Topic Contents
Indigestion, Heartburn, and Low Stomach Acidity
Need to Know
Related Topics
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Use charcoal for gas
Take 388 to 584 mg of activated charcoal within two hours after a gas-forming meal to reduce flatulence.
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Relax your gut with traditional treatments
Try a carminative herbal blend containing peppermint, caraway, and/or fennel to help relax intestinal cramping and relieve gas
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Try artichoke
Take an extract providing 500 to 1,000 mg per day cynarin if your indigestion may be due to insufficient bile production by the liver.
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Get a checkup
See your healthcare provider to make sure your symptoms are not related to a medical problem.
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Slow down at the table
Take time to eat slowly and chew your food thoroughly.
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Try lactase enzymes
If your symptoms seem to be brought on by milk products, try taking lactase digestive enzymes before eating those foods.
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Help digestion with pancreatic enzymes
Taking enzymes at each meal that provide 30,000 USP units (IU) of lipase and also include protease and amylase enzymes can improve digestion.
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Check for food sensitivities
Work with a practitioner knowledgeable about food intolerance to see if certain foods make your symptoms worse.
About
About This Condition
“Indigestion” refers to any number of gastrointestinal complaints, which can include gas (belching, flatulence, or bloating) and upset stomach. “Heartburn” refers to a burning feeling that can be caused by stomach acid regurgitating into the esophagus from the stomach, by gastritis (inflammation of the lining of the stomach), or by an ulcer of the stomach or duodenum (also called peptic ulcer). “Low stomach acidity” refers to the inability to produce adequate quantities of stomach acid that will affect digestion and absorption of nutrients.
In some cases, such as lactose intolerance, symptoms of indigestion are due to a specific cause that requires specific treatment. Sometimes symptoms associated with indigestion are caused by diseases unrelated to the gastrointestinal tract. For example, ovarian cancer may cause a sensation of bloating. Anyone with symptoms of indigestion should be properly diagnosed by a healthcare professional before assuming that the information below is applicable to their situation.
The most common cause of heartburn is gastroesophageal reflux disease (GERD), in which the sphincter between the esophagus and the stomach is not functioning properly. Another, related cause of heartburn is hiatal hernia, in which a small portion of the stomach protrudes through the aforementioned sphincter.
According to Jonathan Wright, MD, another cause of heartburn can be too little stomach acid.1 This may seem to be a paradox, but based on the clinical experience of a few doctors such as Dr. Wright, supplementing with betaine HCl (a compound that contains hydrochloric acid) often relieves the symptoms of heartburn and improves digestion, at least in people who have hypochlorhydria (low stomach acid). The amount of betaine HCl used varies with the size of the meal and with the amount of protein ingested. Typical amounts recommended by doctors range from 600 to 2,400 mg per meal. Use of betaine HCl should be monitored by a healthcare practitioner and should be considered only for indigestion sufferers who have been diagnosed with hypochlorhydria.
Medical researchers since the 1930s have been concerned about the consequences of hypochlorhydria. While all the health consequences are still not entirely clear, some have been well documented.
Many minerals and vitamins appear to require adequate concentrations of stomach acid to be absorbed optimally—examples are iron,2 zinc,3 and B-complex vitamins,4 including folic acid.5 People with achlorhydria (no stomach acid) or hypochlorhydria may therefore be at risk of developing various nutritional deficiencies, which could presumably contribute to the development of a wide range of health problems.
One of the major functions of stomach acid is to initiate the digestion of large protein molecules. If this digestive function is not performed efficiently, incompletely digested protein fragments may be absorbed into the bloodstream. The absorption of these large molecules may contribute to the development of food allergies and immunological disorders.6 , 7
In addition, stomach acid normally provides a barrier against bacteria, fungi, and other organisms that are present in food and water. People with inadequate stomach acidity may therefore be at risk of having “unfriendly” microorganisms colonize their intestinal tract.8 , 9 Some of these organisms produce toxic substances that can be absorbed by the body.
