As more is learned about digestive health, manufacturers broaden their offerings to address new knowledge.

The market for digestive supplements has always been strong and continues to grow, with new innovations and expanded understanding of the direct links between digestion and overall health.

“The focus of digestive supplements has shifted in the last decade or so,” said Isaac Eliaz, MD, MS, Lac, medical director of Amitabha Clinic in Santa Rosa, CA. “It has evolved away from an emphasis on cleansing and purging supplements, to include more comprehensive formulas that support multiple long-term aspects of digestive health.”

For example, Eliaz noted that laxatives and harsh purgatives were more popular in the past, as a quick fix for constipation or as “cleansing” agents. However, many of these digestive products, even natural laxatives, can actually weaken digestive capacity over time. “Now, however, more people are educated about the principles of holistic medicine, aware that we must address the underlying causes of Digestive problems with more comprehensive, long-term solutions,” he said, adding that the consumer base for digestive products has also widened. “In the past, digestive products were more popular among elderly people or those with chronic digestive issues. Yet, many more people now seem interested in comprehensive digestive formulas as a way to support nutrient absorption and overall health.”

Charlsea Foley, product manager/marketing assistant with California-based Health Plus, Inc., agreed with the notion that there is a growing population looking for natural digestive health alternatives. “The digestive market has shown an increase from previous years, with multiple things contributing, such as the Baby Boomers and more people selfmedicating.”

The demographic majority consists of people 40 years and older, she noted, however, the company is seeing a steady increase of purchases from The younger generation. “Some of the reasons for this increase are contributed to the rising number of younger people taking antibiotics and prescription medication, which creates constipation.” With more people selfmedicating, the company is seeing a rise in the popularity of its Colon Cleanse®, which aids and assists with irritable bowel syndrome and helps maintain healthy cholesterol. “Even pregnant women and parents are seeking out the benefits of Colon Cleanse [for their children],” Foley said.

In addition, Angelica Vrablic, PhD, manager of nutrition research with New Jersey-based Solgar, noted that the digestive aids and enzymes supplement category grew more than 10 percent in sales, citing SPINS data for the 52 weeks ending October 27, 2012. She offered her explanation: Consumers are increasingly educated about digestive health and are looking to the supplement category.

Ingredients for Digestion

The leading ingredient in the digestive category is psyllium husk, according to Foley, although, probiotics and prebiotics are gaining ground. “Pro- and prebiotics are essential to replacing good bacteria in the colon. This helps maintain a healthy digestive system and healthy immune system.”

Eliaz agreed pre/probiotics are rising stars of the digestive ingredients category, noting that we’ve barely scratched the surface understanding the true benefits of bacteria/probioitics.

“There are literally hundreds of beneficial/ probiotic bacteria that can populate the digestive tract and support numerous aspects of digestive and overall health,” he said. “Published research continues to highlight the numerous ways various probiotic species influence digestion and other areas of health such as immunity, neurological Function and more. The prebiotic supplement market may be growing even more rapidly. Prebiotics are ingredients that directly promote the healthy growth of probiotic bacteria in the gut—three in particular: transgalactooligosaccharide, fructooligosaccharide (FOS) and inulin.”

Other effective—and evolving— ingredients appearing in digestive supplements are hydrochloric acid and digestive enzymes, Eliaz said. “Many times, upset stomach, heartburn, GERD (gastroesophageal reflux disease) and other related issues are caused by lack of hydrochloric acid in the stomach (HCl) rather than too much stomach acid, even though the symptoms of high or low Hcl are similar (i. e., burning, stomach upset and digestive discomfort),” he explained. “Digestive enzymes are preferably taken in small doses—less than full dose—and combined with other digestive supporting ingredients. By using only a small amount of digestive enzymes (and Hcl when needed), we can stimulate and support the body’s own production of Hcl and enzymes, rather than create a dependency effect with higher doses. “

As the public has gained a fuller understanding of these ingredients’ clinical effects, the evolution of the correct application, doses and combinations has shifted. This led to Eliaz’s developement of Integrative Digestive Formula. This digestive supplement contains a small amount of digestive enzymes, together with spices, herbs and nutrients such as black pepper, cardamom, cinnamon, ginger and others, which can support the body’s natural production of Hcl. “This formula works to balance digestive metabolism and vitality—called digestive heat in traditional Chinese medicine— with coolness and moisture; alleviate digestive discomfort, And support overall digestive capacity and function over time. Different patients with either constipation issues or diarrhea report that this formula alleviates the condition, because it works to balance and improve overall digestive capacity.”

Solgar’s Vrablic also noted that enzyme supplements are gaining ground in the digestive health category. “Consumers who are having difficulty digesting certain foods or are having difficulty with a new dietary plan will look to enzyme supplements for assistance*,” she said, adding that new enzyme supplements include combinations of natural, highactivity enzymes that can assist with the digestion of a broad array of foods.* For example, Solgar® Comfort Zone Digestive Complex Vegetable Capsules include 11 highactivity enzymes and an herbal complex in one single dose.

Celeste Bleicher, manager of Lassens Health Food in Camarilla, CA, said that while the store carries established products such as Enzymedica’s Digest Gold and papaya enzyme products, it has included NOW Foods’ newer Gluten Digest and, most recently, added Solgar’s Comfort Zone. Though it’s too soon to report on sales for that product, “The name is good!” she noted.

