Top 10 Herbs for Intestinal Inflammation

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), 60-70 million people are affected by some type of digestive disease. Localized gastrointestinal inflammation is associated with the development and severity of inflammatory bowel disease (IBD), gastritis, diverticulitis, celiac disease, and irritable bowel syndrome (IBS) – all of which can present with symptoms like abdominal pain, gas, bloating, and abnormal bowel movements. Functional medicine doctors understand the importance of diagnosing and treating intestinal inflammation, which has also been correlated to increased risk systemic diseases, including cardiovascular disease, allergies, and neurodegeneration.    

Pharmaceutical drugs recommended by conventional standards of care for treating inflammatory bowel conditions often come with warning labels of severe and unwanted health consequences. Natural remedies have been proven to be just as, if not more, effective in optimizing gut health, reducing inflammation, and improving patient quality of life without serious side effects.

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Understanding Intestinal Inflammation

Inflammation is the body's natural response to harmful stimuli, such as pathogens or irritants. It is a complex biological process that involves the activation of the immune system to defend the body and promote healing. During inflammation, the body releases chemicals that increase blood flow to the affected area, leading to redness, warmth, swelling, and pain. While acute inflammation is a normal and protective response, chronic inflammation occurs when the body's inflammatory response persists over a long period, potentially leading to various diseases like rheumatoid arthritis, cancer, or IBD. (28) 

Gastrointestinal inflammation specifically refers to inflammation that occurs in the digestive tract. Acute gastrointestinal inflammation is short-lived and resolves once the underlying cause is treated. On the other hand, chronic gastrointestinal inflammation, as seen in conditions like Crohn's disease or ulcerative colitis, involves long-lasting inflammation of the digestive tract lining. Unlike acute inflammation, chronic gastrointestinal inflammation persists over time, leading to persistent symptoms, tissue damage, and potentially severe complications if not managed effectively. Causes of intestinal inflammation include food allergies, medications, stress, infection, dysbiosis, excess alcohol consumption, and smoking. (14) 

Symptoms of intestinal inflammation include: 

• Pain
• Diarrhea or constipation
• Bowel incontinence
• Bloating
• Blood in stool or vomit
• Nausea and vomiting
• Difficulty swallowing

Chronic inflammation can also manifest extraintestinally, with symptoms including:

• Fatigue
• Joint and muscle pain
• Changes in mood
• Unintentional changes in weight

Benefits of Using Herbs for Intestinal Health

Traditional medical systems like Ayurveda in India, Traditional Chinese Medicine, and Greco-Roman medicine extensively employed herbs to alleviate various ailments. Records detailing the medicinal use of plants date back as early as 3000 BC. The knowledge of these herbal remedies was passed down through generations and now forms the backbone of herbalism. 

Scientific research has delved into the efficacy of these traditional herbs, confirming many of their historical uses. For instance, studies have shown that ginger possesses anti-inflammatory properties and can help alleviate nausea and vomiting. Peppermint oil has been found to relax the muscles of the gastrointestinal system and is now recommended in the American College of Gastroenterology's (ACG) treatment guidelines for IBS. However, many herbal remedies lack robust and standardized clinical evidence to support many of their traditional uses, posing challenges to incorporating them into mainstream standards of care. Therefore, functional and integrative healthcare providers often rely on a combination of traditional knowledge, anecdotal evidence, and limited scientific studies to inform their evidence-based practices. 

Botanical medicine offers therapeutic benefits over its pharmaceutical counterpart by employing multiple mechanisms of action to comprehensively improve symptoms of gastrointestinal disorders without having as many associated adverse effects. This may be why, according to one paper, 40% of pediatric patients' parents have used complementary and alternative medicine (CAM), including herbs and spices, to treat their children's gastroenterological symptoms.

Top 10 Herbs for Intestinal Inflammation

In supplemental and whole-food forms, many herbs can support digestion and soothe irritated gastrointestinal tissues. Below are commonly used herbs that can effectively and safely treat intestinal inflammation.