Some researchers have found that people with certain diseases are more likely to have an inability to produce normal quantities of stomach acid. However, this does not mean these diseases are caused by too little stomach acid. Jonathan Wright, MD, usually tests patients’ stomach acid if they suffer from food allergies, arthritis (both rheumatoid arthritis and osteoarthritis), pernicious anemia (too little vitamin B12), asthma, diabetes, vitiligo, eczema, tic douloureux, Addison’s disease, celiac disease, lupus erythematosus, or thyroid disease.10
Symptoms
The symptoms of indigestion or upset stomach may include painful or burning sensations in the upper abdomen, bloating, belching, diffuse abdominal pain, heartburn, passing gas, nausea, and occasionally vomiting. The appearance of these symptoms is often associated with eating.
Eating Right
The right diet is the key to managing many diseases and to improving general quality of life. For this condition, scientific research has found benefit in the following healthy eating tips.
| Recommendation | Why | Get started |
|---|---|---|
| Choose your drinks wisely | Doctors have observed that heartburn and indigestion may be relieved in some people by avoiding or reducing the intake of caffeine and alcohol. | |
Choose your drinks wiselyDoctors have observed that heartburn and indigestion may be relieved in some people by avoiding or reducing the intake of caffeine and alcohol. In addition, some people with symptoms of indigestion appear to have food allergies or intolerances. Avoiding such foods may improve digestive complaints in those people. While most doctors believe there is an important connection between diet and intestinal symptoms, there are few published data documenting such associations. Dietary modifications should be undertaken with the help of a healthcare practitioner.
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| Slow down at the table | Take time to eat slowly and chew your food thoroughly. | |
Slow down at the tablePeople who eat too fast or fail to chew their food adequately may also experience symptoms of indigestion or heartburn.
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| Check for food sensitivities | Work with a specialist to see if certain foods make your symptoms worse. | |
Check for food sensitivitiesDoctors have observed that heartburn and indigestion may be relieved in some people by avoiding or reducing the intake of caffeine and alcohol. Some people with symptoms of indigestion also may have food allergies or intolerances. Avoiding such foods may improve digestive complaints in those people. While most doctors believe there is an important connection between diet and intestinal symptoms, there are few published data documenting such associations. Dietary modifications should be undertaken with the help of a healthcare practitioner.
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| Go decaf | Doctors have observed that heartburn and indigestion may be relieved in some people by avoiding or reducing the intake of caffeine. | |
Go decafDoctors have observed that heartburn and indigestion may be relieved in some people by avoiding or reducing the intake of caffeine and alcohol. In addition, some people with symptoms of indigestion appear to have food allergies or intolerances. Avoiding such foods may improve digestive complaints in those people. While most doctors believe there is an important connection between diet and intestinal symptoms, there are few published data documenting such associations. Dietary modifications should be undertaken with the help of a healthcare practitioner.
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Supplements
What Are "Star" Ratings?
Reliable and relatively consistent scientific data showing a substantial health benefit.
Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.
Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.
For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.
