Digestive System Disorders - Page 3
The historical use of the plant includes its use as an antioxidant, liver-protector, bile-enhancer, and lipid-lowering nutrient. More research is warranted to determine, in detail, the mechanisms of action for these effects. However, there appears to be enough evidence to suggest a potential role for artichoke extract in some areas where modern medicine does not have much to offer.
Artichoke was used as a food/medical remedy as early as the 4th century B.C. At the time, a pupil of Aristotle named Theophrastus was one of the first to describe the plant in detail. Enjoyed as a delicacy, an appetizer, and a digestive aid by the aristocracy of the Roman Empire, it later seems to have fallen into oblivion until the 16th century when medicinal use of the artichoke for liver problems and jaundice was recorded. In 1850 a French physician successfully used extract of artichoke leaves in the treatment of a boy who had been sick with jaundice and made no improvement. This accomplishment inspired researchers to find out more about the effects of this extract and spurred their research resulting in the knowledge we have today about its mechanisms of action.
Artichoke leaf extract is made from the long, deeply serrated basal leaves of the artichoke plant. This part is chosen for medicinal use because the concentration of the biologically active compounds is higher here than in the rest of the plant. The most active of these compounds have been discovered to be the flavonoids and caffeoylquinic acids. These substances belong to the polyphenol group and include chlorogenic acid, caffeoylquinic acid derivatives (cynarin is one of them), luteolin, scolymoside, and cynaroside.
Cynarin was the first constituent of the extract to be isolated in 1934. Interestingly, it is found only in trace amounts in the fresh leaves, but is formed by natural chemical changes that take place during drying and extraction of the plant material. Cynarin was originally believed to be the one active component of the extract. Today, the whole complex of compounds is considered important since it has not yet been completely clarified which component is responsible for each effect. It is claimed that neither cynarin alone nor fresh plant material achieves the potency of the dried total extract (Kirchhoff et al., 1994).
Chlorogenic acid, another major component of the leaf extract, has recently become known as a powerful antioxidant. Laboratory investigations are ongoing worldwide with findings for future clinical applications in areas such as HIV, canc, and diabetes.
Most of the modern research on artichoke is with the German artichoke extract, Hepar SL forte, standardized to contain 3% caffeoylquinic acids. New, even more potent extracts, are now available on the American market (see Digest RC and Artichoke Leaf Extract).
The importance of effective liver function for overall health in general and proper gastrointestinal function is rarely emphasized in this country. One reason may be that there is neither laboratory evidence nor specific physical symptoms to reveal an overburdened liver in the beginning stages. The symptoms may be nonspecific such as general malaise, fatigue, headache, epigastric pain, bloating, nausea, or constipation. Discomfort following meals and intolerance of fat are also notable indications of disturbances in the biliary system.
It is estimated that at least 50% of patients with dyspeptic complaints have no verifiable disease. Because of the liver's essential role in detoxification, even minor impairment of liver function can have profound effects. It is important to take such chronic complaints seriously. In Germany and France, for example, physicians frequently prescribe herbal liver remedies such as artichoke extract with good results when presented with these chronic but non-specific symptoms.
Bloating, Detoxification & Bile Flow
While digestive enzymes facilitate the breakdown of food in the stomach, the impact of bile acids secreted from the liver into the small intestine may be even more important. Bile should freely flow into the small intestine to aid in the digestion of fat and protein. Many European doctors believe that inadequate bile acid flow is a major cause of digestive disorders.
Good bile flow is also essential for detoxification which is one of the major tasks of the liver. The liver is constantly bombarded with toxic chemicals from the environment -- the food we eat, the water we drink, and the air we breathe. Bile serves as a carrier for these toxic substances. It delivers them into the intestines for further elimination from the body. This is the major route for excretion of cholesterol. Another feature of bile is helpful here -- its promotion of intestinal peristalsis which helps prevent constipation.
When the excretion of bile is inhibited for various reasons (gall bladder stones or gall bladder disease), toxins and cholesterol stay in the liver longer with damaging effects. Gall bladder stones obstruct bile ducts. Other impairments of bile flow within the liver can be alcohol ingestion, viral hepatitis, chemicals, and drugs. In the initial stages of liver dysfunctions, laboratory tests such as serum bilirubin, alkaline phosphatase, SGOT, LDH, and GGTP often remain normal. It is not adequate to rely on such tests alone. Symptoms that may indicate reduced liver function are general malaise, fatigue, digestive disturbances, and sometimes, allergies and chemical sensitivities.
