The plant product helps with problems with the gastrointestinal tract

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AUTHOR: Kate Roach, MD

TITLE: Herbal product helps with problems with the gastrointestinal tract

DEAR DR. ROACH: I had gastroparesis for many years. About two years ago, this led to bacterial overgrowth in the small intestine (which I read about in your column once). I worked with a nutritionist for several months. One treatment she suggested was an herbal product called Iberogast. The combination of herbs helps the stomach to empty faster. I use it every night before bed (as part of a 12 hour fast) or whenever I’ve overeaten and feel sick. It helped me a lot. Iberogast is available online. — LE

ANSWER: First, for the benefit of other readers, gastroparesis is emptying the digestive system too slowly. Iberogast is a combination of nine medicinal plant extracts, and studies in Germany and Austria, where it is most commonly used, have shown that it is more effective than placebo (and about as effective as a single conventional prescription drug) in treating functional dyspepsia and irritable bowel disease.

The drug is generally considered safe, but there have been rare cases of liver damage associated with this drug, at least one of which required a liver transplant.

All drugs—prescription or over-the-counter, natural or synthetic—can cause harm. Iberogast is fairly safe, with few bad effects in its 50 years of use, including millions of doses, but it can still cause rare and serious side effects. Iberogast should be considered for people whose symptoms have not been successfully treated with other treatments.

DEAR DR. ROACH: I’ve heard a lot about fat removal procedures like CoolSculpting and red light therapy, and I wonder if they really work. What are your thoughts on these products? — Anon.

ANSWER: The most important point is that these procedures are aimed at improving a person’s appearance, but they do little or nothing to improve physical health. They do not lead to significant weight loss, and removing the superficial fat just under the skin does not improve diabetes or affect heart risk factors. The benefits are purely cosmetic.

CoolSculpting is a brand name for a system that freezes and damages fat cells. Red light therapy, also called “cold laser” or “low-level laser therapy,” damages fat cells without the need for incisions, as would be necessary with liposuction. More technologies are used, such as focused ultrasound and electrical pulse devices, among others.

Tests on CoolSculpting showed that 86% of people noticed an improvement in cosmetically important areas. Laser treatment is not as well studied. A previous study found that 70% of people treated with a laser were satisfied, compared to 26% of those treated with a “sham” device that had no laser, just a red light. The device has indeed shown some effect in slimming the hips, thighs and waist.

Unfortunately, not everyone responds well to these treatments. Several people, including a famous model, have sued the manufacturer over an unusual side effect of the procedure called paradoxical sebaceous hyperplasia, in which fat cells grow and become solid instead of dying — and can’t even be surgically removed.

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Dr. Roach regrets that he cannot respond to individual letters, but will include them in the column when possible. Readers may send questions by e-mail to [email protected] or to 628 Virginia Dr., Orlando, FL 32803.

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