| | | | Other Names | | | Dyspepsia, Dyspepsic, Digestive, Digesting, Digestion,
Digestive Tract, Digestive System, Indigestion, Alimentary Tract,
Alimentary Canal, Alimentary, Gastrointestinal Tract, GI Tract.
View products | | | Digestion, Absorption and Assimilation are the three processes by
which the body incorporates food. In digestion, food is softened and
converted into a form soluble in the watery fluids of the body; or, in the
case of fat, into minute globules. The substances formed are then absorbed
from the bowels and carried throughout the body by the blood. In
assimilation, these substances, deposited from the blood, are used by the
various tissues for their growth and repair. Transit time through the
digestive tract in young and middle-aged people averages two to four days
(slightly longer in the elderly, and dependent on the amount of fibre in
the diet). All but 12 hours of this is spent in the colon.
Salivary Digestion occurs in the mouth with chewing, to
break up the food, and thoroughly to mix the starchy ingredients - such as
bread and potatoes - with saliva containing ptyalin that
changes them into sugar. After swallowing the salivary action is soon
checked by the gastric acid in the stomach.
Gastric
Digestion is facilitated by slow churning movements mixing the food
with the gastric juice and rendering it soluble. The final product,
chyme, passes through the pylorus into the intestine.
Gastric digestion of a simple meal takes about one hour, and a heavy
dinner up to seven hours.
Intestinal Digestion. The
softened food leaves the stomach and enters the intestine where four
factors act on it: (a) bile; (b) pancreatic juice (c)
intestinal juice, and (d) bacteria. Intestinal juice
contains enzymes which complete the breakdown of proteins into their
constituent amino acids, act on disaccharides, such as maltose,
sucrose and lactose, converting them into the monosaccharide
glucose and split fats into fatty acids and glycerin. Bacteria are normal
occupants of both small and large intestines. In the former they have a
fermentive action, acting on carbohydrate to produce acetic, butyric and
lactic acids. In the latter they have a putrefactive action, decomposing
protein into its constituent parts. The intestinal bacteria have a key
part in the manufacture of certain components of the vitamin B complex.
Absorption. The only substance
absorbed from the stomach to any extent is Alcohol. Water quickly
passes through the stomach into the intestine, but it is only after
several hours of intestinal digestion that the bulk of the food is taken
into the system. Fats produced from the chyle leaving the stomach
are taken up by lymph vessels called lacteals, ultimately reaching the
blood, while sugars, salts and amino acids formed from proteins pass
directly into the small blood vessels of the intestine. The process is
facilitated by the large number of microscopic villi which line the
intestine. Food materials are mainly absorbed by the small intestine,
water and salts by the large intestine or colon. The food is passed down
the intestine by contractions of its muscular wall until finally the
indigestible residue, together with various wastes excreted from the liver
and intestinal walls, is expelled from the anus as stools or faeces.
Assimilation takes place more
slowly as the blood circulates through the body and each organ extracts
what is necessary for its own growth and repair. When the food supply
exceeds immediate bodily requirements, it is stored up for future use,
with fat being deposited in various sites, sugar being converted into
glycogen in the liver. Muscles have the greatest
requirements with sugar and amino acids being assimilated for heat
production and work. To function satisfactorily the body requires an
adequate daily water intake of about 1.5 litres (3 pints), with a similar
amount being discharged from the body in the urine, perspiration and other
excretions such as saliva and tears.
Indigestion, Heartburn, and
Low Stomach Acidity
Also knwon as: Bloating (Indigestion),
Dyspepsia, Flatulence, Gas (Stomach), Hypochlorhydria, Poor Digestion,
Stomach Upset, Wind.
"Indigestion" refers to any number of
gastrointestinal complaints, which can include gas (belching or
flatulence) 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). 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
What are the symptoms of indigestion? 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.
Conventional treatment
options: Conventional treatment includes the avoidance of problem foods,
such as citrus fruits, spicy foods, fatty foods, milk, and beans.
Medications may also be prescribed to control stomach acidity: histamine
H2 inhibitors (e.g., cimetidine [Tagamet], famotidine [Pepcid], nizatidine
[Axid], ranitidine [Zantac]), proton pump inhibitors (e.g., lansoprazole
[Prevacid], omeprazole [Prilosec]), and antacids (e.g., Maalox, Mylanta,
Rolaids, Tums). Activated charcoal or simethicone (Gas-X, Mylicon,
Phazyme) may be prescribed for relief of gas and bloating.
