Herbal medicine may ease constipation

(Reuters Health) - People suffering from serious constipation may get some relief from a Chinese herbal medicine consisting of hemp seed and other herbs, a new study finds.

Participants who took 7.5 grams twice a day of hemp seed pill (HSP), which consists of six different herbs, reported some improvements in their symptoms of constipation and fared better than people taking a placebo pill. "We believe HSP works to alleviate constipation," study author Dr. Zhao-Xiang Bian of Hong Kong Baptist University told Reuters Health.

HSP is a classic formula in traditional Chinese medicine and has been used to treat constipation for more than 1,000 years. In theory, the herbs work in combination, acting as a purgative and laxative, and also improving the additional problems associated with constipation, such as dry mouth and trouble sleeping, Bian explained.

All of the participants had a form of constipation known in traditional Chinese medicine as the "excessive syndrome," in which energy ("Qi") accumulates, causing the bowels to dry out. People with this form of constipation have trouble passing stool, feel as if they have not emptied completely, develop a dry yellow coating on their tongue and have abdominal swelling or pain.

During the study, Bian and colleagues first tested different doses of HSP on 96 people with constipation and found that 7.5 grams twice per day, in the form of granules dissolved in 150 milliliters of hot water, appeared most effective.

They then randomly split 120 people with constipation into two groups - a placebo and treatment group, both of which consumed their assigned regimen twice per day for 8 weeks.

Forty-three percent of people who received HSP reported an increase in complete bowel movements, an improvement seen in only 8 percent of those taking the placebo. Those receiving HSP were also more likely to say they felt better, the authors note in the American Journal of Gastroenterology.

However, people taking HSP were also more likely to report potential side effects, such as stomach pain, cramping or bloating. Bian explained that upon investigation, HSP users rated the symptoms as less severe than before beginning treatment and most were just as bad as what the placebo group reported.

The authors also took blood samples from all participants and did not notice any effect on the liver or kidneys. "Thus, we concluded that HSP was safe for alleviating constipation."

The cost for each dose is roughly $1(US), Bian noted in an e-mail. HSP can be purchased online without a prescription, but just because herbal medicine is "natural" doesn't mean it's always safe, the researcher cautioned. Some sellers fail to ensure the medicine contains the right ingredients and lacks contaminants. As a result, the authors recommend patients only purchase herbal medicine from a "reputable seller," and "only under the guidance of registered Chinese medicine practitioners."

Dr. John Johanson of the University of Illinois College of Medicine, who did not participate in the study, told Reuters Health he was pleased to see that the researchers tested the therapy "rigorously" by comparing it to a placebo. The study was "very well done," he said.

However, the patients included in the study were very constipated, and even though they appeared to improve while taking HSP, they were still technically constipated, Johanson noted.

The standard definition of constipation is 3 or fewer complete bowel movements per week, Johanson explained. People who took HSP increased their bowel movements from an average of less than 1 per week to more than 1 1/2 -- an improvement, but not a dramatic one, he noted. "I'm a bit skeptical that this improvement really means anything," he said.

Furthermore, people not used to traditional Chinese medicine may also find it strange to see some forms of constipation classed as "excessive," Johanson added. "It's probably a bit unusual for us in the Western world to make that differentiation."

People with constipation are typically advised to first try a high fiber diet, sometimes with fiber supplements, drink more water and exercise, Johanson noted. If these steps don't work, they can try other over-the-counter products such as stool softeners, milk of magnesia, and laxatives.