Classical medicine routinely prescribes metoclopramide, PPI, and spasmolytics for gastrointestinal complaints. However, herbal preparations from Tibet can also help.
Tibetan medicine is based on the doctrine of the five elements that make up all being: earth, water, fire, air and space. These elements express themselves in the human body through three dynamic, balanced states: rLung (wind; moving), Tripa (bile; warming) and Beken (phlegm; cooling). In case of disease, there is an imbalance, which is corrected first by changing the diet and lifestyle habits, then – if necessary – by herbal multi-substance mixtures. Various Tibetan formulations are also used in Switzerland as medicines and dietary supplements (Table 1).
Better digestion thanks to Se ‘bru 5
The Tibetan formula Se ‘bru 5 (Pomegranate 5) was described as early as the eighth century and consists of five medicinal plants (pomegranate seeds, galangal rhizome, long pepper, cardamom, cassia cinnamon bark) that promote digestive warmth (metö). It can be used for various digestive complaints and release blockages in this regard.
Efficacy and safety with respect to the treatment of GIT complaints such as postprandial fullness, diffuse epigastric discomfort, inappetence, nausea, and gastric cramps were confirmed in an open-label, prospective phase II clinical trial [1]. For this purpose, a total of 37 patients (>18 years; <65 years) were recruited who had been suffering from moderate to severe dyspeptic symptoms at least twice a week since >4 weeks (according to the DIGEST questionnaire). For six weeks, the subjects took three capsules twice daily. Visits were performed at baseline, after three weeks, and after completion of treatment. After another four weeks, the subjects were surveyed regarding their health status. The efficacy parameters were those of the DIGEST questionnaire, which determines the severity of various symptoms; additionally, gastric cramps and loss of appetite were included. Of the 37 patients included, 30 could be used for the intention-to-treat (ITT) analysis. According to their data, dyspeptic symptoms as well as QoL improved significantly (p<0.01). A positive trend was seen for symptoms of early satiety, bloating, constipation, night pain, or discomfort with fasting. Safety and tolerability were reported as good to very good by investigators in 81% of cases and by patients in 76% of cases. Seventeen mild adverse events (AEs) were reported, two of which had a probable association and seven of which had a possible association with the drug. Accordingly, Se ‘bru 5 can be used for functional complaints of the upper digestive system, loss of appetite and nausea.
Cong zhi 6 for gastritis
The Cong zhi 6 formula recently launched in Switzerland as a dietary supplement is very similar in composition. It contains alanth root, cardamom, safflower flowers, pomegranate seeds and long pepper. The effect is also comparable. However, with an additional ingredient – calcium carbonate – Cong zhi 6 experiences an extension of action, neutralizing excess stomach acid in gastritis. This provides a herbal preparation that can be used for gastritis as well as other gastrointestinal complaints such as dyspepsia.
Good against constipation
Another Tibetan preparation can serve very well for constipation. It consists of twelve herbal and three mineral ingredients. It contains 1,8-di-anthracene derivatives, essential oils, bitter substances, tannins, sodium hydrogen carbonate, sodium salt and kaolin. This results in a laxative, spasmolytic, decongestant, digestive, acid-binding and adsorbent effect. Thus, the multi-substance mixture not only acts as a laxative, but also stimulates digestion. Due to the synergy of the ingredients, they can be used in much lower concentrations than is the case with a monosubstance (Tab. 2). It is recommended to take 1-2 tablets daily, ideally before bedtime. The effect occurs after 8-12 hours.
In 2002, a double-blind, randomized, placebo-controlled clinical trial documented the efficacy of this preparation in obstipation-predominant Irritable Bowel Syndrome (IBS) [2]. In this three-month study, 61 patients (verum: n=34; placebo: n=27) suffering from constipation received 1-2 tablets daily. Symptom severity was assessed after each month by the subjects and a gastroenterologist. Subjects kept a study diary of bowel movements and tolerability of the study drug. After three months, there was a significantly greater improvement in symptoms in the verum group compared with placebo. A survey showed that the majority of subjects considered verum treatment to be more effective than previous therapies. In conclusion, the authors of the study described the preparation as safe and effective for the treatment of occasional constipation, especially in combination with flatulence and other digestive complaints or IBS.
Literature:
- Meier R, et al: The Tibetan herbal formula Padma Digestin in functional dyspesia: an open-label study. Forsch Komplementmed 2013; 20(Suppl 2): 2-7.
- Sallon S, et al: A novel treatment for constipation-predominant irritable syndrome using Padma® Lax, a Tibetan herbal formula. Digestion 2002; 65(3): 161-171.
HAUSARZT PRAXIS 2019; 14(2): 4-5