Dietary
changes that may be helpful: Doctors 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.
People who eat too fast or fail to chew their food
adequately may also experience symptoms of indigestion or
heartburn.
Nutritional supplements that may be helpful: Lipase, a
pancreatic enzyme, aids in the digestion of fats and may improve digestion
in some people. In a double-blind trial, a timed-release form of
pancreatic enzymes was shown to significantly reduce gas, bloating, and
fullness after a high-fat meal.11 Participants in this study took one
capsule immediately before the meal and two capsules immediately after the
meal. The three capsules together provided 30,000 USP units of lipase,
112,500 USP units of protease, and 99,600 USP units of amylase. However,
the amount of pancreatic enzymes needed may vary from person to person,
and should be determined with the help of a doctor.
Are there any
side effects or interactions? Refer to the individual supplement for
information about any side effects or interactions.
Herbs that may
be helpful: Three major categories of herbs are used to treat indigestion
when no cause for the condition is known: bitters (digestive stimulants),
carminatives (gas-relieving herbs), and demulcents (soothing herbs). The
effects of these different categories on heartburn and low stomach acid
will be discussed individually. Although there is overlap in the
conditions, the categories are helpful.
Bitter digestive
stimulants Andrographis, Artichoke, Barberry, Bitter melon, Bitter
orange, Blessed thistle, Boldo, Centaury, Dandelion, Devil's claw,
Elecampane, Gentian, Goldenseal, Greater celandine, Horehound, Juniper,
Oregon grape, Picrorhiza, Prickly ash, Vervain, Wormwood, Yarrow, Yellow
dock
Carminatives (gas-relieving) Anise, Basil, Caraway,
Cardamom, Chamomile, Cinnamon, Cloves, Coriander, Dill, European angelica,
Fennel, Ginger, Lavender, Lemon balm, Linden, Oregano, Peppermint,
Rosemary, Sage, Thyme, Turmeric
Demulcents
(soothing) Bladderwrack, Licorice, Marshmallow, Slippery
elm
Multiple, unclear actions Chaparral
Bitter
herbs are thought to stimulate digestive function by increasing saliva
production and promoting both stomach acid and digestive enzyme
production.12 As a result, they are particularly used when there is low
stomach acid but not in heartburn (where too much stomach acid could
initially exacerbate the situation). These herbs literally taste bitter.
Some examples of bitter herbs include greater celandine, wormwood, and
gentian. Bitters are generally taken either by mixing 1-3 ml tincture into
water and sipping slowly 10-30 minutes before eating, or by making tea,
which is also sipped slowly before eating.
A double-blind study
found that a standardized extract of greater celandine could relieve
symptoms of indigestion (such as abdominal cramping, sensation of
fullness, and nausea) significantly better than placebo.13 The study
employed an extract standardized to 4 mg of chelidonine per capsule and
gave 1-2 tablets three times daily for six weeks. However, recent reports
of hepatitis following intake of greater celandine have raised concerns
about its safety for treating indigestion.14
Artichoke, in addition
to being an edible plant, is a mild bitter. Extracts of artichoke have
been repeatedly shown in double-blind research to be beneficial for people
with indigestion.15 Artichoke is particularly useful when the problem is
lack of bile production by the liver.16 Extracts providing 500-1,000 mg
per day of cynarin, the main active constituent of artichoke, are
recommended by doctors.
Wormwood is sometimes used in combination
with carminative herbs for people with indigestion. One double-blind trial
found that a combination with peppermint, caraway, and fennel was useful
in reducing gas and cramping in people with indigestion.17 Other bitters
are gentian, dandelion, blessed thistle, yarrow, devil's claw, bitter
orange, bitter melon, juniper, andrographis, prickly ash, and centaury.18
The amounts used are the same as the general recommendations for bitters
when they are employed for the treatment of indigestion.
Some
bitters widely used in traditional medicine in North America include
yarrow, yellow dock, goldenseal, Oregon grape, and vervain. Oregon grape's
European cousin barberry has also traditionally been used as a bitter.