| Supplement | Amount | Why |
|---|---|---|
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Artichoke
|
500 to 1,000 mg cynarin in a standardized herbal extract three times per day |
Extracts of artichoke have been repeatedly shown in research to be beneficial for people with indigestion. |
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| Supplement | Amount | Why |
|---|---|---|
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Bitter Orange
|
3 cups of tea daily, prepared with 1 to 2 grams of dried peel |
Bitter orange has traditionally been used as a digestive aid. |
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| Supplement | Amount | Why |
|---|---|---|
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Caraway
|
50 mg of oil plus 90 mg of peppermint oil in enteric-coated capsules taken three times per day for indigestion only |
One trial found that a combination with peppermint, caraway, and fennel was useful in reducing gas and cramping in people with indigestion. |
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| Supplement | Amount | Why |
|---|---|---|
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Charcoal
|
Refer to label instructions |
Supplementing with charcoal may help relieve gas. |
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| Supplement | Amount | Why |
|---|---|---|
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Digestive Enzymes
|
Consult a qualified healthcare practitioner |
Lipase, a pancreatic enzyme, aids in the digestion of fats and may improve digestion in some people. |
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| Supplement | Amount | Why |
|---|---|---|
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Fennel
|
1/2 tsp (2 to 3 grams) of ground or crushed seeds three times daily, taken directly or as tea |
Studies have found that a combination of peppermint, caraway, and fennel is useful in reducing gas and cramping in people with indigestion. |
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| Supplement | Amount | Why |
|---|---|---|
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Ginger
|
2 to 4 grams daily fresh ginger or equivalent for indigestion |
Ginger, with its anti-inflammatory and anti-nausea effects, has a history of use in treating gastrointestinal complaints, from flatulence to ulcers. It has been shown to enhance intestinal movements that aid digestion. |
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| Supplement | Amount | Why |
|---|---|---|
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Greater Celandine
|
4 to 8 mg chelidonine in a standardized herbal extract three times per day |
One study found that a standardized extract of greater celandine could relieve indigestion symptoms (such as abdominal cramping, sensation of fullness, and nausea) significantly better than placebo. |
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| Supplement | Amount | Why |
|---|---|---|
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Linden
|
Several cups of tea per day, made with 2 to 3 tsp of dried flowers per cup of hot water, for indigestion |
Linden has a long tradition of use for indigestion. It has antispasmodic action and may help people who suffer from upset stomach or excessive gas. |
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| Supplement | Amount | Why |
|---|---|---|
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Peppermint
|
90 mg of oil plus 50 mg of caraway oil in enteric-coated capsules taken three times per day, for indigestion only |
A combination of peppermint, caraway, and fennel has been shown to reduce gas and cramping in people with indigestion |
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| Supplement | Amount | Why |
|---|---|---|
|
Sage
|
4 to 6 grams daily of dried leaf or equivalent, for indigestion |
Sage is a gas-relieving herb that may be helpful in calming an upset stomach. |
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| Supplement | Amount | Why |
|---|---|---|
|
Turmeric
|
500 mg four times per day, for indigestion |
In a double-blind trial, turmeric was found to relieve indigestion. |
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| Supplement | Amount | Why |
|---|---|---|
|
Vitamin B12
(Delayed Gastric Emptying, Helicobacter Pylori Infection, Vitamin B12 Deficiency) |
1,000 mcg daily |
Vitamin B12 may be beneficial for people with delayed emptying of the stomach in association with Helicobacter pylori infection and low blood levels of vitamin B12. |
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| Supplement | Amount | Why |
|---|---|---|
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Andrographis
|
Refer to label instructions |
Andrographis acts as a digestive stimulant and may be helpful for indigestion. |
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| Supplement | Amount | Why |
|---|---|---|
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Anise
|
Refer to label instructions |
Anise is a gas-relieving herb that may be helpful in calming an upset stomach. |
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| Supplement | Amount | Why |
|---|---|---|
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Barberry
|
Refer to label instructions |
Taking barberry may help stimulate digestion and relieve an upset stomach. |
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| Supplement | Amount | Why |
|---|---|---|
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Basil
|
Refer to label instructions |
Basil is a gas-relieving herb that may be helpful in calming an upset stomach. |
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| Supplement | Amount | Why |
|---|---|---|
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Betaine Hydrochloride
|
Consult your doctor |
Supplementing betaine hydrochloride with meals may improve digestion in people who have been diagnosed with low stomach acid (hypochlorhydria).
