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Bot Med - Gastrointestinal Flashcards

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1
Q

Indigestion (dyspepsia) is?

A

complaints after eating that include: fullness, belching, bloating and gas

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2
Q

Herbal actions to use for indigestion?

A
  • bitter

* carminatives

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3
Q

Herbs to use for indigestion with:
Digestive enzymes?
Bitters?
Carminatives?

A 
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)
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4
Q

What do digestive enzymes do?

A

supplemental enzymes that help with digest proteins.

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5
Q

Action of digestive enzymes?

A

digestive

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6
Q

when would one use digestive enzymes?

A

indigestion

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7
Q

what herbs are digestive enzymes present in?

A
  • papaya (Carica papaya)

* pineapple (Ananas comosus)

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8
Q

phytochemicals in digestive enzymes?

A

• proteins (papain, bromelain)

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9
Q

What does a bitter tonic do?

A

stimulate appetitie, promotes digestion and “tonifies” the digestive tract.

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10
Q

what actions do bitter tonics (and bitter herbs) have?

A
  • stomachic
  • cholagogue
  • choleretic
  • hepatic
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11
Q 
what herbs have bitters?
iridoid glyosides
quinoline alkaloids
isoquinoline alkaloids
sesquiterpene lactones
A 
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)
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12
Q

how do bitters cause the release of digestive juices?

A
  • gastrin - increase stomach acid and sphincter tone

* cholecystokinin (CCK) - increase bile and pancreatic enzyme release

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13
Q

When would bitters be used?

A
  • indigestion (dyspepsia)
  • “atonic” stomach
  • poor apetite (anorexia)
  • hypochlorhydria
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14
Q

Caution regarding bitters?

A

can aggravate gastritis, ulcers and GERD

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15
Q

What does stomachic do?

A

tones the stomach and helps support digestion

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16
Q

when would one use stomachics?

A
  • Indigestion

* hypochlorhydria

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17
Q

what herbs have stomachic properties

A 
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)
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18
Q

are bitters the only type of stomachics?

A

no. the main types are bitters but non-bitters exists (cannabis, ginsing, cayenne)

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19
Q

caution concerning stomachics?

A

can aggravate gastritis, ulcers and GERD

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20
Q

Choloretics do?

A

increase the production and release of bile from the liver

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21
Q

when would choloretics be used?

A
  • indigestion
  • cholestasis
  • gall bladder sludge
  • gallstones
  • detoxification
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22
Q

What herbs have choloretic properties?

A 
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)
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23
Q

cholagogue does?

A

stimulates contraction of the gallbladder and the expulsion of bile

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24
Q

when would cholagogues be used?

