For GI complaints: Which herbs and supplements spell relief?

Health-care providers face questions like these every day from parents concerned about a child's nausea, constipation, or "tummy ache." Gastrointestinal complaints are common. Recurrent abdominal pain occurs in 10% to 30% of children and adolescents; many such children ultimately develop symptoms compatible with irritable bowel syndrome in adulthood. When given a choice between a prescription and a home remedy, most patients choose a home remedy.¹ Many families use herbs such as chamomile and peppermint for GI disorders, and an increasing number of gastroenterologists recommend dietary supplements such as probiotics. Patients with chronic or recurrent symptoms are especially likely to use complementary or alternative medical (CAM) therapies. This review considers the herbs and dietary supplements most often used to treat or prevent common GI problems. It does not address herbs and supplements used to treat hepatitis, pancreatitis, and related disorders.

Herbs for chronic benign abdominal pain

Chamomile (Matricaria recutita) is one of the most widely used herbs for children. After all, it was good enough for Peter Rabbit when he had a stressful experience in Mr. MacGregor's garden! The herb is listed on the formularies of more than 25 countries around the world; more than 4,000 tons a year are produced in Germany alone. The German Commission E, Germany's equivalent to the United States Food and Drug Administration, recommends chamomile to treat GI spasms and inflammatory diseases of the GI tract.

During infancy, chamomile tea is sometimes given in a small amount to treat colic. In school-age children, it is used as a home remedy, often in combination with peppermint, star anise, or fennel for stomachaches, gas, indigestion, and bloating. Adolescents may turn to chamomile as a mild anxiolytic.

Chamomile's antispasmodic effects appear to be caused by water-soluble flavonoids such as apigenin and volatile oil constituents alpha-bisapolol and chamazulene.² Apigenin and the volatile oils also have anti-inflammatory effects, inhibiting phospholipase A, cyclo-oxygenase, and lipoxygenase pathways. Apigenin binds to benzodiazepine receptors in the brain. In studies on rats and mice, chamomile had significant sedative and anxiolytic effects and reduced stress-induced increase in ACTH production.