Dyspeptic Syndrome Natural Treatment

Clinical Considerations
➤ General comments
– Dyspeptic syndrome is the generic term for all types of upper abdominal and retrosternal pain, abdominal discomfort, heartburn, nausea, vomiting, and other gastrointestinal symptoms.
– It is characterized by prolonged upper abdominal problems due to an underlying functional disorder with or without an additional psychovegetative component. The symptoms occur in the intestinal lumen without significant intestinal wall involvement. The following types can be distinguished:
• Epigastric meteorism with distended abdomen (most common type): The stomach and intestine are often jointly involved.
• Arteriosclerosis of gastrointestinal arteries: Characterized by deficient absorption of intestinal gases and flatulence.
• Cholecystopathies (latent or manifest), food intolerance, the characteristic symptoms of which are distension of the stomachal region with bloating and belching.
• Dysmotility type: Abdominal distension and bloating, premature feeling of satiation, diffuse abdominal pain in daytime only, nausea, food intolerance, vomiting, aversion to food, and constant discomfort.

➤ Herbal treatment measures
– Herbal remedies can be used for trial treatment (for 14 days) or symptomatic treatment.
– Symptomatic herbal therapy
• Dyspepsia with motor disorders: Bitters can be used to counteract motor disorders of the upper gastrointestinal tract, e. g., a large flaccid stomach or motor disorders related to bile and pancreatic juice secretion. If the problem is already long-standing, treatment must usually be continued for several weeks before the preparations become effective. A high-fiber diet is also recommended.
• Meteorism: Carminatives are used to treat meteorism (see below). They are sometimes combined with bitters, antiphlogistics, and/or tannincontaining herbs, depending on the symptoms involved.

➤ Clinical value of herbal medicine
– Herbal remedies permit differentiated treatment according to the type and severity of the predominant symptoms.
– Synthetic drugs and chemical remedies (e. g., prokinetic drugs) are used when there is positive evidence of organic disease or if the patient fails to respond to trial herbal therapy.

Recommended Herbal Remedies (Overview)
Carminatives
➤ Caraway seed (Carvi fructus); fennel seed (Foeniculi fructus); aniseed (Anisi fructus).
– Action: When taken orally, carminatives induce a feeling of warmth and facilitate eructation and the passage of gas after meals. They contain essential oils that either induce spasmolysis or promote bowel motility and probably
also have antibacterial effects. They are not as potent as the specific anti-biotics or antispasmodics. The most potent carminative is caraway, followed by fennel and aniseed.
– Contraindications: Patients with gallstones should not use carminatives unless directed by a physician.
– Side effects: Carminatives reduce the pressure in the esophageal sphincter and can therefore cause heartburn. Bitters
➤ Wormwood (Absinthii herba); angelica root (Angelicae radix); gentian root (Gentianae radix); chicory herb and root (Cichorii herba et radix); bogbean leaf (Menyanthidis folium); dandelion root and herb (Taraxaci radix cum herba); blessed thistle (Cnici benedicti herba); yarrow herb (Millefolii herba).
– Action: Stimulate gastrointestinal motility.
– Contraindications: (cf. Anorexia):
• Patients prone to gallstones should not use bitters unless directed by a physician.
• Gentian root: Ulcer-related dyspepsia, acute gastritis.
• Yarrow: Known allergy to composite plants.
• Dandelion: Biliary tract obstruction, gallbladder empyema.
• Wormwood: Pregnancy.
– Side effects: See Anorexia.

Aromatic Herbs
➤ Aniseed (Anisi fructus); calamus root (Calami rhizoma); caraway seed and oil (Carvi fructus et aetheroleum); cinnamon bark (Cinnamomi cassiae cortex, C. zeylanici cortex); turmeric root (Curcumae longae rhizoma, C. xanthorrizae rhizoma); bitter orange peel (Aurantii pericarpium); coriander (Coriandri fructus); fennel seed (Foeniculi fructus); chamomile flower (Matricariae flos); balm leaf (Melissae folium); peppermint leaf (Menthae piperitae folium); rosemary leaf (Rosmarini folium).
– Action: Antispasmodic and antibacterial; increases peristalsis.
– Contraindications
• Turmeric: Should not be used by patients with biliary tract occlusion or gallstones.
• Anise: Known allergy to anise or anethole.
• Calamus: Should not be used by children under 12 years of age or during pregnancy or breast feeding.
• Chamomile: Known allergy to chamomile.
• Menthol: Biliary tract obstruction, gallstones, gallbladder inflammation, severe liver damage.
– Side effects: (Cf. Anorexia):
• Anise: Although rare, allergic reactions of the skin, respiratory tract, and gastrointestinal tract may occur.
• Turmeric: May irritate the gastric mucosa if used for extended periods or overdosed.