A
  • indigestion
  • cholestasis
  • gall bladder sludge
  • gallstones
  • detoxification
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25
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) ```
26
caution regardin cholagogue?
gallstones - may increase the risk of bile duct obstruction
27
What is the action of Yellow Gentian (Gentiana lutea)?
bitter (stomachic, hepatic, cholagogue, choleretic, sialogogue)
28
when would one use yellow gentian?
* digestive complaints * dyspepsia * hypochlorhydria * gallstones
29
what phytochemicals are in yellow gentian?
* secoiridoids (e.g. amarogentin) | * alkaloids
30
cautions regarding yellow gentian?
Contraindications: Pregnancy and lactation (uterine stimulant). Caution: May aggravate gastritis, hiatal hernia, peptic ulcers, GERD.
31
how can aggravation be prevented?
concomitant ingestion of demulcent herbs
32
What is colic?
• cramping pain that results from smooth muscle spasms (e.g. biliary colic, intestinal colic, renal colic)
33
what herbal actions are used to treat colic?
* carminative | * antispasmotic
34
what herb is used to treat colic?
"Gripe water" - contains many carminative herbs and is used for infantile colic
35
Carminatives do?
promote digestion and relieves gas and bloating
36
When would carminatives be used?
* indigestion * colic * flatulence
37
what herbs have carminative properties?
* peppermint (Mentha piperita), | * lemon balm (Melissa officinalis)
38
what phytochemicals are present in carminatives?
essential oils
39
What other two actions do carminatives have?
* Increase blood flow to intestines | * relax smooth muscles (sphincters) & normalizes peristalsis
40
Caution regarding carminatives?
can aggravate GERD
41
What actions does peppermint possess?
* carminative * antispasmodic * antiemetic
42
when would one use peppermint?
* indigestion (dyspepsia) * bloating & gas * flatulence * colic * irritible bowel syndrome (IBS) * nausea * motion sickness
43
what phytochemicals are in peppermint?
volatile oils (menthol)
44
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.
45
what actions do aromatic bitters have?
* bitter (stomachic, hepatic, cholagogue, choleretic, sialogogue) * carminative
46
when would aromatic bitters be used?
• atonic stomach conditions (e.g. indigestion, annorhexia,hypochlorhydria, dyspepsia) • colic • gall blader complaints
47
what herbs contain aromatic bitters?
* garden angelica (Angelica archangelica) | * wormwood (Artemisia absinthium)
48
Actions of Garden angelica (angelica archangelica)?
* aromatic bitter * carminative * antispasmodic
49
when would garden angelica be used?
* digestive complaints * colic * bloating & gas
50
what phytochemicals are in garden angelica?
* coumarins, pthalides, furanocoumarin | * phenolic acids
51
caution regarding garden angelica?
• Photosensitization (due to furanocoumarins)
52
Actions of Wormwood (artenesia absinthium)?
* bitter (stomachic, hepatic, cholagogue, choleretic, sialogogue) * carminative * antispasmodic
53
When would one use wormwood?
* gallbladder disease | * digestive complaints
54
what phytochemicals are in wormwood?
* sesquiterpene lactone dimer (absinthin) | * monoterpene (thujone)
55
caution regarding wormwood?
• Neurotoxin - thujone acts as stimulant of neurons (GABA antagonist). Essential oil causes seizures and death. • pregnancy & lactation - contra-inidication (abortifacient)
56
wormwood significance in absinthe and vermouth?
* absinthe - made of anise, fennel and wormwood. | * vermouth - sometimes includes wormwood
57
what are gallstones?
stones made of cholesterol and/or bilirubin found in the gallbladder, usually caused by cholestasis and/or infection.
58
herbal action to treat gallstones?
* antilithic * bitters * cholagogue * choloretic * antispasmodics
59
herbs used to treat gallstones?
* Boldo (Peumus boldus) * Greater Celandine (Chelidonium majus) * Barberry (Berberis vulgaris) * Peppermint (Mentha piperita)
60
Biliary colic (aka gall bladder attack) occurs when?
occurs when stones irritate the | smooth muscles of gall bladder and/or bile duct.
61
Antilithic does?
Prevent and aid in the expulsion of liths (i.e. stones) from the body.
62
when would one use antilithics?
* gallstones | * kidney stones
63
what herb has antilithic properties?
Boldo (peumus boldus)
64
What actions does boldo (peamus boldos) have?
* antilithic * bitter * carminative
65
when would one use boldo?
