Abstract
Nutritional ingredients, including various fibers, herbs, and botanicals, have been historically used for various ailments. Their enduring appeal is predicated on the desire both for more natural approaches to health and to mitigate potential side effects of more mainstream treatments. Their use in individuals experiencing upper gastrointestinal (GI) complaints is of particular interest in the scientific space as well as the consumer market but requires review to better understand their potential effectiveness. The aim of this paper is to review the published scientific literature on nutritional ingredients for the management of upper GI complaints. We selected nutritional ingredients on the basis of mentions within the published literature and familiarity with recurrent components of consumer products currently marketed. A predefined literature search was conducted in Embase, Medline, Derwent drug file, ToXfile, and PubMed databases with specific nutritional ingredients and search terms related to upper GI health along with a manual search for each ingredient. Of our literature search, 16 human clinical studies including nine ingredients met our inclusion criteria and were assessed in this review. Products of interest within these studies subsumed the categories of botanicals, including fiber and combinations, and non-botanical extracts. Although there are a few ingredients with robust scientific evidence, such as ginger and a combination of peppermint and caraway oil, there are others, such as melatonin and marine alginate, with moderate evidence, and still others with limited scientific substantiation, such as galactomannan, fenugreek, and zinc-l-carnosine. Importantly, the paucity of high-quality data for the majority of the ingredients analyzed herein suggests ample opportunity for further study. In particular, trials with appropriate controls examining dose–response using standardized extracts and testing for specific benefits would yield precise and effective data to aid those with upper GI symptoms and conditions.
Highlights
A global survey indicates that 40% of adults worldwide suffer with one of many functional gastrointestinal disorders (FGIDs), with upper GI conditions representing a large component of those disorders [2]
1746 articles and the remaining abstracts that were included for further screening by the 1746 articles and the remaining abstracts that were included for further screening by the primary author totaled 212
Melatonin and marine alginate appear promising for gastro-esophageal reflux disease (GERD) use; a comprehensive systematic review assessing the current body of evidence for melatonin and additional trials investigating marine alginate against a placebo would be helpful to determine their effectiveness and the appropriate dose for each
Summary
Functional disorders involving the upper GI tract include GERD, esophageal hypersensitivity, esophageal dysmotility, and non-ulcer dyspepsia. Nutritional ingredients (a collective term used to describe botanicals, including dietary fibers, and non-botanicals) have been employed throughout history for a myriad of GI conditions and symptoms due to their claimed anti-ulcer, carminative, spasmolytic, soothing, and laxative effects, to name a few [9]. The usage of these products continues to increase, as evidenced by sales growth of 8.6% in 2019, the second largest percentage increase since 1998 [10,11].
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