an entire aisle to alleviating the nausea, gas and belching associated with it. And that's not counting the prescription antacids and antispasmodics behind the counter. But relief doesn't have to be expensive or come with side effects. Herbs and enzymes offer an easy-to-swallow alternative to that awful full feeling.
Often described as "something not sitting right," indigestion is a vague collection of uncomfortable symptoms that can stem from incompletely or imperfectly digested food. Bacterial infections, anxiety, ulcers and other conditions may trigger similar discomfort, but the term indigestion is generally used when there's no obvious medical problem.
"If someone says they have indigestion, I generally think of gas, bloating, nausea, heartburn and burping," says Dan Lukaczer, N.D., director of clinical research for Healthcomm Inc., in Gig Harbor, Wash.
Most of what is considered digestion occurs in the stomach and small intestine, but the gastrointestinal tract technically begins in the mouth, where a combination of salivary enzymes and chewing starts the digestive process. Everything afterward is purely chemical. A barrage of enzymes, acids, bile and other secretions released by the stomach, gallbladder, liver and small intestine breaks fats, proteins and carbohydrates into absorbable parts.
Some indigestion can be overcome by making simple lifestyle and/or dietary changes. For instance, persistent belching could be the result of swallowing too much air while eating, drinking carbonated beverages or taking antacids. More persistent cases may require additional measures to ease the symptoms.
Many indigestion treatments, both conventional and natural, affect digestive chemicals either increasing or decreasing the amounts of enzymes, acids and bile. Antacids and some prescription drugs (such as H2-receptor antagonists) reduce stomach acid, whereas numerous herbs stimulate bile flow or encourage enzyme secretion.
Herbal medicine practitioners have traditionally treated the pain, cramps and bloating of indigestion with three categories of herbs bitters, carminatives and cholagogues.
Bitters, the extracts of bitter tonic herbs, such as gentian and wormwood, enhance digestion by stimulating the flow of saliva and gastric juices. When a bitter substance interacts with the taste buds at the base of the tongue, certain stimuli pass to the brain. Once the taste is interpreted as bitter, the brain forwards a message via the vagus nerve to the salivary glands and the stomach.
"The taste itself stimulates the release and production of digestive juices everything from saliva to bile," says Ellen J. Kamhi, Ph.D., R.N., on-staff herbalist at Nature's Answer in Hauppauge, N.Y. In the United States, bitters are usually made in tincture form and may contain a single herbal bitter or a blend. Nature's Answer offers single herbal bitters such as gentian root, barberry root, Oregon graperoot and a combination formula that blends ginger with several bitter herbs.
Gentian aperitifs and liqueurs are popular in Europe, where they are sipped before and after dinner to aid digestion. But it's not only herbal tinctures and aperitifs that step up digestive secretions, bitter foods such as dandelion greens and escarole have the same effect.
Carminative herbs include anise, caraway, chamomile, fennel, peppermint and spearmint. Their volatile oils are thought to relax the linings of the stomach and small intestine, making it easier for gas to escape. Ginger, sometimes included in the carminative category, is especially effective for nausea. "These specific herbs are known to aid digestion both by stimulating the release of digestive enzymes and by soothing the gastrointestinal lining," says Kamhi.
Peppermint is one of the best-studied carminatives and is recommended by the German E Commission for indigestion. While many people sip a cup of peppermint tea when their stomachs ache, they aren't getting the most out of the herb. That's because the volatile oils that make carminatives effective are nearly insoluble in water. It's best then to recommend encapsulated, standardized peppermint extracts or tinctures instead.
Cholagogues contain volatile oils and other constituents that stimulate bile production in the liver and empty the gallbladder (which stores extra bile). Bile helps digest fats; a painful, bloated feeling after eating fatty foods is often attributed to low bile levels.
Peppermint and gentian are considered cholagogues, but turmeric, an Indian herb often included in curry powder, is more commonly recommended to help stimulate bile production. Curcumin, one of turmeric's active constituents, gives the spice its yellow color. Because turmeric's volatile oils and active constituents are insoluble in water, it's rarely administered as a tea. Turmeric tinctures and encapsulated powders are more effective.
Customers who have a hard time digesting dairy foods might be missing lactase, the enzyme necessary to digest the milk-sugar lactose. Other lesser known digestive enzymes present similar, and sometimes serious, problems when they're in short supply.
Digestive enzymes are made in the pancreas (hence, pancreatic enzymes), but a few also occur in foods. All enzymes have specific functions, and it's helpful to remember them by their niche proteolytic enzymes digest proteins, lipases digest fats and amylases digest carbohydrates. Of the four best-known proteolytic enzymes, trypsin and chymotrypsin are made in the body, while bromelain and papain are found in pineapple and papaya.
Most digestive enzyme formulas cast a wide net. "Companies often combine digestive enzymes because some digest proteins, some digest fats and others digest carbohydrates," says Lukaczer. "It's a good idea to have a broad spectrum unless you're absolutely sure of a specific problem. Combination products are very useful, especially if someone has several symptoms such as heartburn and gas."
Enzyme formulas commonly include herbal digestive blends. "Our Advanced Enzyme contains a wide range of enzymes that anyone would need to digest starches, fats and proteins," says Susan Beck, M.T.C.M., L.Acp., senior manager of herbal science at Rainbow Light in Santa Cruz, Calif. "It has amylase, lipase, protease, bromelain and papain. It also has an herbal component to aid digestionapple pectin, ginger, turmeric, papaya, fennel and peppermint. So you're getting the digestive enzymes, but you're also getting the herbal component."
"We have a major focus on digestion across the line," she adds. "Our products almost always contain an herbal digestive blend. We came out with a new herbal line, and each of the 10 products contains a blend of ginger, gentian and citrus peel, which are commonly used in Chinese medicine to aid digestion."
Digestive Enzymes and Herbs, manufactured by Pioneer Nutritional Formulas Inc. in Shelburne Falls, Mass., also includes digestive herbs. The vegetarian formula combines eight enzymes such as protease, amylase and lactose with six herbs including artichoke, peppermint, fennel and gentian.
"It's an all-around indigestion formula," says Carole Groman, sales and customer service.
Indigestion has many causes, ranging from serious disorders including stomach cancer, stomach ulcers, intestinal ulcers and stomach inflammation to anxiety, depression and irritable bowel syndrome. The bacterium Helicobacter pylori that causes stomach and duodenal ulcers may also contribute to indigestion. Any customer with persistent indigestion should see a doctor to rule out more serious causes of GI discomfort.
Indigestion: The Quick Fix
Catherine Monahan is a health and food writer based in Lafayette, Colo.
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