* gallstones * poor gall bladder function * indigestion
66
what phytochemicals are in boldo?
* Isoquinoline alkaloid (e.g. boldine) | * essential oil
67
antispasmodics do?
Prevents and relieves spasms and cramping of smooth muscles
68
when would one use antispasmodics?
* intestinal colic (gas) | * biliary colic (gallstones)
69
what herbs have antispasmodic properties?
* greater celandine (Chelidonium majus) * deadly nightshade (Atropa belladona) * opium poppy (Papaver somniferum)
70
what phytochemicals are in antispasmodics?
* essential oil * alkaloids (isoquinoline & tropane) * coumarin & phladies
71
Actions of Greater celandine (chelidonium majus)?
* antispasmodic * bitter * stomachic * hepatic * cholagogue * choleretic
72
when would one use greater celandine?
* gallbladder spasm (biliary colic) * biliary dyskinesia * gallstones * indigestion * irritible bowel syndrome (IBS)
73
phytochemical in greater celandine
isoquinoline alkaloids (chelidonine, berberine)
74
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.
75
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).
76
herbal actions useful for treating nausea and vomiting?
* antiemetic | * carminative
77
herbs useful in treating nausea and vomiting?
* ginger (Zingiber officinales) * German chamomile (Matricaria recutita) * peppermint (Mentha piperita)
78
antiemetics do?
Relieves nausea and vomiting.
79
when would one use antiemetics?
* nausea and vomiting * morning sickness * sea sickness * side-effects of medications (e.g chemotherapy)
80
herbs with antiemetic properties?
* ginger (Zingiber officinale) | * peppermint (Mentha piperita)
81
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)
82
Actions of ginger (zingiber officinale)?
* antiemetic * pungent bitter * carminative * antispasmodic * antiinflammatory
83
when would one use ginger?
* nausea * morning sickness (pregnancy) * motion sickness * side-effects of chemotherapy * indigestion
84
phytochemicals of ginger?
* essential oils | * phenolic (e.g. Gingerol)
85
caution regarding ginger?
* Heartburn - may aggravate it | * Anticogulant drugs - may potentiate them (antithrombotic)
86
herbal actions useful for treating dry mouth?
* silagogue * bitter * parasympathomimetic
87
herbs useful for treating dry mouth?
* yellow Gentian (Gentiana lutea) * ginger (Zingiber officinale) * cayenne (Capsicum frutescens)
88
Silagogue does?
stimulates salivation
89
when would one use silagogue?
indigestion
90
herbs with silagogue properties?
* yellow Gentian (Gentiana lutea) * ginger (Zingiber officinale) * cayenne (Capsicum frutescens)
91
what is heartburn?
burning pain in the epigastric region caused by stomach acid travelling up the esophagus
92
herbal actions useful to treat heartburn?
* demulcent * vulnerary * bitters* (controversial)
93
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) ```
94
cautions regarding heartburn?
* Carminatives can aggravate GERD | * Bitters - not recommended in many texts but can increae LES tone
95
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
96
demulcents do?
soothes irritated mucous membranes
97
when would one use demulcents?
* heartburn * esophagitis * gastritis * colitis * bronchitis * cystitis
98
what herbs contain demulcents?
* marshmallow (Althaea officinalis) * licorice (Glycherrhiza glabra) * slippery elm (Ulmus rubra) * ground flax (Linum usitatissimum) seeds * oatmeal (Avena sativa)
99
caution regarding demulcents?
creates slimy mucilage and/or stimulates the production of mucous
100
actions of marshmellow (althea officinalis)?
* demulcent * expectorant * emollient
101
when would when use marshmellow?
* heartburn * gastritis * gastric & peptic ulcer
102
phytochemicals in marshmellow?
* mucilage * soluble fiber * tannins (root) * flavonoids * phenolic acids
103
Actions of licorice (glycyrrhiza glabra)?
* antiulcerogenic | * demulcent
104
when would one use licorice?
* gastric & peptic ulcer | * Gastroesophageal reflux disorder (GERD)
105
phytochemicals of licorice?
* Triterpenoid (e.g. glycyrrhizic acid) * Saponin (e.g. glycyrrhizin) * Flavonoids * Isoflavenoids
106
what licorice can be used with hypertension...what does it have removed?
``` Deglycerrated licorice (DGL) has glycyrrhizin removed. Can be safely used with hypertsion. ```
107
caution regarding licorice?
Glycyrrhizin causes "pseudoaldosteronism" leading to elevated blood pressure.
108
