Digestive System
This chapter deals with phytomedicines that are used in the treatment of poor appetite, functional dyspepsia (irritable stomach syndrome), irritable bowel syndrome (irritable colon), gastritis and ulcer disease, acute diarrhea, constipation, and chronic l
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This chapter deals with phytomedicines that are used in the treatment of poor appetite, functional dyspepsia (irritable stomach syndrome), irritable bowel syndrome (irritable colon), gastritis and ulcer disease, acute diarrhea, constipation, and chronic liver disease. These diseases and ailments are based only partly on underlying organic pathology; most are "functional" disturbances of the gastrointestinal tract and bile ducts. The remedies that are used for these indications are not always covered by health insurance in Germany, and certain groups, such as laxatives, have been largely excluded from coverage. The result has been an increase in the self-prescribing of these products by patients with digestive complaints. But functional dyspepsia and irritable bowel syndrome are examples of conditions in which it is imperative that the family doctor continue to provide appropriate counseling and guidance.
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Anorexia
In natural healing, anorexia refers to a syndrome featuring nausea, epigastric pressure, bloating, flatulence, and crampy abdominal pains, presumably due to the deficient secretion of gastric juice, deficient bile production, impaired filling and emptying of the gallbladder (biliary dyskinesia), or the deficient secretion of pancreatic juice (exocrine pancreatic insufficiency) (Fintelmann et aI, 1993). Effective herbal remedies may be selected from the categories of bitters, cholagogues, or carminatives, depending on whether the dysfunction involves the stomach, biliary tract, or bowel. In practical terms, however, categorical distinctions of this kind cannot be consistently drawn from either a diagnostic or therapeutic standpoint. Lack of appetite may be a symptom of organic disease (infectious diseases, gastrointestinal disorders, malignant tumors), or it may be psychosomatic (anorexia nervosa, emotional stress) or drug-induced (cancer chemotherapy, antibiotics). In other cases lack of appetite or early satiety may occur in the setting of a dyspeptic syndrome V. Schulz et al., Rational Phytotherapy © Springer-Verlag Berlin Heidelberg 2004
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I 5 Digestive System (see Sect. 5.2), resulting in overlaps in treatment. In psychophysiologic terms, appetite is an instinctive mechanism of which the main locus of control resides in the hypothalamus (limbic system) (Adler, 1979). Mechanisms involved in the anticipatory-metabolic taste reflexes may be even more important in understanding the effects of appetite-stimulating and secretagogic agents, including herbal chalogogues (Nicolaidis, 1969).
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Bitter Herbs (Bitters)
Two different interpretations, each supported by experimental data, can be found in the pharmacologic literature regarding the mechanism of action of bitters. Both interpretations agree that stimuli originating in the mouth can reflexively induce gastric secretions. A bitter in the form of an aperitif or stomach bitter, taken in a moderate amount 20-30 min before eating, can stimulate gastric and biliary secretions, increasing the acidity of the gastric juice and aiding digestion (Bellom
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