Other Herbs for Dyspeptic Syndrome
➤ Galangal root (Galangae rhizoma); papaya peel (Caricae papayae fructus); pineapple (Ananas comosus); artichoke leaf (Cynarae folium).
– Action: Used to treat enzyme deficiencies. Galangal bark stimulates the secretion of pancreatic enzymes. Papaya and pineapple contain digestive enzymes.

Range of Applications in Bloating and Meteorism
Mild Pain and Meteorism
➤ Caraway; aniseed; fennel; balm; peppermint; wormwood.
– Dosage and administration
• Tea Rx: Carvi fructus, Foeniculi fructus, aa 20.0; Menthae piperitae folium, Melissae folium, aa 30.0. Steep 1 teaspoon in 1 cup of boiled water for 15 minutes. Take 1 cup of the tea while hot, 3 to 6 times a day.
• Tincture Rx: Ol. Carvi 5.0, Tinct. Absinthii, Tinct. Foeniculi Compos., aa 20.0. Take 20 to 30 drops in water, 3 times a day.
• Aniseed: Pour 1 cup of boiled water onto 1 heaped teaspoon of the freshly crushed or coarsely powdered herb, then cover and steep for 10 to 15 minutes. Take 1 cup, 3 to 5 times a day.
• Anise oil: 3 drops on a cube of sugar, several times a day.
• Commercial products: Take as directed on the product label.
– Clinical value: All of these remedies are generally recognized in Europe as safe and effective. Hence, they can be selected according to the taste preference of the patient.

Mild Gastrointestinal Pain, Bloating, and Meteorism
➤ Caraway; fennel; wormwood; yarrow.
– Dosage and administration
• Tea Rx: Carvi fructus, Foeniculi fructus, Absinthii herba, Millefolii herba, aa 25.0. Steep 1 teaspoon in 1 cup of boiled water for 15 minutes. Take 1 cup of the hot tea before each meal.
– Clinical value: Effective and well-recommended tea formulation, owing to inclusion of wormwood, the duration of application should be limited.

Severely Distended and Painful Stomach
➤ Caraway; olive oil; fennel; aniseed.
– External remedies: Dosage and administration
• Liniment Rx: Ol. Carvi 10.0, Ol. Olivinarum ad 100.0. Apply 10 to 15 drops onto the stomach in a circular pattern, 2 to 3 times a day. Can also be used in small children.
– Internal remedies: Dosage and administration
• Tea Rx: Carvi fructus (crushed), Foeniculi fructus (crushed), Anisi fructus (crushed), aa 20.0. Steep 1 teaspoon in 1 cup of boiled water for 20 minutes. Drink a cup of the warm tea after each meal.
• Caraway oil: 2 to 3 drops in a small amount of water at meal time.
• Caraway seed: Pour 1 cup of boiled water onto 1 teaspoon of the freshly crushed seeds, then cover and steep for 5 minutes. Take 1 cup at or after meals.

– Clinical value: These herbal remedies, especially caraway oil, have good effects in this indication according to clinical experience in Europe. Postprandial Bloating and Meteorism
➤ Caraway; fennel; wormwood herb (see p. 129); yarrow herb; turmeric root; artichoke leaf.
– Dosage and administration
• Tea Rx: Carvi fructus, Foeniculi fructus, Absinthii herba, Millefolii herba, aa 25.0. Pour 1 cup of boiled water onto 1 teaspoon of the tea mixture, then cover and steep for 15 minutes. Take 1 cup of the hot tea before each meal.
• Turmeric root, artichoke leaf: Use commercially available preparations Meteorism and Cramping with Inflammation and Diarrhea

➤ Caraway; fennel; chamomile.
– Dosage and administration
• Tea Rx: Carvi fructus, Foeniculi fructus, aa 20.0; Matricariae flos, ad 100.0. Steep 1 to 2 teaspoons in 1 cup of boiled water for 10 minutes and sip slowly while hot.
– Clinical value: Effective and well-tolerated remedies. Bloating and Meteorism with Cramplike Gallbladder Pain