Gastritis & gastric ulcer definition and symptoms?
``` • gastritis is inflammation of the lining of the stomach that may result in ulcer formation. • symptoms include: • abdominal (epigastric) pain • bloating and gas • burping • loss of appetite • black tarry stool ```
109
herbal actions useful in treating gastritis and gastric ulcers?
* demulcent * antimicrobials * antiulcer * antacid * antiulcerogenic * vulnerary * astringent * antispasmotic
110
``` herbs useful for treating gastritis and gastric ulcers; demulcent? antacid? vulnerary? chamomile? ```
``` Demulcent • Licorice (Glycherrhiza glabra) • Marshmallow (Althea officinalis) Antacid • meadowsweet (Filipendula ulmaria) Vulnerary • chamomile (Matricaria recutita) Chamomile • goldenseal (Hydrastis canadensis) ```
111
comments regarding gastritis and gastric ulcers?
Roberts formula - geranium maculatum - hydrastis - slippery elm
112
caution regarding gastritis and gastric ulcers?
``` Bitter herbs (e.g. Goldenseal) can aggravate gastritis by increasing stomach acidity. Demulcent herbs can reduce aggravation. ```
113
antiulcerogenics (antiulcer/ulceroprotective) does?
decreases the formation and speeds up the healing of ulcers
114
actions of antiulcerogenics?
* astringent * vulnerary * antacid
115
when would one use antiulcerogenics?
* gastric ulcer | * peptic ulcer
116
herbs containg antiulcerogenic properties?
* licorice (Glycyrrhiza glabra) * meadowsweet (Filipendula ulmaria) * german chamomile (Matricaria recutita)
117
actions of meadow sweet (filipendula ulmaria)?
* stomachic * antacid * antiulcerogenic * antiinflammatory
118
when would meadowsweet be used?
* gastic ulcer * gastritis * gastric esophageal reflux disease (GERD) * hyperchlorhydria
119
phytochemicals in meadowsweet?
* simple phenolics (e.g. salicyclates) * tannins * flavonoids
120
caution regarding meadowsweet?
* Pregnancy and lactation; safety has not yet been established * Contr-indicated: salicyclate sensitivity, children (Reye's syndrome). * Anticoagulants (Coumadin) - may interact due to salicyclates.
121
Astringents do?
contracts and thickens tissues to decrease permeability and increase resistance to physical stress
122
when would one use astringents?
* diarrhea * ulcers * wound healing
123
what herbs have astringent properties?
* oak (Quercus spp.) | * witch hazel (Hamamelis virginiana)
124
phytochemicals of astringents?
tannins
125
what affect do astringents have on some toxins?
deactivates certain toxins form micro-organisms
126
caution regarding astringents?
tannins can impair absorption of nutrients
127
actions of Crane's bill (geranium maculatum)?
* astringent | * styptic
128
when would one use crane's bill?
* ulcers * diarrhea * lacerations
129
phytochemicals in crane's bill?
tannins
130
relation to witch hazel and oak?
same actions
131
caution regarding crane's bill?
• Long-term use - high amounts internally can decrease permeability of the intestinal tract and lead to malabsorption. • Interactions - may bind to certain nutrients. Take on empty stomach.
132
what do internal vulneraries do?
speed up the healing of wounds
133
when would one use unternal vulneraries?
* gastric ulcers * mouth ulcers * esophagitis (heartburn)
134
what herbs have internal vulnerary properties?
* chamomile (Matricaria chamomilla) * marigold (Calendula officinalis) * greater plantain (Plantago major)
135
caution regarding internal vulnerary?
The following are not recommended for internal use: • arnica (Arnica montana) • comfrey (Symphytum officinalis)
136
Actions of chamomile?
* vulnerary * carminative * antiinflammatory * antiulcer * antiemetic * antispasmotic
137
when would one use chamomile?
* gastric ulcer * duodenal ulcer * colic * flatulence * nausea * motion sickness
138
phytochemicals of chamomile?
sesquiterpenes (bisabolol, matricin, chamazulen)
139
what has similar properties as chamomile?
yarrow (Achillea millefolium)
140
what herbal actions are useful for treating acute poisoning?
* emetic | * stimulating laxative
141
what herbs are useful for treating acute poisoning; emetic? stimulating laxative?
``` Emetic • Ipecac (Cephaelis ipecacuanha) • Indian tobacco (Lobelia inflata) Stimulating laxative • Castor oil ```
142
what do emetics do?
induce vomiting
143
when would one use emetics?
* poisoning * detoxification * certain infections
144
what herbs have emetic properties?
* Ipecac (Cephaelis ipecacuanha) | * Indian tobacco (Lobelia inflata)
