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Bloating, Gas, and Indigestion

2/15/2019

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PictureBitters: a classic cure for indigestion (dyspepsia)
When we have CF or any other condition with significant digestive involvement, bloating and indigestion are common nuisances. Fortunately, digestive complaints are nothing new to the human species, therefore the world's many herbal healing traditions have a huge amount of knowledge to contribute to this issue. Interestingly, digestion is one of the things that I feel conventional medicine has the hardest time understanding and helping with, especially for chronic digestive issues. So in this article I'd like to briefly mention a few herbs and techniques to use to address bloating and indigestion. There are so many herbs that help with digestive issues of all sorts and I couldn't possibly discuss all of them in one article, but I'll touch on a few that I use frequently for myself and my clients. 

Indigestion can mean a bunch of things and has a lot of synonyms: dyspepsia, stomach ache, sick stomach, colic, collywobbles (!), and so on. It can be an umbrella term that includes gas, bloating, stomach cramps, intestinal cramps, nausea, burping, constipation, delayed gastric emptying, and so on. If you get indigestion often and the gastroenterologist doesn't know why or how to help you, they will likely give you a label of "IBS" (irritable bowel syndrome) and probably send you hope with proton-pump inhibitors and/or prozac. We herbalists don't really use that term because we have a more complex understanding of indigestion and can differentiate its causes better than conventional docs can. Depending on the specific symptoms, certain herbs are more or less helpful. So I'll break things down by symptom. 

Before I do so, I want to reiterate here the strong connection between the lungs and the guts. In Chinese medicine, the lungs and large intestine are connected through the Metal element. In Ayurveda, eating certain foods that are hard to digest, like dairy, have an impact on our respiratory mucus production. I see this connection over and over again in my clients and in myself. Foods that we have particular sensitivities to (an over-reaction of the immune system as a result of poor digestion of proteins) can cause excessive mucus production in our intestines, and by reflex (connected through the vagus nerve) cause excessive mucus production in the lungs and sinuses. I also experience this when I over eat or when I eat a meal with an incompatible combination of foods that is hard to digest. The body produces mucus to flush irritating things out of it more quickly, and so when foods irritate us, the guts produce mucus. Recognizing the connection between respiratory and gut mucus production helps us make smarter dietary choices for our lung and sinus health. I've found that keep a food journal can help track these connections. 

I will also mention that the first step to having good digestion is eating the right foods. Everyone digests differently and has different dietary needs, so the foods we eat need to be tailored to our particular bodies. There is no "one size fits all" diet. I discuss this much more in depth in the rest of my website, so please browse to learn more. 

Carminatives
Carminatives are a class of herbs that assist with gas, bloating, nausea, delayed gastric emptying, and intestinal spasms, among other things. They contain volatile oils that are usually spicy and aromatic, and these have a counter-irritating effect that causes relaxation of the smooth muscles in our stomach, intestines, and gallbladder and pancreatic ducts. When we have gas and bloating, what often causes pain is the spasming and griping of the muscles of our stomach and intestines as they try to move the gas down and out of our intestines through the rectum (farting). So carminatives can help relax these spasms to help the gas pass more easily. 

Gas is generally caused by the bacteria in our gut when they ferment upon certain types of carbohydrates. Different bacteria prefer different types of carbs for food - some like simple sugars like cane sugar, lactose, simple starches in white potatoes or refined flours, or dried fruit. Bacteria that like simple sugars tend to be less beneficial to our health, but not all of them are bad. If we eat a lot of simple sugars a lot of the time, these bacteria will overgrow and cause chronic digestive issues. Other bacteria, generally the ones that are good for our health, like complex carbohydrates and fibers contained in fibrous plants and whole grains, also called "prebiotics". The more prebiotics we eat, the more we feed these beneficial bacteria, and the more they educate our immune systems to work properly. The not-helpful bacteria are usually the ones that like to produce the most gas, so a first step can be to cut out simple sugars and instead eat more fruits and vegetables. Sometimes eating fiber can cause bloating temporarily as our gut bacteria population shifts to favor the helpful species, so gas is not alway a bad thing. But when it happens, here's some herbs that can help. 
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Ginger root is number one on this list because it does almost everything to help the guts. It's anti-inflammatory, it speeds up gastric emptying, improves a weak appetite, and relaxes spasming intestinal muscles. It is amazing for nausea, motion sickness, stomach aches, and almost anything gut-related. It should be taken with caution in people with severe GERD, ulcers, or super sensitive stomachs. A small amount goes a long way - it's very spicy! I take capsules (1-3 capsules of 500mg each) as needed, especially after I've eaten a big meal that I need help digesting. Other methods are ginger tea, ginger candy, ginger tincture, powder, glycerite, vinegar extract, and so on. And of course, you can cook with it, as is most traditional! Remember to start with a low dose and work your way up - it's powerful! It is considered warming or even "hot", so not as good for use when it's very hot out or if there's a fever. 

