Inflammatory bowel disease (IBD) is a condition of chronic inflammation of the digestive tract. The two main forms of IBD are Crohn’s disease (CD) and ulcerative colitis (UC). Common symptoms of IBD include diarrhea, abdominal pain, nausea and fatigue. Medications to help manage IBD and its symptoms, such as aminosalicylates, immunomodulators, corticosteroids, antibiotics, and biologic therapies are the most important part of therapy and are the only treatments that have been scientifically proven to be effective in treating the disease.
However, some people may choose to take some kinds of additional alternative supplements, such as herbal supplements. It is very important to understand that these supplements should never be used instead of medications prescribed to treat IBD: they are not a replacement for medications and they do not treat the disease itself. Research has not yet determined how these supplements work, or if they work at all. However, some people find that such supplements may have some positive effect on the symptoms that IBD causes.
It is important to talk to your doctor about all supplements, as some may interfere with prescribed medications.
What is herbal medicine?
Herbal medicine is the use of various plant parts, including roots, seeds, leaves and flowers, for medicinal purposes.2 The practice of herbal medicine, also known as Herbalism, has a long history of use dating back to as early as 3,000 BC. The extent of which plants can be used for medicinal purposes has not yet been proven (or disproven) by scientific research. However, some people find that they have a beneficial effect as a supplement.
The most commonly used medicinal herbs for IBD include:
- Slippery Elm
- Marshmallow
- Turmeric
- Cat’s Claw
- Boswelia
How might herbs work as a complementary treatment?
Herbs are often used together as a blend, instead of individually, as it is thought that they may be more effective when combined.1,2 It is thought that the herbs work as a whole with many ingredients. Healthcare providers who recommend herbal supplements take into consideration the part of the plant to use, how the herb was processed, how the supplement is stored, and potential contaminants.
Where can I find herbal supplements?
According to the U.S. Dietary Supplement Health and Education Act (DSHEA), herbal supplements are classified as dietary supplements and can be obtained without a prescription.2,3 They can be purchased at some drug stores and most health food stores. Herbal supplements are commonly found in five forms:
- Capsules
- Tablets
- Tinctures
- Tea
- Topical creams and salves
Capsules and tablets are two types of pill forms taken orally. Capsules are typically gelatin or vegetable based clear pills which are filled with dried forms of herbs. These can be opened and taken in juice or a smoothie or simply swallowed whole. Tablets are pills that are made by pressing dried ingredients together to form a small solid pill. These are taken orally and can be crushed up and used in drinks similar to capsules.
Tinctures are liquid extractions of botanical ingredients. They are often made by distilling the plant in a small amount of alcohol. They are purchased in glass bottles with dropper lids. They can be taken by dropping recommended amounts directly onto the tongue, or can be added to drinks or smoothies.
Herbal tea can be made by purchasing recommended parts, such as seeds, stems, bark, flowers, or leaves, and then steeped in hot water. Depending on the part of the plant being used, herbal teas could steep anywhere between two minutes and two days. It is important to consult a healthcare provider about the best way to brew the herbs you intend to use for treatment.
Some herbs are blended into a wax or oil based cream or salve for topical use. This form can not be ingested orally and is usually intended to treat skin-related conditions.
Who can I consult about herbal supplementation?
Herbal medicine is becoming more common as a form of supplementary treatment for a wide range of diseases and illnesses.2 The first person patients should consult about herbal supplementation is their healthcare provider. If they consider it safe for the patient to try herbal supplementation, then the patient may consult with an herbalist or a naturopathic physician.
It is important to note that some herbal supplements can interact with IBD medications. Some people may have the mistaken belief that anything “natural” cannot do any damage. In fact, some herbs can change the way that IBD medications work when they are taken at the same time. For this reason, it is very important to consult with a healthcare provider about any supplements you are taking.
Herbalists are people who specifically study the medicinal benefits of herbs. They have studied a variety of medicinal plants, their uses, and how to prepare them to be taken. Herbalists are often certified through an herbalism program.
Naturopathic physicians study herbalism as a type of treatment that falls within the naturopathic philosophy. Naturopathy believes that the body has the ability to help itself find balance and that natural therapies, such as medicinal herbs, compliment the healing process. Naturopaths train in a 4-year postgraduate institution. Their studies combine traditional medicine with various complimentary and alternative forms of treatment. Although naturopathic physicians are very well trained in their area of practice, they are not necessarily well versed or educated in the area of IBD. If at all possible, it is best to find a naturopathic physician who is familiar with inflammatory bowel disease such as CD and UC.