➤ Gentian root; wormwood herb; peppermint leaf; belladonna.
– Dosage and administration
• Tincture Rx 1: Tinct. Gentianae, Tinct. Absinthii, aa 20.0; Tinct. Menthae Piperitae 10.0. Take 30 drops in a glass of water, shortly before meals,
3 times a day.
• Tincture Rx 2: Tinct. Belladonnae 2.0, Tinct. Menthae Piperitae 10.0; Tinct. Gentianae 20.0. Take 10 to 15 drops in a glass of water shortly before meals, 3 times a day.
Note: Pharmacists are required to standardize belladonna tincture with respect to its alkaloid content. The use of belladonna tincture for more than 3 weeks is not recommended.
– Clinical value: Effective and safe for short-term use.

More Severe Colics and Meteorism
➤ Peppermint leaf; aniseed; calamus root; blessed thistle; wormwood.
– Dosage and administration
• Tea Rx 1: Menthae piperitae folium, Anisi fructus, Calami rhizoma, aa 20.0. Steep 1 tablespoon in 1 liter of water for 1 hour. Warm and drink 1 cup before each meal.
• Tea Rx 2: Cnici benedicti herba, Absinthii herba (see p. 129), Melissae folium, aa 20.0. Steep 1 teaspoon in 1 cup of boiled water for 20 minutes. Take 1 cup, 3 times a day.
– Clinical value: Large interindividual differences in the effects of these remedies can be observed.

Range of Applications in Functional Epigastric Complaints Spastic Functional Epigastric Syndrome
➤ Peppermint leaf; belladonna; wormwood; caraway seed; valerian root.
– Dosage and administration
• Peppermint leaf: Pour 1 cup of hot, not boiling water onto 1 to 2 teaspoons of the herb, then cover and steep for 10 to 15 minutes. Take 1 cup after or between meals. The tea should be drunk slowly while warm.
• Peppermint tincture: 5 drops in half a glass of water. Gives two doses daily. Preferably used for acute symptoms only.
• Tincture Rx: Ol. Carvi 3.0, Tinct. Belladonnae, Tinct. Absinthii, Tinct. Carminativa, aa 10.0; Tinct. Valerian. Aeth., ad 50.0. Take 30 drops in water, after meals, 3 times a day.

Warning: The latter formulation contains belladonna and should not be used for more than 3 weeks.
Note: Antacids can dissolve the enteric coating of some tablets, leading to stomach upset.
– Clinical value: Large interindividual differences in the effects of these remedies can be observed.

Roemheld’s Complex
(Spastic Functional Epigastric Syndrome with Severe Meteorism)

➤ Galangal root.
– Dosage and administration
• Dried herb: Pour 1 cup of boiled water onto 1 teaspoon of the finely chopped or coarsely powdered herb, then cover and steep for 5 to 10 minutes. Take 1 cup, 15 to 30 minutes before each meal.
• Tincture (1 : 10): Take 10 drops in lukewarm water, 15 minutes before meals, 3 times a day.
– Clinical value: Large interindividual differences in the effects of these remedies can be observed.

Roemheld’s Complex with Poor Evacuation of the Bowels
➤ Caraway; fennel; senna leaf.
– Dosage and administration
• Tea Rx: Carvi fructus, Foeniculi fructus, aa 20.0; Menthae piperitae folium, Sennae folium, aa 30.0. Steep 1 to 2 teaspoons in 1 cup of boiling water for 20 minutes. Take 1 cup in the morning and evening.
Warning: This formulation contains senna and should not be used for more than one month at a time.
– Clinical value: Effective, but duration of use is restricted.

Dyspepsia Associated with Enzyme Deficiencies
➤ Papaya peel; pineapple, or their derivatives, papain and bromelain.
– Dosage and administration
• Papain, bromelain, pancreatin, trypsin, chymotrypsin: Commercial tablets are widely used.
Warning: Allergic reactions, ranging from mild reactions to anaphylactic shock, can occur. Bloating, flatulence and occasional nausea can occur when administered at high doses.
Warning: Bromelain can increase the potency of antibiotics and anticoagulants. Other side effects include harmless changes in the consistency, color, and smell of stools.
– Contraindications: Severe congenital or acquired coagulopathies, known hypersensitivity to any of the ingredients. Should not be used before surgery.
– Clinical value: Large interindividual differences in the effects of these remedies can be observed.

Posted in: Disease and Complications of the Digestive Organs