145
what phytochemica is present in emetics?
alkaloids
146
cautions regarding emetics?
Contra-indicated with certain corrosive agents.
147
actions of Ipecac (cephaelis ipecacuanha)?
* emetic | * antimicrobial
148
when would one use ipecac?
overdose & poisoning
149
Comment on syrup of ipecac?
once used to treat poisoning. It is no longer recommended because of lack of evidence on efficacy in treating poisoning and potential for harm.
150
cautions regarding ipecac?
* Contra-indicated during pregnancy. | * Contra-indicated for ingestion of corrosive chemicals.
151
phytichemicals of ipecac?
isoquinoline alkaloid (emetine)
152
what is a "toxic" liver?
liver becomes over-burndened with toxins (drugs, endogenous waste, environmental pollutants) when the body is exposed to lots of toxins and/or the routes of elimination are not functioning
153
symptoms of "toxic" liver?
nausea, fatigue, poor mental function, skin | problems, sensitivity to drugs.
154
detox steps in the liver?
1) Phase I - involves redox reactions using p450 enzymes 2) Phase II - conjugates the toxins with other compounds • Sulfur compounds (e.g. glutathione, cysteine) • Glycine • Methyl groups (SAM, B12, Folic acid) • Acetyl groups (e.g. acetyl CoA) • Glucoronic acid
155
herbal actions useful to treat "toxic" liver?
* alteratives (depuratives) * cholagogoue & cholorectic * hepatoprotective * laxatives (stimulating and bulk) * diuretics
156
``` herbs useful for treating "toxic" liver; hepatoprotective? choloretic & cholagogues? bulk laxative? bowel tonic? phase 2 support? ```
``` Hepatoprotective • milk thistle (Silybum marianum) Cholorectic & Cholagogues • chicory (Cichorium intybus) • dandelion (Taraxacum officinalis) Bulk laxative • psyllium husk (Plantago psyllium) Bowel tonic • yellow dock (Rumex crispus) Phase 2 Support • garlic (e.g. allicin) • cruciferous vegetables (e.g. sulforaphane) ```
157
what does a hepatic do?
aids in liver function
158
actions of a hepatic?
* bitters * cholagogoue * cholorectic * hepatoprotective
159
when would one use a hepatic?
* detoxification * liver disease * "hepatic torpor" (i.e. lazy liver)
160
herbs with hepatic properties?
* dandelion * barberry * chickory
161
hepatics and bitters?
Most "bitter" herbs are classified as hepatics
162
action of dandelion (taraxacum officinale)?
bitter (stomachic, hepatic, cholagogue, choleretic, sialogogue)
163
when would one use dandelion?
* indigestion * gallstones * detox
164
phytochemicals in dandelion?
* Sesquiterpene lactone | * fiber (inulin)
165
cautions regarding dandelions?
* Considered safe. | * Gallstones - may increase the risk of bile duct obstruction.
166
Burdock, chicory and dandelion are in what family and are bitter why?
Burdock, chicory and dandelion are all in the Asteraceae. They are all bitter due to sesquiterpene lactones and contain inulin in their roots.
167
actions of chicory (cichorium intybus)?
* bitter (stomachic, hepatic, cholagogue, choleretic, sialogogue) * alterative
168
when would one use chicory?
* indigestion * gallstones * detox
169
phytochemicals in chicory?
* Sesquiterpene lactone | * fiber (inulin)
170
cautions regarding chicory?
* Considered safe. | * Gallstones - may increase the risk of bile duct obstruction.
171
what is hepatitis and what causes it?
``` Inflammation of the liver (typically associated with elevated liver enzymes). Causes include: • infection • drugs • herbs • toxins • alcohol • fatty liver disease ```
172
herbal actions useful in treating hepatitis?
* hepatoprotective * antiinflammatory * antioxidant * cholagogoue & Cholorectic * antimicrobial
173
herbs useful in treating hepatitis?
milk thistle (Silybum marianum)
174
Hepatoprotectives do?
direclty and/or indirectly helps protect the liver.
175
actions of hepatoprotectives?
* antioxidant | * antiinflammatory
176
when would one use hepatoprotectives?
* general detoxification * hepatitis * adverse drug reaction * mushroom poisoning
177
what herbs contain hepatoprotective properties?
``` Flavonolignans • milk thistle (Silybum marianum) Triterpenoids • ginseng (Panax quinqefolium) Polyphenolics • turmeric (Curcuma longa) ```
178
actions of milk thistle (silybum marianum)?
* hepatoprotective | * bitter
179
when would one use milk thistle?
* hepatitis * toxic liver disease * mushroom poisoning * skin conditions
180
phytochemicals of milk thistle?