Animal studies indicate that yarrow, barberry, and Oregon grape, in
addition to stimulating digestion like other bitters, may relieve spasms
in the intestinal tract.19
Boldo has been used in South America for
a variety of digestive conditions, although this may have stemmed from its
impact on intestinal infections or liver function. Studies specifically
showing a benefit from taking boldo in people with indigestion and
heartburn have not been performed. Picrorhiza, from India, has a similar
story to that of boldo. While it is clearly a bitter digestive stimulant,
human studies to confirm this have not yet been
completed.
Horehound contains a number of constituents, including
alkaloids, flavonoids, diterpenes (e.g., marrubiin), and trace amounts of
volatile oils.20 The major active constituent marrubiin and possibly its
precursor, premarrubiin, are herbal bitters that increase the flow of
saliva and gastric juice, thereby stimulating the appetite.21 Similar to
horehound, elecampane has been used by herbalists to treat people with
indigestion.
Carminatives (also called aromatic digestive tonics or
aromatic bitters) may be used to relieve symptoms of indigestion,
particularly when there is excessive gas. It is believed that carminative
agents work, at least in part, by relieving spasms in the intestinal
tract.22
Among the most notable and well-studied carminatives are
peppermint, fennel, and caraway. Double-blind trials have shown that
combinations of peppermint and caraway oil and a combination of
peppermint, fennel, caraway, and wormwood have been found to reduce gas
and cramping in people with indigestion.23 24 25 Generally, 3-5 drops of
natural essential oils or 3-5 ml of tincture of any of these herbs, taken
in water two to three times per day before meals, can be helpful.
Alternately, a tea can be made by grinding 2-3 teaspoons of the seeds of
fennel or caraway or the leaves of peppermint, and then simmering them in
a cup of water (covered) for ten minutes. Drink three or more cups per day
just after meals.
Linden also has a long tradition of use for
indigestion. Older clinical trials have shown that linden flower tea can
help people who suffer from upset stomach or from excessive gas that
causes the stomach to push up and put pressure on the heart (also known as
the gastrocardiac syndrome.)26 27 The reputed antispasmodic action of
linden, particularly in the intestines, has been confirmed in at least one
human trial.28 Linden tea is prepared by steeping 2-3 tsp of flowers in a
cup of hot water for 15 minutes. Several cups per day are
recommended.
In a double-blind trial, the spice turmeric was found
to relieve indigestion.29 Two capsules containing 250 mg turmeric powder
per capsule were given four times per day.
Chamomile (German
chamomile or Matricaria recutita) is effective in relieving inflamed or
irritated mucous membranes of the digestive tract. Since heartburn
sometimes involves reflux of stomach acid into the esophagus, the
anti-inflammatory properties of chamomile may also be useful. In addition,
chamomile promotes normal digestion.30 However, modern studies to prove
chamomile beneficial for people with heartburn or indigestion are lacking.
Roman chamomile (Anthemis nobilis) has not been studied for indigestion
though it has traditionally been used similarly to German
chamomile.
Typically taken in tea form, chamomile is recommended
three to four times per day between meals. Chamomile tea is prepared by
pouring boiling water over dried flowers, and steeping for several
minutes. Alternatively, 3-5 ml of chamomile tincture may be added to hot
water or 2-3 grams of chamomile in capsule or tablet form may be taken
three to four times per day between meals.
Lemon balm is another
carminative herb used traditionally for indigestion.31 Lemon balm, usually
taken as tea, is prepared by steeping 2-3 teaspoons of leaves in hot water
for 10 to 15 minutes in a covered container. Three or more cups per day
are consumed immediately after meals. Three to five milliliters of
tincture can also be used three times per day.
There are numerous
other carminative herbs, including European angelica root (Angelica
archangelica), anise, basil, cardamom, cinnamon, cloves, coriander, dill,
ginger, oregano, rosemary, sage, lavender, and thyme.32 Many of these are
common kitchen herbs and thus are readily available for making tea to calm
an upset stomach. Rosemary is sometimes used to treat indigestion in the
elderly by European herbal practitioners.33 The German Commission E
monograph suggests a daily intake of 4-6 grams of sage leaf.34 Pennyroyal
is no longer recommended for use in people with indigestion, however, due
to potential side effects.
Demulcents are the third category of
herbs used to treat indigestion and heartburn. These herbs seem to work by
decreasing inflammation and forming a physical barrier against stomach
acid or other abdominal irritants. Examples of demulcent herbs include
ginger, licorice, and slippery elm.
