Response of irritable bowel syndrome with constipation patients administered a combined quebracho/conker tree/M. balsamea Willdextract

Abstract

The aim of this case series was to retrospectively examine the symptom response of irritable bowel syndrome with constipation (IBS-C) patients administered an herbal extract in a real-world setting. Twenty-four IBS-C patients in a community office practice were provided a combination over-the-counter dietary supplement composed of quebracho (150 mg), conker tree (470 mg) and M. balsamea Willd (0.2 mL) extracts (Atrantil™) and chose to take the formulation for a minimum of 2 wk in an attempt to manage their symptoms. Patient responses to the supplement were assessed by visual analogue scale (VAS) for abdominal pain, constipation and bloating at baseline and at 2 wk as part of standard-of-care. Patient scores from VAS assessments recorded in medical chart data were retrospectively compiled and assessed for the effects of the combined extract on symptoms. Sign tests were used to compare changes from baseline to 2 wk of taking the extract. Significance was defined as P < 0.05. Twenty-one of 24 patients (88%) responded to the dietary supplement as measured by individual improvements in VAS scores for abdominal pain, bloating and constipation symptoms comparing scores prior to administration of the extract against those reported after 2 wk. There were also significant improvements in individual as well as mean VAS scores after 2 wk of administration of the combined extract compared to baseline for abdominal pain [8.0 (6.5, 9.0) vs 2.0 (1.0, 3.0), P < 0.001], bloating [8.0 (7.0, 9.0) vs 1.0 (1.0, 2.0), P < 0.001] and constipation [6.0 (3.0, 8.0) vs 2.0 (1.0, 3.0), P < 0.001], respectively. In addition, 21 of 24 patients expressed improved quality of life while taking the formulation. There were no reported side effects to administration of the dietary supplement in this practice population suggesting excellent tolerance of the formulation. This pilot retrospective analysis of symptom scores from patients before and after consuming a quebracho/conker tree/M. balsamea Willd extract may support the formulation's use in IBS-C.

Oral Iron Supplementation—Gastrointestinal Side Effects and the Impact on the Gut Microbiota

“…The supplement Atrantil could also be explored for use in methane eradication. Evidence suggests a benefit of methane-positive patients with a response rate of 88% of constipation-predominant IBS patients and marked improvements in both constipation and abdominal pain [84]. However, this has not been tested alongside breath testing to investigate whether the decrease in symptoms is accompanied by a decrease in methane levels.…”

Does Irritable Bowel Syndrome Exist? Identifiable and Treatable Causes of Associated Symptoms Suggest It May Not

“…Side-effects were fewer and less severe in those receiving herbal therapy. In addition, a novel herbal complex containing quebrach, horse chestnut and peppermint leaf (Atrantil™, USA) developed for the management of SIBO characterized by high methane production and IBS-C was found to improve constipation, bloating and abdominal pain [196,197]. However, these studies did not measure the impact of treatment on bacterial overgrowth or methane production; only clinical symptoms were reported [196,197].…”