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| Supplement | Amount | Why |
|---|---|---|
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Bitter Melon
|
Refer to label instructions |
Bitter melon acts as a digestive stimulant and may be helpful for indigestion. |
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| Supplement | Amount | Why |
|---|---|---|
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Bladderwrack
|
Refer to label instructions |
Bladderwrack is a demulcent herb, meaning it seems to work by decreasing inflammation and forming a barrier against irritants such as stomach acid. |
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| Supplement | Amount | Why |
|---|---|---|
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Blessed Thistle
|
Refer to label instructions |
Blessed thistle acts as a digestive stimulant and may be helpful for indigestion. |
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| Supplement | Amount | Why |
|---|---|---|
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Boldo
|
Refer to label instructions |
Boldo has a history of use in South America for a variety of digestive conditions. |
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| Supplement | Amount | Why |
|---|---|---|
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Cardamom
|
Refer to label instructions |
Cardamom is a gas-relieving herb that may be helpful in calming an upset stomach. |
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| Supplement | Amount | Why |
|---|---|---|
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Centaury
|
Refer to label instructions |
Centaury acts as a digestive stimulant and may be helpful for indigestion. |
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| Supplement | Amount | Why |
|---|---|---|
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Chamomile
|
Refer to label instructions |
Chamomile is effective in relieving inflamed or irritated mucous membranes of the digestive tract. |
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| Supplement | Amount | Why |
|---|---|---|
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Chaparral
|
Refer to label instructions |
People in the southwestern United States and northern Mexico have long used chaparral tea to help calm upset stomachs. |
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| Supplement | Amount | Why |
|---|---|---|
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Cinnamon
|
Refer to label instructions |
Cinnamon is a gas-relieving herb that may be helpful in calming an upset stomach. |
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| Supplement | Amount | Why |
|---|---|---|
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Cloves
|
Refer to label instructions |
Cloves are a gas-relieving herb and may be helpful in calming an upset stomach. |
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| Supplement | Amount | Why |
|---|---|---|
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Coriander
|
Refer to label instructions |
Coriander is a gas-relieving herb that may be helpful in calming an upset stomach. |
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Dandelion
|
Refer to label instructions |
Dandelion acts as a digestive stimulant and may be helpful for indigestion. |
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| Supplement | Amount | Why |
|---|---|---|
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Devil’s Claw
|
Refer to label instructions |
Devil’s claw acts as a digestive stimulant and may be helpful for indigestion. |
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| Supplement | Amount | Why |
|---|---|---|
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Dill
|
Refer to label instructions |
Dill is a gas-relieving herb that may be helpful in calming an upset stomach. |
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Elecampane
|
Refer to label instructions |
Elecampane has been used by herbalists to treat people with indigestion. |
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| Supplement | Amount | Why |
|---|---|---|
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European Angelica
|
Refer to label instructions |
European angelica is a gas-relieving herb that may be helpful in calming an upset stomach. |
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| Supplement | Amount | Why |
|---|---|---|
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Fructo-oligosaccharides
|
5 grams per day |
Supplementing with fructo-oligosaccharides may help relieve abdominal discomfort, fullness, constipation, urgency, and diarrhea.
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| Supplement | Amount | Why |
|---|---|---|
|
Gentian
|
Refer to label instructions |
Gentian is a bitter herb thought to stimulate digestion by increasing saliva production and promoting stomach acid and digestive enzyme production. |
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| Supplement | Amount | Why |
|---|---|---|
|
Goldenseal
|
Refer to label instructions |
Goldenseal is a digestive stimulant widely used in traditional medicine in North America. |
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| Supplement | Amount | Why |
|---|---|---|
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Horehound
|
Refer to label instructions |
Horehound’s major active constituent increases the flow of saliva and gastric juice. |
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| Supplement | Amount | Why |
|---|---|---|
|
Juniper
|