Flavolignin (silymarin, silybin)
181
mechanism of action of milk thistle?
* Liver regeneration - stimualting RNA polymerase I activity * Stabilizes lipids - protects cell membranes * Antioxidant * Increase glutathione * Prevent binding of toxins * Inhibits beta-glucoronidase
182
hepatotoxics do?
damages the liver and may cause hepatitis or liver cancer
183
herbs that have hepatotoxic properties?
Case of hepatotoxicity exist for the following: • black cohosh (Cimicifuga racemosa) • greater celandine (Chelidonium majus) • comfrey (Symphytum officinalis)
184
phytochemicals with hepatotoxic properties?
``` Case of hepatotoxicity exist for the following: • pyrrolizidine alkaloids • phenylpropenes • isoquinoline alkaloids • coumarins ```
185
what is p450 inhibitor?
Inhibits phase I detoxification enzymes, which can result in a decrease in the clearance of certain substances (i.e. increase drug effects)
186
what is the p450 inhibitor found in?
grapefruit juice
187
what phytochemicals have p450 inhibito qualities?
* flavanone (e.g. naringin) | * furanocoumarins (e.g. burgomontein)
188
caution regardin p450 inhibitor/grapefruit juice?
grapefruit juice alters bioavailability of certain drugs and can dangerously elevate their blood levels.
189
what is p450 inducer?
Increases the activity of p450 enzyme, which can result in faster clearance of certain substances (e.g. drugs, hormones) and/or formation of toxic intermediate products.
190
what herbs posses p450 inducer qualities?
* St. John's Wort (Hypericum perforatum) | * cruciferous vegetables (Indole-3-carbinol)
191
caution regarding p450 inducers?
• drug interaction - can increase the clearance of certain drugs • p450 induction without adequate phase 2 support can lead to the production of reactive intermediates (hepatotoxic and carcinogens)
192
what are phase 2 inducers?
• induce the phase 2 enzymes and supply them with substrates for conjugation.
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herbs containing phase 2 inducer qualities?
* garlic (Allium sativum) * cruciferous vegetables * milk thistle (Silybum marianum)
194
phytocemicals of phase 2 inducers?
organosulfur compounds (allicin, sulforaphane. glutathione)
195
herbal actions useful for treating constipation?
* bulk laxative * stimulating laxative * carminative
196
herbs useful for treating constipation; bulk laxatives? stimulating laxatives? Carminitives?
``` Bulk laxatives • ground flax (Linum usitatissimum) seeds - • Psyllium Husk (Plantago psyllium) Stimulating laxatives • Senna (Senna sp.) Carminatives • peppermint (Mentha piperita) • lemon balm (Melissa officinalis) ```
197
stimulating laxatives do?
Promotes bowel movements by causing influx of water into the lumen and stimulating peristalsis.
198
action of stimulating laxatives?
* Increase influx of fluid into the lumen | * Increases peristalsis.
199
when would one use a stimulating laxative?
constipation
200
Herbs with stimulating laxative properties
* Castor oil * Senna (Senna spp.) * Aloe "resin" (Aloe vera)
201
caution regarding stimulating laxatives?
* Dependance may occur if taken for more than 7-10 days. | * May affect electrolytes (sodium and pottasium) levels in the blood
202
Action of Senna (senna sp.)
stimulating laxative
203
when would one use senna?
acute constipation
204
phytochemicals of senna?
anthraquinone (sennosides)
205
when does senna cause bowel movement?
in 6-8 hours
206
what would you combine senna with to decrease colic?
carminitives
207
cautions regarding senna?
• Colic - often causes it • Discoloration of urine (red/brown) • Melanosis - brown discoloration of the bowels • Dependance may occur if taken for more than 7-10 days. • May affect electrolytes (sodium and pottasium) levelsand cause hypokalemia
208
Action of Castor oil (ricinus communis)
* purgative | * stimulating laxative
209
when would one use castor oil?
* poisoning | * constipation
210
phytochemical of castor oil?
fixed oil (ricinoleic acid)
211
when does it cause bowel movement?
3-5 hours
212
cautions regarding castor oil?
* not recommended as a laxative * long-term use may cause "leaky gut syndrome" * Colic - often causes it
213
what is a bulk laxative
• absorbs water and expands creating "bulk" that stimulates stretch receptors.
214
when would one use a bulk laxative?
* sluggish bowels | * chronic constipation
215
what herbs are bulk laxatives?
