Natural Anti-Inflammatory Agents for Gut Health: An Evidence-Based Review

There are over 100 million ambulatory visits each year due to digestive diseases, and this number is expected to grow continuously as the population ages. Maintaining a healthy gut can help reduce the risk of digestive diseases along with other health conditions such as metabolic issues, cardiovascular problems, immune imbalances, and central nervous system disorders. Functional medicine practitioners often focus on gut health for this reason. A key component to maintaining proper gut health is regulating inflammatory responses in the gut and throughout the body. This article will explore the importance of gut health and its relationship to other common health conditions, how to address gut inflammation through various natural agents, and some functional labs to assess for several gastrointestinal conditions affected by inflammation.

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Why is Gut Health So Important?

Gut health is usually a top priority for functional medicine and naturopathic doctors. Many other health conditions can stem from or be attributed to gut health imbalances, particularly imbalances in the gut microbiome. The gut microbiome comprises trillions of microorganisms, including bacteria, viruses, and fungi. Typically in a healthy individual, the gut microbiome can aid in the functioning of digestion, metabolism, immune response, and neuroendocrine signaling. However, if there are imbalances in the microbiome where the beneficial microbes aren't keeping the pathogenic (disease-promoting) microbes in check, this imbalance, called dysbiosis, can lead to other health conditions.

These conditions include Obesity, Diabetes, irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), Cancer, Cardiovascular problems, and Central nervous system disorders‌. A by-product of consuming red meat and eggs made by a bacteria in the gut called TMAO (trimethylamine-N-oxide) has been linked with heart and kidney disease.

Regarding mental health, studies show that the balance of the gut microbiome may affect mood/emotions and the way your brain processes information inputs from your senses. Poor gut health is also associated with mental health conditions like autism, ADHD, anxiety, depression, and even PTSD. As research continues to grow on gut health, it's important to note that the current research shows many connections as to why a healthy gut is so important in overall health and minimizing the risk of other health conditions.

Natural Anti-Inflammatory Agents for Gut Health: An Evidence-Based Review

Saccharomyces boulardii (S. boulardii)

Saccharomyces boulardii is a well-researched type of probiotic that comes from a non-pathogenic yeast. It's been shown to protect the gut against antibiotics and have anti-inflammatory effects. S. boulardii has regulated inflammatory responses from conditions such as IBD and inflammatory diarrhea caused by E.Coli, C. Diff, and Shigella infections. S. boulardii seems to inhibit proinflammatory cytokines and be protective of gut inflammation. In the case of acute diarrhea, the recommended dose is 500-750 mg for 8 to 10 days. Depending on the severity, the recommended dosing protocol for IBD is 750-1000 mg with concurrent therapy for 7 weeks to 6 months.

Probiotics

Taking probiotics can improve gut health by helping to reestablish the balance in the gut microbiome. The probiotics can help our gut produce more mucus and protect against damage to tight junction proteins. When these proteins are damaged, they can cause inflammatory processes in the gut. Probiotics can also help reduce gut problems and prevent inflammation from happening by decreasing the number of lipopolysaccharides (LPSs) that activate immune cells. When these immune cells are activated, they can cause inflammation throughout the body. Probiotics are shown in research to be helpful in gut inflammatory conditions such as IBD, celiac, IBS, and obesity. Supplements can vary in dosages and strains. Some of the more commonly used strains are Lactobacillus (L.), Bacillus (B.), and Bifidobacterium.

Prebiotics

Prebiotics are fibers that help feed the good bacteria in our gut, producing short-chain fatty acids (SCFAs). These SCFAs can have beneficial effects throughout the body, including anti-inflammatory effects. Consuming prebiotics can increase the number and diversity of beneficial bacteria in our gut, which can help with digestion and absorption of nutrients. They also strengthen our gut lining, reducing inflammation and improving gut health. Some common forms of prebiotics in supplements include FOS (fructooligosaccharides), GOS (galactooligosaccharides), and inulin. To get these benefits, consuming at least 3 to 5 grams of prebiotics is recommended. However, prebiotics should not be taken if you have SIBO (Small Intestine Bacterial Overgrow). Prebiotics can aggravate symptoms such as gas and bloating in patients who have SIBO.

Boswellia Serrata

Boswellia serrata is an herb from India that has been used in traditional medicine. Its resin contains boswellic acid, which is believed to benefit gut inflammation. Boswellic acid has anti-inflammatory effects by blocking 5-lipoxygenase. Studies have confirmed that boswellic acid effectively reduces inflammation in the small intestine and improves ulcerative colitis (UC) symptoms. UC is an inflammatory gut condition. The dosing recommendation for UC is 250 mg per day for adults for 4 weeks and at the same dosage for 1 to 6 months for IBS.

Licorice root (Glycyrrhiza glabra)

Glycyrrhiza is an anti-inflammatory herb that can soothe the digestive tract. The whole root contains glycyrrhizin, which can raise blood pressure. It's not recommended to use this with patients who have hypertension. However, a form of this herb called DGL does not have glycyrrhizin and is commonly used to treat heartburn, GERD, and gastritis. DGL promotes the production of mucus, which acts as a barrier to acid in the upper digestive tract, allowing damaged tissues to heal and preventing future irritation. Research has shown that DGL is more effective than drugs that reduce acid in treating gastritis and GERD.

