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November 2020 #DDHChat Recap: Natural and Herbal

EA TwitterChat

Diet & Digestive Health (DDHChat) Twitter Chat with IFFGD, and EA Stewart, MBA, RD, CLT  

The Diet & Digestive Health (#DDHChat) Twitter chat series with the International Foundation for Gastrointestinal Disorders (IFFGD), co-host EA Stewart, MBA, RD, CLT.  We are excited to help to educate patients, caregivers, and others about Natural and Herbal Remedies for GI Symptoms. 

IFFGD – introductory tweets and remarks:

The views and experiences shared by our participant are their own and do not reflect the official positions of IFFGD. Each patient is different. Always consult with your health care provider or a registered dietitian (RD) on a diet treatment plan that is right for you. Information and resources shared during today’s chat should not replace medical care that you are receiving. And reminder, be sure to include #DDHChat in each of your tweets.

IFFGD – welcomes everyone to the chat and introduces co-host EA Stewart, MBA, RD, CLT:

Welcome to our November #DDHChat on Natural and Herbal Remedies with lead host @TheSpicyRD (EA Stewart, MBA, RD, CLT). Often, symptoms related to gastrointestinal (GI) disorders can be uncomfortable or even disrupt or daily routines. When conventional medicine has been tried and shows no relief to symptoms, some might ask their healthcare provider about natural or herbal treatment options. Natural or Herbal medicine can be used in the form of tablets, capsules, powders, teas, extracts, and fresh or dried plants. A dietitian might recommend the use of herbal medicines to help a patient maintain or improve their health.

We’re joined today by #GIdietitan @TheSpicyRD to share her unique insights on Natural and Herbal Remedies for GI Symptoms. #DDHChat

IFFGD and EA Stewart, MBA, RD, CLT Q&A:

Q1: What are natural and herbal remedies, and why might someone seek this approach to treat their GI symptoms? #DDHChat

EA Stewart, MBA, RD, CLT: In my practice I utilize a “food first” (i.e. #lowfodmap diet) approach to treating digestive symptoms but will explore #natural and herbal remedies as needed to further help alleviate GI symptoms. While lifestyle approaches (i.e. sleep, stress management, gut-directed hypnotherapy, etc.) are extremely important, for today’s #DDHChat we’ll focus on botanicals, vitamins/minerals, fiber supplements, and probiotics in our discussion on natural & herbal remedies. For today’s #DDHChat I won’t be mentioning any products by brand name. If you have any questions about what products I recommend, feel free to message me after the chat or email me at

Q2: What are herbal supplements, and how might it help someone with GI-related symptoms after they have gotten approval from their healthcare provider to use? #DDHChat

EA Stewart, MBA, RD, CLT: Herbal supplements are derived from plants and/or their oils, roots, seeds, berries, or flowers. They may be taken as a capsule, tea, or liquid/tincture. A few examples include ginger, mint, chamomile, & turmeric. It’s very important to keep in mind that herbal/natural supplements may have side effects or interfere with medications.     And because they are not strictly regulated it’s important to work with your gastroenterologist or dietitian to choose safe options. Keep in mind that “more” is usually not better. While herbal/natural remedies MAY be helpful, if you are consuming multiple supplements and still having symptoms, discuss removing most/all of them with your physician or dietitian & see if your symptoms improve. #DDHChat

Q3: For some people living with GI disorders, gas & bloating are very troublesome symptoms. How can natural and herbal remedies help relieve the two? #DDHChat

EA Stewart, MBA, RD, CLT: Although studies are mixed, some Bifidobacterium and Lactobacillus probiotic strains (i.e. Bifidobacterium infantis & Lactobacillus rhamnosus) may help with gas & bloating, esp. with IBS-C. When starting probiotics, go “low and slow”, allowing 2-4 weeks (if tolerated) to assess if helping. I sometimes recommend digestive enzymes with lactase, alpha-galactosidase, and/or xylose isomerase to help with gas & bloating. Take at the start of a meal containing foods high in lactose, galacto-oligosaccharides (i.e. beans), and/or fructose. While evidence is largely anecdotal, fennel seeds/tea may help with gas & bloating and have been found to be safe with occasional use. At the very least, you’ll have fresh breath! #DDHChat

Q4: Constipation can be very uncomfortable and often difficult for people to discuss with their healthcare provider. What are some tips to help individuals who are constipated? #DDHChat

EA Stewart, MBA, RD, CLT: Besides a fiber rich diet (as tolerated) & staying well hydrated, fiber supplements, inc. psyllium husk powder, PHGG (partially hydrolyzed guar gum), and/or acacia fiber may help constipation. As with probiotics, start “low & slow” & stop if constipation worsens. Magnesium is another one of my go-to’s for #constipation. I typically recommend Mg citrate or oxide at 300-400 mg to start & increasing as needed. Vitamin C may also be useful to normalize bowels with constipation. Dosages up to 2000 mg for adults may be used. Keep dosage to 1000 mg or less with h/o kidney stones. #DDHChat