Refer to label instructions |
Juniper acts as a digestive stimulant and may be helpful for indigestion. |
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| Supplement | Amount | Why |
|---|---|---|
|
Lavender
|
Refer to label instructions |
Lavender is a gas-relieving herb that may be helpful in calming an upset stomach. |
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| Supplement | Amount | Why |
|---|---|---|
|
Lemon Balm
|
Refer to label instructions |
Lemon balm is a gas-relieving herb that is used traditionally for indigestion. |
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| Supplement | Amount | Why |
|---|---|---|
|
Licorice
|
Refer to label instructions |
Licorice protects the mucous membranes lining the digestive tract by increasing the production of mucin, a compound that protects against the adverse effects of stomach acid and various harmful substances. |
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| Supplement | Amount | Why |
|---|---|---|
|
Marshmallow
|
Refer to label instructions |
Marshmallow is a demulcent herb, meaning it seems to work by decreasing inflammation and forming a barrier against irritants such as stomach acid. |
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| Supplement | Amount | Why |
|---|---|---|
|
Oregano
|
Refer to label instructions |
Oregano is a gas-relieving herb that may be helpful in calming an upset stomach. |
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| Supplement | Amount | Why |
|---|---|---|
|
Oregon Grape
|
Refer to label instructions |
Oregon grape may stimulate digestion and relieve spasms in the intestinal tract. |
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| Supplement | Amount | Why |
|---|---|---|
|
Picrorhiza
|
Refer to label instructions |
Boldo has been used in South America for a variety of digestive conditions. |
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| Supplement | Amount | Why |
|---|---|---|
|
Prickly Ash
|
Refer to label instructions |
Prickly ash acts as a digestive stimulant and may be helpful for indigestion. |
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| Supplement | Amount | Why |
|---|---|---|
|
Rooibos
|
Refer to label instructions |
Rooibos is traditionally used as a tea as a digestive aid. |
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| Supplement | Amount | Why |
|---|---|---|
|
Rosemary
|
Refer to label instructions |
Rosemary is a gas-relieving herb that may be helpful in calming an upset stomach. |
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| Supplement | Amount | Why |
|---|---|---|
|
Slippery Elm
|
Refer to label instructions |
Slippery elm may have an anti-inflammatory effect in the stomach and intestines, and its mucilage content appears to protect against the damaging effects of acid on the esophagus. |
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| Supplement | Amount | Why |
|---|---|---|
|
Thyme
|
Refer to label instructions |
Thyme is a gas-relieving herb that may be helpful in calming an upset stomach. |
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| Supplement | Amount | Why |
|---|---|---|
|
Vervain
|
Refer to label instructions |
Vervain is a digestive stimulant widely used in traditional medicine in North America. |
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| Supplement | Amount | Why |
|---|---|---|
|
Vitamin B-Complex
(Vitamin B12 Deficiency) |
Refer to label instructions |
For people who have inadequate absorption of vitamin B12 due to low stomach acid, supplementing with vitamin B complex can help correct a deficiency. |
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| Supplement | Amount | Why |
|---|---|---|
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Wormwood
|
Refer to label instructions |
Wormwood is believed to stimulate digestion and relieve spasms in the intestinal tract. |
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| Supplement | Amount | Why |
|---|---|---|
|
Yarrow
|
Refer to label instructions |
Yarrow is a digestive stimulant widely used in traditional medicine in North America. |
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| Supplement | Amount | Why |
|---|---|---|
|
Yellow Dock
|
Refer to label instructions |
Yellow dock is a digestive stimulant widely used in traditional medicine in North America. |
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References
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32. Westphal J, Hörning M, Leonhardt K. Phytotherapy in functional upper abdominal complaints. Results of a clinical study with a preparation of several plants. Phytomedicine 1996;2:285–91.
33. Madisch A, Heydenreich CJ, Wieland V, et al. Treatment of functional dyspepsia with a fixed peppermint oil and caraway oil combination as compared to cisapride. Arzneimittelforschung 1999;49;925–32.
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38. Micklefield GH, Redeker Y, Meister V, et al. Effects of ginger on gastroduodenal motility. Int J Clin Pharmacol Ther 1999;37:341–6.
39. Stickel F, Pöschl G, Seitz HK, Waldherr R, Hahn EG, Schuppan D. Acute hepatitis induced by Greater Celandine (Chelidonium majus). Scand J Gastroenterol 2003;38:565–68.
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43. Benninger J, Schneider HT, Schuppan D, et al. Acute hepatitis induced by greater celandine (Chelidonium majus). Gastroenterol 1999;117:1234–7.
44. Forster HB, Niklas H, Lutz S. Antispasmodic effects of some medicinal plants. Planta Med 1980;40:303–19.
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