Curcumin

Curcumin is a compound found in turmeric. Curcumin has been found to have anti-inflammatory, antioxidant, and anti-cancer effects. It can diminish inflammation in the body by controlling oxidative stress. Research shows that curcumin can help improve symptoms in individuals who have inflammatory bowel diseases (IBD), such as ulcerative colitis (UC) and Crohn's disease (CD), along with peptic ulcers. Curcumin may be a natural way to help manage inflammation in the gut. The recommended dose for peptic ulcers is 600 mg 5 times per day for 4 weeks.

Omega 3s

Omega-3 fatty acids found abundantly in seafood like fish have been shown in research to have multiple benefits for our bodies. They have anti-inflammatory effects and are also an essential nutrient, meaning we can't make it in our bodies and need to consume it. Omega 3 fatty acids seem to be good for our gut bacteria, which can make them act like prebiotics. Future studies are still needed to fully understand how omega-3 fatty acids affect our gut bacteria and how they can benefit our health. The recommended dose for UC is 500 mg twice per day adjunct to standard therapy and 1,500 mg (with 600 mg EPA/ 300 mg DHA bound to free fatty acids) three times per day for 12 months for Crohn's disease.

Aloe Vera

Aloe vera is a plant used in traditional medicine worldwide, and it's been shown to be effective in treating UC. The mucous from the plant's leaves, called aloe gel, has been shown to have anti-inflammatory effects in the gut. Some practitioners have been using it to treat UC. In a study, participants took 100 mg of aloe gel orally for 4 weeks, and 30% experienced clinical remission, while 37% showed improvement. Aloe is also effective at treating gastritis and GERD.

Oil of Oregano

Oregano is a herb that's commonly used in cooking, but it also has medicinal properties such as anti-inflammatory and antioxidant effects. Regarding gut health, the oil from oregano can help eliminate harmful bacteria by acting as an anti-microbial agent. Due to its anti-microbial effects, oregano oil helps treat dysbioses such as SIBO and Candida overgrowth. Oil of oregano is usually available as a liquid or gel capsule.

Ginger

Ginger is a popular herb used for its taste and health benefits worldwide. It's been used in India, China, and Europe for thousands of years. Ginger contains more than 400 different compounds, which give it a wide variety of health benefits. These benefits include its ability to reduce nausea, fight inflammation, kill harmful bacteria, lower cholesterol, regulate blood sugar levels, prevent cancer, act as an antioxidant, and modulate the immune system. Regarding gut health, it has been shown to inhibit the proinflammatory responses of NF-kB and IL-1β in the large intestine. The dosing recommendation for ginger as a supplement for general inflammation is 1,000-3,000 mg per day for 2 to 3 months.

‍Functional Medicine Labs That Can Help You Determine Which Gut Healing Supplement is Best for You

Functional medicine labs can help assess gastrointestinal disorders such as the conditions mentioned in the previous section and help determine which gut healing supplements may be best for you. Here are some of the functional labs to consider:

H. Pylori

H. pylori is a bacteria that adheres to the gastrointestinal mucosa and causes inflammation and ulcerations. It accounts for 90% of duodenal ulcers and 70-90% of gastric ulcers and gastritis. However, an upper endoscopy is the definitive diagnosis for peptic ulcers and gastritis. A stool test can help assess for H. pylori if peptic ulcers or gastritis are suspected.

Intestinal Permeability

Imbalances in the gut microbiome are often associated with intestinal permeability (leaky gut), which can create various inflammatory responses. The Advanced IBA profile measures zonulin, DAO, and LPS levels. All of these are markers of intestinal permeability.

Breath Test For SIBO

SIBO is a small intestine bacterial overgrowth, another form of dysbiosis. The SIBO breath tests measure hydrogen and methane gas levels derived from intestinal bacteria. This is a noninvasive test, and the results can provide insight into the diagnosis of SIBO. SIBO is also prevalent in GERD and can contribute to symptoms associated with GERD, such as chronic reflux.

Inflammatory Markers

These two markers are utilized to assess for general inflammation. The C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) will quantify levels of systemic inflammation along with assessing for inflammatory disease severity.

Saccharomyces Cerevisiae Antibodies

People with IBD often have immune proteins that attack a yeast called anti-Saccharomyces cerevisiae antibodies (ASCA). However, it's essential to note that a colonoscopy/endoscopy with biopsies is used for a definitive diagnosis of Crohn's or UC.

Comprehensive Stool Analysis

This test analyzes the makeup of the gut microbiome. The Gut Zoomer analyzes over 300 microorganisms, such as candida overgrowth, to determine if dysbiosis is occurring that may cause chronic disease. This is a great test to consider if any imbalances in the gut microbiome are suspected.

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Summary

It is vital to maintain proper gut health. A healthy gut can help prevent the risk of digestive diseases along with other health conditions such as obesity, diabetes, cardiovascular problems, immune system imbalances, and mental health issues. Having a well-balanced gut microbiome is an essential part of having a healthy gut, as it can help regulate inflammatory processes in the gut and throughout the body. Natural anti-inflammatory agents are a functional medicine approach that can help manage gut inflammation. Some of these agents include probiotics, aloe, and curcumin. These natural agents can help reduce symptoms associated with inflammatory gastrointestinal disorders such as peptic ulcers, gastritis, and IBD. It's essential to work with a qualified healthcare provider, such as a licensed naturopathic doctor, if you have digestive issues or before starting any of the recommended anti-inflammatory agents discussed in this article.