Herbs for Upper Digestive Overgrowth of Flora.

Herbal medicine has a major therapeutic role in patients with upper digestive overgrowth of flora (UDOF), often incompletely called small intestinal bacterial overgrowth. Here, the use of herbs with various types of effects on gut motility are reviewed, along with their known antimicrobial effects relevant to UDOF. Bitter and pungent herbs that stimulate gut motility (“prokinetics”) are crucial in UDOF patients with slow transit time. Berberine-containing herbs such as Berberis aquifolium (Oregon grape) and Hydrastis canadensis (goldenseal), as well as various members of the genus Artemisia, including but not limited to Artemisia annua (sweet Annie) and Artemisia absinthium (wormwood), are particularly reviewed, as antimicrobial bitters useful for many UDOF patients. The steam-distilled volatile oils of carminative herbs, which are antimicrobial and actually inhibit overactive gut motility and thus are most useful in patients with diarrhea and cramping, are also discussed at length. Mentha x piperita (peppermint), Melissa officinalis (lemonbalm), Coriandrum sativum (coriander), and Pimpinella anisum (anise) are all reviewed in particular. A combination formula containing bitters and carminatives is reviewed. The safety of these herbs with various antibiotics used to treat UDOF is discussed, along with the use of partially hydrolyzed guar gum as an adjunct to rifaximin therapy. [ABSTRACT FROM AUTHOR]