1. Turmeric (Curcuma longa) 

Curcumin is a natural compound derived from turmeric, a bright yellow spice. It is renowned for its potent anti-inflammatory, antioxidant, and anti-cancer properties, which are particularly relevant in the context of diseases like IBD, IBS, and gastritis.

Doses often range from 500-2,000 mg per day, typically divided into two or three doses; however, some studies have used curcumin safely in doses as high as 600 mg five times daily for one month. Curcumin has a low oral bioavailability due to low absorption by the small intestine; therefore, many dietary supplements will add piperine (an alkaloid of black pepper) to enhance absorption. However, in treating gastrointestinal inflammation, it may be beneficial to use lower-absorbed forms to achieve a more direct effect of the herb on the inflamed intestinal mucosa. 

2. Slippery Elm (Ulmus rubra) 

The benefits of slippery elm for intestinal health can be attributed to its high concentration of mucilage and polysaccharides, which form a gel-like protective coating when they come in contact with water. This coating action helps soothe irritated mucosa, making it useful for inflammatory bowel conditions like IBD. Its mucilaginous nature also has been shown to relieve IBS symptoms, including pain, bloating, and constipation.

Slippery elm root is often dosed in powdered form and mixed in a preferred liquid (one tablespoon per cup of water) to form a gruel or tea. However, it is also available in tablet, capsule, and lozenge form. (13)

3. Peppermint (Mentha piperita)

Peppermint is associated with many actions that make it relevant for treating IBS. Peppermint oil contains L-menthol, which blocks calcium channels in smooth muscle, producing antispasmodic effects. Additionally, it is known to be carminative, antimicrobial, anti-inflammatory, antioxidant, immunomodulating, and anesthetic. Numerous clinical trials have shown that enteric-coated peppermint oil effectively reduces the severity of symptoms, especially abdominal pain and bloating, in patients with IBS. (1, 22)

4. Marshmallow Root (Althaea officinalis) 

Marshmallow root is very similar to slippery elm, rich in mucilage polysaccharides, including arabinogalactans, galacturonorhamnans, glucans, and arabinans, which are responsible for its anti-inflammatory and soothing properties. Because of this, marshmallow root (in powdered or encapsulated form up to 6 grams daily) is often recommended for treating intestinal inflammation related to gastritis, ulcers, GERD, and IBD. (6, 47) 

5. Ginger (Zingiber officinale) 

Ginger is a widely recognized spice and medicinal herb with a history spanning thousands of years. Its active compounds, such as gingerol, are responsible for its numerous medicinal properties. Ginger has long been employed to address various gastrointestinal disorders due to its anti-inflammatory and anti-spasmodic effects. Ginger is known to relax the digestive tract's muscles and increase gastric motility, reducing spasms and easing discomfort. Its anti-inflammatory nature helps in soothing irritated tissues in the GI tract. Ginger has been proven effective in alleviating indigestion, bloating, nausea/vomiting, and abdominal pain.

(10, 33) 

Dosing recommendations for ginger can vary based on the form of the supplement and the specific condition being treated. For instance, ginger tea, made by steeping fresh ginger slices in hot water, is a popular and soothing remedy for digestive discomfort. Alternatively, ginger supplements in capsules or tinctures are available and can be taken as healthcare providers recommend or based on the product label instructions. A standard dose of ginger for digestive relief ranges from 500 mg to 3 grams per day, divided into multiple doses. 

6. Chamomile (Matricaria recutita) 

Chamomile flowers contain volatile oils and flavonoids that possess anti-inflammatory, antispasmodic, and carminative properties that result in dispelling trapped gas, soothing inflamed tissues, and relaxing the intestinal smooth muscles. Traditionally, chamomile is used for numerous gastrointestinal conditions, including colic, abdominal pain, gas, ulcers, diarrhea, and hemorrhoids. (23) 

Chamomile is most commonly administered in capsule or tea forms to support intestinal health. In capsule form, a typical dose is 500-1,000 mg up to four times daily. Alternatively, people may make chamomile tea by steeping 1-3 teabags or one tablespoon of dried herb per one cup of hot water for 10-15 minutes and drinking up to four cups daily. (25) 

7. Aloe Vera (Aloe barbadensis miller) 

The gel-like substance found inside aloe vera leaves contains numerous bioactive compounds, including vitamins, minerals, enzymes, and polysaccharides, which contribute to the gel's mucilaginous, anti-inflammatory, and wound-healing properties. Clinical studies have shown aloe vera gel is an effective natural intervention for treating IBS symptoms, inducing ulcerative colitis remission, and healing chronic ulcers. 