Q5: What is a practical approach for someone who is experiencing diarrhea? #DDHChat

EA Stewart, MBA, RD, CLT: As with constipation, psyllium husk powder may also help with #diarrhea as it soaks up water & makes stools firmer and slower to pass. Saccharomyces Boulardi, a yeast-based probiotic-like supplement is one of my go-to’s for diarrhea. Start with 2 capsules 1-2 x per day and increase if needed. Certain additional #probiotic strains, inc. Lactobacillus rhamnosus & Bifidobacterium lactis, may also be helpful w/ diarrhea. Keep in mind most positive results are for antibiotic-associated diarrhea. #DDHChat

Q6: Abdominal pain can be mild or extremely debilitating for some. What herbal or natural remedies might help reduce their pain? #DDHchat

EA Stewart, MBA, RD, CLT: Peppermint oil is my first choice for abdominal pain & cramping, as it helps relax smooth muscles & has an antispasmodic effect. There are several varieties available, inc. one with caraway seed oil that has been found to pain intensity. While peppermint tea may be soothing & relaxing, studies on peppermint are with capsules. Choose enteric-coated capsules & use caution if GERD is also present, as peppermint can worsen symptoms. An herbal preparation referred to as STW 5 in research studies has been shown to help with abdominal pain & other GI symptoms and may be worth trying. Keep in mind that it contains licorice root which may raise blood pressure, so do not exceed the recommended dose. #DDhChat

Q7: Mild or persistent nausea is extremely common, especially among those living with Gastroparesis. What are some ways to help relieve this symptom naturally? #DDHChat

EA Stewart, MBA, RD, CLT: Ginger, which contains gingerol, has the most research behind it when it comes to natural treatments for nausea. Dosing is typically 1-3 gram per day. Forms include tea, hard candies, chews, syrup, and fresh ginger root. When choosing a form of ginger, read labels for dosing as amounts can vary widely. For fresh ginger, 1 gram is approximately 1 tsp fresh grated ginger or 4 8-oz cups ginger tea (½ tsp grated ginger steeped in water for 5-10 minutes). With nausea, I highly recommend checking forms of any supplements taken, as tablets/capsules may contribute to nausea. Choose powders, liquids, chews/gummies, or sublingual tablets instead. #DDHChat

Q8: GERD Awareness Week is November 22-28th this year. Why might someone with acid reflux seek relief naturally, and what are some alternative treatments? #DDHChat

EA Stewart, MBA, RD, CLT: In my experience, lifestyle and dietary strategies (i.e. smaller meals) seem to be more helpful for GERD than any herbal/natural supplements, however I’d love to hear what works for others. If GERD is exacerbated with gas & bloating, specific digestive enzymes, as mentioned earlier, in conjunction with dietary changes, may be beneficial. Melatonin, a natural hormone that can also be taken in supplement form, is being studied for the treatment of GERD. More studies need to be done, but preliminary results suggest a dosage between 3-6 mg may be effective in helping to relieve epigastric pain & heartburn. #DDHChat

Q9: Inflammation can cause many of the unwanted symptoms we have touched on during this chat. What might be a good natural dietary modification for someone concerned about gut health and inflammation? #DDHChat

EA Stewart, MBA, RD, CLT: Besides following an anti-inflammatory diet, like the #MediterraneanDiet , some natural treatments under investigation for #inflammation include turmeric (curcumin), fish oil, & ginger. Curcumin, a bioactive component of turmeric, has been one of the most studied natural anti-inflammatories. Studies showing benefits have used large amounts of turmeric at ~ 1.5 gram or more/day. Piperine, a natural substance in black pepper, helps with absorption. Fish oil and ginger have shown mixed results in reducing inflammation. My recommendation is typically to consume omega-3 rich fatty fish, such as wild salmon, ~ 2 x week, as opposed to taking fish oil supplements. #DDhChat

Q10: As we wrap things up, what advice or tips would you provide someone who might be considering a more natural approach to treating their GI symptoms? #DDHChat

EA Stewart, MBA, RD, CLT: It’s important to use a balanced approach when it comes to managing GI symptoms. As I mentioned earlier, I start with a food and lifestyle approach then layer in herbal/natural treatments if needed. While “less is more” is often best, if an herbal/natural treatment has a good safety profile & can help GI symptoms with a LESS restrictive diet, I’m all for that as well! Lastly, if you are looking for reputable sources to find out more information on herbal/natural therapies for GI symptoms, I recommend @NIH_HCCIH @ConsumerLab @medlineplus #DDHChat

IFFGD- final tweets and remarks:

We hope that you all have learned something new about natural & herbal remedies today. To learn more about EA Stewart, MBA, RD, CTL visit: #DDHChat

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IFFGD is a nonprofit education and research organization. Our mission is to inform, assist, and support people affected by gastrointestinal disorders.

Our original content is authored specifically for IFFGD readers, in response to your questions and concerns.

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