Alternative Therapies for Gastrointestinal Problems

Therapy	Best Evidence *	Probably Useful †	Least Evidence ‡
Herbals	Aloe (constipation), 30 ml t.i.d.; cascara (constipation), tea from 1 tsp. bark b.i.d., 1 ml tincture b.i.d.; deglycyrrhizinated licorice (DGL) (peptic ulcer disease [PUD]), 380–760 mg t.i.d./ac; peppermint (indigestion), 0.2 ml–0.4 ml enteric coated oil b.i.d.–t.i.d./ac; senna (constipation).	Aloe (heartburn), 30 ml t.i.d.; bilberry (diarrhea); boldo (cholagogue, indigestion); caraway; chamomile (antispasmodic, colic, PUD) 2–3 g/day, 3–5 ml tincture t.i.d., as tea t.i.d.–q.i.d.; ginger (nausea), 500 mg t.i.d.; goldenseal (diarrhea) 500 mg t.i.d., use with caution; fennel (colic, antispasmodic), tea 1 cup t.i.d.; 600-mg caps t.i.d., for infants, 2 tsp seeds t.i.d.; garlic (antispasmodic), up to 3 g b.i.d.; lemon balm; marijuana (nausea); raspberry tea; sage (antispasmodic); white wine (increases gastric emptying).	Bitters (indigestion): barberry, dandelion; Oregon grape, yellow dock, wormwood; butcher's broom (hemorrhoids); horse chestnut (hemorrhoids).
Diet and Nutrition/Lifestyle	Lactase (for those with lactose intolerance); lipase (pancreatic insufficiency).	Bismuth (PUD), 240 mg subcitrate b.i.d./ac, subsalicylate 500 mg q.i.d./ac; cabbage (PUD), 1 L juice daily, effects possibly due to glutamine content; charcoal (excess gas); lactobacillus acidophilus (diarrhea, antibiotic-induced diarrhea).	Betaine HCl (low stomach acidity); flavonoids (PUD), 500 mg t.i.d.; proteolytic enzymes; yogurt (antibiotic-induced diarrhea); vitamin A up to 25,000 IU/day; vitamin C 500 mg t.i.d.; vitamin E 100 IU t.i.d.; zinc 30 mg/day.
Mind-Body Interventions	Depression (functional bowel complaints), detect and treat; exercise (constipation); psychotherapy; stress management (PUD).
Alternative Systems of Care		Acupuncture (nausea); acupressure (nausea); ayurveda.	Homeopathy: Colic: cuprum metallicum 6C t.i.d.–q.i.d.; chamomile 6C t.i.d. for 3–4 days; colocynthis 30C t.i.d.; nux vomica 6C q 15 min until vomiting ceases; belladonna 6C q 1 hr for up to 6 doses; bryonia 6C q 1 hr for up to 6 doses. Constipation: nux vomica 6C t.i.d. for 10 days; sepia 30C: 3 doses in 24 hr once a month; sulfur 6C t.i.d. up to 10 days. Diarrhea: arsenicum album 6C q 30 min for up to 6 doses, then t.i.d.; argentum nitricum 6C q 1 hr up to 6 doses; podophyllum 30C t.i.d.–q.i.d. for 2 days; pulsatilla 6C q 2 hr for up to 6 doses; sulfur 6C q 1 hr up to 6 doses, then t.i.d. Hemorrhoids: hamamelis 6C t.i.d. for 3 days; calcarea fluorica 6C t.i.d.–q.i.d. for 3–4 days; arnica 30C q.i.d. for 2–3 days; aesculus; hippocastanum 30C t.i.d. for 3 days. Heartburn, indigestion, and gas: nux vomica 6C q 30 min for 2 hr; carbo vegetabilis 6C q 30 min for 2 hr; lycopodium 6C 2–3 times after meals; natrum phosphoricum 6C q 30 min for 2 hr; arsenicum album 6C q 1 hr up to 6 doses, then t.i.d.

^*Therapies with the highest degree of scientific support for efficacy and safety.
^†Therapies that are often helpful but that do not have the highest degree of supporting evidence for efficacy and safety.
^‡Therapies that may be useful but that have limited scientific evidence for efficacy and safety.
NOTE: C denotes the number of times that a substance is diluted at a ratio of 1:100.
SOURCE: Sierpina, VS: Integrative Health Care: Complementary and Alternative Therapies for the Whole Person, F.A. Davis, Philadelphia, 2000.