Bem Vindos

Módulo Aplicado
Aula 2 – Saúde digestiva e Microbiota
 O que eu preciso
saber para • Fases da digestão: boca,
estabelecer estômago, intestino
estratégias para a • Permeabilidade intestinal
saúde digestiva? • Sintomas para diferentes
condições: distensão
abdominal, constipação,
diarreia
Ervas e plantas para
saúde digestiva
• Substâncias amargas (estimulam secreção
digestiva): Genciana (Gentiana lutea); Artemisia
absinthium (losna); Carqueja (Baccharis trimera);
Macela (Achyrocline satureioides).
• Reduz a vontade de comer doce e melhora a digestão:
Licorice + Dente de leão + Artemisia absinthium ou Boldo ou
Carqueja ou macela
Cuidado para quem já tem muita acidez
e úlcera.
• Tônico: Matcha + Curcuma
Ervas e plantas para
saúde digestiva • Melhorar inflamação e barreira intestinal:
Licorice: saber diferenciar a forma íntegra
da forma DGL
Aloe vera
Folha de oliveira
Calêndula (para condições inflamatórias do
trato digestivo, como úlceras, irritações de
refluxo, doença inflamatória intestinal
Spirulina e Wheatgrass
com atuação na
proteção na mucosa
gástrica.
Received: 24 May 2019 Revised: 1 August 2019 Accepted: 8 September 2019
DOI: 10.1002/ pt r.6517

REV I EW

Herbal medicinal products for inflammatory bowel disease:

A focus on those assessed in double-blind randomised
controlled trials

Grainne Holleran 1 | Franco Scaldaferri 2 | Antonio Gasbarrini 2,3 | Diego Currò 4,5

1
Department of Gastroenterology and Clinical
Medicine, Trinit y Centre for Health Sciences, Inflammatory bowel disease patients frequently use herbal products as complemen-
Tallaght Hospital, Dublin, Ireland
tary or alternative medicines to current pharmacotherapies and obtain information
2
Unità Operativa Complessa di Medicina
Interna e Gast roenterologia, Dipartimento di on them mainly from the internet, social media, or unlicensed practitioners. Clinicians
Scienze Gastroenterologiche, Endocrino- should therefore take a more active role and become knowledgeable of the mecha-
Metaboliche e Nefro-Urologiche, Fondazione
Policlinico Universitario “A. Gemelli” IRCCS, nisms of action and potential drug interactions of herbal medicines for which evi-
Rome, 00168, Italy dence of efficacy is available. The therapeutic efficacy and safety of several herbal
3
Istituto di Patologia Speciale Medica,
medicines have been studied in double-blind randomised controlled trials (RCTs). Evi-
Universit à Cattolica del Sacro Cuore, Rome,
00168, Italy dence of efficacy is available for Andrographis paniculata extract; curcumin; a combi-
4
Unità Operativa Complessa di Farmacologia, nation of myrrh, extract of chamomile flower, and coffee charcoal; and the Chinese
Direzione Sanit aria, Fondazione Policlinico
Universit ario “A. Gemelli” IRCCS, Rome,
herbal medicines Fufangkushen colon-coated capsule and Xilei san in patients with
00168, Italy ulcerative colitis; and Artemisia absinthium extract and Boswellia serrata resin extract
5
Istituto di Farmacologia, Università Cattolica in patients with Crohn's disease. However, most of this evidence comes from single
del Sacro Cuore, Rome, 00168, Italy
small RCTs with short follow-up, and the long-term effects and safety of their use
Correspondence have not yet been established. Thus, our findings indicate that further appropriately
Prof Diego Currò, Institute of Pharmacology,
School of Medicine, Catholic University of the sized RCTs are necessary prior to the recommended use of these herbal medicines in
Sacred Heart, L.go F. Vito 1, Rome 00168, therapy. In the meantime, increasing awareness of their use, and potential drug inter-
Italy.
Email: diego.curro@unicatt.it actions among physicians may help to reduce unwanted effects and adverse disease
outcomes.

K EY W O RD S
Crohn's disease, herbal medicines, herbs, inflammatory bowel disease, plants, ulcerative colitis

1 | I N TRO D U CTI O N and immunosuppressants, to more aggressive therapies with biologic

Inflammat ory bowel disease (IBD) is a multifactorial, chronic, relapsing,
immune-mediated inflammatory condition composed of two main
subtypes, namely, Crohn's disease (CD) and ulcerative colitis (UC). IBD
follows an unpredictable course characterised by episodes of disease
activity and remission involving gastrointestinal and various systemic
symptoms, which have a significant physical and psychological impact
on the quality of life of affected patients (Lönnfors, Vermeire, &
Avedano, 2014). The main treatment options for IBD range from con-
ventional medical treatment with 5-aminosalicylates, corticosteroids,
agents, and to surgery, depending on disease phenotype and severity
(Gomollón et al., 2016; Harbord et al., 2017). Although the aetiology
of IBD is not fully understood, it is thought to be due to a complex
and multifaceted interaction between the immune system and envi-
ronmental, genetic, and microbial factors (Ramos & Papadakis, 2019).
The treatment objectives are to induce and maintain remission of dis-
ease measured by clinical, endoscopic, histological, and quality of life
assessments.
Herbal medicine is becoming more popular among IBD patient s.
Over 50% of IBD patients have used some form of complementary

Phytotherapy Research. 2019;1–17. wileyonlinelibrary.com/ journal/ ptr © 2019 John Wiley & Sons, Ltd. 1
Ervas e plantas para
• Ervas utilizadas no refluxo gastroesofágico:
saúde digestiva
Licorice
Genciana
Camomila
Funcho (Foeniculum vulgare)
Dente de leão (Taraxacum officinalis)
Espinheira santa
Folhas de oliveira
Ervas e plantas para
saúde digestiva • Ervas carminativas (redução de gases e
distensão abdominal):
Licorice
Hortelã (Mentha pipperita)
Gengibre
Erva doce (Pimpinella anisium): é mais
eficiente na forma de tintura
 • Ervas no equilíbrio da microbiota e
Ervas e plantas para modulação do sistema imunológico
saúde digestiva Camellia sinensis (especialmente Chá preto e
Pu-erh)
Rooibos
Tomilho
Uxi amarelo
Echinacea (Echinacea spp.)
Sabugueiro (Sambucus nigra)
Cogumelos (Maitake, Turkey tail,Reishi,
Cordyceps, Chaga)