Ginger is a spice well known
for its traditional use as a treatment for a variety of gastrointestinal
complaints, ranging from flatulence to ulcers. Ginger has
anti-inflammatory and anti-nausea properties. Ginger has been shown to
enhance normal, spontaneous movements of the intestines that aid
digestion.35
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.36 The extract of licorice root that is most often used by
people with indigestion is known as deglycyrrhizinated licorice (DGL).
Glycyrrhizin, which occurs naturally in licorice root, has cortisone-like
effects and can cause high blood pressure, water retention, and other
problems in some people. When the glycyrrhizin is removed to form DGL, the
licorice root retains its beneficial effects against indigestion, while
the risk of side effects is greatly reduced. The usual suggested amount of
DGL is one or two chewable tablets (250-500 mg per tablet), chewed and
swallowed 15 minutes before meals and one to two hours before bedtime.37
Although many research trials show that DGL is helpful for people with
peptic ulcers, the use of DGL for heartburn and indigestion is based
primarily on anecdotal information.
The mucilage content in
slippery elm appears to act as a barrier against the damaging effects of
acid on the esophagus in people with heartburn. It may also have an
anti-inflammatory effect locally in the stomach and intestines. Two or
more tablets or capsules (typically 400-500 mg each) may be taken three to
four times per day. Alternatively, a tea is made by boiling 1/2-2 grams of
the bark in 200 ml of water for 10 to 15 minutes, which is then cooled
before drinking; three to four cups a day can be used. Tincture (5 ml
three times per day) may also be taken but is believed to be less helpful.
Marshmallow and bladderwrack may be used the same way as slippery
elm.
People in the southwestern United States and northern Mexico
have long used chaparral tea to help calm upset stomachs. It is unclear
into which of the above categories-if any-chaparral fits. This strong
tasting tea was used only in small amounts. Modern research has not
confirmed the usefulness of chaparral for indigestion, and there are
serious concerns about the safety of improper internal use of this herb.
Before taking chaparral, consult with a knowledgeable healthcare
professional.
Are there any side effects or interactions? Refer to
the individual herb for information about any side effects or
interactions.
References:
1. Wright JV. Dr. Wright's
Guide to Healing with Nutrition. New Canaan, CT: Keats Publishing, 1990,
155.
2. Murray MJ, Stein N. A gastric factor promoting iron
absorption. Lancet 1968;1:614.
3. Sturniolo GC, Montino MC,
Rossetto L, et al. Inhibition of gastric acid secretion reduces zinc
absorption in man. J Am Coll Nutr 1991;10:372-5.
4. Allison JR. The
relation of hydrochloric acid and vitamin B complex deficiency in certain
skin conditions. South Med J 1945;38:235-41.
5. Russell RM,
Krasinski SD, Samloff IM. Correction of impaired folic acid (Pte Glu)
absorption by orally administered HCl in subjects with gastric atrophy. Am
J Clin Nutr 1984;39:656.
6. Mayron LW. Portals of entry: A review.
Ann Allergy 1978;40:399-405.
7. Walker WA, Isselbacher KJ. Uptake
and transport of macro-molecules by the intestine. Possible role in
clinical disorders. Gastroenterology 1974;67:531-50.
8. Drasar BS,
Shiner M, McLeod GM. Studies on the intestinal flora. I. The bacterial
flora of the gastrointestinal tract in healthy and achlorhydric persons.
Gastroenterology 1969;56:71-9.
9. Giannella RA. Influence of
gastric acidity on bacterial and parasitic enteric infections. A
perspective. Ann Intern Med 1973;78:271-6.
10. Wright JV. Dr.
Wright's Guide to Healing with Nutrition. New Canaan, CT: Keats
Publishing, 1990, 33.
11. Suarez F, Levitt MD, Adshead J, Barkin
JS. Pancreatic supplements reduce symptomatic response of healthy subjects
to a high fat meal. Dig Dis Sci 1999;44:1317-21.
12. Schulz V,
H„nsel R, Tyler VE. Rational Phytotherapy: A Physician's Guide to Herbal
Medicine. 3rd ed, Berlin: Springer, 1998, 168-73.
13. Ritter R,
Schatton WFH, et al. Clinical trial on standardized celandine extract in
patients with functional epigastric complaints: Results of
placebo-controlled double-blind trial. Comp Ther Med
1993;1:189-93.
14. Benninger J, Schneider HT, Schuppan D, et al.
Acute hepatitis induced by greater celandine (Chelidonium majus).
