PharmD Program: Herbal & Alternative Medicine

Study Notes

The digestive system is a complex process that involves mechanical and enzymatic breakdown of food in the alimentary canal.
Enzymes are secreted by the stomach, pancreas, and small intestine, and mucus produced by glands in the intestine helps to lubricate and protect the digestive tract.
Digestion is facilitated by peristalsis, a wave of muscle contractions that begins in the duodenum and spreads towards the colon.

Gingivitis: inflammation of the gum tissue, often triggered by infection, and can lead to diminished saliva secretion, difficulty in speaking and swallowing, and infections like stomatitis and glossitis.
Glossitis: inflammation of the tongue, often triggered by infection, and can cause the tongue to swell and change color.
Stomatic plants: herbal medicines that can be used to treat oral infections and ulcers, such as propolis, which has antimicrobial and anti-inflammatory effects.

Composition: complex mixture of about 150 compounds, including flavonoids, coumaric acids, lignans, terpenoids, aromatic compounds, sugars, hydrocarbons, and mineral elements.
Mode of action: possesses anti-inflammatory, antifungal, antiviral, antibacterial, and tissue regenerative activities.
Adverse events: can cause allergic eczematous contact dermatitis and acute oral mucositis with ulceration.

Composition: contains volatile oil, resin, and gum, which fixes the active compounds and promotes a local leukocytosis.
Uses: traditionally used to treat mild inflammation of the oral and pharyngeal mucosa, and is relatively nontoxic.

Composition: contains mucilage, which has anti-inflammatory, immunomodulating, and antibacterial activities.
Uses: traditionally used to treat dyspepsia, and can act as a protective barrier, promote healing, and have anti-inflammatory effects.

Clinical picture: functional dyspepsia is a syndrome characterized by nausea, epigastric pressure, bloating, flatulence, and cramps abdominal pain.
Causes: deficiency in gastric secretion, motility gastric disorders, deficient bile production, diet, alcohol, tobacco, aspirin-like drugs, psychosocial factors, and Helicobacter pylori infection.

Traditional herbal remedies: bitter drugs, cholagogues/choleretics, and carminatives.
Examples: Gallexier Herbal Bitters, which contains artichoke leaves, dandelion, turmeric root, gentian root, and blessed thistle.

Composition: contain iridoid glycosides, such as amarogentin, amaroswerin, amaropanin, and gentiopicroside.
Mode of action: stimulate the taste buds and increase the flow of saliva and stomach secretions.
Adverse events: may cause headache, and are contraindicated in gastro-duodenal ulcers, high blood pressure, and individuals with high blood pressure.

Composition: contain volatile oil, with up to 90% of the terpene limonene.
Mode of action: inhibit gastric smooth muscle contractions, and have antimicrobial activity.
Examples: caraway, fennel, and anise.

Clinical picture: excessive amount of gas in the stomach or intestine, causing abdominal bloating, abdominal pain, and belching.
Causes: swallowed air, and normal breakdown of certain undigested foods by colon bacteria.
Treatment: changing diet, reducing the amount of air swallowed, taking digestive enzymes, and using herbal medicines such as carminatives.

Clinical picture: inflammation of the mucosa lining of the stomach, often caused by factors such as alcohol, tobacco, spices, toxins, bacteria, and drugs.
Mechanisms of mucosal injury: imbalance of aggressive factors, such as gastric juice, and defensive factors, such as mucus production, bicarbonate, and blood flow.
Treatment goals: relief of discomfort, protection of the gastric mucosal barrier, and eradication of H. pylori infection.

Composition: contains a saponin-like glycoside glycyrrhizin, and flavonoids.
Mode of action: possesses anti-inflammatory properties, and inhibits 15-hydroxyprostaglandin dehydrogenase, leading to an increase of protective prostaglandins in the stomach.
Adverse events: can cause sodium and water retention, hypertension, and hypokalaemia, and is contraindicated in patients with cardiac, liver, and kidney problems.

Clinical picture: nausea and vertigo, often triggered by traveling, and can lead to excessive salivation, nausea, and vomiting.
Treatment: preventing kinetosis by administering an anti-kinetosics 30-60 minutes before departure.

Composition: contains volatile oil, oleoresin, and zingerone.
Mode of action: works on the gastrointestinal system, and has anti-5-HT action.
Adverse events: should not be taken during pregnancy, and has an antithrombotic effect, which is a concern for patients taking anticoagulants or those with bleeding disorders.