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Curr Treat Options Gastroenterol. 2017 Dec;15(4):618-636. doi: 10.1007/s11938-017-0154-y.

Drug-Herb Interactions in the Elderly Patient with IBD: a Growing Concern.

Author information

1
Department of Internal Medicine, Albany Medical Center, 47 New Scotland Ave, Albany, NY, 12208, USA.
2
Division of Gastroenterology, New York Presbyterian Brooklyn Methodist Hospital Weill Cornell College of Medicine, 506 Sixth Street Suite 312 Buckley Pavilion, Brooklyn, NY, 11215, USA. Mak9236@nyp.org.
3
New York University School of Medicine, 550 1st Avenue NBV 16 North 30, New York, NY, USA.
4
Perelman School of Medicine, Division of Gastroenterology, University of Pennsylvania, Penn Presbyterian Medical Center, Philadelphia, PA, 19104, USA.
5
Division of Gastroenterology, New York University School of Medicine NYC North Shore University - Long Island Jewish Hospital System, Manhasset, NY, USA.
6
St. Francis Hospital, Roslyn, NY, USA.

Abstract

Inflammatory bowel disease (IBD), which includes conditions such as Crohn's disease and ulcerative colitis, is becoming more prevalent with the elderly being the fastest growing group. Parallel to this, there is an increasing interest in the use of complementary and alternative medicine (CAM). Nearly half of patients with IBD have used CAM at one time. The elderly patients, however, are burdened by comorbid conditions, polypharmacy, and altered functional status. With increasing use of complementary and alternative medicine in our elderly patients with IBD, it is vital for the provider to provide counsel on drug-herb potential interactions. CAM includes herbal products, diet, dietary supplements, acupuncture, and prayer. In this paper, we will review common CAM, specifically herbs, that are used in patients with IBD including the herb background, suggested use, evidence in IBD, and most importantly, potential interactions with IBD medications used in elderly patients. Most important evidence-based adverse events and drug-herb interactions are summarized. The herbs discussed include Triticum aestivum (wheat grass), Andrographis paniculata (chiretta), Boswellia serrata, tormentil, bilberry, curcumin (turmeric), Plantago ovata (blond psyllium), Oenothera biennis (evening primrose oil), germinated barley foodstuff, an herbal preparation of myrrh, chamomile and coffee extract, chios mastic gum, wormwood (absinthe, thujone), Cannabis sativa (marijuana, THC), tripterygium wilfordii (thunder god vine), Ulmus rubra (slippery elm bark), trigonella foenugraecum (fenugreek), Dioscorea mexicana (wild yam), Harpagophytum procumbens (devil's claw), ginger, cinnamon, licorice, and peppermint.

KEYWORDS:

Absinthe; Adverse events; Aging; Alternative; Barley; CAM; Cannabis; Chios mastic gum; Cinnamon; Complementary; Crohn’s disease; Drug-herb interactions; Elderly; Ginger; Herbal; IBD; Inflammatory bowel disease; Interactions; Licorice; Marijuana; Peppermint; Primrose; THC; Turmeric; Ulcerative colitis; Wheatgrass; Wormwood

PMID:
28918484
DOI:
10.1007/s11938-017-0154-y

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