* psyllium husk (Plantago psyllium) | * ground flax (Linum usitatissimum) seeds
216
what phytochemicals are bulk laxatives?
soluble fiber
217
are bulk laxatives recommended for acute constipation?
No
218
Actions of psyllium husk (plantago psyllium)?
* bulk laxative | * mucilage
219
when would one use psyllium husk?
* constipation * diarrhea * IBS
220
what effect does psyllium husk have on flatus?
May increase flatus.
221
is psyllium husk recommended for acute constipation? why or why not?
not recommended because it may aggravate the | situation
222
what is a prebiotic?
• a substance that increases the growth of "good" bacteria in the gut.
223
what are actions of prebiotics?
* immunomodulator | * laxative
224
when would one use a prebiotic?
* dysbiosis * poor immune function * constipation * diarrhea * leaky gut
225
what herbs contain prebiotic properties?
* chickory root (Cichorium intybus) * burdock root (Arctium lappa) * dandelion root (Taraxacum officinale) * oatmeal (Avena sativa)
226
what phytochemicals are prebiotic?
* soluble fiber * inulin * oligosaccharides e.g. fructooligosaccharides (FOS)
227
Prebiotic effect on flatus?
may increase flatus
228
Significance of short-chain fatty acids and prebiotics?
short-chain fatty acid (SCFA) - produced by gut bacteria consuming prebiotics. They are important in feeding enterocytes and maintaining gut health.
229
what is diarrhea?
the inability of the bowels to reabsorb water and form "solid" blowel moviement
230
causes of diarrhea?
* infections (e.g. E. coli, giardia, cholera) and dysbiosis * stress * irritants (e.g. drugs, food sensitivities, etc) * inflammatory bowel diseases (e.g Chron’s ulcerative colitis) * lactose intolerance
231
associated symptoms of diarrhea?
* fecal incontinence * rectal bleeding * cramping pains * low blood pressure
232
herbal actions useful in treating diarrhea?
* bulk laxatives * astringent * antispasmotic * carminatives * antimicrobial
233
``` Herbs useful in treating diarrhea; soluble fiber? tannins? antimicrobial? carminatives? ```
``` Soluble fiber • slippery elm (Ulmus rubra) • psyllium Husk (Plantago psyllium) • marshmallow Root (Althaea officinalis) Tannins • green bannanas • crane's bill (Geranium maculatum) • oak (Quercus spp.) • Bilberry (Vaccinium myrtillus) Antimicrobial • goldenseal (Hydrastis canadensis) Caminatives • peppermint (Mentha piperita) ```
234
caution regarding treatment of diarrhea?
astringents should not be used long-term
235
actions of bilberry (vaccinium myrtillus)?
* astringent * antimicrobial * antiinflammatory * antioxidant
236
when would one use bilberry?
infantile diarrhea
237
Phytochemicals of bilberry?
* tannins (non-hydrolyzable) | * anthocyanin
238
anthocyanin concentration in bilberries vs blueberries?
4 times higher in bilberries
239
what is IBS?
A functional bowel conditions that presents with abdominal pain (colic) and alternating diarrhea and constipation
240
potential causes of IBS?
* dysbiosis * stress * food sensitivities * lactose intolerance * poor diet (low fiber and high refined sugar)
241
herbal actions useful in treating IBS?
* carminatives * bitters * bulk laxative * antimicrobials
242
Herbs useful in treating IBS?
``` Carminatives & Antispasmotic • lemon balm • chelidonium • peppermint Herbs containing soluble fiber: • psyllium Husk (Plantago psyllium) • ground flax ```
243
other important therapies in treating IBS?
* probiotics * elimination diet * stress-management
244
Actions of lemon balm (melissa officinalis)?
* carminative * antispasmodic * nervine
245
when would one use lemon balm?
* 'nervous stomach' * irritible bowel syndrome (IBS) * dyspepsia * bloating * flatulence * colic
246
phytochemicals of lemon balm?
volatile oils
247
caution regarding lemon balm?
Caution in hypothyroidism; may potentially modulate thyroid function.
248
herbal actions useful in treating inflammatory bowel disease?
* antiinflammatories * carminatives * bitters * antimicrobials
249
herbs useful in treating inflammatory bowel disease?
Antiinflammatories • turmeric (Curcuma longa) • ginger (Zingiber officinale) • wormwood (Artemesia absinthium)
250
other important therapies in treating inflammatory bowel disease?
* probiotics * elimination diet * Vitamin D
251
caution regarding inflammatory bowel disease?
Soluble fiber - should be used with caution because it can aggravate acute flare ups of IBD

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