Digestive Trends

As more people understand the holistic relationship of digestion and overall health, comprehensive formulas that focus on multiple aspects of digestive health are becoming increasingly popular. According to Eliaz, rather than rely on a symptom-based digestive supplement that can offer only temporary relief from stomach discomfort or constipation, people are looking to improve nutrient assimilation and support Overall digestive vitality and general health in the process.

“The use of medicinal mushrooms in digestive products may be a new trend in this category of comprehensive digestive formulas,” he said. “The mushroom species hericium, poria and maitake are especially useful, and we included them in Integrative Digestive Formula because they help strengthen and support the connections between the digestive system and the immune system.”

Vegetable-based enzymes and high activity level products are also appearing in this category, as well as adding probiotics and prebiotics to a cleansing regimen. The latter is found in Health Plus products such as Super Fiber Blend, Probiotic Fiber and Digesti Cleanse, all three products that make up the Colon Cleanse Max Line™.

The company is gearing up to launch a new Colon Cleanse Every Day Cleanse™, noted Foley. “This is a specially formulated fiber and herbal blend to not only support the colon, but the liver and kidneys as well. There are multiple different things that contribute to digestion and Health Plus is now offering a power-packed formula to cleanse and support the whole digestive system.”

Retailer Joanna Noll, manager of Pacific Health in Carpinteria, CA, confirmed that high dose probiotics are important offerings at her store, as well as combination enzymes. “People are having success with them,” she said. “So many [customers] are deficient, and we find that a low dose of probiotics doesn’t make a dent. Once they are replenished, I suggest they back off to a lower dosage probiotic product.” Noll said the store has been successful selling Digest More by Renew Life. She often suggests customers take it along with one of the Mega probiotic supplements.

While sublingual is a new innovation for digestive health product delivery, Eliaz said he believes the best system for digestive supplements is still in capsule or powder form. “Some companies are using liquid delivery systems, but there can be issues with stability, solubility and, often, taste. New capsules that are smaller, smoother and thus easier to swallow may become more popular in the future,” he said. “Enteric coating on probiotic supplements can help ensure they reach the small intestines for absorption, without getting hydrolyzed by stomach acids. Some patented modification processes can alter certain natural ingredients to make them more easily digested and active in the body.”

Research on the Fringes

Weird, yet hopeful, new research backs a type of therapy that may sound odd to some—fecal microbiota therapy, also known as fecal transplant or implant. The treatment has demonstrated dramatic beneficial results for chronic digestive diseases such as Crohn’s disease. “While the concept sounds difficult to digest, so to speak, it is actually proving to be extremely effective,” noted Eliaz. “A fecal sample is taken from a person with a good balance of probiotic bacteria, and implanted into the person with the digestive condition (usually a partner or family member is the donor). This treatment demonstrates the importance of a healthy micro-flora environment, similar to taking probiotics though much more powerful since there are hundreds of different bacteria species but supplements can only administer a handful in comparison.” However, until the sanitary and aesthetic aspects of the treatment are refined to make this a more desirable procedure, it will probably remain on the fringe.

Eliaz also noted that in recent years, researchers have been heavily investigating the links between digestion and immunity, neurology and hormone balance. “The gut-brain connection is proving to be especially interesting, demonstrating that the health of our digestive environment may directly affect our emotional and cognitive health and vice versa, with depression and anxiety as major disruptors of Digestive function. A large percentage of our immune system as well as our neurotransmitter system is actually located in the digestive tract, for example,” he concluded. “By applying a holistic approach to digestive health, using herbs and ingredients that exert multiple benefits, we can harness these connections for more targeted and effective treatments.”

* These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.

For More Information:

■ Amitabha Clinic, (707) 542-5900
■ Health Plus, Inc., (800) 822-6225
■ Solgar, Inc., (201) 944-2311

Food Allergies, Sensitivities & Supplements

Of all the dietary trends of late, the gluten-free movement may be one of the fastest growing. More people are finding that their digestion and overall health is improved greatly by eliminating gluten, noted Eliaz. “However, confusion still remains over the official diagnosis. That’s because many people who test for gluten sensitivity and its more extreme autoimmune manifestation called Celiac disease, come back with inconclusive lab results. Yet these people may still exhibit all the classic digestive symptoms of gluten sensitivity. If this is the case, regardless of what the test results indicate, removing gluten from the diet can significantly improve digestive function, as well as clear up other symptoms such as chronic fatigue, depression, allergies, skin conditions and much more. Gluten seems to have a powerful proinflammatory effect on many people and may damage the intestinal environment over time.”

Also of note, according to Eliaz, food allergies may be improved by taking digestive supplements. “Many times, food allergies are caused by an unhealthy digestive environment. Over time, damage to the intestinal lining allows larger-than-normal food particles to enter into the circulation where immune cells mistake them for harmful Invaders. The digestive environment and the immune system are closely linked in a number of ways, so an unhealthy gut can lead to immune regulation problems. The situation is further complicated when large food particles enter the circulation and trigger an inappropriate immune response which causes the allergic reaction.”

Eliaz said by treating overall digestive and immune health with a comprehensive digestive supplement, both issues can be addressed: 1) heal the digestive lining so that large food particles do not enter into the blood stream, and 2) support gastroimmunology and improve immune function in order to reduce overactive immune responses.