Oral use of aloe gel is generally well tolerated. However, aloe latex has strong cathartic laxative action and can cause abdominal pains, cramping, and diarrhea; prolonged use can increase the risk of dehydration and electrolyte imbalance. (3, 18) 

8. Licorice Root (Glycyrrhiza glabra) 

Licorice is a versatile herb commonly recommended as part of a gut-healing treatment plan because of its anti-inflammatory, demulcent, antimicrobial, and laxative properties. The whole-root form of the herb contains glycyrrhizin, which can raise blood pressure. However, the deglycyrrhizinated form of the herb (called DGL) does not increase blood pressure and is used to treat heartburn, GERD, gastritis, peptic ulcers, IBD, and constipation. 

Glycyrrhizin can also activate mineralocorticoid receptors, increasing sodium reabsorption and potassium excretion. Not only does this contribute to its hypertensive effects, but it can lead to low potassium levels. Whole-root licorice is not recommended for patients with preexisting high blood pressure, heart disease, or kidney disease. (12) 

DGL is generally considered safe and well-tolerated. The standard dose for DGL is 760-1,520 mg between or 20 minutes before meals. (41) 

9. Fennel (Foeniculum vulgare) 

Studies have attributed fennel's essential oils to being responsible for its antioxidant, antibacterial, antifungal, carminative, and anti-inflammatory properties. (46) 

One study found that fennel was effective in neutralizing free radicals, which are associated with chronic inflammation. Researchers concluded that this finding suggests fennel extracts should be considered a potent source of natural antioxidants to treat inflammatory diseases. 

Other clinical trials have shown that fennel seeds, tea, and seed oil improve gastric motility and ease smooth muscle contractions within the intestinal walls (2, 44). Additionally, ground fennel seeds effectively treat bacteria that cause indigestion and diarrhea. 

Fennel is easily incorporated into the diet. Fennel bulbs can be eaten raw (in salads) or cooked by roasting, grilling, or braising. They offer a hint of licorice-like sweetness to the meal. Fennel fronds are often used as a garnish for soups and salads. Fennel seeds are aromatic and used to flavor baked goods, meat and fish, desserts, spice blends, and herbal teas. (46) 

10. Boswellia (Boswellia serrata) 

The gum resin of Boswellia plants contains boswellic acid, which has anti-inflammatory effects by blocking 5-lipoxygenase, an enzyme involved in producing inflammatory cytokines. This makes Boswellia an excellent treatment option for intestinal inflammation. Studies have shown that 250-1,200 mg (in divided doses) daily for 4-6 weeks improves clinical parameters of ulcerative colitis and microscopic colitis. Positive clinical outcomes have included reductions in gastrointestinal pain and cramping, frequency of diarrhea, blood in stool, and need for pharmaceutical medications. (33) 

Precautions with Herbal Remedies for Digestion

When considering herbal remedies, exercise caution and be aware of potential risks. Natural does not always equate to safe. Herbs hold the potential to negatively affect the body, causing allergic reactions or side effects, including digestive upset. Furthermore, herbal supplements can interact with prescribed medications, either diminishing their efficacy or amplifying their effects, leading to serious health complications. Therefore, it is crucial to consult with a healthcare professional, especially if you have underlying health conditions, are pregnant, nursing, or taking medications. Healthcare providers can offer personalized guidance, considering your medical history and any medications you're currently taking, ensuring that herbal remedies are safe and suitable for your specific situation. 

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Summary

The therapeutic benefits of herbs in treating inflammatory intestinal conditions offer a promising avenue for individuals seeking natural and holistic approaches to managing their health. Herbs such as turmeric, ginger, aloe vera, and slippery elm, among others, have shown remarkable anti-inflammatory and soothing properties, making them valuable allies in combating intestinal inflammation.