Medically reviewed by Onikepe Adegbola, MD, PhD
When it comes to gastrointestinal (GI) problems like irritable bowel syndrome (IBS), celiac disease (CD), and colitis, conventional therapy has several limits.
Alexandra Russell, MD, of Monroe Carell Jr. Children’s Hospital at Vanderbilt in Nashville, Tennessee, spoke at the Pediatric Academic Societies Meeting 2022 in Denver, Colorado, about alternative treatments.
She discussed various options in complementary and alternative medicine (CAM) to improve the pain and discomfort children often experience with GI disorders.
At the premier national meeting for pediatric research, she encouraged pediatric health care providers to consider CAM approaches in their clinics. According to her, 40 to 75% of patients treated with CAM at GI clinics have experienced positive results.
She highlighted five well-studied complementary medicine options namely, melatonin, licorice, Iberogast/STW 5, FD Gard, and peppermint oil.
Increased acid exposure can affect the quality of sleep. Melatonin plays regulate GI motility and modulates visceral sensations like nausea and bloating. It also promotes an anti-inflammatory response within the gut.
Russell emphasized that patients with Gastroesophageal reflux disease (GERD) had lower melatonin levels and nearly half of them with functional dyspepsia experienced sleep disturbances. She highlighted a pediatric study done in 2016.
The study, “Therapeutic effect of melatonin on pediatric functional dyspepsia,” was published in the World Journal of Gastrointestinal Pharmacology and Therapeutics. It showed that 42% of patients on melatonin experienced a moderate to excellent improvement in abdominal pain vs 50% on the placebo.
Her second recommendation was licorice. The popular children’s candy is gastroprotective as it inhibits inflammatory compounds like prostaglandins and lipoxygenase. She prescribes 760 mg or 2 chewables of Deglycyrrhizinated licorice (DGL) per dose for kids. They are taken before meals and bedtime.
Russell mentioned Iberogast/STW 5 as another CAM option. Lemon balm leaf, peppermint leaf, licorice root, chamomile flower, caraway fruit, Angelica root, milk thistle fruit, and greater celandine are included in this commercial formulation of nine medicinal plant extracts.
Russell pointed out that Iberogast has been shown to decrease gastric acid production, increase mucin production, increase the release of prostaglandin E2, and decrease leukotrienes for IBS and FD. According to her, it does not induce acid rebound but has a similar effect to antacids. She recommended 3 times daily dosage for children which is about 10-20 drops depending on the age of the child.
FD Gard was another alternative proposed by Russell. This duodenal-release formulation of caraway oil and I-menthol works within an hour of treatment. It relieves pain, is gastroprotective, and can reduce inflammation.
Finally, she advised using peppermint oil. This aromatic oil has shown to be effective in treating IBS symptoms in children. She mentioned a study in which enteric-coated peppermint oil capsules or a placebo were given to 42 youngsters with IBS.
In the study, it was observed that 75% of those taking the peppermint oil had reduced the severity of IBS-associated abdominal pain. The study, “Enteric-coated, pH-dependent peppermint oil capsules for the treatment of irritable bowel syndrome in children,” was published in the Journal of Pediatrics.
Russell also discussed many other alternatives for the relief of IBS and GI disorders. Some of them were fiber supplements like glucomannan, green banana, cocoa husk, fiber mixtures, Senna, and curcuminoid found in turmeric.
She concluded that several CAM options can be used in conjunction with allopathic medicine approaches. Russell encouraged the medical fraternity to be open. In the end, she said, “Being knowledgeable and open to holistic approaches can bolster the doctor-patient-family relationship.”
Melatonin, licorice, Iberogast/STW 5, FD Gard, and peppermint oil are well-studied alternative treatments for gastrointestinal (GI) disorders. 40 to 75% of patients treated with CAM at GI clinics have experienced positive results. Other alternatives include fiber supplements, turmeric, cocoa husk, and fiber mixtures.
Kline, R. M., Kline, J. J., Di Palma J, & Barbero, G. J. (2001). Enteric-coated, pH-dependent peppermint oil capsules for the treatment of irritable bowel syndrome in children. The Journal of pediatrics, 138(1), 125–128. https://doi.org/10.1067/mpd.2001.109606
Zybach, Katherine. (2016). Therapeutic effect of melatonin on pediatric functional dyspepsia: A pilot study. World Journal of Gastrointestinal Pharmacology and Therapeutics. 7. 156. 10.4292/wjgpt.v7.i1.156.