Can herbal remedies, spices, and dietary fibers offer effective treatment options for children with irritable bowel syndrome (IBS)?

In a recent review published in Nutrients, researchers examined recent studies on the positive effects and adverse reactions of spices, dietary fiber, and medicinal herbs for pediatric patients with irritable bowel syndrome (IBS).

Study: The Use of Fibers, Herbal Medicines and Spices in Children with Irritable Bowel Syndrome: A Narrative Review. Image Credit: FotoDuets/Shutterstock.comStudy: The Use of Fibers, Herbal Medicines and Spices in Children with Irritable Bowel Syndrome: A Narrative Review. Image Credit: FotoDuets/Shutterstock.com

Background

IBS, a prevalent functional abdominal pain illness, is impacted by various variables and has been attempted to be treated with various approaches, including nutrition, pharmaceutical and psychological therapies, and neuromodulation.

Infections, inflammation, distension, microbiota modifications, nutrition, allergies, and immune system activation all influence the gut microbiota, which is important in IBS pathogenesis.

The cause of IBS is unknown, but when other treatments fail to relieve symptoms,  individuals seek alternative remedies such as herbal therapy.

About the review

In the present review, researchers reviewed existing data on alternative therapies for pediatric IBS patients, including dietary fibers, spices, and herbal remedies.

The review includes randomized controlled trials, prospective observational-type studies, randomized cross-over studies, cluster-randomized clinical trials, and systematic reviews written in English and published in the Cochrane, Scopus, and PubMed databases.

Use of dietary fibers and herbs for children with IBS

Dietary fibers improve digestive health by regulating stool consistency and frequency of feces, as well as the microbiota and metabolism. Fiber fermentation generates short-chain fatty acids (SCFAs) and gases.

SCFAs promote colonic function by influencing myenteric neuron activity and exerting immunoregulating effects. Insoluble fibers (such as corn, cellulose, lignin, wheat barn, and hemicellulose) speed up intestinal transit by thickening feces and enhancing its water content. Bloating and stomach discomfort are the most common complaints regarding dietary fibers, usually caused by insoluble fibers.

The seeds of Plantago ovata Forsk are used to produce psyllium fiber (or ispaghula, water-soluble). The mucilage contains acidic arabinoxylan, branched polysaccharides, and prebiotics that promote the development of beneficial bacteria and stimulate SCFA formation.

Psyllium gel (arabinoxylan) is partly fermented and holds water within the small bowel, boosting stool production. Psyllium also influences the gastric epithelial immune function. In a previous study, Psyllium fiber, six to twelve grams per day for four to six weeks, decreased pain frequency in IBS children, with 42% achieving remission.

Guar gum is a gel-forming galactomannan derived from the seeds of Cyamopsis tetragonolobus. Partially hydrolyzed guar gum is a water-soluble, low-viscosity, non-gelling derivative of guar gum.

Guar gum is a gel-forming galactomannan derived from the seeds of Cyamopsis tetragonolobus. Partially hydrolyzed guar gum is a water-soluble, low-viscosity, non-gelling derivative of guar gum.

Five g/dose of partly hydrolyzed guar gum in 50 mL of fruit juice for four weeks lowered the Birmingham IBS symptom score and three subscale scores for diarrhea, constipation, and pain at four and eight weeks in children aged eight to sixteen. Improvements to the Bristol Stool Form Scale (BSFS) were also noted.

Use of herbal medicines and species for IBS children

Herbal medicines, including STW-5, peppermint oil, ginger, curcumin, fennel, and cannabis, have been demonstrated to work together to treat IBS. STW-5 is a herbal mixture of nine extracts from medicinal plants that operate on gastrointestinal smooth musculature, increase gastric secretion, have spasmolytic, choleretic, and anti-inflammatory actions, and diminish visceral hypersensitivity.

STW-5 usage (10 to 20 drops three times a day) has been shown in studies to relieve gastrointestinal symptoms by 75%.

Mentha piperita, a perennial blooming plant, yields peppermint oil, which is the main component of menthol. Peppermint oil is readily absorbed and possesses antispasmodic, anti-inflammatory, antibacterial, and antifungal properties.

Ginger, derived from Zingiber officinale Roscoe roots, has antiemetic properties and has been used to treat nausea and vomiting associated with pregnancy, chemotherapy, dyspepsia, gastroenteritis, and other conditions. In addition, it possesses anti-inflammatory, antibacterial, hepatoprotective, and antioxidant properties.

Curcumin, a yellow pigment derived from turmeric, is an anti-inflammatory, antioxidant, hepatoprotective, and antiallergic agent. However, researchers have raised about curcumin's limited absorption, bioavailability, and rapid excretion.

Curcumin's pharmacokinetics appear to improve when combined with other botanical extracts. Curcumin appears to be effective on digestive symptoms among IBS patients when used independently or as a constituent of herbal mixtures.

Fennel oil, derived from the seeds of Foeniculum vulgare, soothes the smooth muscles of the gut, reducing stomach discomfort among IBS sufferers.

Research on adult IBS patients found that fennel oil, when used with curcumin, improved symptoms, and life quality; however, evidence among pediatric individuals is lacking.

Cannabis, which contains two primary cannabinoids, cannabidiol, and delta-9-tetrahydrocannabinol, may help relieve discomfort in IBS sufferers. However, no significant change in pain levels was identified among adult IBS patients who received cannabidiol rather than a placebo. Artichoke leaf extract lowers cholesterol and possesses antiemetic, choleretic, and spasmolytic properties.

Senna, an anthranoid glycoside laxative derived from the leaves and fruits of Cassia acutifolia, Cassia augustifolia, and Senna alexandrina, enhances intestinal motility by influencing the gut's enteric nervous system. Senna has shown purgative actions among individuals suffering from chronic constipation or for preparing the bowel before a colonoscopy.

Conclusion

Based on the review findings, herbal therapies, soluble fibers, and spices may benefit IBS patients; however, existing evidence is scarce.

Moreover, there is inadequate high-quality research data to support cannabis and endocannabinoid modulators as IBS therapeutics.

Studies have focused on functional gastrointestinal diseases rather than IBS, with limited sample sizes, short follow-ups, and symptom measure validation only among adults. Therefore, further research is required on alternative therapies for pediatric IBS patients.

Journal reference:
Pooja Toshniwal Paharia

Written by

Pooja Toshniwal Paharia

Dr. based clinical-radiological diagnosis and management of oral lesions and conditions and associated maxillofacial disorders.

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