Fatty Livers, Alcohol, & Artichoke
Because of its long historical use for liver conditions, it seemed reasonable to investigate the artichoke plant scientifically and the first clinical studies were conducted in the 1930s with encouraging results. In the 1990s the interest has been intensified and several excellent clinical studies have been conducted during the last decade.
Realizing the importance of adequate healthy bile flow, German researchers set out to confirm the earlier findings of the artichoke plant in a controlled double-blind study on healthy volunteers (Kirchhoff et al., 1994). The participants were given a one-time dose of artichoke extract or placebo and their bile secretion was measured with special techniques over the following hours. The bile secretion was found to be significantly higher in the group that received the artichoke extract.
Another clinical study showed an improvement of symptoms in 50% of patients with dyspeptic syndrome after 14 days of treatment with artichoke leaf extract. The study involved 60 patients with nonspecific symptoms such as upper abdominal pain, heartburn, bloating, constipation, diarrhea, nausea, and vomiting. In the placebo group, as a comparison, improvements of less distinct quality were noticed in 38% of the participants (Kupke et al., 1991).
Interesting results were also demonstrated in a large open label study of 417 participants with liver or bile duct disease. Most of these patients had long-standing symptoms for many years. They suffered from upper abdominal pain, bloating, constipation, lack of appetite, and nausea. These patients were treated with artichoke leaf extract for 4 weeks. After 1 week, around 70% of the patients experienced positive results and after 4 weeks the percentage was even higher (approximately 85%) (Held 1991).
Even more remarkable, another open label study (Fintelmann, 1996) was done involving 553 outpatients with nonspecific dyspeptic complaints. They were treated with standardized artichoke leaf extract. The subjective complaints declined significantly within 6 weeks of treatment. Improvements were found for vomiting (88%), nausea (83%), abdominal pain (76%), loss of appetite (72%), severe constipation (71%), flatulence (68%), and fat intolerance (59%). Ninety-eight percent of the patients judged the effect of the extract to be considerably better, somewhat better, or equal to that achieved during previous treatment with drugs. The dose used in this study was 1 to 2 capsules 3 times daily of the preparation Hepar SL Forte. One capsule contains 320 mg of dry extract of artichoke leaves standardized to provide 3% caffeoylquinic acid.
The study by Fintelmann confirmed the efficacy of the artichoke extract for dyspepsia and demonstrated a significant effect on fat (lipid) metabolism. In addition, the researchers discovered a significant positive cholesterol and triglyceride blood level relationship which confirmed a discovery made in the 1930s.
Local eczema reactions have been reported after occupational exposure and skin contact with the fresh plant or its dried parts. Such an allergy should be considered a contraindication for external use of the extract. No reactions to orally ingesting the extract have been observed. Because of its bile-stimulating effect, the extract should not be taken by individuals with gall stones or other bile duct occlusion. Get rid of the stones before you use artichoke. If doing a search for Dr. Hulda Clark in Yahoo or Google, you will find several links that lead to her suggestions on dealing with gallstones.
Artichoke leaf extract has proven to be a safe and natural way to deal with general health because of its many applications to essential physiological functions. As a nutritional supplement and antioxidant, it can safely be used as an adjunct to conventional therapies.
How Eastern Europeans Cope with Digestive
One dietary explanation for the decreased life span among Eastern Europeans is that their intake of antioxidants from fruits, vegetables, and nuts is much lower compared to the West. A severe deficiency of antioxidant vitamins, along with a low intake of folic acid and bioflavonoids, partially accounts for the high level of cardiovascular disease in Eastern Europe.
The traditional Eastern European diet consists of lots of animal fats and protein and very little in the way of fresh fruits and vegetables. This poor diet not only shortens life span, but also creates an epidemic of acute digestive disorders.
While digestive complications increase as people age, the bad health habits of the Eastern Europeans exacerbate common problems such as heartburn, bloating, gas, constipation, nausea, cramps, diarrhea, and irritable bowel syndrome.
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