Herbal supplements in the print media: communicating benefits and risks

Factors affecting the use of herbal products in patients with Irritable Bowel Syndrome and their results: case-control study

Background

Irritable bowel syndrome (IBS) is a functional bowel disease that is characterized by abdominal pain, discomfort, and changes in the frequency and form of stool without any organic pathology. In this study, the factors that affect the herbal treatment choices of IBS patients and their results were investigated.

Methods

Included in the study were 248 IBS patients who were over the age of 18. A questionnaire that comprised 25 questions was applied to the participants. Survey questions were asked to the participants regarding their age, place of birth, gender, educational status, demographic details, social standing, socioeconomic status and job, place of residence, and marital status. In addition, The participants were asked about which IBS symptoms they had, from whom they had received the recommendation for use of herbal products, whether the media had an effect on their selection of herbal products, and whether they had benefited from herbal products.

Results

It was observed that 41.1% of the patients with IBS who participated in the study used herbal medicine, 9.8% of whom used them regularly. It was found that the IBS patients participating in the study made their decision to use herbal products mostly based on the recommendations that they were given by acquaintances (57%) and the media (34%). When the patients were evaluated according to their gender, IBS was found to be more common in unemployed women who had a low level of education, while it was more common in working men (p = 0.015, P < 0.001, respectively). The IBS patients who were single used more herbal products that those who were married (P = 0.036). While the use of herbal herbs and oils was predominant in patients whose recommendation content comprised the media/internet and acquaintances, the herbal treatment content recommended by healthcare professionals consisted of traditional treatments and mixtures (P = 0.012). It was determined that a higher percentage of those who used herbal treatments lived in city centers when compared to those who did not (P < 0.001). In addition, it was determined that patients with constipation used herbal products more than those without (P < 0.001). Among the IBS patients, those who had diarrhea and those who were receiving medical treatment preferred to use significantly less herbal products (P = 0.007 and P = 0.041, respectively). It was found that the patients who visited the Gastroenterology Outpatient Clinic mostly used herbal therapy, while those who visited a family doctor used herbal therapy the least (P = 0.029 and P < 0.001, respectively).

Conclusion

The IBS patients revealed whose recommendations they followed when purchasing herbal products, which of the products they preferred, and how useful/beneficial they felt that these products were. In this regard, the addition of training curricula related to herbal treatment for professional healthcare workers will further raise awareness on this topic.

Multielement Determination in Medicinal Plants and Herbal Medicines Containing Cynara scolymus L., Harpagophytum procumbens D.C., and Maytenus ilifolia (Mart.) ex Reiss from Brazil Using ICP OES

Worldwide, medicinal plants and herbal medicines are widely consumed. The aim of this study was to determine macro- (Ca, K, Mg, Na, and P) and microelements (Al, As, Ba, Cd, Co, Cr, Cu, Fe, Mn, Mo, Ni, Pb, Sb, Se, Si, Sn, Sr, V, and Zn) in medicinal plants and herbal medicines: "globe artichoke" - Cynara scolymus L., "devil's claw" - Harpagophytum procumbens D.C., and "espinheira santa" - Maytenus ilifolia (Mart) ex Reiss. Concentrations of 24 (essential and toxic potentially) elements in samples from Brazil were determined using a sequential optical emission spectrometer with inductively coupled plasma optical emission spectrometry (ICP OES) after acid digestion, assisted by microwave radiation. Principal component analysis (PCA) and hierarchical cluster analysis (HCA) were used to carry out an exploratory analysis of samples. The elements were quantified (in μg/g): Al (20.24-1261.64), Ba (18.90-63.18), Ca (2877.6-19,957.40), Cr (0.28-1.38), Cu (4.16-21.99), Fe (8.54-627.49), K (1786.12-32,297.19), Mg (505.82-6174.52), Mn (0.40-205.64), Na (1717.23-18,596.45), Ni (< LoQ-0.99), P (35.12-2899.91), Se (1.52-3.71), Sn (1.53-12.43), Sr (52.33-84.31), V (< LoQ-0.24), and Zn (2.60-30.56). As, Cd, Co, Mo, Pb, and Sb, in all the investigated samples, were found to be below the limit of detection (LoD) and quantification (LoQ) values of ICP OES. These medicinal plants and herbal medicines can be sources of Ca, K, Mg, Na, P, Cu, Fe, Mn, Se, and Zn. All samples showed considerable levels of Al. PCA and HCA showed that the samples separated into two large groups.

Herbal medicine use among patients with viral and non-viral Hepatitis in Uganda: prevalence, patterns and related factors

Background

There is some evidence that patients with liver diseases commonly use complementary and alternative therapies to address general and liver-disease specific health concerns. The purpose of this study was to assess and describe prevalence, patterns and related factors of herbal medicine use among adults diagnosed with viral and non-viral hepatitis in Kampala, Uganda.

Methods

A cross-sectional study was conducted on 310 adult patients attending the gastrointestinal clinic in Mulago hospital referral hospital in Kampala. Data on prevalence, types and reasons for herbal medicine use was collected using standardized questionnaires and focus group discussions. Modified Poisson regression analyses were used to examine factors related to use.

Results

Usage of various herbal remedies within 12 months prior to April 2018 was reported by 46.1% (143/310) of patients with 27.3% (39/143) of these reporting having used conventional and herbal therapies concurrently. Herbal remedies were used to treat various health conditions including hepatitis. Patients with hepatitis C virus infection (PRR = 1.16, p = 0.02) compared to those with hepatitis B virus infection, and those who believed that it was safe to use herbal and conventional therapies concurrently (PRR = 1.23, p = 0.008) had higher prevalence odds of herbal medicine use. Conversely, patients who had been newly diagnosed with hepatitis (PRR = 0.69, p = 0.03) compared to those who had been diagnosed more than one-year prior, had lower prevalence odds of herbal medicine use. Various types of local herbs were reported as most commonly used however most patients did not know the ingredients of commercially prepared herbal therapies.

Conclusion

A high prevalence of herbal medicine use was found among newly-diagnosed patients and patients with hepatitis C more likely to use herbal remedies after adjusting for other factors. Usage was influenced by the belief that herbal medicine is safe and effective. Health workers need to consistently elicit information about herbal remedy use. Research is needed on benefits, adverse effects and outcomes in patients who use herbal remedies to treat primary liver diseases in order to facilitate evidence of efficacy and product safety.