Gastroenterol 1999;117:1234-7.
15. Kraft K. Artichoke leaf
extract--recent findings reflecting effects on lipid metabolism, liver and
gastrointestinal tracts. Phytomedicine 1997;4:370-8 [review].
16.
Kirchhoff R, Beckers C, Kirchhoff GM, et al. Increase in choleresis by
means of artichoke extract. Phytomedicine 1994;1:107-15.
17.
Westphal J, H”rning 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.
18. Blumenthal M,
Busse WR, Goldberg A, et al. (eds). The Complete German Commission E
Monographs: Therapeutic Guide to Herbal Medicines. Austin: American
Botanical Council and Boston: Integrative Medicine Communications, 1998,
425-6.
19. Tewari JP, Srivastava MC, Bajpai JL. Pharmacologic
studies of Achillea millefolium Linn. Indian J Med Sci
1994;28(8):331-6.
20. Leung AY, Foster S. Encyclopedia of Common
Natural Ingredients Used in Food, Drugs, and Cosmetics, 2d ed. New York:
John Wiley and Sons, 1996, 303.
21. Bradley PR. British Herbal
Compendium, vol. 1. Great Britain: British Herbal Medicine Association,
1990, 218-9.
22. Forster HB, Niklas H, Lutz S. Antispasmodic
effects of some medicinal plants. Planta Med 1980;40:303-19.
23.
May B, Kuntz HD, Kieser M, Kohler S. Efficacy of a fixed
peppermint/caraway oil combination in non-ulcer dyspepsia.
Arzneimittelforschung 1996;46:1149-53.
24. Westphal J, H”rning 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.
25. 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.
26. Fiegel VG, Hohensee F.
Experimental and clinical screening of a dry, water extract of tiliae
libri. Arzneimittelforschung 1963;13:222-5 [in German].
27. Sadek
HM. Treatment of hypertonic dyskinesias of Oddi's sphincter using a wild
Tilia suspension. Hospital (Rio J) 1970;77:141-7 [in
Portuguese].
28. Langer M. Clinical observations on an antispastic
factor extracted from Tiliae silvestris alburnum. Clin Ter 1963;25:438-44
[in Italian].
29. Thamlikitkul V, Bunyapraphatsara N, Dechatiwongse
T, et al. Randomized double blind study of Curcuma domestica Val for
dyspepsia. J Med Assoc Thai 1989;72:613-20.
30. Mills SY. Out of
the Earth: The Essential Book of Herbal Medicine. London: Viking Press,
1991, 448-51.
31. Weiss RF. Herbal Medicine. Beaconsfield, UK:
Beaconsfield Publishers Ltd, 1985.
32. Blumenthal M, Busse WR,
Goldberg A, et al. (eds). The Complete German Commission E Monographs:
Therapeutic Guide to Herbal Medicines. Austin: American Botanical Council
and Boston: Integrative Medicine Communications, 1998, 425-6.
33.
Weiss RF. Herbal Medicine. Beaconsfield, UK: Beaconsfield Publishers Ltd,
1988, 185-6.
34. Blumenthal M, Busse WR, Goldberg A, et al. (eds).
The Complete German Commission E Monographs: Therapeutic Guide to Herbal
Medicines. Austin: American Botanical Council and Boston: Integrative
Medicine Communications, 1998, 198.
35. Micklefield GH, Redeker Y,
Meister V, et al. Effects of ginger on gastroduodenal motility. Int J Clin
Pharmacol Ther 1999;37:341-6.
36. Goso Y, Ogata Y, Ishihara K,
Hotta K. Effects of traditional herbal medicine on gastric acid. Biochem
Physiol 1996;113C:17-21.
37. Reed PI, Davies WA. Controlled trial
of a carbenoxolone/alginate antacid combination in reflux oesophagitis.
Curr Med Res Opin 1978;5:637-44.
Source: NOW Foods
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Please Note: This Traditional Use information is provided as a courtesy only. The products indicated above may be listed in error. This information is based on Traditional and Folklore Medicine which uses natural materials to support health. This information has not been evaluated or approved by the FDA and is not based on scientific evidence from any source. These statements have not been evaluated by the Food and Drug Administration (FDA). These products are intended to support general well being and are not intended to treat, diagnose, mitigate, prevent, or cure any condition or disease. If conditions persist, please seek advice from your medical doctor.
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