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Peppermint is a carminative almost everyone has used at some point in their lives. It is one of the most warming mints and yet is also anti-inflammatory in its after effect, similar to ginger. Other mints that have a similar effect but slightly different flavor are spearmint, chocolate mint, apple mint, winter mint, and for kids, catnip. Catnip is considered a little gentler and is great for colic in babies, toddlers, and kids of all ages. All mints are great for nausea, intestinal spasms, gas, and bloating. The best form to take is in tea of dried leaves, but you can also take tincture or capsules (capsules are the least effective form because they have already lost a lot of their essential oils due to the powdering/processing). There have been many studies on the use of peppermint essential oil in very small doses taken orally to help with the symptoms of IBS. 

Culinary spices like fennel, cardamom, clove, turmeric, anise, and other spices (including ginger of course) contained in curry care all carminatives. Adding these spices to hard to digest foods can sometimes help prevent or relieve indigestion. Almost every culture has their preferred arsenal of carminatives, so use what is most common, comfortable, and tasty for you!

Bitters
I've talked about bitters many times on this website, so I recommend reading about them more deeply here. But I will briefly say that they're alcohol (or vinegar) extracts of bitter herbs (usually roots) combined with carminative herbs used as an all-around digestive tonic. They're wonderful when taken 5-15 minutes before meals to stimulate our digestive organs to secrete their juices optimally: stomach acid from the stomach, bile from the liver, pancreatic enzymes and pancreatic bicarbonate from the pancreas, as well as saliva and salivary enzymes. If our digestive secretions are produced at the right time and in the right amounts, this helps us digest our fats, proteins, and carbohydrates most effectively, reducing incomplete digestion that can lead to gas, bloating, and mucus production. Some excellent bitters are artichoke leaf, dandelion root, burdock root, angelica root (which is also carminative), chamomile (also carminative and nervine, making it excellent for colicky babies), horehound (also carminative and expectorant for the lungs), elecampane (carminative and expectorant), and many more. In Europe, some cultures take "aperitifs" before or after meals, and in the US the hippest hipster bars are getting into bitters. But before the turn of the 20th century, doctors, pharmacists and healers of all kinds would suggest bitters for indigestion all over the Western world (as shown in the label at the top of this article). So it's an old remedy that's making a comeback because it just works so well, and there are not drugs that can do what it does. They also can be used to relieve gastric reflux/ heart burn. It's easy to make your own bitters with alcohol or vinegar, but you can also buy it from a few companies. I recommend Urban Moonshine. 
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PictureMeadowsweet (Filipendula) leaf and flower.
Anti-inflammatories
Sometimes the inflammation in our guts can get really bad and cause diarrhea, pain, and even trigger inflammation in other parts of our bodies. There are some digestive herbs that I consider to be "topical" anti-inflammatories (that is, topical to our gut tissue when drunk). One of the best anti-inflammatory herbs that I know of is meadowsweet leaf and flower. It is somewhat astringent, so it's great for loose stools and diarrhea, and it is aromatic (so a little carminative) and tastes great in tea. It also contains methyl-salicylates which are strongly anti-inflammatory (salicylic acid, that is aspirin, was originally derived from the methyl-salicylates in willow bark and meadowsweet leaf). It's great in tea and tincture.

Other great anti-inflammatory herbs for tea are marshmallow leaf, comfrey leaf, and plantain leaf. Each of these is demulcent (gooey) and soothing, helping to coat the gut tissue and protect it from irritants. These can also help rebuild a deficient mucosal lining that has been degraded by chronic inflammation (which leads to "leaky gut" or increased intestinal permeability). For leaky gut in particular, comfrey root is the best. It's good in tea (steep in warm or cook water, but not hot water) or in tincture. It's the slimiest, gooey-est herb I know of, and contains allantoin which helps speed up healing and tissue proliferation. It also has prebiotic fiber to feed good bacteria. It needs to be used sparingly however, because the root contains pyrrolizidine alkaloids, which are liver-toxic in large doses. Use at moderate doses for only a few weeks at a time, or small doses for up to one or two months, then take a break. Do not use if you have liver disease. Marshmallow root has a similar slimyness to comfrey root, and is a safe alternative for those who are concerned about the pyrrolizidine alkaloids. It's best as a root powder mixed in a little cold water, letting it sit for 15-30 min until the mixture turns into goo. Then drink between meals. In the old days, "slippery elm" (the powdered inner bark of the elm tree) was used the same way marshmallow root powder is used today, but as a result of over harvesting and climate change, elm trees have become endangered so I discourage people from using slippery elm. In general it's best to take slimy herbs away from meals and supplements because the fiber can bind to supplements and make them less easy to absorb. 

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    Mica is a clinical herbalist specializing in cystic fibrosis, severe respiratory diseases, nutrition and digestion, diabetes and blood sugar disregulation, and immune disregulation. Through their own personal experiences with chronic illness, they are passionate about empowering people to take charge of their own health with natural, holistic, and integrative approaches. Please ask questions or share what's worked for you! 

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    Disclaimer: The content of this website and blog is for educational purposes only and should not be considered medical advice. I am not a licensed medical professional and do not take responsibility for any actions taken by the reader as a result of access to this information. 
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